I disagree with the person who said HRT is a lie. I tried every supplement probably on the market that I could find. I was still in menopausal hell! Two weeks after hrt( estrodial, progesterone and testosterone ) i felt like a completely different person. I finally slept ALL night for the first time in years. I later found out that with strength training and HRT my osteopenia was reversed.
This video has been so helpful . Been on hrt for 2 years. Started spotting. Realized that I started intermittent fasting 6 months ago. No food after 4pm. Wonderful for insulin resistance, but caused me to take my progesterone 4-5 hrs after last meal. Looked it up, progesterone absorbes 2x better with food. I was only getting half my dose.
What an AWESOME comment. Thank you for this. I also intermittent fast, so I don't take my progesterone around food at all. I end up taking it 6, or so, hours after, at bedtime. This makes total sense. Bless you!
13:45 I think those older docs knew what they were doing. They were mimicking the healthy CYCLE of a younger woman so you can get the full benefits of the estrogen (gas) and progesterone (brakes). The way we are prescribing now with lower doses of both estrogen and progesterone together all month long is like riding the brakes. We don't get to where we want to go in terms of new dendrites in the brain, new heart cells, remodeling bone etc. Physiologic doses of bioidentical hormones in a CYCLICAL manner makes the most sense. Can you endure a predictable monthly bleed to know you achieved enough growth factors to avoid Alzheimer's and avoid breaking a hip? Count me in! 😊
I’m following this protocol recommended by Dr. Felice Gersh (she has a TH-cam channel) and I’m very happy to have found her as my journey into menopause began this year. I feel amazing and know that I’m doing the right thing for healthy longevity. So many online drs still telling women low dose and it’s not doing them any favors. Bleeding is no big deal especially when you understand all the benefits of doing so!!
I agree, Suzanne Summers had researched and said it was best to mimic our cycle. That has been many years ago, now but that's what I was doing when I was using progesterone cream and herbal estrogen boosters. I took the progesterone for 14 days at a time.
Over the years I had a uterine biopsy twice (40) yrs apart . It HURT, a LOT! This procedure has not changed for 50 years. The Dr said it's because women don't complain to the hospital . I agree. We need to speak up and let them all know we're tired of putting up with pain when it's not necessary! I did call the hospital & did complain but more woman need to let them know it must change or it won't.
So grateful for your videos, Dr. H! I do have to say, though- I don't want to see anyone minimize the pain of an endometrial biopsy. I'm premenopausal, and I've had 2 for irregular bleeding. Now, I haven't had kids, so they do say it's more painful if that's the case, but let me tell you- mine were excruciating, and I wasn't warned the first time. It was awful. The second time, I was offered ibuprofen and valium, which did NOTHING. My OB/GYN, who is a woman, laughed at me and said, "It's not going to be that bad!" I made my husband come with me so he could have some perspective (and hold my hand), and he was like, "There's literally NO procedure a man has to go through that's anywhere NEAR this." I'm not really a soapbox-type person, but better pain control is needed if women are expected to endure these procedures in-office. If men had to go through this, you KNOW there would be fuzzy stirrups, morphine and margaritas! :(
I’ve had 3 children and usually handle pain well but this hysteroscopy was pretty rough . I had cramping and bleeding quite a bit with bright blood ( not just spotting ) for 10 days. It worried me quite a bit as I expected it to be a lot less by the way it was explained. If you have not had children they are suppose to give you a cervix softener the week before the procedure. I had a general anaesthetic but when that wore off the pain was terrible.
@@doreenryan7325 Thank you so much for your comment, Doreen. I'm so sorry that you had a similar experience- and you've HAD kids! I've never even heard of the cervix softener thing- I'm super grateful to know that! You know, my GP is a guy, and he's got experience in the OB/GYN space, and he agreed with me. He said he'd prescribe something stronger for me if I couldn't find an office that would offer twilight sedation. For me, they had to clamp my cervix, which hurt and she warned me, but the scraping hurt a lot more. Eek, it was pretty bad! I felt like such a wimp- women who've had kids have told me, "Nah, it's just like a baby kicking me." Whoa, really? Not my experience. ;)
Oh, I know what you mean. I've had an endometrial biopsy. It was horrible!! The doctor was male, but he was kind enough to warn me beforehand that it will hurt. He was very sympathetic too while he did the procedure, but it didn't help the pain. I was given painkillers before the test, but it did not help at all. I really feel this procedure should be done with some kind of medication that will numb the pain. Ibuprofen does nothing.
@@carascottvo I have had 2 kids. Heck, I have suffered from endometriosis, and therefore extremely painful periods all my life. But the endometrial biopsy as I commented before, was VERY painful.
@@whatareyourdreams So much this. Ibu is completely useless! I was talking with a friend who had 2 C-sections and needed a biopsy. She said that she was told that because she didn't have any vaginal births, that it would hurt her, too. She was given a cervix softener the night before, and she said it wasn't super bad. I was never offered that. No one even broached the subject with me! I was so mad.
Thank you, thank you, thank you! I was told that I had to stop HRT because of the bleeding and fibroids that I have. I was provided the option of taking medication to stop hot flashes. However, I'm concerned about the effects of not having estrogen in my body and how that contributes to heart disease, diabetes, dementia, etc. I'll be advocating to live my best life. I appreciate your knowledge and advice. ❤
It sounds like you need to find a menopause/hormone specialist! ..I've had trouble with this in Greece.. my gyne first of all just said "We don't give HRT.. we're modern." ..but after doing my own research, I kept on at him and he's since started me on a low-dose pill (Cyclacur: 2mg Estradiol, 0.5mg Norgestrel) and he's told me to stop it for 7 days at the end of every 21-day pack.. like a contraceptive, but it's not.. so not sure this is right! Also noooo mention of taking it with food (I take it morning empty tum, sometimes still in bed, to not forget!) So, I'm not feeling very confident in him now and have looked at alternatives. There are fertility clinics here that have specialists who work with menopause.. maybe where you are there's something similar!
Great video! I have 2 friends who went off of their HRT regimen due to bleeding/spotting after being on HRT for a few months. I don’t think anyone explained to them what was going on, the reason and most importantly, the SOLUTION to being able to stay on HRT but to get the bleeding to stop.
Biopsy lasts more than 20 seconds, and the pain is unbearable. I almost vomited from the pain. If I ever have another biopsy, I will ask for pain meds or sedation.
Ok! I like the idea of no bleeding but I am confused given the different informations I am getting. The main reason why I need to get on hormone therapy is to protect myself from osteoporosis. I am going through the process of starting HRT, just met with the doctor and getting blood work this week. I am gathering information so I can ask her the right questions when I meet with her next week. I want to make sure I will get the full benefit of HRT mainly to prevent osteoporosis ( I am 59 and small framed). I was listening to a TH-cam episode by a doctor Felice Gersh, and she was explaining the importance of cyclic therapy, and that giving progesterone continuously, will have a down regulating effect on estradiol. She explained the science behind this by the T. She was saying that the purpose of estradiol is to up regulate many body functions, and that this is how we get the positive effects on the brain, the bones, the mitochondria and so on, but that pretty much we do not get these benefits when progesterone is constantly there to down regulate estradiol. As a registered nurse I totally appreciate her explanations more so because backed by science, only I wonder if there are other scientific explanations that would also make sense for continuous HRT. There is not a lot of available research or maybe I am not good at finding the studies, but I want to make sure I get it right as I only have one shot at this due to my late start. Could you make a video where you explain why you think that I can still get the full benefit of HRT while being on it continuosly. And, I am posting my question on different you tube channels ran by HRT doctors in order to get different experts views on this important aspect of HRT. Thanks!!
