Bleeding with HRT after menopause

by Traci Al-NAjjar
(Saudi Arabia)

I am 2 years post menopause (46 years old) trying to deal with it naturally. This year hot flashes and night sweats so bad had to go to the Dr to ask for help. She put me on ostrogel at night and progesterone tablets 10mg twice a day, hot flashes stopped within a day was feeling normal again after about 2 months i started spotting and bleeding. I stopped the ostrogel at night and the progesterone tablets and started with progesterone cream (a guartersize dab of Emerita (Pro-Gest) 2 times and day and then added DHEA cream once a day my hot flashes and night sweats are still gone for now but the spotting/bleeding still there after 2 weeks of using the creams. Had a ultrasound everything was fine. Do i need to do something different than what i am doing to stop the bleeding. Please, any suggestions.

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Mar 31, 2014
Bleeding with HRT after menopause
by: Anonymous

The hormones you are taking are not natural and that could be part of your problem. I take the natural progesterone cream only as my estrogen levels are high in relation to the progesterone. It regulates the estrogen so progesterone is most important. I don't think the natural comes in a pill but I could be wrong. They have found that progesterone isn't effective in pill form so try to have your doctor prescribe some natural compounded progesterone cream. That alone could stop your hotflashes etc. and it is not know for making you bleed but you could have another issue.

Mar 31, 2014
Bleeding after menopause
by: Diane

Stop progesterone and let bleed fully happen and then resume progesterone. You may need minimum 100 to 200mg daily to stop bleed.. With the cream your using, you have to use a tsp plus a forth to get 100mg dose. I hope it helps.
Diane

Apr 01, 2014
Bleeding with HRT after menopause
by: Carol K

Hi there

I definitely do not agree that you should stop Progesterone and then resume it. You are bleeding because you are not using enough and your Estrogen is dominant. I cannot comment on the cream you are using but there is lots of information on this site about how to use this product.

Good luck.

Apr 01, 2014
Bleeding after menopause
by: Diane Adams

Btw...Progest by Emerita is natural progesterone. It's just that you have to apply a lot of cream to get a 100mg dose. Try stopping the progest and allow bleed to fully finish and then restart.but at a higher dose of at least 100mg. In our office, our doctor prefers progesterone in sublingual 100mg every night because subl promote good sleep as well, where as cream will not promote sleep. But either way, I do not think you are getting enough progesterone and that may be causing the spotting/bleed.
Let us know how that works:)
Di~

Apr 01, 2014
Bleeding with HRT after Menopause
by: Joy

Hi Traci

Excellent choice going the natural route as all drug based HRT’s have a potential to cause harm – see here. Menopause can be a difficult time for most women and it needn't be, progesterone is very much needed to help with those dreaded hot flushes and night sweats, which are caused by excess estrogen. Estrogel would certainly be adding to your Estrogen Dominance symptoms, no women needs to take extra estrogen as there are over 100 mimics in our environment as it is, please read Our Stolen Future.

Oral progesterone is not the best delivery method as 96% gets destroyed by the gut and liver – see here, resulting in you getting virtually nothing. Now here is a problem, what is a ‘dab’? If progesterone is not used correctly it will not work resulting in people thinking that progesterone does not work, it does work, it just needs to be used correctly and according to ones symptoms. Please read How to use Progesterone Cream. The progesterone cream used should be of the correct progesterone concentration, if not, adverse symptoms are felt, and this is what you are now feeling. You would have to double the amount of ProGest used to reach the required amount need. It really is vital that you use the correct progesterone cream – see here.

The spotting/bleeding that you are experiencing is because too little progesterone is being used, nothing less that 100mg/3ml should be used, but most menopausal women need 200mg/6ml, more if symptoms are severe. IF the correct amount of progesterone cream is used and bleeding occurs, this is quite normal and is merely the build-up of estrogen lining in the uterus being expelled, this is a good thing and nothing to be concerned about. It should only last one or two months.

Continued ....

Apr 01, 2014
Bleeding with HRT after Menopause
by: Joy

Hi Traci

For hot flushes/night sweats, 400mg–500mg of progesterone cream is needed for 4 to 6 days, possibly longer if they are severe. Once they have gone and you feel stable enough, the cream can be SLOWLY reduced to a level that suits you. If you reduce by too much and too soon, hot flushes will return, if this happens simply increase the amount of cream again. This is the beauty of a cream, it can be used to suit one’s symptoms.

A vital thing to consider is Vitamin D, do you know what your level is? If not please consider having a test done as a deficiency reduces the benefits of progesterone, it is also connected to every single cell and its formation in our bodies. It is so important to get your vitamin D level up high. Your level is bound to be low as I doubt very much if you go out into that blazing sun and heat.

Hope this helps you.

Apr 02, 2014
Thanks to everyone responding!
by: Anonymous

What I have done is stopped all estrogen and keeping the progestrone cream and the progesterone tablets the bleeding is less but still there. What is the best progestrone cream to use where I can measure 400mg , I feel I am using have of my tube to get enough. After the bleding totally stops and I get back to normal should I add a small amout of estrogel back in my routine or just stick with the progesteone cream? Thanks to everyone again.

Apr 02, 2014
Bleed and menopause
by: Diane

I work with an Expert BHRT Doctor, Internal medicine, MD, and her protocol is That if you have constant bleed while using progesterone to then stop using progesterone for about a week, allow bleed to happen because uterine lining has probably thickened due to estrogen dominance, and when bleeding stops to start progesterone but at a much higher dose as I noted in my previous comment, 100 to 200mg. to prevent reoccurrence of bleed. This protocol has successfully worked on hundreds of women in our office.
Wish you the best.

