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[loulou2]

Hi Ladies...

Wondering if anyone can give me a bit of advice....

I live in France and nearly 12 weeks ago went onto HRT for the first time.  I am almost 65 and had a late menopause at 57.  I suffered awful flushes since the menopause, so many per day and night I couldn't count them, thought about HRT over the years but decided against it due to breast cancer scares in the newspapers.  Had enough of it this year, and after doing a lot of research decided to give it a try.    Dr was fully supportive and I went onto Oestrodose (estradiol) 2 pumps and 100mg Progesterone each night.  All was well, flushes stopped for the first time in 10 years, which was bliss....BUT last week (Tuesday night) I started bleeding, started off light and has got heavier, so much so that for the past 3 days I have had to resort to tampons...4 a day.

  So, 3 days ago thought I would reduce the Oestrodose to 1 and half pumps, to see if that would sort the problem, it hasn't, can anyone advise me if I should reduce the Oestrodose even more, or increase it?  Incidentally the flushes have not come back on 1 and half pumps of Oestrodose.  I have an appointment with my Dr next week but are so many knowledgeable people on this forum I wanted to ask your opinion.

This menopause/HRT lark is a right bummer!!!!!

[Dotty]

Hi bleeding can be expected in the first 3-6 months of starting HRT. If you change the dose in this time then you could make the situation worse. Stick with the same dose and things should settle x

[sheila99]

If it doesn't settle it might be worth having a scan as the bleeding could be caused by fibroids or polyps. Oestrogen can make fibroids grow.

[loulou2]

Thanks both for your replies.....I do have a phobia regarding Dr's, scans, etc., also white coat syndrome so the thought of a scan makes me feel a bit sick, I've never had children so find it difficult even having a smear test.

So you think I should go back to the original dose of 2 pumps?, its only the past 3 nights that I reduced the dose, but will go back to 2 pumps tonight.

Not sure if I will continue with HRT as I don't think I can go through the period stage again at 65..(even though its not really a period it certainly looks and feels like it!).

Thanks xx

[sheila99]

As you've had a long break from oestrogen the nhs would have started you on 1 pump so your body finds it easier to adjust. You can increase if you find it isn't enough but many women in your situation find 1 pump sufficient (not all obviously). The right dose is the minimum that controls your symptoms,too much can cause as many problems as too little.

[loulou2]

Thank you for your reply Sheila.....I did ask at the time if I ought to try 1 pump but my Dr said she didn't think that would be enough, initially I tried 1 pump but only for 3 nights and it didn't do anything, not realising at that point that it would take time to get into my system as to be quite honest I am new to all of this!...so upped the dose to 2 pumps, after around 6 weeks all the hot flushes stopped.

 I also used to get palpitations, they stopped as well, so I thought all was working well but after 11 weeks I started bleeding, the bleeding has been going on for 5 days now, but I have an appointment to see my Dr on Tuesday morning so I am hoping that all is well, and just an adjustment to the dose will be effective.

Thank you again for your response! xx

[loulou2]

Hi.....an update!

Saw my Dr this morning, I think something was lost in translation at my last appointment,(French/English) it looks like I should have had 1 pump to start not 2, and this has caused the bleeding which has now stopped.  I reduced the dose to 1 and a half pumps 6 days ago, and she has advised to take it down to 1 and a quarter pumps for the next week, and then down to 1 pump after that.  She also is sending me for an ultra sound just to make sure everything is ok and it was too high a dose of oestrogen which caused the bleeding.

Thank you again Sheila....you were correct about the dosage being too high in my situation!

[sheila99]

That's good news. You seem to have knowledgeable doctor too (unlike many of us in the UK!  ).

[loulou2]

Hi Sheila,

Thank you for your reply....yes my Doctor is lovely, very thorough and very approachable, even to the point that if I am not sure of something I can email her and she will get back to me that day, in fact she advised me to try HRT some years ago and couldn't understand my reluctance as my constant hot flushes were epic!