I'd love to connect with you as I'm wondering similar stuff and feeling quite lost!!! ..Just finally convinced/bullied my gyne to start me on HRT.. but it seems to be a low-dose combo pill (Cyclacur: 2mg Estradiol, 0.5mg Norgestrel) and he's told me to stop it for 7 daysat the end of every 21-day pack.. like a contraceptive, but it's not.. so shouldn't I continue.. heeeelp!!!
Yes! I feel Dr. Gersh seems able to explain the science and reasoning why we should cycle and bleed or shed the lining. Makes more sense than just being “annoyed” by the pesky bleeding.
@hollywoodwear123 -any luck in finding answers? I’m on the front end of research, too and 3 months into continuous body identical HRT and keep having breakthrough bleeding that lasts a week at a time. I see the doc in 2 days to touch bases on this and don’t know what to say/😂do. I feel “stuck”- need the estrogen for the protective effects, yet, the issue with bleeding shouldn’t be there. ???
Ok! After more research, I have learned that continuous HRT is appropriate for women who have not had a period for at least a year. Women who have a menstrual cycle should not be on continuous HRT. I hope that a video will be made on this to provide all of us with more on this subject.
After going through the menopause for 6 years naturally I started to suffer from very debilitating symptoms and was begrudgingly prescribed HRT by my GP. I was amazed at the difference and felt like my old self again... I was so happy, until 9 months down the line when the spotting began (I was also suddenly dreaming I was pregnant most nights!!! I've never had or wanted children so it was quite a shock) and was told to stop while I waited for the ultrasound investigation you mentioned. That was a 3 month wait because of the Covid backlog on the NHS (I'm in the UK) and then began a tug of war between the Specialist at the hospital and my HRT ignorant/opposed GP (who I had to battle to get HRT in the first place) - this lead to another, longer, wait as the GP demanded yet more tests be done, despite the Specialist being certain it was all benign. As you can imagine, I became very upset at it all and did not know who to believe at first. Even though the lovely Specialist explained everything in great detail and assured me it was perfectly safe to go back on HRT, I have hesitated, it's almost a year now. Thank you for explaining this all so clearly here, you've reminded me how certain the Specialist was that I would be fine, and why. After listening to you, I think I might have caused the peaks and dips by taking my pills erratically and in the morning on an empty stomach often (who read the instruction leaflets, right? 🙄) after about 7 months in, as my work routine changed. I think I feel educated enough to give HRT another try now. :)
Thank-you Dr…..started to have post menopausal bleeding I’m almost 65, been on hormone replacement going on a decade; had a biopsy a year ago was fine. But: been intermittent fasting, last meal by 4:00pm ….so at bedtime my stomach is empty, hope this is the reason for this bleeding episode.
I had ablation done in 2008 and it left me with so much internal scar tissue that my gynaecologist couldn’t get a biopsy. Even after a general anaesthetic she couldn’t get a proper biopsy. It was a great solution to the heavy, painful periods for about 8 years but I didn’t know that I could have problems later on down the line.
Thank you for this! Unfortunately, both gynos I visited didn't consider that my estradiol may be too high, even though I mentioned to them spotting, breast tenderness, and heart palpitations. I asked for an increase in Progesterone to address the spotting. It worked for a month, but then more spotting and, 3 months in, was rushed to ultrasound (they tried to get me to do a painful biopsy, to which I said no) and found a 6mm lining with no other internal concerns found. She threatened to stop my HRT if it grew any further, but didn't think to reduce my very high (0.1mg patch) estradiol dosage that I had been on since day one. After watching your videos, I took your advice and cut my patch in half and all my breast tenderness stopped and abdominal bloating reduced. I am hoping that this simple step will reverse the growth of the lining and stop the spotting. I will give it at least 6 weeks before moving to biopsy.
Oh my goodness I had that issue until I did research and I learned you must be on progesterone. That is what stops your lining from growing and will reduce your lining. It has to be progesterone 150 mg daily and your problems will reverse, I really do love the extra dial patch0.0375 or 0.05
I have had my third round of pellets after not having a good response to patches. Life is good; feeling awesome as you can imagine. Then today boom I go to the bathroom and see blood. Of course I panic and immediately think CANCER!!! You totally eased my mind 🤎🤎🤎. I will be calling my doctor on Monday I probably do need to have My dose increased. One thing of advise I will take from you, I take my progesterone in the evening but not necessarily with food. I will start incorporating this. Thank you so much for your knowledge!
I realize people have their own channel and it is their own. What I appreciate from watching your channel is that 1) you ARE a licensed physician and 2) you have your personal preference, but you don’t shame using other HRT treatment.
Thank u so much, I was scared to death! Iv had several test, I have some fibroids, and have had them since I was a teenager, never had one issue with them. I was told, they didn’t need to be removed. I’m now 59, and have had some spotting(mild) never heavy! I’m so glad, I came across this video! I asked family members on both sides, has anyone pass from uterine cancer, bit sides never has! 🙏🏾🙏🏾🙏🏾
Thank you thank you thank you for all of this beautiful information!!! I feel so good with HRT and did not want to stop!!! My partner wishes to expend his gracious thank you! We are both very happy
How do you get testosterone in perimenopause/menopause? Maybe the question should be, how do I find a doctor who can prescribe it for me? Thank you for making such informative videos!
I choose to continue having a withdrawal bleed because for me taking progesterone continually just isn't an option - it makes me feel dreadful. Once the progesterone leaves my body it's like a huge dark cloud lifts - exactly how it was in my fertile years with my own hormones! It would be a shame if some women are put off HRT just because they want to avoid a bleed - it's only a few days inconvenience for a whole lot of oestrogen benefit. I use micronized progesterone as a pessary for 14 days every other month. Using the capsules vaginally minimizes the unpleasant side effects I experience if I try to swallow them! I've been on this regime for over 10 years and it works just fine for me.
Someone said if the oestrogen is at a correct level the progesterone tablets side effects lessen, was that not the case for you? I’m the same with progesterone constantly battling the dark mood. I use my progesterone vaginally too. X
I only need a medium dose of oestrogen to keep my symptoms at bay. Not sure it would be wise to go higher just to try and offset progesterone side effects. I just do whatever I can to minimize progesterone exposure!
@@essanjay8604 totally get you there, I have just knocked back 1/2 a pump on the oestrogel to see if the bleeding stops. I have been referred for an emergency scan. tbh I think for the current issue it is either I’m not absorbing the progesterone properly or I need a different one. I currently have Utrogestan and oestrogel continuous regime. Its only been 4 cycles on continuous, but 18 months since my HRT journey began. The switch to continuous was due to turning 55, i may have to go back to sequential. Its quite a minefield imho progesterone messes with my head completely, I have always been very insecure with little confidence but its gets so much worse. I do feel my GP is winging it as lovely as she is. Told my partner I feel like weaning myself off the lot due to lack of medical input, maybe its just my mood. 😞
I have a problem with progesterone as well Would you please tell me what dose are you taking vaginally for 14 days? Even given vaginally, it makes me extremely bloated and I gain weight immediately. I am continuing to experiment with different doses Hopefully something will work
@@marzenarongione4968 I use 200mg for 14 days at bedtime. I have a scan of the endometrium annually. I think it's entirely possible that half this dose would be adequate for me personally but everyone's different. Bear in mind also I am a decade past menopause. This may be totally unsuitable for younger women.