Apr 03, 2014
Thanks to Everyone Responding
by: Joy

Hi Traci

As mentioned previously, oral progesterone is not a good delivery method, so together with this and the estrogel, it would cause bleeding. Please do not go back on any form of estrogen, it is not needed and only creates problems. Try what I have suggested, excellent results have been achieved by this. Remember that vitamin D is vital.

You could try what Diane suggests, go off progesterone and start again, but if you do not used the correct amount of progesterone cream with the correct concentration and take tablets again, your bleeding will not clear. Please read the How to Use Progesterone Cream given above, it explains everything that you need to know.

Apr 04, 2014
Progesterone cream
by: Diane

If your having trouble finding a progesterone cream OTC in high enough concentration, then can you get an RX from a dr to get 50mg per pump? If that isn't possible for you, then you could go to Dr. Michael Platt's website and order his progesterone cream on his website plattwellness.com I believe it's 50mg per pump. He has a great book called The Miracle of Bioidentical Hormones and is a huge proponent of progesterone cream.
I personally use progesterone cream for day use at a 100mg per day and 100mg sublingual progesterone at night depending where I am in my cycle. Subl help with my wicked insomnia. Orals (tabs) have the worst absorption. Subl are better because most will go through the mucosa into the blood stream (though some does get injested with saliva). Creams have the best absorption but if you have insomnia like me than subl at night are a good option.
If your bleeding then stop progesterone for a week, allow bleed to fully happen and then when stopped resume at MUCH HIGHER dose. At least 200mg. Again this protocol is used by the dr I work for and has helped many women. Now if you are just spotting lightly, then just simply increase your dose to at least 200mg and see if that works.
Good luck.
Di~

Apr 07, 2014
Progesterone Cream
by: Joy

Hi Diane

Many thanks for helping Traci and to stress the importance of using a progesterone cream that has the correct concentration.

I notice that you suggest using Dr Platt's progesterone cream, are you aware that he uses Natpro which is what I suggested to Traci?

Any form of oral progesterone is not good as explained, if the sublingual method that you are using are in drops, then may I suggest that you use it topically for better absorption.

Apr 07, 2014
Thanks
by: Traci

I think my problem was too little progesterone i looked and Emerita contains 20mg per 1/4 teaspoon. I was using about 1/2 teaspoon so was not getting much. I will order Natpro today, how many teaspoons do i need to use to get 300mg a day. My bleeding finally stopped once i stopped the progesterone cream and oh course all my menopausal symptoms are back, hot flashes , etc. So now i will start all over but use the right amount of progesterone cream. Will keep you updated and thanks for all the help.


Apr 07, 2014
Cream vs subl
by: Diane

Hi Joy~
I use both cream and subl. Creams for day use and subl for night because creams for some reason keep me awake at night. Subl byproduct induces sleep.
I hope Traci gets relief . I see a lot of women in our practice who come in with same problem and are able to get relief with the protocol.
Take care:)
Diane

Apr 08, 2014
Thanks
by: Traci

Finally all bleeding stopped after I stopped the progestrone and estrogen. All of my menopausal symptoms did return though :( ..... I am now gonna start all over with 300mg of progestrone, should that stop the hot flashes and night sweats? Thanks to everyone for helping me through this awful time. All the advice has been so helpful.

Apr 08, 2014
Thanks
by: Joy

Hi Traci

I am so pleased to read that you have stopped the estrogen, as mentioned, no women needs to take extra.

Hot flushes really require 400-500mg for 4 - 6 days before relief is felt, longer if they are severe. Please read the HOW TO USE PROGESTERONE CREAM page given further up, it's important that you understand this. Click on the HOT FLUSHES link and things will be explained to you in more detail.

Take care.


Apr 27, 2014
Progesterone tablets or mirena
by: Traci

I went back to the dr and it looks like my skin is not absorbing enough progestrone cream so she put me on tablets also. Is there a natural progestrone tablet that i can buy instead of the "lab made" one. Also she suggested that i try a mirena coil because i keep having problems with the lining of my uterus thickening. Any advice greatly appreciated.

Apr 28, 2014
Progesterone tablets or mirena
by: Joy

Hi Traci

I am somewhat puzzled as I have mentioned a few times that oral progesterone is NOT the best delivery method, 96% is destroyed by the gut and liver. I do not believe in the Mirena coil at all, see side effects. Besides it will not help with the thickening, the correct progesterone method and the correct progesterone concentration will help.

The skin absorbs progesterone extremely well, so do hair follicles. Please read the references on progesterone misconceptions. How to use Progesterone Cream also explains a lot.

There is not much else I can advise, but best of luck.

Take care.

Jul 02, 2014
Oral vs. cream
by: Michael E. Platt, M.D.

Traci: Progesterone cream does not provide high levels on blood testing because the progesterone readily attaches to receptor sites and are thus not able to be tested. Oral progesterone gives higher levels because it converts into allopregnaneolone, which is not progesterone but is counted on lab tests as progesterone. Since it cannot attach to progesterone receptor sites it provides high levels giving doctors the mistaken impression that oral progesterone gives higher levels.

I would avoid using a Mirena coil - as a progestin it will prevent you from making your own natural progesterone and possibly lead to a 50 pound weight gain.

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