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[Karras77]

Hi All

Hope this is the right forum but looking for some post menopause progesterone advice / pointers.

I had my last normal period June 21, aged 44, but wasn't confirmed as menopausal and started on hrt (50 evorel patch, utrogestan as pessary or pill and vagirux for atrophy) until 11 months later in May 22 aged 45. At the first gyn app I was told to take hrt continuous as there was a uterine cancer risk to taking sequential post menopause. But I really missed having periods (I know im weird) and also nervous of starting more than one new medication at a time i.e patches and utrogestan so started as sequential instead.

When I had my follow up gyn app in Aug 22 they said okay you can stay on sequential as I was doing fine apart from normal progesterone side effects but only for a year maximum i.e up to May 23 then on to continuous due to uterine cancer risk.

My questions are:

If I take utrogestan as a pessary one tab a night as continuous - how do you have sex? Sorry gross but when taking two tabs for 12 days as sequential obv hangs around the next day and I'm guessing gives your partner a dose if you have sex? I also tend to get thrush in the 12 days so not looking forward to this every day. I don't swallow the tabs as I have an upper stomach and bowel disorder and suspect the side effects would be too much and the 12 days on 2 tabs can be quite tough by the end with headaches / hot flushes etc so also worried what every day feels like.

The gyn had mentioned at the second appointment trying the mirena iud but im a bit nervous about post application side effects like infection / pain as have a few chronic health problems and dont want to add to them.

Early on when I thought I was perimenopausal in Feb 20 I was briefly tried on hrt but didn't cope well. But if I had been left on it I wouldn't know I had gone through menopause and would surely be taking sequential until aged 50/51 so is the uterine cancer risk really high / significant?

I am going to try and get a gyn follow up for these questions but wondered if anyone here has any experiences or advice?

Thank-you

[sheila99]

I'm still on long cycle (6 weeks) sequi aged 62 and I intend to stay on it. I was told slightly higher cáncer risk but I thought it was endometrialnot uterine? I get fatigue on utro so will take the risk rather than be permanently doped. I have no idea how much research they've done to come up with this but I suspect very little. They have agreed I can stay on sequi (though perhaps they'd worked out I was going to with or without their agreement).
As I understand it sex the morning after is OK as the white stuff is the casing but at night you should use utro afterwards.

[Karras77]

Thank-you that's interesting especially re the casing. I might be misremembering / being thick as to uterine/ endometrial cancer. I remember finding one paper online after the appointment but it was hard to make out the actual risk in layman's terms. Do you mind if I ask if you still have withdrawal bleeds? Mine last 4 days so seem satisfactory although not as heavy as my old periods which 6 days and quite intense.

[sheila99]

I bleed roughly one in three. For me the hrt induced ones are noticeably shorter and lighter than 'proper' ones with hardly any pmt symptoms and rarely any pain.