Omg! Thank you soooo much this is the best clear concise guidance I’ve received while dealing with this spotting… it is now 5 months I’ve been dealing with this and I was tempted to just stop taking the meds all together.
My bleeding/spotting is happening after 4 years on the same does of Estrodil and progestrone , not sure why yet, but I am going to try the talking progestrone while still have food in me, was never told that, thank you
Thank you Dr. Susan Hardwick-Smith. I’ve been on HRT for about 10 months & I started spotting at about month 8. The first time it scared me & it lasted about a week. I’ve had spotting 2 other times since then.
I take 0.0375 patch twice a week/115 mg of progesterone capsule daily, I do want to add a small dose of testosterone for a full balance, I just wanted you to know it’s the progesterone that stops the bleeding a lot of people just do the patch alone, but you have to have both, this is such a benefit. It keeps your bones from getting fragile. I hope you get back on it maybe you could consider a hysterectomy, taking out your uterus and then continuing hormones.
I went on HRT in perimenopause because I was going cookoo, but quit after 6 months, never going cookoo again and hit menopause. I am not on anything because yeah-don't need an inkling of endometreosis back!
Thank you so much. I have tiny fibroids. And had an ultrasound which the endometrial lining is fine. Watching your video put my mine to rest. I’ll have another appointment to adjust, which is offered. This just calmed me.
In the beginning of this HRT journey, I had a doctor who was very much a proponent of HRT. She put me on 0.1 mg of estradiol patch twice weekly and 400 mg of progesterone nightly. Had no spotting at all. She retired and about a year ago I started having spotting and the doctor I now have always wants to know, and then she does the ultrasound. Everything was very normal. It happened again and did another ultrasound and again, normal. She is not a proponent of HRT. In fact, she dropped my progesterone to 200 mg nightly. I asked her what about testing, she said it is not necessary. I have been spotting the past couple days again, but I have doubled my progesterone this time instead of calling again since it has only been 3 months since my last ultrasound which again was normal. This video has given me insight on what my problem may be. I intermittent fast and do not eat past 6 pm. I am up until midnight, and I am taking my progesterone on an empty stomach. So, I am going to start taking it 2 hours after I have had my last meal and see if that helps. I'm just concerned about not being able to sleep as well, but it is definitely worth the try. Thank you for this informative video.
Thank you for this video! I had a d&c in January for bleeding. I'm 10ish yrs post menopausal. The bleeding is annoying. I just assumed it was the price to pay for taking hrt 💁♀️. My dr said to give it a couple of weeks (post procedure) for the bleeding to stop. It currently has but I'm holding my breath, crossing my fingers that it will not start up. I'm on 300 mg of progesterone 🫣 I love how I feel on hrt and cannot imagine not having it!
I’m so grateful for this video. I went through vaginal bleeding and based on the information and comments I read on this video I asked my doctor to increase my daily PROGESTERONE dose from 200MG to 400MG a day for six days and the bleeding stopped. Now I’m back on my 200mg daily dose again. Thanks so much doctor Susan. You’re THE BEST!! ✨🙏❣️
Shall I stop the HRT until the bleeding stops and once stopped to start again but with a smaller dose of Estrogen and equal amount of Progesterone? I used to take 50 Estrogen patch twice a week and 100mg Estrogen but on empty stomach as Dr recommended but then I increased myself the dose of Estrogen to 100mg and same 100mg Progesterone in the morning. When I went to gynecologist she told me to increase the dose of Progesterone to 200mg but at night. I did that and just after 3 days after I started having lots bleeding as on my period but not super heavy. Now I wonder if I should stop all HRT till the bleeding stops?
@@gabrielanita8319 Hi, according to what the doctor Susan said on this video and according to my doctor as well you should never take progesterone on an empty stomach or in the morning but at night after a meal. Did you watch the whole video?
@@gabrielanita8319 I wouldn’t stop the HRT. Talk to your doctor about increasing your progesterone even higher just until the bleeding stops. I’m on a 0.025 mg/day estradiol two patches a week and on a 200ml progesterone pill daily. Hope this helps.
@@carlahabib1768 Hi. Thank you for your reply. Yes, I watched the video and as I mentioned I started taking the Progesterone at night after food and a higher dose of 200mg. I think that's what triggered the bleeding. I'm thinking to stop the Estrogen all together for the moment and maybe the Progesterone too, until bleeding stops. The video was very helpful. Thanks
I also agree the biopsy hurts like hell, and I generally have a pretty high tolerance to pain. The worst part was afterwards, and I’m glad I asked my husband to come along to drive me home. The first one I had about 8 years ago and I drove myself…don’t really remember the after being so excruciating. But this time I had to go an hour and a half away vs 20 minutes so I didn’t want to take a chance. What are the protocols for having ablation, or even just getting a hysterectomy, so we can use hrt without the “annoyances”? The last theory for my issues is the possibility I’ve got adenomyosis, due to having a c-section. But that’s not definitely diagnosed unless they take out the uterus.
I was on birth control pills continuously for years due to endometriosis they worked fabulous. Now they switched me to hrt combination patch. I started bleeding. Never had that problem on bc pills. I wish I could just go back to taking them. I don’t think men would put up with what we are made to endure.
I was taking Combi patch and started bleeding after about eight months, so switch to the higher progesterone Combi patch. Did fine on that patch for another couple of months then started bleeding again. Finally went to an estrogen patch, and an oral progesterone. 🤞 It’s been 10 months .
same for me!!! switched to estrogen patch & 200 mg progesterone it stopped the combo patch bleeding but now bleeding again. They said try & double my progesterone for 5 days. So 400 mg i'll try. 👀
@@helenhernandez2197 I tried the micronized progesterone and I could not take the side effects. I just asked for 2.5 mg of Provera . May be synthetic but I do so poorly on the micronized . I could not do it .Its almost been a year with no bleeding 🤞
I'm on estradot 100mg and mireena coil, had biopsy all clear been on this over a year, I'm 54, I've been spotting and having periods everything month , then I stop for 10 days then I go back spotting😮
Hi if I'm in perimenopause and I star hormone replacement therapy and I started bleeding again it's normal? I was not have my period for 7 months before the hrt
My experience w biopsy wasn’t too bad. I stopped HRT because of the bleeding. Now I am listening to this and found out whether I need to reevaluate my options. My family doc advised me to stop using HRT as bleeding wasn’t something she thought safe for me. I am very healthy in my mid 50’s, I used patch. My OBGYN thought I was a perfect candidate for HRT. I did a couple of Ultrasounds and it showed good except last time the thickness of my uterus wall grow a bit (7mm or unit I forgot)
I am post menopausal and on the bioidentical estadiol patch, testosterone cream and progesterone pill. My Dr told me to make sure to take 7 days off a month from the progesterone pill otherwise the receptors get "clogged up" after awhile. Have you heard of this and is that even safe to do?
Evrol patches for 7 months. Post menopause 4 years. Starting bleeding after 2 months. Have been heavy bleeding for 7 months, not spotting even though I have upped progesterone to 200mg and also the mini pill to try and stop it. Private patient and sick to death of no solution. I have stopped taking estrogen patch and continued with progesterone and bleeding has stopped. Going to try again and reintroduce Evrol 25 patch. If it doesn't work I am coming off hrt.
