Print

Please login or register.
1 Hour 1 Day 1 Week 1 Month Forever
Login with username, password and session length

[Sid]

Hi ladies

I recently posted that my attempts to move onto a continuous regime have not worked due to absorption issues with Utrogestan (break-through bleeding even on 100mg Utrogestan vaginally every day). As a result,I have had to go back to 200mg vaginally for 12 days (2 pumps of Oestrogel daily). No break-through bleeding on this regime (although painful cramps before bleed).  My problem is that I have just had an HRT review with my GP and she is not happy for me to be on a sequential regime at my age (56 - started HRT at 53 and had not gone through menopause at that point).  She said that my uterus needs progesterone every day to be protected (to be honest I got the impression she was not keen on HRT at all - she asked me how long I intended to be on it).  Is she right about continuous HRT being safer?  A continuous routine has not worked for me (tried it twice) and I don’t want to come off HRT yet (I have severe osteopenia and will be due another DEXA scan in just over 2 years). There is a history of severe osteoporosis on my mother’s side which was a major factor in both mum’s and gran’s deaths.  Any advice much appreciated x

[Dandelion]

Hi ladies

I recently posted that my attempts to move onto a continuous regime have not worked due to absorption issues with Utrogestan (break-through bleeding even on 100mg Utrogestan vaginally every day). As a result,I have had to go back to 200mg vaginally for 12 days (2 pumps of Oestrogel daily). No break-through bleeding on this regime (although painful cramps before bleed).  My problem is that I have just had an HRT review with my GP and she is not happy for me to be on a sequential regime at my age (56 - started HRT at 53 and had not gone through menopause at that point).  She said that my uterus needs progesterone every day to be protected (to be honest I got the impression she was not keen on HRT at all - she asked me how long I intended to be on it).  Is she right about continuous HRT being safer?  A continuous routine has not worked for me (tried it twice) and I don’t want to come off HRT yet (I have severe osteopenia and will be due another DEXA scan in just over 2 years). There is a history of severe osteoporosis on my mother’s side which was a major factor in both mum’s and gran’s deaths.  Any advice much appreciated x

I am not very knowledgeable but I can't see how you are not absorbing utro if it is going direct to your vagina?
Maybe you need to add more utro, maybe the amount is not sufficient.
If you are not happy with your GP can you discuss this with another GP?
I had problems absorbing oestrogen orally, on femoston sequi, so took it transdermally.
It would make more sense to me (bear in mind I am not knowledgeable) if you were taking it orally and not absorbing it, as it has to go through the digestive system, but vaginally?
sorry this doesn't answer your question.

[Taz2]

I can't see the problem with using a sequi regime as I swapped back to it when I was 60 as have others on here. Is there a different GP within the practice you could see?

Taz x

[Uptick]

Hi Sid, you don't need progesterone every day to protect your womb as long as you're having a bleed on a sequential regime. Moreover, progesterone is the component in HRT that can increase the risk of breast cancer, so continuous prog is potentially more dangerous (albeit it's more stable for some women who are sensitive to fluctuations).
 

[sheila99]

I'm on a sequi regime at 59 and there are people on here in their 60s on it. Your gp isn't watching so she won't know how you take it.

[Cassie]

There are loads of older ladies using HRT sequi, I intend to use it that way, I cannot understand why she is saying this, my gynae was quite happy for me to stay on it as long as I want using Utro only 12 days per month and getting a bleed.

[Hurdity]

Yes I am one using progesterone sequentially and in my 60's. (NHS) Doc is happy.

Incidentally theoretically there is increased risk of endometrial cancer from taking it sequentially but there are also questions marks over continuous progesterone re breast cacner as already stated. Endometrial cancer is probably easier to detect and to treat at a much earlier stage because the red flag (!) is usually abnormal bleeding.

You just need to make sure you minimise your other risk factors for cancer ie if you are overweight - then work towards achieving a normal BMI. Eat a good diet with plenty of fresh foods, reduce alcohol and stop smoking if you need to, and take plenty of regular exercise.

You also don't need to have a bleed on a sequential regime as this depends on the dose of oestrogen and dose/duration of progesterone. Not everyone bleeds on a cyclical regime.

Hurdity x

[Cassie]

Interesting Hurdity, can you explain further regarding not needing to have the bleed on sequi, would that be by choice or by a low dose oestrogen, would not getting a bleed still give adequate protection to the endometrial lining?
I only use 1 pump and I take Utro every 6 or so weeks and always get a bleed which lasts a few days, albeit fewer days than when I was younger.

[Uptick]

I'm also interested in the explanation.

[sheila99]

Me too. I take the 12x200mg utro but get a bleed about half the time. Not sure if I should be worried.

[Uptick]

Currently 'listening' to this article 'Uterine bleeding with hormone therapies in menopausal women: a systematic review'  (Sept 2020) https://www.tandfonline.com/doi/full/10.1080/13697137.2020.1806816