You have given me so much helpful information Louise. I have had fibroids since 35 and polyps removed some fibroids removed had uterine artery embolization at 47. Im 58 years now. Thought they had all gone but told I still had two they have shrunk. But I thought they would go eventually this isnt true. Been on HRT for 3 years. Was alot better. Put on continuous HRT now But symptoms have come back same 6 years ago and other symptons especially anixety and crying. This seems strange since NICE guideline have doubled dose to 200mg daily of progesterone. I wondered if the Estrogen is out of balance now? Apparently there is evidence now regarding the dosage change that this dose keeps the lining of the womb thinner than the 100mg per day.
Thank you Louise. This has finally answered questions I had about experiencing unexplained bleeding after being on continuous HRT for a year and nine months (75 patches plus 200mg Utrogestan). My periods had stopped nearly three years ago. Along with the bleeding I experienced quite intense period pains and extremely painful breasts. After the ultrasound scan showed absolutely nothing unusual and a very thin lining, I was told to come off the oestrogen for two months. I continued with the progesterone. The bleeding stopped quickly but the menopause symptoms were horrendous and I was counting the days until I could go back on oestrogen . I have now been back on 50 patches for 3 months with no bleeding and mildly sore breasts. I appreciate you explaining about the need to balance the two hormones and individualise the approach to bleeding.
I'm bleeding so badly. I bleed everyday since October 2023. Did you have awful vasomotor symptoms return when you went off the ostrogen for 2 months? I have terrible migraines and I'm scared that they'll return.
I’m so sorry for your suffering. Unfortunately, yes, the migraines were almost daily when I came off the oestrogen patches and stopped soon after I went back on them. After watching this video presentation, I now believe it wasn’t necessary to come off oestrogen completely. If it happens again I would ask to try a lower dose for a while, possibly halving or even quartering a 50 patch. I really hope you can see someone who is competent and able to balance your hormones. Xxx
@catmozzy6106 Thank you. I'm sorry you've gone through this too. My story is similar to yours except I am 47 and haven't stopped having a cycle yet. I started with two heavy periods a year ago. My gyno started me on HRT 50 estrodiol patch and 100mg nightly of Prometrium October 5, 2023. She suggested the Mirena IUD. I had a terrible experience with the Mirena about 10 years ago. I had it for 9 months and I bled everyday that I had it in, cystic acne, migraines... The only reason I kept it in so long was because it cost $500 so every month I would say one more month hoping things would improve because my gaslighting doctor kept telling me it would. Fast forward to recently my gyno said she would give me one at no cost. She said hormones change and it would be worth a try. I agreed and had it inserted on October 18, 2023. She told me to stop the Prometrium that I started on October 4th. I was bleeding when I had it inserted. I have bled every day since. I held out 7 months and had it removed on May 17, 2024. I started on 100mg of Prometrium nightly again. My Estrodiol patch was increased in December 2023 to a 75 patch because I was still experiencing vasomotor symptoms plus migraine. I was having 15+ migraine and headache days a month. 50 estrodiol patch decreased my migraine days but 75 has been a huge improvement. A couple weeks ago my gyno suggested trying a new patch Estalis 250/50. She thought the increase in progesterone would help with the bleeding. Of course I am willing to try anything to stop bleeding. I didn't look into Estalis. I presumed that all patches were made with bioidentical hormones. Sadly the Estalis combi patch is a progestin NOT progesterone. I started the patch on a Monday by Wednesday the following week my face had cystic acne all around my mouth and I had a migraine that lasted Wednesday, Thursday, Friday and another on Sunday. I compteplated putting the Estalis back on last Monday on change day to give it another week. It did decrease my bleeding to spotting a couple days but I couldn't do it. The migraines are debilitating. I thankfully had some 75 estrodiol patches so I put that back on and called my gyno to say I couldn't do the Estalis. She called me a prescription in for the 75 patch and I started on 200mg of Prometrium nightly. I have been bleeding heavily since. What a mess. Because the gyno made the choice to start me on HRT and the IUD at the same time I don't know if my bleeding is from the HRT or the Mirena IUD. I had the Mirena removed 2 months ago but have read testimonials from women that it took some a few months to completely rid their bodies of the hormones from the Mirena. I can't remember how long it took to stop my bleeding last time I had it removed. Some women are telling me that my bleeding is from the HRT. The only way I can know is to completely stop everything and go through the Hell of my migraines and symptoms returning. My workplace is not understanding at all. They took an entire day a week from me last year without consultation. When I asked they said it was for missed days. I only missed 4 days of work in 10 months. I had to work many many days with migraine. The 4 days I missed were because they were unbearable. I got the day back because I fought for it. I don't want surgery either. I'm scared. I literally have the worst luck of any person that I know. I have some 50 estrodiol patches from before. I am going to put that on instead of the 75 and see what happens.