I think you want to bleed which is part of a normal healthy cycle. That way you know you've taken enough estradiol to have healthy growth factors to grow new heart cells, brain cells, remodel bone, grow a uterine lining etc. After two weeks, stop the estradiol and for 2 weeks take a full physiologic dose of bioidentical progesterone so the uterine lining sheds fully.
Oh my gosh. Thank you for making me feel normal. I got started at .075mg and I really should have started out at a lower dose. My lab results showed barely any estrogen so my body had a strong reaction to starting it. I kept being told I shouldn't be having issues with starting the HRT and made to feel like I was being overly anxious, etc. But I thought the same thing. My body has had no estrogen and was like woahhhhhhh....when I suddenly started at such a high dose. Thank you!
I decided to not stay on the patch, I'm just doing the estradiol cream every other night. may still investigate progesterone options, but wasn't comfortable with the patch. I say listen to your own body to do what's best ♡
@@edelucia74 really I love the patch, but it is a individual liking, I do the 0.0375 estradiol patch twice a week love it because it’s made with yams, and definitely progesterone 150 mg every day, this is been so great because it helps you sleep at night
Thank you. This was helpful. I started HRT at 59. I had been on herbal estrogen boosters since 55, and progesterone cream. Both helped but eventually i knew they wouldn't be strong enough. So now I have a low dose estradiol patch and progesterone pills. After 5 days, the skin irritation from the patch drives me crazy so i take it off and stopped the matching progesterone until i put it back on. Yep, I have full blown periods. Now, i just move the patch to a new spot with medical tape to avoid skin rash and dont stop the progesterone. But I just wanted to make sure that these periods are not harmful. And to make sure that the low dose 0.0375 estradiol is not too much. I am a small person and told the doctor I wanted a low dose.
That does is the perfect dose, this particular doctor always recommends .05 she thinks that’s best for your bones you could go up and still be safe but if your levels look good, you are just fine. Definitely do not go lower the patches safe it’s made with yams, you definitely need progesterone. Make sure it’s not progestin it has to be progesterone, which is natural you want to get at least 100-200 mg every day if you only do it a few days a month you will have a period, I personally went with 150 mg. Hope this helps.
Got the pellets done in june of 24 and for 3 months everything went great..well, went back in September to restore my pellets , well in the middle of September I started bleeding and in the month of October , i bleed so bad thinking i was going to die ..then had a ultrasound found out i had a fibroid cyst in my uterus ..then kept bleeding until i found out , this provider had me on estrogen pellets almost 5 months without progesterone and me with a uterus ..so now im taking progesterone 200mg at night and still yet when i pee im still bleeding pretty bad..hopefully i can find a better doctor that knows what there doing ..
@Dr. Susan Hardwick-Smith I have come back to this video to rewatch it several times. I started HRT almost 1 yr. ago. Unfortunately, 3 months ago I started having what appears to be a regular monthly cycle. In March after an appointment with my GYN, she increased my progesterone to 200mg & kept my Estradiol patch at 0.1 mg. I am at my whits end bcos this is month 3 of having a full on monthly cycle. Not to mention the increased progesterone has my emotions all over the place as well as increased bloating. Any further advice you can give would be great. Help!
I was on HRT for 6 years and started spotting. Got an ultrasound, an MRI and a biopsy. Nothing. My thyroid medicine needed adjustment at this time. The biopsy was fine. My gyno used a local lidocaine and I barely felt it. Increased my progesterone to 400 mg. Bleeding stopped.
Thank you so much, Dr. Hardwick-Smith, for the thorough explanation. Just discovered your channel last night and lots of going ons with my body is clearing up :) love how simple your explanations are.
I have been on HRT for years and had bleeding after menopause. My doc discovered it was a benign cyst in my uterus and surgery removed it. No more bleeding.
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 everyday 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. 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. Attaching a picture to show what happened to my face within a week. 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 to Monday. 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’m not an MD, but I had bleeding after many months of no bleeding on .05 estradiol patch and 200 mg nightly bio progesterone . I asked my doc to increase progesterone , so now take 300mg nightly and bleeding stopped. Also had ultrasound after a few months of new dosage and lining thin and healthy, so that worked . However , having breast tenderness and sort of PMS moody … I’m going to try progesterone vaginally and take progesterone cyclically, so u will have a controlled bleed, but I know it’s the hormones and not anything else since ultrasound was fine. If I were you, I’d see how patch with more progesterone works to stop bleeding and symptoms and maybe ultrasound after a bit for peace of mind🤗
oh that little hysteroscopy and removal of 2 polyps..yeah that was gonna be about $4000 at the facility my doc wanted me to go to, yes outpatient so ask before you go
My experience w biopsy wasn’t too bad. I stopped HRT because of the bleeding. Now I am listening to this and found out whether I need to reevaluate my options. My family doc advised me to stop using HRT as bleeding wasn’t something she thought safe for me.
I have had a terrible time with bleeding while on HRT. I have had a pelvic ultrasound and 2 endometrial biopsies. The ultrasound revealed many fibroids but none within the endometrium. My doctor recommended an IUD. I now have an IUD and taking progesterone pill each day and still having bleeding (more than spotting). I think I will ask my doctor about the hysteroscopy. Thank you for this information. I am at my wits end with the bleeding on one hand and feel so much better from the menopausal symptoms with the hormones on the other hand.
Hi Stacy how are you doing? I hope all is well your right the hrt helps us with so many things but the bleeding is so annoying. I hope your well and let us know the out come so we can learn. Thank you Stacy!💞
Same exact story here. My OBGYN is lowering my estrogen dosage patch and hoping for the best. I’m still having bad tummy issues and feeling the progesterone is to blame but it could be that I already had these problems and they’re just coming to a head. I’m fasting and changing my diet drastically hoping for change.
@@cindybrown1398how did you get your doctor to double up your progesterone? To what amount if you don’t mind me asking. I am having spotting a lot it’s driving me crazy. I never went a whole year without a cycle so I think I am still pre menopausal so my doctor has me on progesterone and estrogen every day which I am wondering if taking the progesterone and estrogen every day to early might have caused this. How are you doing now?
What should a woman in perimenopause who is still regularly ovulating and cycling expect when starting hrt treatment for peri symptoms? I've started a .05 estradiol patch and daily oral 100mg progesterone tab which has done wonders for my symptoms. BUT Didnt ovulate this month (unusual for me, I track mucus signs and basal temps to confirm ovulation) but had a light to medium 3 day bleed around day 32-34.
I am also ovulating and in perimenopause, I just turned 50. I started 0.5 estradiol gel 8 days ago, and I have been bleeding ever since, soon to see a doctor about ot. I have a cyclic regimen, meaning I should be adding a progestin (Provera 10mg) from day 11-21, then 1 weeek off from both, and then restart. My symptoms are bad sleep, low mood and libido, brain fog, dry eyes. One doctor says it is normal to bleed, other says to stop the gel… hard to know who is right
I had a full period 18 months after I thought I was in menopause. I have been on estradiol 2 mg and progesterone 50 mg. I'm thinking it may be because the progesterone is too low? I had an ultrasound and am awaiting the result. I'm a little worried. 😔
W have the Climara pro patch which is a combination patch. It’s supposed to stay on 7 days but yesterday it was basically off and I put it back on. Only the outer edges were really in contact with my skin, now I’m spotting. I’m gonna try a different route because the patch is just not working for me.
