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[Mariamaria]

I'm on the new Bijuve/Bijuva tablet for a six weeks now.
Anybody else taken this or on it?
Could you share your experience please, positive or negative.
Thanks 😊

[Nanookster]

I took it for nearly two years and it helped so much. I’ve recently switched to a different conti-pill as I needed a higher dose. Is it your first time trying HRT?

[Mariamaria]

I was on 50 patches with duphaston for two years. Then I went on to 50 patches with 100mg utrogesten continuously for a year and I felt fine but started with lots of light break through bleeding. All tests were clear so Gynie put me on bijuve. I'm on it now for six weeks, no bleeding but night flushes have come back.

[Hurdity]

Hi mariamaria

 

Yes it's clear that if your flushes have come back that you need a higher dose as Bijuve is only 1 mg estradiol.  I'm guessing you're not in UK as Duphaston is ( unfortunatrely) not available here?

Depending on where you are in menopause and your age, the bleeding can be due to all sorts of reasons . It doesn,t mean the oestrogen dose is too high per se, but that the balance can be wrong ( amongst other causes of uterine bleeding). The minimum oestrogen dose required is whatever dose prevents flushes and sweats, if those are your main symptoms. Other symptoms generally improve concomitantly. As you were already taking the oestrogen and progestogen separately, you could have increased the dose of Duphaston to a level that controlled the bleeding ( having rules out other causes of bleeding eg polyps, fibroids). Alternatively you could have taken the hRT cyclically with a predictable withdrawal bleed. This would also be advised if you were still peri-menopausal, which can also (obviously) mean bleeding while on continuous HRT when your own cycle overrides the HRT cycle.

Hurdity x

[Mary G]

You could trying topping the Bijuve up with an extra dose of oestrogen.  I did it for a number of years when I was used Angeliq (combined oral HRT) and it worked well with no breakthrough bleeding or womb lining thickening.

You could try using one pump of Oestrogel.  You have a gynaecologist so you have access to scans etc.

[Mariamaria]

I'm British but was living in Ireland and duphaston was available. Now I'm in Spain and duphaston is not available so that is why I went on to the utrogesten with the 50 patch but since I was on that I have suffered with bleeding and my ultrasounds and my smears have all been clear. Now I am on Bijuva I am not bleeding but I am having hot flashes at night. The advantage of living in Spain is that I can buy patches and gel and all the HRT without a prescription however I am taking the Bijuva on the advice of my gyne but I do think I need more estrogen because of hot flushes and not sleeping at night. My bleeding only started when I took the utrogesten. My Gynie told me I could pop him an email and let him know how I was going on and he would advise me but I could go and buy some gel and just take a little dab at night and see how I go. I'm three years post menopausal and 58 and on continuous hrt for three years.

[Mary G]

So your gynaecologist said virtually the same as me ie top up with some Oestrogel.

That's a coincidence, I'm now Irish and I'm in Spain too.  I think it's great that we can buy HRT over the counter and without a prescription.  By the way, Oestrogel is called Oestraclin here and it costs about €10.00.

If you specifically want Duphaston, the only way to get it is to go to Gibraltar (if viable of course) and buy it in the form of Femoston which is either cyclical or continuous containing oestrogen.  I ordered and bought some for someone without any problems and it cost about £90.00 for a six month supply.

How much does Bijuve cost in Spain?

[Mariamaria]

Bijuve is ABIT expensive. It's 28 euro for a month and it's not available on your SIP card yet (medical card).
Patches are 6 euros and utrogesten is 6 euros to buy but because they are covered by the SIP card, I paid 2 euros a month for both (1 euro each)

[Mary G]

Thanks, that's interesting.  I'm not in the Spanish state health system, I have private health insurance so I pay the full price for all medication!

I hope the extra gel works well for you.

[Hurdity]

Hi again

The problem with adding extra oestrogen without progestogen is that without knowing what was the cause of the bleeding, it could happen again. Looking at the dose of progesterone in Bijuve, since 100 mg progesterone is the recommended dose ideally for medium dose oestrogen ( though the licensed dose of progesterone doesn't give any variation with higher doses oestrogen) it may be that adding extra oestrogen will be sufficient to protect the lining.

I still would want to know why you had bleeding and would be reluctant to add gel without knowing this.

In veiw of what you say about the cost - and that is high, as you seem to be happy with oral oestrogen and duphaston, are you able to get Femoston - as Mary G says it is the only HRT that contains that same progestogen, ie dydrogesterone. The good news for that is that it also comes in 2 mg oestrogen doses so should alleviate your flushes.

Personally I think you need to be on a regime where you can tweak oestrogen or progestogen, because if you get bleeding on Bijuve + extra gel, if you then get bleeding - you have no separate progestogen to control it.

So - as utrogestan and patches are cheaper, why don't you go back to them, and try for example 200 mg utrogestan and see if that controls the bleeding. Alternatively go onto cyclical HRT which means the bleed is predictable?

Hurdity x

[Mariamaria]

Hi,
I tried 200 of progesterone but I felt dealthy on it. Femoston isn't available in Spain. I will proceed with Bijuva and if the hot flushes stay and there is no bleeding I will speak to my Gynie again x