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[Butterfly16]

Hi Ladies,
Just looking for some advice/reassurance please

After two years with no periods (diagnosed with POI), I've finally started HRT.  I went to see a private meno specialist, who recommended 2x pumps of gel and 100mg every day. I asked about trying cyclically first, but she wanted me to try continuous due to the length of time from my last period and she thought I might feel more stable on a consistent dose. She said I could take it either orally or vaginally, I was very apprehensive about possible side effects so opted vaginally and apart from about a week where u felt a bit zombie like and had bad headaches, I've not felt too bad. I started this at the beginning of April, after about 3 weeks I started spotting (was light brown at first) and had slight bleeding. I also experienced stomach cramps, nothing major but just like I used to get at the start of my periods. I also experience some breast tenderness but am hoping that will settle down too!

Anyway the bleeding lasted for about 10 days and then just stopped, again it felt like I'd had a light period so I wonder if I had some lining to shed? I thought that was the end of it, but 3 weeks later the pattern started again. This time the bleeding didn't last as long, but I still had minor stomach cramps/ovary pain just before it started and at the beginning. Well a week ago, the brown/pink spotting started and has now developed into bleeding. It feels like I'm having a period and I also have the horrid stomach cramps too 😢

My question is...does this sound normal?! Has anyone experienced this and will the bleeding settle down? I'm not sure if this is due to taking it vaginally. Ideally I want to try and take it orally, but don't want to suddenly swap at the moment and make things even worse I know it's still early days and she told me it's common to experience spotting/bleeding for up to 6 months but I just feel apprehensive about everything at the moment. My doctor knows nothing about hrt which is why I paid to see a private specialist, so I'm hoping someone can help I know I need the hormones due to my age, but in all honesty I was considering just stopping after the way I felt yesterday! Having said that, I've found when I started to take it, I felt calmer and had less anxiety attacks, so I've definitely noted some benefits. Any advice greatly appreciated 

Thank you xx

[CLKD]

My advice would be to the put the product names into the search box here and make notes from the threads that pop up?  I am sure someone will be along with experiences.  Or ask a local Pharmacist? 

[Taz2]

It's common to have breakthrough bleeding or even (as in my case) continuous bleeding for the first six months on any conti HRT. If it doesn't settle after that then you could ask for a sequential regime which woukd at least give you a more predictable bleed. It sounds normal to me but it is worrying if you've not been told to expect it!

Taz x 

[Butterfly16]

Thank you Taz, that is very reassuring to know. I've stopped bleeding again today, so I suppose I'll just have to go with it for a bit and hope that my body settles down eventually. But I really appreciate your reply  x

[Taz2]

You're welcome. I hope it soon settles down.

Taz x

[juliemargaret]

Hi....im peri and on alternate days utro 100mg vaginally...only been 6.weeks this week so unsure of how feel BUT now on bleed 3 in 5 weeks .....i didnt even bleed this much on 'normal' period. I first bled about 6 days into starting....for 5 days....heavy then eased.....then...4 wreks later another....for 5 days again with lik tum.cramps..this stopped last thurs thrn in sunday eve browny and now bleeding again!! I was advised to take alternaye days utro by a well respected meno doc...so not questioning that.....but....a bit uh uh with these bleeds.......(bit been told.can happen and MAY settle). My left boob is a bit sore too....and tum pains..not bad but there.  So im.going to maybe seeing how i go for another week or so then maybe consider a.cycle instead (maybe go off licence and do the last 12 days of a month). Its hard isnt it....the not knowing but the trusting or trying to....and just let body adjust! I do though like the sound of continuing alternate days if it works...feel it will be more balanced than taking utro for so many days per month.and the ups n downs..etc.
X

[anais]

Butterfly, you're going to hear different experiences from different perspectives with HRT, so here's my take on it. 

I had quite a lot of breakthrough bleeding after starting HRT. In my case, 100mg Uterogestan wasn't enough to prevent it.

Initially I was prescribed Estrogel x2 per day with 100mg x1 Uterogestan, and I had some breakthrough bleeding. After blood tests, my Estrogel was increased to 3x per day to bring my oestrogen levels up to the optimum for treating osteoporosis, which was previously diagnosed. I had even more breakthrough bleeding on this higher dose.

My consultant recommended a Mirena instead of the Utrogestan as a better option to control the bleeding, so I did that. It took 5-6 months for the bleeding to settle down. I was told it was normal and that it takes time for the body to get used to the Mirena. After that happened, the bleeding more or less stopped, apart from very rare spotting.

However.... I was having troublesome night sweats so my consultant suggested 4x Estrogel daily, and although there was a tiny bit of spotting a couple of times, the Mirena seemed to be keeping it all under control. But then one day.... I had a bleed. So I rang the clinic and they arranged another scan. I had some thickening of the endometrium so I had a biopsy there and then.  My consultant thought that the scan was otherwise OK and recommended that I add 100mg Uterogestan to my HRT regime. This is with the Mirena still in place.

I have to stress that I've had quite a few scans because of the bleeding in the past 3 years or so that I've been on HRT. The biopsy appeared to be OK.

You need sufficient progesterone on continuous combined HRT. If you are post menopausal, my consultant says there should be no bleeding and that cyclical HRT can potentially mask other conditions because of the scheduled bleeding. He didn't rule it out if that was what I wanted but he didn't recommend it. I take a higher dose of Estrogel because firstly, my oestrogen levels need to meet the optimum threshold for osteoporosis, and for symptom control. Not everyone needs to be on this high a dose. Secondly, even on 2x pumps of Estrogel daily, 100mg Utrogestan wasn't enough to prevent bleeding.

My advice — report any bleeding to whoever is prescribing your HRT. An ultrasound scan is only reliable for 6 months. If you are bleeding and haven't had a scan in the past 6 months, you need one to rule out any other causes of bleeding. If everything is fine, you need to consider either a Mirena OR increasing your Uterogestan to 200mg.

Everyone has different experiences though. There's no ‘one size fits all' with HRT. But you really should have any bleeding checked out.