Thanks - I needed this info. Now I know how my doctor ought to approach fixing this. Was on Premarin (oral) and progestin for 5 years. Switched to estrogen patch and a different progesterone and began getting a full period every three weeks. I suppose I could always go back to taking the Premarin orally...I only changed to patches because I didn't want my liver filtering the estrogen and thought transdermal would be a better delivery system. I think I may have been wrong about that. Time will tell. I'll see if the progesterone can be increased because these patches have sorted out my hot flashes and vaginal atrophy perfectly. They're a bit of a pain but they work well.
Hi Susan. I take my progesterone at bedtime which for me is at 11:30. I stop eating at 6 pm. I was never told by my doctor to take it with food. So, since that is the case, I would think it is too early to take it as I need it also for sleep. Any suggestions you may have would be helpful. Thanks for your informative content.
I also have read that taking it with food may INCREASE the strength of the pro pill. I go to bed at 9:30pm and sometimes eating dinner at 7pm. I don’t think this time frame is working for me. Started experiencing dizziness. After taking it and still have the symptoms before driving to work… not good. I sleep better though.
I've been on hormone replacement 5 yrs without problems except for when I first started had some spotting did biopsy all was clear since then over 4 yrs.2 months ago I switched compound pharmacy started getting cramping on and off that then became intense Then today gushed pretty good for about an hour brown thick yucky old blood. I had already went to GP with the cramping and I have an ultrasound scheduled for the 18th ..now I'm really worried and stressing out. Will call my GP in morning see if I can get moved up for ultrasound tell her I'm now bleeding. I'm wondering if this new compound pharmacy would have anything to do with it? I never had problems before or just a coincidence ? I hate procedures etc the biopsy was brutal I had 5 yrs ago. Thanks in advance for any thoughts on this
So glad I found your channel Dr Smith. I have been on HRT - continuous, now for two and a half years and every now and then I start spotting. Is this normal? I can go for months being ok then back spotting again for few days at a time. Thank you for your helpful videos 🙏
This information is super informative and I truly appreciate this. I’ve been dealing with breakthrough bleeding for months, and my doctor appears to not be as first in this topic so now I have a starting point to either allow my doctor to better assist me or shop for a more equipped position.
Started with CombiPatch with the low progesterone first. Started bleeding after a few months . Then went to the CombiPatch with higher P was fine for a few months then it started again . Now will try estradiol, patch and progesterone at night. 😐 Hoping this works 🤞 ( had ultrasound and all was well there luckily )
I have had two experiences of bleeding on hrt , I was sent to the hospital to get checked out the fist time it was discovered that I had polyps on my cervix the second time I had a large ectropion on the cervix. I would still encourage women to get checked as there are several other reasons for bleeding when taking hrt .
DR. Susan, I am thankful for the information. I have a question about fibroids and HRT. Unfortunately, due to a delay in my compound progesterone being delayed, I went about 2 1/2 months without progesterone. I have gained 8 pounds around my middle, have uncomfortable pain in my belly and severe bloating. I was on a very low dose of estradiol for 8 months and went off for about 7 months. Went i went back on I asked to be pushed up to 0.075 and no progesterone. I am a little concerned about the pain, bloating and bleeding. Can you please provide me information on what I should do.
I started Estradiol patch and topical progesterone compound cream 7 months ago. I started bleeding. My doctor put me on a progesterone pill higher than the cream and bleeding stopped. She still ordered a vaginal ultrasound. She said the limo was a bit thick and even though I’m still not bleeding she is ordering me for an endometrial biopsy. :( Meanwhile- hot flashes have resumed along with the WORST night sweats! 😢😮 At this point I’m worried. And wondering what is after this if that is okay. 🤷♀️ I’m really wanting the Mirena IUD or give up. To go through this for every minor bleed at 54 Not interested. This is why women give up. What a hassle.
I started a hormone cream 5 of estrogen 200 of progesterone. After one week I started spotting. I was like ok my body needs to adjust. By Second week I was having a full on heavy period that would not stop. After 10 days of bleeding heavily I was done. I quit the cream. It’s been 5 days since I stopped using the cream and I am still spotting daily. I know I have 2 small uterine fibroids was diagnosed with those last year. Previous to starting hormone therapy I had not had a period for 8 months.
Same situation but my Dr said I must stop for a week but after a week and a half of having blood I am now spotting! Then he said I need to halve my progesterone. I don't think he knows what he's doing. 😢😢Time to change Dr!
I had pellets put in December. On January 19-25, I had a period. Now it looks like it is coming again almost a month later. I am confused as another doctor on YT said having a period on HRT is normal, but spotting should be looked at. I' m confused.
Thank you soooooo much for this info. I've had breakrhru bleeding everytime. Even with a small amount of estrogen. But now I understand the how/why of the progesterone! I'll be making the adjustments starting today. Hopefully I can get it figured out. Thank you. sincerely, Karla vae
I started hrt pellet therapy while I was premenopausal so I never went a whole year without a period. I think that’s why I still have a cycle. This is all so confusing.
Is there anything unsafe about taking progesterone 1/2 the month and opting for a predictable period? Thank you so much for all the helpful information. Very much appreciated....💗💗💗
Im 47, haven’t had a period for 4 months, but was having symptoms of insomnia, vaginal dryness, low libido, and night sweats. Labs were at post menopausal levels. Testosterone was also in the toilet. Dr, prescribed compounded estradiol 2mg/Testosterone 2 mg cream (4 clicks/1 gram in AM and 100 mg progesterone. In just the first few days, symptoms improved. But on day 10, I started spotting and now have a full blown period with cramps and related loose bowels. I was told bleeding could happen when starting BHRT. But this soon? Could this be a true blue period stimulated by the hormones? Or a coincidence?
I'M only on my 2nd week. I'm on 0.1 mg estradiol patch and I take 200mg progesterone pill at night. I'm hoping not having enough food in my stomach and maybe not absorbing enough of the hormone.
I’m perimenopausal extremely light period with crazy symptoms on .50 mg patch and 100mg of progesterone all month is ok not to shed the lining? Also just got on the mirena 3months ago is it ok?
Thank you, this video is so important. Unfortunately I have a gyn who refuses to raise the progesterone so I'm just shedding. Can you recommend an HRT-literate gyn in NYC?
Ha spotting!? I was 2 weeks in and was bleeding through everything for 9 days. I was cycling 2 weeks on 2 weeks off. I was expecting spotting not full on period. Now started taking est and progesterone both daily. Not my preference but at 51 I definitely don't want to be like a 12 yr old again.
Hi Dr. Susan, I emailed you awhile ago about post menopausal bleeding on HRT and you were so kind to answer a lot of questions. My problem is that I'm still bleeding. I'm 53 post menopausal for 3 years and on HRT 2 yrs and bleeding/ spotting a good amt. We've tried adjusting everything (on 0.1 estradiol patch 200 mg progesterone also tried .05 patch and 100/200 mg progesterone) nothing stops it. My gyn is scheduling another endoscopy with D&C and says if that doesn't work that I should consider a hysterectomy or maybe an ablation. What do you think? Should a post menopausal women have an ablation? During our earlier correspondence I thought you said a post menopausal woman shouldn't get an ablation. What would you suggest a hysterectomy or ablation? Thanks, I am absolutely at my wits end!
@@cj705 I thought this too and my doctor was going to place a mirena coil during my hysteroscopy but couldn't because I have a very small, arcuate shaped uterus that wouldn't accommodate it.
