53, Bleeding on HRT and history of Endo

[Brambledoggy]

I am 53, post menopausal and been on combined continuous HRT (patches and pills, 75mg patches, 100mg pills) for nearly two years with no problem, my menopause symptoms were HORRENDOUS and the HRT solved them almost overnight…. then a month ago I started heavy bleeding and it hasn’t stopped since, every flipping day heavy and bright red and lots and lots of dragging pelvic pain. If you read my profile you’ll see my sad and long endometriosis history. Anyone else been in my position and do you have to stop HRT? It took my three years to make the decision to go on the flipping stuff knowing it was risky. My HRT doctor said the progesterone would balance out the oestrogen and stop it coming back and being oestrogen dominant.

If you stop the HRT, does it immediately stop the bleeding and pain I don’t understand why it’s happened out of the blue and where the blood is coming from….and when this happened once briefly (but not like this!!) before I had to have a hysteroscopy under general anaesthetic and the procedure was medieval, way worse pain than my ectopic pregnancy, results were clear of cancer thank god. My GP has booked me an urgent ultrasound for next week or two. Yes, another flipping ultrasound.

I am so upset as I thought my endo and pains and bleeding were over, is the HRT causing it?

In the past I’ve had polyps and fibroids and cysts removed, I’ve had ectopic pregnancy, ablations and laparoscopies (three) and the whole nine yards of gynaecology hell etc. Now wondering if hysterectomy is next step or if to totally stop the combined HRT. Why okay for so long and then this?

It also hurts when I have a bowel movement though no bleeding from bowel, and I’ve also been diagnosed yesterday with lichen sclerosis which I had never heard of. One thing after another after another after another, now going on over 30 years. I am really fed up today. Cue the painkillers….

[99anon]

I am 43 and had severe endometriosis - had a total hysterectomy in Jan - the op was quite intense as had to have the endo removed from several places and the recovery took longer than I expected - I’m also now on the same hrt as you it was the best decision I ever made - I finally have my life back I wouldn’t be afraid of having one. I know everyone else’s experiences are different but the quality of life I have now compared to what I had whilst dealing with endo is well worth it.

[Sunset-lady]

Morning, you are very similar to me lovely. I'm stage 4 endo and been bleeding for 2 years. It IS the estrogen. No matter what anyone says it's the balance between estrogen and progesterone. However if you increase your progesterone to 200mg per day and slowly decrease your estrogen via gel you'll see an Improvement. I still have a small (tiny) amount of estrogen. I thought I'd be crazy without the estrogen but I'm OK- we need the progesterone much more. Read Lara Briden's books. Speak to a professional and lower the estrogen. I'm on zoladex too which, despite the horror stories, works really well. I finally have my life back. Don't let anyone tell you that it's not estrogen. If you are stage 4 endo then you are estrogen sensitive and possibly have fibroids too xxx

[Brambledoggy in reply to Sunset-lady]

Interesting. I definitely have a fibroid that showed up on my last ultrasound and was never dealt with. I forgot why. The pain on opening my bowels could easily be down to endo as donkeys years ago a surgeon “mentioned” it was scattered everywhere. I’ll await my ultrasound on Monday as they’re doing it urgently due to cancer risk.

Instinctively last night I doubled my progesterone to 20mg to counteract the oestrogen patch but I was worried this was too much. The problem with endo is if you talk to 10 different doctors they’ll tell you 10 different things.

I’m loathe to come off my HRT as my menopause symptoms were so bad I counted over 20 symptoms and the night sweats were ruining my life.

I’ve stopped bleeding over night and hope it never ever returns. I should have shared in stain removing spray!!! The shock of going to the loo to find a load of blood was really triggering for me as I’ve bled for England all my life. Endometriosis has altered my life, changed the course of who I wanted to be, debilitated my career, put an end to my relationship (his loss) and I’ve finally moved to a new area where I don’t know a soul. I want to start a new chapter and will NOT let my body stop this.

I will read those books. Knowledge is power in this battle. Hope you remain well and in good gynaecological health. Thank you for replying. Nina.

[Brambledoggy in reply to Sunset-lady]

p.s what is zoladex? I will Google.

[Sunset-lady]

I can relate to this in so many ways. My hysterectomy was abandoned last September due to endometriosis which I didn't know I had. Everything is fused. I've been hemorrhaging for nearly 2 years but the zoladex injection has stopped it and I'm not anaemic anymore thank goodness. I had terrible peri menopause symptoms too and I refused to come off estrogen as i thought it was helping as when I started Hrt I felt better almost overnight. I do get hot sweats but everything else is better without estrogen and I had no idea that would be the case. Zoladex puts you in chemical menopause. I've finally stopped bleeding and I feel really good. Read about progesterone therapy - if you have endo and fibroids you need to be careful about taking estrogen as it's not the answer we think it is xxx

[Brambledoggy in reply to Sunset-lady]

Just this minute, got my letter from NHS to go to Ultrasound. Title is urgent suspected cancer…. Rapid access…. been through so much I’ll cross this bridge when I come to it.

[Sunset-lady]

I got put on that pathway too. Try not to worry it'll be the HRT xx ask for an MRI before any surgery as it's imperative with endometriosis xxx

[Brambledoggy]

What I don’t understand is why after so long on being on HRT did I start bleeding? Thats what’s mostly on my mind. Going for 3 years and then bam. What’s going on down there to start the heavy bleeding for a month when nothing has changed. Body just decides to bleed. Which ironically today has “dried up”…..probably never get the answers. I feel like we’re all HRT/Endo Guinea Pigs. Experimenting with our hormones and our bodies till they find the answers . When we’re all dead and gone maybe Endometriosis will be a disease of the past. X

[Realtiger]

Sorry that you’re going through this and hope you get some answers soon. I had endo diagnosed due to heavy bleeding at 49 and the discovery of an endometrioma on my right ovary. It came as a surprise as I didn’t have a history of painful periods but have had severe pelvic musculoskeletal issues.

Fast forward to terrible meno symptoms which cyclical HRT has really helped with. I’ve just been through investigations for post menopausal bleeding as, like you, I thought I was clear after 18 months of no bleeding and it all came back with a vengeance. Hello referral on 2ww pathway, two ultrasounds and a hysteroscopy under GA to remove a cervical polyp and endometrial biopsy (I hear you about the pain - fentanyl and morphine for me when I came round, it was brutal) . The consultant told me I’m bleeding because of the HRT and that I should switch to continuous HRT. She said if I wanted to stay on the 75mg patches I would need to take 200mg Utrogestan every day and that it might cause tender breasts etc. I’m planning to switch to a 50mg patch and 100mg Utrogestan daily. Based on this, your HRT dose makes me wonder if you’re on too much oestrogen in relation to progesterone.

[Brambledoggy]

yes, that’s what others have said, I guess it’s getting the balance right, I think more progesterone might be a good idea, but I’ll check after my ultrasound with my menopause lady. Loathe to give it up as my menopause symptoms were horrendous and I didn’t sleep for years due to drenching night sweats. Oh to be a woman eh? 🧐