 I mentioned that the HRT had stopped my heart palpitations as well, immediately she wanted to know how often I had them, how long they lasted, what exactly they felt like, did I get any pain, did they happen when I exerted myself etc., she then deduced she thinks that they are not palpitations but a sort of miss- firing of electricity, as I only used to get them maybe a few times a month, and they only lasted a few seconds, but she still insisted that if they do reappear, it would be best to have me wired up to a monitor whilst I go about my daily life to see if it is something else.

 I must admit it is true that in France the medical profession is very much about preventative medicine, but we do all pay money into the health system, have private insurance top-up as well, and pay the Dr there and then after the appointment....not sure how that would go down in the UK, but you get re-imbursed by your top-up health insurance If you really cannot afford it, your finances are looked at and providing it is genuine you are able to join a different health scheme, but all heart and cancer diagnosis and treatment is free to everyone who is in the system.

[loulou2]

P.S.....Forgot to say, I asked about the Progesterone to Oestrodose ratio and she advised that I should take one capsule of Prog to 1 pump of Oestrodose, and the amount of Prog would be the same if I was on 2 or 3 pumps, but to take it on an empty stomach before bed.

[Kenny]

Hi , sounds like you are going in right direction now 👏.I have just started on the same regime as you,it is continuous so I am hoping this will avoid the bleed , couldn’t bear that after 19 years x

[Marchlove]

Interesting Loulou to hear about the health care system in France. Do you think it works well enough for everyone compared with the uk? X

[loulou2]

Hi Kenny and Marchlove...

Unfortunately, after having the ultrasound and internal scans, the consultant has found that I have a polyp.  The polyp has either been caused by the HRT or may have been there already, but either way the consultant told me I must stop HRT immediately, because of the bleeding and to see my Dr who will explain.

 Here in France the Consultants tell you at the time of having scans what is wrong, you don't have to wait for the results you get them immediately including the x-rays, but the report takes a few hours which you pick up from your medical account on the internet.

Anyway, a few days later I saw my Dr who explained that they are going to give me another scan in 3 months time to see if the polyp has grown or it may disappear as sometimes this does happen if it was caused by the HRT.  If it has grown I will have to have it removed.  Dr also told me that my uterus was in good condition otherwise which was re-assuring.

Very bizarrely, the hot flushes came back for the whole morning a day and a half after stopping the HRT, and then stopped, and I haven't had any more since (5 days). I have been having serious hot flushes and chronic insomnia for 10 years and tried every over the counter remedy going...I used to get so many I couldn't even count them, I told my Dr and she said she has seen this happen before, its the brain accepting that there is no more treatment available and compensating. (Dr also practices hypnosis and is knowledgable in this sort of thing).  It doesn't happen to everyone but it has happened in my case....I'm not complaining!!!!!  Hope this gives some encouragement to other ladies.

Kenny....I am almost 65 and 8 years post meno, if you do bleed have it investigated as my Dr and I were both sure the bleeding happened because the Oestragen dose was too high, but they always investigate a bleed here no matter what, if you ask the question on the internet it does say that it is normal for some ladies to get a bleed between 3 and 6 months when starting HRT, but sometimes it obviously is caused by something else, as in my case.

Marchlove...Yes it does work well for everyone, but remember we do have to pay a lot more into the health system than in the UK, and also pay 30% of any treatment which is covered by health insurance, (the health system pays 70%) if you don't have health insurance you must pay the 30% yourself at the time of the appointment.

[joziel]

Um, if you only started HRT 12 weeks ago there is pretty much no way that 12 weeks of HRT can 'grow' a polyp like that 

Are you sure you want to stop HRT and have all the increased health risks that go along with not having any estrogen? Personally, I wouldn't accept that. The polyp was there before, not caused by the HRT. Have it removed or treated, maybe have a Mirena coil put in to stop the bleeding - but it's not a reason to stop HRT....

[Nas]

Agree 100% with joziel. A polyp wouldn’t grow that quick
I don’t think.

Think carefully if you want to be without oestrogen indefinitely. The symptoms could come back at any time.
A coil would almost certainly stop any irregular bleeds.

Plus, polyps are incredibly common and are no way a reason to come off Hrt (unless you want to).
It could be removed and a coil fitted at the same time ( if you wanted).
Good luck 🤞