I disagree with the person who said HRT is a lie. I tried every supplement probably on the market that I could find. I was still in menopausal hell! Two weeks after hrt( estrodial, progesterone and testosterone ) i felt like a completely different person. I finally slept ALL night for the first time in years. I later found out that with strength training and HRT my osteopenia was reversed.
This video has been so helpful . Been on hrt for 2 years. Started spotting. Realized that I started intermittent fasting 6 months ago. No food after 4pm. Wonderful for insulin resistance, but caused me to take my progesterone 4-5 hrs after last meal. Looked it up, progesterone absorbes 2x better with food. I was only getting half my dose.
Good grief, me too! I didn’t realize I needed to take it with food. I prefer to take right before bed.😩
I was told to take mine at bed!
What an AWESOME comment. Thank you for this. I also intermittent fast, so I don't take my progesterone around food at all. I end up taking it 6, or so, hours after, at bedtime. This makes total sense. Bless you!
Awesome to know I’ll try that since having spotting issues too
Thank you. This is so helpful to know.
Estrogen Matters is a great book every woman should read.
13:45 I think those older docs knew what they were doing. They were mimicking the healthy CYCLE of a younger woman so you can get the full benefits of the estrogen (gas) and progesterone (brakes). The way we are prescribing now with lower doses of both estrogen and progesterone together all month long is like riding the brakes. We don't get to where we want to go in terms of new dendrites in the brain, new heart cells, remodeling bone etc. Physiologic doses of bioidentical hormones in a CYCLICAL manner makes the most sense. Can you endure a predictable monthly bleed to know you achieved enough growth factors to avoid Alzheimer's and avoid breaking a hip? Count me in! 😊
Best comment I've seen in a long time and it only makes sense, thankyou and hi from Tasmania 🙌👋
I’m following this protocol recommended by Dr. Felice Gersh (she has a TH-cam channel) and I’m very happy to have found her as my journey into menopause began this year. I feel amazing and know that I’m doing the right thing for healthy longevity. So many online drs still telling women low dose and it’s not doing them any favors. Bleeding is no big deal especially when you understand all the benefits of doing so!!
I agree, Suzanne Summers had researched and said it was best to mimic our cycle. That has been many years ago, now but that's what I was doing when I was using progesterone cream and herbal estrogen boosters. I took the progesterone for 14 days at a time.
Over the years I had a uterine biopsy twice (40) yrs apart . It HURT, a LOT! This procedure has not changed for 50 years. The Dr said it's because women don't complain to the hospital . I agree. We need to speak up and let them all know we're tired of putting up with pain when it's not necessary! I did call the hospital & did complain but more woman need to let them know it must change or it won't.
I told my doctor it was painful, and my doctor saw the physical condition I was in. She offered me cool, wet towels to cover my face. That was it.
Yes. I have had it twice once pre.enopausal and post. A little pinch it's NOT! Take 4 Aleve 2 hrs before you go.
Here in Australia they do them under a general anaesthetic day surgery.
So grateful for your videos, Dr. H! I do have to say, though- I don't want to see anyone minimize the pain of an endometrial biopsy. I'm premenopausal, and I've had 2 for irregular bleeding. Now, I haven't had kids, so they do say it's more painful if that's the case, but let me tell you- mine were excruciating, and I wasn't warned the first time. It was awful. The second time, I was offered ibuprofen and valium, which did NOTHING. My OB/GYN, who is a woman, laughed at me and said, "It's not going to be that bad!" I made my husband come with me so he could have some perspective (and hold my hand), and he was like, "There's literally NO procedure a man has to go through that's anywhere NEAR this."
I'm not really a soapbox-type person, but better pain control is needed if women are expected to endure these procedures in-office. If men had to go through this, you KNOW there would be fuzzy stirrups, morphine and margaritas! :(
I’ve had 3 children and usually handle pain well but this hysteroscopy was pretty rough . I had cramping and bleeding quite a bit with bright blood ( not just spotting ) for 10 days. It worried me quite a bit as I expected it to be a lot less by the way it was explained. If you have not had children they are suppose to give you a cervix softener the week before the procedure. I had a general anaesthetic but when that wore off the pain was terrible.
@@doreenryan7325 Thank you so much for your comment, Doreen. I'm so sorry that you had a similar experience- and you've HAD kids!
I've never even heard of the cervix softener thing- I'm super grateful to know that! You know, my GP is a guy, and he's got experience in the OB/GYN space, and he agreed with me. He said he'd prescribe something stronger for me if I couldn't find an office that would offer twilight sedation. For me, they had to clamp my cervix, which hurt and she warned me, but the scraping hurt a lot more. Eek, it was pretty bad! I felt like such a wimp- women who've had kids have told me, "Nah, it's just like a baby kicking me." Whoa, really? Not my experience. ;)
Oh, I know what you mean. I've had an endometrial biopsy. It was horrible!! The doctor was male, but he was kind enough to warn me beforehand that it will hurt. He was very sympathetic too while he did the procedure, but it didn't help the pain. I was given painkillers before the test, but it did not help at all. I really feel this procedure should be done with some kind of medication that will numb the pain. Ibuprofen does nothing.
@@carascottvo I have had 2 kids. Heck, I have suffered from endometriosis, and therefore extremely painful periods all my life. But the endometrial biopsy as I commented before, was VERY painful.
@@whatareyourdreams So much this. Ibu is completely useless! I was talking with a friend who had 2 C-sections and needed a biopsy. She said that she was told that because she didn't have any vaginal births, that it would hurt her, too. She was given a cervix softener the night before, and she said it wasn't super bad. I was never offered that. No one even broached the subject with me! I was so mad.
Thank you, thank you, thank you! I was told that I had to stop HRT because of the bleeding and fibroids that I have. I was provided the option of taking medication to stop hot flashes. However, I'm concerned about the effects of not having estrogen in my body and how that contributes to heart disease, diabetes, dementia, etc. I'll be advocating to live my best life. I appreciate your knowledge and advice. ❤
Should you have the fibroids removed?
It sounds like you need to find a menopause/hormone specialist! ..I've had trouble with this in Greece.. my gyne first of all just said "We don't give HRT.. we're modern." ..but after doing my own research, I kept on at him and he's since started me on a low-dose pill (Cyclacur: 2mg Estradiol, 0.5mg Norgestrel) and he's told me to stop it for 7 days at the end of every 21-day pack.. like a contraceptive, but it's not.. so not sure this is right!
Also noooo mention of taking it with food (I take it morning empty tum, sometimes still in bed, to not forget!)
So, I'm not feeling very confident in him now and have looked at alternatives. There are fertility clinics here that have specialists who work with menopause.. maybe where you are there's something similar!
Great video! I have 2 friends who went off of their HRT regimen due to bleeding/spotting after being on HRT for a few months. I don’t think anyone explained to them what was going on, the reason and most importantly, the SOLUTION to being able to stay on HRT but to get the bleeding to stop.
Biopsy lasts more than 20 seconds, and the pain is unbearable. I almost vomited from the pain. If I ever have another biopsy, I will ask for pain meds or sedation.
The biopsy hurts a LOT! Don't let them do it without some sort of anesthetic. I am still traumatized right years later.
It is unconscionable that they would do that to a woman who is awake with no painkiller!
Thanks for the painkillers advice x
I had it done and it was sooo painful!
Never again!
I had it done by a female gyn. but she also gave me nothing. I also felt violated that I wasn't told how much it would hurt.