@@earthlover1I’m so so sorry, what a horrendous time you’ve been having! Well done for fighting for justice with your job. How you found the energy I don’t know. It sounds like your gyno is not as well informed as Louise Newson. Can you seek a second opinion? I do think you’re on the right track with reducing your estradiol patch. Here in the uk, women frequently cut/trim their patches. Of course you need to be as accurate as possible so you get a fairly consistent dose. Maybe there’s a ‘sweet spot’ where you stop bleeding but don’t get the migraines etc. and maybe you need a different dose of progesterone? I am now trying a small amount of testosterone too, which seems to be giving me more energy. I am at a very different stage to you as I am 57 and my cycle stopped several years ago. But we are both sensitive to hormones and I can only imagine in a limited way what you are going through, my dear. I really hope you can get more competent care. Keep in touch, I will always reply. Xxx
Glad to have come across this as I’ve been on HRT for 5 years unfortunately on and off due to bleeding. Very frustrating trying to find the right balance, having started off with the patch and progesterone tablet to oestrogen gel & progesterone IUD. Having started at a low dose (one pump gel progressing some months later to 4 pumps). At every stage in this process the spotting continued. Over the course of the 5 years I’ve had at least one ultrasound scan per year & further investigative procedures due to concerns over the bleeding and subsequent thickening of the lining of the uterus. I’ve how stopped HRT yet again and actually have no idea of next steps.
I was wondering, if you are on cyclic progesteron and get a withdrawal period anyway, how would you know you have become no longer perimenopausal, but menopausal instead? In other words when is the decision taken to go non cyclical with the progesteron? Thanks!
I asked my GP this and she said that, basically, you don't! Unless you come off all hormones to see what happens there is no way of knowing. But I think if you've been on cyclical for a year or two and also taking your age into account then they can make the decision to switch you over to continuous.
I am 49, still having periods, but I am experiencing low to no libido, brainfog and dry eyes. I have just been finally prescribed HRT, but am a little bit confused about it: I was advised to start on the fifth day on my next period, and should use for 21 days: first 11 days only estrogen (gel), 10 days estrogen+progesterone (gel+tablet), then 7 days full stop. I have never seen a dosage like this, I only hear about continuous usage. Does anyone have experience?
You have given me so much helpful information Louise.
I have had fibroids since 35 and polyps removed some fibroids removed had uterine artery embolization at 47. Im 58 years now. Thought they had all gone but told I still had two they have shrunk. But I thought they would go eventually this isnt true. Been on HRT for 3 years. Was alot better. Put on continuous HRT now But symptoms have come back same 6 years ago and other symptons especially anixety and crying. This seems strange since NICE guideline have doubled dose to 200mg daily of progesterone. I wondered if the Estrogen is out of balance now? Apparently there is evidence now regarding the dosage change that this dose keeps the lining of the womb thinner than the 100mg per day.
Thank you Louise. This has finally answered questions I had about experiencing unexplained bleeding after being on continuous HRT for a year and nine months (75 patches plus 200mg Utrogestan). My periods had stopped nearly three years ago. Along with the bleeding I experienced quite intense period pains and extremely painful breasts. After the ultrasound scan showed absolutely nothing unusual and a very thin lining, I was told to come off the oestrogen for two months. I continued with the progesterone. The bleeding stopped quickly but the menopause symptoms were horrendous and I was counting the days until I could go back on oestrogen . I have now been back on 50 patches for 3 months with no bleeding and mildly sore breasts. I appreciate you explaining about the need to balance the two hormones and individualise the approach to bleeding.
I'm bleeding so badly. I bleed everyday since October 2023. Did you have awful vasomotor symptoms return when you went off the ostrogen for 2 months?
I have terrible migraines and I'm scared that they'll return.
I’m so sorry for your suffering. Unfortunately, yes, the migraines were almost daily when I came off the oestrogen patches and stopped soon after I went back on them. After watching this video presentation, I now believe it wasn’t necessary to come off oestrogen completely. If it happens again I would ask to try a lower dose for a while, possibly halving or even quartering a 50 patch. I really hope you can see someone who is competent and able to balance your hormones. Xxx
@@earthlover1 Please see my reply below. Xx
@catmozzy6106 Thank you. I'm sorry you've gone through this too.
My story is similar to yours except I am 47 and haven't stopped having a cycle yet.
I started with two heavy periods a year ago. My gyno started me on HRT 50 estrodiol patch and 100mg nightly of Prometrium October 5, 2023. She suggested the Mirena IUD. I had a terrible experience with the Mirena about 10 years ago. I had it for 9 months and I bled everyday that I had it in, cystic acne, migraines... The only reason I kept it in so long was because it cost $500 so every month I would say one more month hoping things would improve because my gaslighting doctor kept telling me it would.
