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[Susie B]

Hello,
Thank you for the supportive advice I have read in the last month here before joining.  I am 53, but up until 4 months ago I had been having completely regular 28 day cycles with tempertaure changes, distinct PMT for a week before period and clear jelly like discharge mid month. Family history of late menopause - My sister has regular 28 day periods till 56 when she had to have a hysterectomy due to pre cancerous changes in womb lining. I have have had PCOS all my life, though slim and take metformin which gave me regular cycles. 2 miscarriages, no children and then at 52 had to have one ovary removed due to a very large 12 cm endometrioma ( didn't know I had endometriosis up until that point) . 

 4 months ago I started getting 7-8  days of dark brown spotting before my period, increasing in heaviness as the days go on till I got a bright red heavy period which lasted about 9 days. So about 16 days of some sort of bleeding and my 'cycle' extended to 6 weeks. The red heavy part of the last 4 periods has also been heavier than ever before, with so much blood!

I went to a private gynae and have had endometrial biopsies ( after last heavy bleed had stopped), they were fine. I also had a scan and the womb lining was thin at that particular time (though a bit thick on a mid cycle scan 6 months ago) and she saw only a 1 cm ovarian cycst which the doctor wasn't worried about, no polyps or fibroids. Gynae says my FSH is high and my ovaries are " packing up" . I was told to start Uterogestan continuously 100 mg per day to lessen/stop the bleeding and keep the lining thin. I have not been prescribed estrogen. I feel I am progesterone sensitive as I have alway had very bad PMT( tearful, angry etc ) in the week before my periods so after reading the very interesting posts from Hurdity and others I have been using it vaginally for the last 3 weeks, inserting as high as I can with an applicator at night. Sleep has been great so thats one positive.  For the first 2 weeks it seemed to stop the light brown discharge I was having but in the last 5 days the brown discharge got heavier, my hair became greasy and my blood sugar felt low, which is what would normally happen before a period. I doubled the dose of uterogestan , and have been on 200 per night for the last 2 nights. Last night I felt very hot and this morning I have very heavy red bleeding- It feels like a full period ?? Could my own hormones be pushing through ? I'm just not sure what to do - should I continue with the Uterogestan or Stop it completely for a few days and allow the heavy bleeding to happen?  Would this get rid of some of the blood or will it just keep coming....feeling very down about the constant bleeding ( brown or red)  does anyone else have similar experiences?   I  also have dense fibrocystic breasts, a personal history of breast cysts and mother and grandmother both had breast cancer in 70's. I've also got something called factor V lieden which means I am more likely to get blood clots ( though haven't had one so far, fingers crossed ) so favour a natural progesterone... Husband is being supportive but I'm feeling very down, and would appreciate any advice...

[sheila99]

Utrogestan won't override your own hormones, I think the idea here is to prevent the lining building up so much so your periods aren't as heavy. If you want to be bleed free you might be better with a mirena or a bcp.

[Susie B]

What is a bcp please?

[sheila99]

Birth control pill. They're designed to override your own system whereas hrt works alongside it. How long have you been on utro for? If it's less than 3 months you might give it longer to see if it settles.

[bombsh3ll]

I agree utrogestan either orally or vaginally is generally not strong enough to shut down your own cycle.

It would be a particularly progressive gynaecologist who would initiate a combined pill at 53 in the UK, however in the US they are used until 55.

The mirena IUS is a good option for perimenopausal bleeding.

The progestin only pill desogestrel can also be tried - in a lady over 50 with one ovary there's a good chance this will achieve suppression.

[Susie B]

Thank you for your advice. I have only been on the Uterogestan for one month. I'm just confused as initially a few moths ago ( when I was getting brown spotting before my period) the gynae said to take it for the second 2 weeks of the month every month and then I hadn't actually started taking it but had a very very heavy period after a 6 week cycle and then she said to take it every day continuosly with no break. I've been taking it every day for the last 3 weeks but now I seem to be having a proper heavy period, despite doubling the dose for the last few days. I don't know whether to carry on taking it at the lower dose of 100 or to stop taking it completely for a few days, or for 2 weeks and then start on the 14 days on 14 days off regime.

[Susie B]

Surprisingly my sister ovulated regularly till 56 on only one ovary too

[bombsh3ll]

If you want to persevere with the utrogestan and you are still having fairly regular cycles, taking two 100mg caps for 2 weeks out of every 4 is probably best.

This aims to produce more regular bleeds which should in theory be lighter as you are not building up a thicker lining over longer cycles, some of which may be anovulatory.

Usually measures like this are best taken consistently for at least 3 cycles rather than chopping and changing in order to get the benefit.

Utrogestan can also be taken vaginally which leads to a stronger effect on the uterine lining and hence bleeding, than oral if that's something you would like to try.

[Susie B]

Thank you very much. I'm going to try this. I stopped it yesterday as I seem to definitely be having a full blown period, cramping, heavy red blood and clots etc. Sorry for details! I will try taking yesterday as day 1 and take it vaginally at 200 from day 14 to 28. I have read that the uterogestan has a stronger effect on the endometrium vaginally and was frightened of side effects so I have taken it this way so far actually. I was surprised by the wonderful sleep it has given me and have felt a little bit tired in the day, though not depressed or weepy as I often used to be with PMT. It must be being absorbed systemically via the vaginal route surely to give the amazing sleep? One of these days I will pluck up courage to try it orally but I imagine that will have an extremely sedating effect if it is already doing that vaginally....