I’ve been searching everywhere for this information. Thank you so much, it’s exactly what I wanted ❤
Ok! I like the idea of no bleeding but I am confused given the different informations I am getting. The main reason why I need to get on hormone therapy is to protect myself from osteoporosis. I am going through the process of starting HRT, just met with the doctor and getting blood work this week. I am gathering information so I can ask her the right questions when I meet with her next week. I want to make sure I will get the full benefit of HRT mainly to prevent osteoporosis ( I am 59 and small framed). I was listening to a TH-cam episode by a doctor Felice Gersh, and she was explaining the importance of cyclic therapy, and that giving progesterone continuously, will have a down regulating effect on estradiol. She explained the science behind this by the T. She was saying that the purpose of estradiol is to up regulate many body functions, and that this is how we get the positive effects on the brain, the bones, the mitochondria and so on, but that pretty much we do not get these benefits when progesterone is constantly there to down regulate estradiol. As a registered nurse I totally appreciate her explanations more so because backed by science, only I wonder if there are other scientific explanations that would also make sense for continuous HRT. There is not a lot of available research or maybe I am not good at finding the studies, but I want to make sure I get it right as I only have one shot at this due to my late start. Could you make a video where you explain why you think that I can still get the full benefit of HRT while being on it continuosly. And, I am posting my question on different you tube channels ran by HRT doctors in order to get different experts views on this important aspect of HRT. Thanks!!
I agree… would be great for an explanation on this…
I'd love to connect with you as I'm wondering similar stuff and feeling quite lost!!!
..Just finally convinced/bullied my gyne to start me on HRT.. but it seems to be a low-dose combo pill (Cyclacur: 2mg Estradiol, 0.5mg Norgestrel) and he's told me to stop it for 7 daysat the end of every 21-day pack.. like a contraceptive, but it's not.. so shouldn't I continue.. heeeelp!!!
Yes! I feel Dr. Gersh seems able to explain the science and reasoning why we should cycle and bleed or shed the lining. Makes more sense than just being “annoyed” by the pesky bleeding.
@hollywoodwear123 -any luck in finding answers? I’m on the front end of research, too and 3 months into continuous body identical HRT and keep having breakthrough bleeding that lasts a week at a time. I see the doc in 2 days to touch bases on this and don’t know what to say/😂do. I feel “stuck”- need the estrogen for the protective effects, yet, the issue with bleeding shouldn’t be there. ???
Ok! After more research, I have learned that continuous HRT is appropriate for women who have not had a period for at least a year. Women who have a menstrual cycle should not be on continuous HRT. I hope that a video will be made on this to provide all of us with more on this subject.
After going through the menopause for 6 years naturally I started to suffer from very debilitating symptoms and was begrudgingly prescribed HRT by my GP. I was amazed at the difference and felt like my old self again... I was so happy, until 9 months down the line when the spotting began (I was also suddenly dreaming I was pregnant most nights!!! I've never had or wanted children so it was quite a shock) and was told to stop while I waited for the ultrasound investigation you mentioned. That was a 3 month wait because of the Covid backlog on the NHS (I'm in the UK) and then began a tug of war between the Specialist at the hospital and my HRT ignorant/opposed GP (who I had to battle to get HRT in the first place) - this lead to another, longer, wait as the GP demanded yet more tests be done, despite the Specialist being certain it was all benign. As you can imagine, I became very upset at it all and did not know who to believe at first. Even though the lovely Specialist explained everything in great detail and assured me it was perfectly safe to go back on HRT, I have hesitated, it's almost a year now. Thank you for explaining this all so clearly here, you've reminded me how certain the Specialist was that I would be fine, and why. After listening to you, I think I might have caused the peaks and dips by taking my pills erratically and in the morning on an empty stomach often (who read the instruction leaflets, right? 🙄) after about 7 months in, as my work routine changed. I think I feel educated enough to give HRT another try now. :)
Thank-you Dr…..started to have post menopausal bleeding I’m almost 65, been on hormone replacement going on a decade; had a biopsy a year ago was fine. But: been intermittent fasting, last meal by 4:00pm ….so at bedtime my stomach is empty, hope this is the reason for this bleeding episode.
I had ablation done in 2008 and it left me with so much internal scar tissue that my gynaecologist couldn’t get a biopsy. Even after a general anaesthetic she couldn’t get a proper biopsy. It was a great solution to the heavy, painful periods for about 8 years but I didn’t know that I could have problems later on down the line.
Thank you for this! Unfortunately, both gynos I visited didn't consider that my estradiol may be too high, even though I mentioned to them spotting, breast tenderness, and heart palpitations. I asked for an increase in Progesterone to address the spotting. It worked for a month, but then more spotting and, 3 months in, was rushed to ultrasound (they tried to get me to do a painful biopsy, to which I said no) and found a 6mm lining with no other internal concerns found. She threatened to stop my HRT if it grew any further, but didn't think to reduce my very high (0.1mg patch) estradiol dosage that I had been on since day one. After watching your videos, I took your advice and cut my patch in half and all my breast tenderness stopped and abdominal bloating reduced. I am hoping that this simple step will reverse the growth of the lining and stop the spotting. I will give it at least 6 weeks before moving to biopsy.
Oh my goodness I had that issue until I did research and I learned you must be on progesterone. That is what stops your lining from growing and will reduce your lining. It has to be progesterone 150 mg daily and your problems will reverse, I really do love the extra dial patch0.0375 or 0.05
I have had my third round of pellets after not having a good response to patches. Life is good; feeling awesome as you can imagine. Then today boom I go to the bathroom and see blood. Of course I panic and immediately think CANCER!!! You totally eased my mind 🤎🤎🤎. I will be calling my doctor on Monday I probably do need to have My dose increased. One thing of advise I will take from you, I take my progesterone in the evening but not necessarily with food. I will start incorporating this. Thank you so much for your knowledge!
How did everything work out? I'm on my third round of pellets as well and spotting! Dr said up progesterone to 200 mg
I realize people have their own channel and it is their own. What I appreciate from watching your channel is that 1) you ARE a licensed physician and 2) you have your personal preference, but you don’t shame using other HRT treatment.
Thank u so much, I was scared to death! Iv had several test, I have some fibroids, and have had them since I was a teenager, never had one issue with them. I was told, they didn’t need to be removed. I’m now 59, and have had some spotting(mild) never heavy! I’m so glad, I came across this video! I asked family members on both sides, has anyone pass from uterine cancer, bit sides never has! 🙏🏾🙏🏾🙏🏾
Yeah hell no on the biopsy!!!it hurts last time i cried.don’t act like it’s nothing.i rather just lower the estrogen
Yeah, it’s like lower the estrogen before you go into all of these painful tests! The doctors these days are not paying attention
They have to give you a sedative. Same when they insert the IUD. Biopsy is very painful. Don’t lower the estrogen.
Thank you thank you thank you for all of this beautiful information!!! I feel so good with HRT and did not want to stop!!! My partner wishes to expend his gracious thank you! We are both very happy
How do you get testosterone in perimenopause/menopause? Maybe the question should be, how do I find a doctor who can prescribe it for me? Thank you for making such informative videos!
I choose to continue having a withdrawal bleed because for me taking progesterone continually just isn't an option - it makes me feel dreadful. Once the progesterone leaves my body it's like a huge dark cloud lifts - exactly how it was in my fertile years with my own hormones! It would be a shame if some women are put off HRT just because they want to avoid a bleed - it's only a few days inconvenience for a whole lot of oestrogen benefit. I use micronized progesterone as a pessary for 14 days every other month. Using the capsules vaginally minimizes the unpleasant side effects I experience if I try to swallow them! I've been on this regime for over 10 years and it works just fine for me.
