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[Moonflower]

Hi has anybody else had this? I was fine on 2 pumps and utrogestan everyday, then went up to 3 pumps after a few months which made me spot, so I went back down to 2 pumps and was ok for a very short while, then I add testosterone to the mix and had brown discharge most months followed by what seems like a real bright red period with the pains.  I had the scan late last yr and was spared the hysteroscopy as lining looked ok, just a few fibroids (they didn't tell me the size but were small before HRT).  I had endometriosis in the past controlled by the birth control pill.  Any similar stories or ideas?

[CLKD]

Speak to your prescribing practitioner, any un-explained bleed should be investigated.

How do you feel otherwise?

[Moonflower]

I have been mega stressed about something else lately but feel ok otherwise.

I realise I have to go through another scan etc and will call doc first thing on Monday in order to get an appoinment.

Thank you.

[Taz2]

Oestrogen causes both fibroids and endometriosis to grow. I hope you won't have to wait long for a scan.

Taz 

[Moonflower]

Thanks Taz. I started to take HRT for my ectopics mainly and it's worked for that.  I wonder what the way forward will be.  I'd hate to be having ectopics again.

[Kato]

Hi Moonflower, I have some similarities to you. 4 years on HRT, no periods or bleeding, last 2 on estrogel and continuous Utrogestan and fine until started very minor spotting a few months ago. I reduced 200mg Utrogestan to 100mg at practice nurse’s suggestion but remained on 4 pumps of estrogel. I started more period-like bleeding and went to GP as advised. Had a scan and hysteroscopy with biopsy - all clear but I have a small ovarian cyst, uterus lining was 8mm and very scarred following an ablation (microwave removal of uterus lining) following very heavy bleeding 15 years ago. I am to have scans every 4 months to check lining and the consultant gynaecologist suggested trying to reduce does to 2 pumps and 100mg. I tried for 3 weeks and felt awful so returned to 4 pumps and 200mg. All fine but yesterday started period type cramping and bright red bleed. I don’t know if this is just the readjustment following the messing about with doses or something else. I am hoping time will settle it because everything was fine for 2 years on this dose before. I’m less worried because I’ve had a clear biopsy but interested to read other responses to your experience. Like you I really don’t want periods again

[Moonflower]

Thanks for sharing Kato.  It does seem like every time one changes dosages there is a good chance of spotting or bleeding.  I'm wondering when this period will stop too as it's quite heavy, like it used to be.  I'm hoping it's just about finding a balance but I have no clue what I'm doing. 

[Kato]

Yes it would be good to know what has caused the bleeding and whether it's just temporary while things settle down again... had to strip and wash my bedding for the second time in three nights due to leakages and have had constant 'pulling' and cramping low down in my belly. The only positive about menopause is finishing periods but if this is the start of things to come I don't know what to do. I have zero faith in my GP's ability to guide me in this situation which is probably unreasonably unfair of me but I just want to know what to do next. Sorry for hijacking your thread Moonflower but it sounds like we're looking for similar advice xx

[KarineT]

HRT or fibroids could be the reason for this bleed.  I very much doubt it's your periods coming back after 4 years without.

[Kato]

I agree Karine - it all points to HRT balance based on what I'm reading on here and elsewhere. I see that oestrogen can cause existing fibroids to grow and bleed and it seems a continuous regimen is best post menopause, hopefully with the balance of progesterone and oestrogen being correct and stopping or minimising the bleed from fibroids. In my case I recently had a hysteroscopy and no fibroids were noted although 15 years ago I was diagnosed with a single fibroid which allegedly would have been removed by the microwave endometrial ablation I had for my very heavy periods at that time. It would be good to hear about anyone else having similar experiences and what they did to solve it (if there is a solution?).

[Moonflower]

Hi all,
Thanks for all of your responses.  Well, I've just spoken to the the nurse practitioner at my GP and as I had a scan late last year, she is not alarmed and taking no action at this time and said I can wait to see the NHS gynae next month.  She said that bleeding can start up on HRT. She said that it's probably my fibroids! She said that utrogestan isn't the best progesterone for stopping bleeding and if I were under her direct care, she would recommend norethisterone (given my history of endometriosis) but this is not body identical of course.  She also said the mirena coil would be a good alternative.  So for now, to try and stop the bleeding, she's asked me to double up on the utrogestan to 200mg per night (2x100mg) and take 1 pump of oestrogel one night, then two the next.  I wondered if testosterone increases oestrogen too.  I asked her and she said no, but google says yes..  She gave me blood test results which the gynae ordered, and my testosterone was 1.8 i.e. normal (it was less than 0.5 before i.e. abnormal) and my oestrodiol was a whopping 792!! So I must be absorbing well on two pumps! She said ideally she would like the oestrodiol levels to be 300-600.  All very interesting.  Oh and it was last reported that my largest fibroid was only 20.5mm, but I think this was before HRT.  I hate to think how much they are growing now..

[CLKD]

Well done and tnx for sharing.

[Kato]

Sounds like you’ve had some great attention from a knowledgeable medic and thanks for taking the time to share the information. Do you think the timing of when you apply your estrogel has any bearing on your bleeding? I recently changed to applying all 4 pumps of estrogel in the mornings and take 200mg of Utrogestan at night. I notice the cramp and bleeding increases in the mornings - does the estrogel get into my system so fast and cause the bleeding to increase? I think I’m going to try splitting the dose again… and going down to 3 pumps.

[Moonflower]

Hi Kato,
I really don't know if applying the gel at night or in the morning makes any difference as I've only applied at night time.  Bleeding always seems heavier in the morning, probably due to lying down at night, for me.
I was going to ask, how do you feel taking 200mg of Utrogestan?  Do you take this daily? I chickened out last night but did reduce the gel.  I already feel dizzy, tired and bloated and blaming the paws but it could be the Utrogestan I guess, so if I double up I might even feel like a bigger zombie than I already am.  I told a friend and she questioned what I was instructed to do.  At the end of the day she is a nurse practitioner and I think she has more experience of HRT at the GP practice but none of them are experts.  I will see how the flow goes.  it was still pretty heavy yesterday at day 4.  How long do bleeds last for you Kato? A thought just popped into my mind, I wonder if applying on the arms would make any difference too? I'm currently applying gel on my thighs. 
I'll keep on posting anything I find out.  I might see if I can somehow ask the gynae.  I have another month to wait.

[Kato]

Hi Moonflower, this current bleeding has been the first time it’s been so heavy and lasted so long - it started exactly a week ago and got worse until today  - it’s lightened today. Previously I’ve had random spotting increasing to maybe a day or two of very light bleeding. Today I just applied two squirts to my arms and plan to use one tonight, instead of all 4 in a morning which I think might have caused the bleeding. I have been fine with the 200mg Utrogestan taking it at night as it helps me sleep, although I do feel tired in the morning (but I also have a new rescue cat who wakes me at 4.30am which might have some bearing on things 😆). I did try taking the Utrogestan vaginally a couple of weeks ago but stopped when the bleeding started because I was using tampons and didn’t want to overcrowd things ‘down there’ 😆. Some people find it a lot easier that way and need a bit less as it’s absorbed more directly (but as we always note, everyone is slightly different so you just have to give things a try). I think it’s worth trying putting the gel on your arms like you say - worth trying anything really! Hope you’re feeling OK and thanks for sharing xx