Fast forward to recently my gyno said she would give me one at no cost. She said hormones change and it would be worth a try. I agreed and had it inserted on October 18, 2023. She told me to stop the Prometrium that I started on October 4th. I was bleeding when I had it inserted. I have bled every day since. I held out 7 months and had it removed on May 17, 2024. I started on 100mg of Prometrium nightly again. My Estrodiol patch was increased in December 2023 to a 75 patch because I was still experiencing vasomotor symptoms plus migraine. I was having 15+ migraine and headache days a month. 50 estrodiol patch decreased my migraine days but 75 has been a huge improvement.
A couple weeks ago my gyno suggested trying a new patch Estalis 250/50. She thought the increase in progesterone would help with the bleeding. Of course I am willing to try anything to stop bleeding. I didn't look into Estalis. I presumed that all patches were made with bioidentical hormones. Sadly the Estalis combi patch is a progestin NOT progesterone. I started the patch on a Monday by Wednesday the following week my face had cystic acne all around my mouth and I had a migraine that lasted Wednesday, Thursday, Friday and another on Sunday. I compteplated putting the Estalis back on last Monday on change day to give it another week. It did decrease my bleeding to spotting a couple days but I couldn't do it. The migraines are debilitating. I thankfully had some 75 estrodiol patches so I put that back on and called my gyno to say I couldn't do the Estalis. She called me a prescription in for the 75 patch and I started on 200mg of Prometrium nightly. I have been bleeding heavily since. What a mess. Because the gyno made the choice to start me on HRT and the IUD at the same time I don't know if my bleeding is from the HRT or the Mirena IUD. I had the Mirena removed 2 months ago but have read testimonials from women that it took some a few months to completely rid their bodies of the hormones from the Mirena. I can't remember how long it took to stop my bleeding last time I had it removed.
Some women are telling me that my bleeding is from the HRT. The only way I can know is to completely stop everything and go through the Hell of my migraines and symptoms returning. My workplace is not understanding at all. They took an entire day a week from me last year without consultation. When I asked they said it was for missed days. I only missed 4 days of work in 10 months. I had to work many many days with migraine. The 4 days I missed were because they were unbearable. I got the day back because I fought for it.
I don't want surgery either. I'm scared. I literally have the worst luck of any person that I know.
I have some 50 estrodiol patches from before. I am going to put that on instead of the 75 and see what happens.
@@earthlover1I’m so so sorry, what a horrendous time you’ve been having! Well done for fighting for justice with your job. How you found the energy I don’t know. It sounds like your gyno is not as well informed as Louise Newson. Can you seek a second opinion? I do think you’re on the right track with reducing your estradiol patch. Here in the uk, women frequently cut/trim their patches. Of course you need to be as accurate as possible so you get a fairly consistent dose. Maybe there’s a ‘sweet spot’ where you stop bleeding but don’t get the migraines etc. and maybe you need a different dose of progesterone? I am now trying a small amount of testosterone too, which seems to be giving me more energy. I am at a very different stage to you as I am 57 and my cycle stopped several years ago. But we are both sensitive to hormones and I can only imagine in a limited way what you are going through, my dear. I really hope you can get more competent care. Keep in touch, I will always reply. Xxx
Glad to have come across this as I’ve been on HRT for 5 years unfortunately on and off due to bleeding. Very frustrating trying to find the right balance, having started off with the patch and progesterone tablet to oestrogen gel & progesterone IUD. Having started at a low dose (one pump gel progressing some months later to 4 pumps). At every stage in this process the spotting continued. Over the course of the 5 years I’ve had at least one ultrasound scan per year & further investigative procedures due to concerns over the bleeding and subsequent thickening of the lining of the uterus. I’ve how stopped HRT yet again and actually have no idea of next steps.
I was wondering, if you are on cyclic progesteron and get a withdrawal period anyway, how would you know you have become no longer perimenopausal, but menopausal instead?
In other words when is the decision taken to go non cyclical with the progesteron?
Thanks!
I Would love to know the answer to this also
I would also like to know the answer to this, can’t find any explanation on the internet.
I asked my GP this and she said that, basically, you don't! Unless you come off all hormones to see what happens there is no way of knowing. But I think if you've been on cyclical for a year or two and also taking your age into account then they can make the decision to switch you over to continuous.
Excellent information. Thank you
Thankyou so much this is very assuring to my circumstances
I am 49, still having periods, but I am experiencing low to no libido, brainfog and dry eyes. I have just been finally prescribed HRT, but am a little bit confused about it: I was advised to start on the fifth day on my next period, and should use for 21 days: first 11 days only estrogen (gel), 10 days estrogen+progesterone (gel+tablet), then 7 days full stop. I have never seen a dosage like this, I only hear about continuous usage. Does anyone have experience?
Dr. Louise can i ask something?