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[Jems512]

Was diagnosed as perimenopausal two years ago, now 47. Had last period 10months ago. After a lot of wrangling with GP managed to get an appointment to discuss HRT. V brief discussion which was basically what are my symptoms (mainly exhaustion, joint pain at shoulder, hips and ankles every day, headaches and some anxiety) and did i want a monthly period (no).
I was given premique low dose and was warned there may be spotting. I read all the leaflet and started taking them three weeks ago. The spotting has become full on heavy bleed with cramps and feels like i have gone back to square one. Yesterday was horrific with flooding that i cried twice while sitting in the bathroom and today doesnt look any better. My periods for the year before they stopped were extremely heavy to the stage i kept several changes of clothes at work and had to take sick days. I do not wish to go back to then and was overjoyed to discover menopause was round the corner.
So my dilema is do i carry on with taking the hrt as i dont think i have given it enough time, leaflet says 3 months is needed to see any changes. If i stop i assume the bleed will stop and i can go back to putting up with aches and pains and look for another way.
Please help

[Dancinggirl]

Hi and welcome to MM

I haven't got time to give you a proper response at the moment but you shouldn't be on a conti HRt yet - you are not truly post menopause.  You have also been given an old fashioned type of HRT - not good!
You need a sequential HRT that give a monthly bleed and I always suggest Femoston 1/10 is a good one to try first.

If you want a non bleed HRT option then the Mirena would be your best option adn simply add in oestrogen as pills, gel or patch.

Mirena details:
 
MIRENA
Mirena is a levonorgestrel (type of progestogen) releasing system which sits inside the womb, gradually releasing the progestogen into the womb. It is licensed in the UK and Ireland as a contraceptive agent, for treatment of heavy periods and, from August 2004, also for the progestogen component of HRT. It can be used in both the perimenopause and postmenopause and it is particularly useful for:

Persistent progestogenic side effects from systemic HRT despite changes in type and route of progestogen.
When contraception is required along with HRT in the perimenopause.
When withdrawal bleeds on sequential HRT are heavy, after investigation if indicated. (see WHEN TO BE REFERRED )
With Mirena in place, systemic estrogen alone can be taken as the Mirena provides adequate protection of the womb lining and the estrogen dose and route can be tailored to meet the individual's needs.

Progestogenic absorption throughout the body is minimal so reducing progestogenic side effects. The effect of Mirena on the womb lining can significantly reduce bleeding and when used as part of an HRT regimen, in time, 30 to 60% of women have no bleeding at all. Although Mirena used for contraception is licensed for 5 years, the license for use for the progestogen part of HRT is currently 4 years.
Price: £88.00

I would stop the Premique ( yes, the bleeding should stop after a few days) and pop back to the GP or simply phone them.

DGx

[Jems512]

Thank you, I have stopped the tablets and now waiting for the flood to recede. I have to wait until wednesday to try to get hold of GP, the one in the practice that deals with women's health is part time! TBH this experience has put me off trying again. Will read through natural help for aches and pains

[Daisydot]

 :-XHi Jems512 and welcome to the forum.
DG has given you some great advice there so it would be worth trying again you've everything to gain I tried for so many years down the “ natural route “ and so regret doing that I only delayed the inevitable but cost myself a fortune in the prices.my life has changed so much now but it took me three goes to find the right combination for me oesrtogel and vagifem,do be careful of the V.A and get help at the first sign if it.good luck with whatever you decide to do at the end of the day it's your choice xx

[Hurdity]

Hi Jems512

  from me too.

Just to add that it will not be the HRT which caused your heavy bleeding as such - but is a sign that your womb lining had built up during the time that your periods had stopped - probably due to anovulatory cycles. The addition of a progestogen was sufficient to change the womb lining structurally and because it was too thick - it shed, and needed to be shed. Alternatively it might just be coincidence and you were due to have a period then anyway.

Dancinggirl's suggestion of a Mirena sounds like a good option as it will stop the bleeding and you won't have to put up with all that flooding.

In view of the time since your last bleed and the fact that it was very heavy only a few weeks into starting HRT - I agree with Dancinggirl - I would definitely mention this to the doctor in case s/he thinks a check-up (referral and U/S scan) would be appropriate. For example you might have fibroids which can cause heavy beeding.

You haven't mentioned flsuhes and sweats which are usually the classic menopausal symptoms which send women to the doc for HRT - so I presume these are not a problem - or maybe you are taking medication such as some anti-depressants which can stop them (ie mask them as menopausal symptoms)?

If you are close to menopause then it is advised to take HRT at least until the 51/52 - the average age of natural menopause - for health protection ( heart and bones mainly).

In the meantime do have a look at this article which explains what is happening to your body:

https://www.menopausematters.co.uk/magazine/pdf/Article%20-%20Perils%20of%20the%20Perimenopause.pdf

Hope this helps and keep us posted.

Hurdity x