Someone said if the oestrogen is at a correct level the progesterone tablets side effects lessen, was that not the case for you? I’m the same with progesterone constantly battling the dark mood. I use my progesterone vaginally too. X
I only need a medium dose of oestrogen to keep my symptoms at bay. Not sure it would be wise to go higher just to try and offset progesterone side effects. I just do whatever I can to minimize progesterone exposure!
@@essanjay8604 totally get you there, I have just knocked back 1/2 a pump on the oestrogel to see if the bleeding stops. I have been referred for an emergency scan. tbh I think for the current issue it is either I’m not absorbing the progesterone properly or I need a different one. I currently have Utrogestan and oestrogel continuous regime. Its only been 4 cycles on continuous, but 18 months since my HRT journey began. The switch to continuous was due to turning 55, i may have to go back to sequential. Its quite a minefield imho progesterone messes with my head completely, I have always been very insecure with little confidence but its gets so much worse. I do feel my GP is winging it as lovely as she is. Told my partner I feel like weaning myself off the lot due to lack of medical input, maybe its just my mood. 😞
I have a problem with progesterone as well
Would you please tell me what dose are you taking vaginally for 14 days?
Even given vaginally, it makes me extremely bloated and I gain weight immediately.
I am continuing to experiment with different doses
Hopefully something will work
@@marzenarongione4968 I use 200mg for 14 days at bedtime. I have a scan of the endometrium annually. I think it's entirely possible that half this dose would be adequate for me personally but everyone's different. Bear in mind also I am a decade past menopause. This may be totally unsuitable for younger women.
Been watching a few of yoir videos now, and I SO agree with your views...who wants a period? We want constant steady hormones all the time.
This is the video that answered questions I have not been able to find anywhere else. Thank you!
Omg! Thank you soooo much this is the best clear concise guidance I’ve received while dealing with this spotting… it is now 5 months I’ve been dealing with this and I was tempted to just stop taking the meds all together.
Same, girl, but then my estrogen patch was lowered from .10 to
.05 and I haven't bled in over 4 weeks. Praise the Lord!
My bleeding/spotting is happening after 4 years on the same does of Estrodil and progestrone , not sure why yet, but I am going to try the talking progestrone while still have food in me, was never told that, thank you
Thank you Dr. Susan Hardwick-Smith. I’ve been on HRT for about 10 months & I started spotting at about month 8. The first time it scared me & it lasted about a week. I’ve had spotting 2 other times since then.
Did your Dr let you know to up the Progesterone dose? I'm in same situation. Hope you have answers soon.
I have too many fibroids and HRT just caused bleeding. I also had the biopsy done so no cancer. I came to the conclusion that HRT was not for me.
Then how did the bleeding stop
I take 0.0375 patch twice a week/115 mg of progesterone capsule daily, I do want to add a small dose of testosterone for a full balance, I just wanted you to know it’s the progesterone that stops the bleeding a lot of people just do the patch alone, but you have to have both, this is such a benefit. It keeps your bones from getting fragile. I hope you get back on it maybe you could consider a hysterectomy, taking out your uterus and then continuing hormones.
@ I stopped the HRT and it stopped.
I went on HRT in perimenopause because I was going cookoo, but quit after 6 months, never going cookoo again and hit menopause. I am not on anything because yeah-don't need an inkling of endometreosis back!
Thank you so much. I have tiny fibroids. And had an ultrasound which the endometrial lining is fine. Watching your video put my mine to rest. I’ll have another appointment to adjust, which is offered. This just calmed me.
In the beginning of this HRT journey, I had a doctor who was very much a proponent of HRT. She put me on 0.1 mg of estradiol patch twice weekly and 400 mg of progesterone nightly. Had no spotting at all. She retired and about a year ago I started having spotting and the doctor I now have always wants to know, and then she does the ultrasound. Everything was very normal. It happened again and did another ultrasound and again, normal. She is not a proponent of HRT. In fact, she dropped my progesterone to 200 mg nightly. I asked her what about testing, she said it is not necessary. I have been spotting the past couple days again, but I have doubled my progesterone this time instead of calling again since it has only been 3 months since my last ultrasound which again was normal. This video has given me insight on what my problem may be. I intermittent fast and do not eat past 6 pm. I am up until midnight, and I am taking my progesterone on an empty stomach. So, I am going to start taking it 2 hours after I have had my last meal and see if that helps. I'm just concerned about not being able to sleep as well, but it is definitely worth the try. Thank you for this informative video.
Did you try it? How are you doing now?
Thank you for this video! I had a d&c in January for bleeding. I'm 10ish yrs post menopausal. The bleeding is annoying. I just assumed it was the price to pay for taking hrt 💁♀️. My dr said to give it a couple of weeks (post procedure) for the bleeding to stop. It currently has but I'm holding my breath, crossing my fingers that it will not start up. I'm on 300 mg of progesterone 🫣
I love how I feel on hrt and cannot imagine not having it!
I’m so grateful for this video. I went through vaginal bleeding and based on the information and comments I read on this video I asked my doctor to increase my daily PROGESTERONE dose from 200MG to 400MG a day for six days and the bleeding stopped. Now I’m back on my 200mg daily dose again. Thanks so much doctor Susan. You’re THE BEST!! ✨🙏❣️
Shall I stop the HRT until the bleeding stops and once stopped to start again but with a smaller dose of Estrogen and equal amount of Progesterone?
I used to take 50 Estrogen patch twice a week and 100mg Estrogen but on empty stomach as Dr recommended but then I increased myself the dose of Estrogen to 100mg and same 100mg Progesterone in the morning.
When I went to gynecologist she told me to increase the dose of Progesterone to 200mg but at night. I did that and just after 3 days after I started having lots bleeding as on my period but not super heavy. Now I wonder if I should stop all HRT till the bleeding stops?
@@gabrielanita8319 Hi, according to what the doctor Susan said on this video and according to my doctor as well you should never take progesterone on an empty stomach or in the morning but at night after a meal. Did you watch the whole video?
@@gabrielanita8319 I wouldn’t stop the HRT. Talk to your doctor about increasing your progesterone even higher just until the bleeding stops. I’m on a 0.025 mg/day estradiol two patches a week and on a 200ml progesterone pill daily. Hope this helps.
@@carlahabib1768 Hi. Thank you for your reply. Yes, I watched the video and as I mentioned I started taking the Progesterone at night after food and a higher dose of 200mg. I think that's what triggered the bleeding. I'm thinking to stop the Estrogen all together for the moment and maybe the Progesterone too, until bleeding stops. The video was very helpful. Thanks
I also agree the biopsy hurts like hell, and I generally have a pretty high tolerance to pain. The worst part was afterwards, and I’m glad I asked my husband to come along to drive me home. The first one I had about 8 years ago and I drove myself…don’t really remember the after being so excruciating. But this time I had to go an hour and a half away vs 20 minutes so I didn’t want to take a chance.
What are the protocols for having ablation, or even just getting a hysterectomy, so we can use hrt without the “annoyances”? The last theory for my issues is the possibility I’ve got adenomyosis, due to having a c-section. But that’s not definitely diagnosed unless they take out the uterus.
I was on birth control pills continuously for years due to endometriosis they worked fabulous. Now they switched me to hrt combination patch. I started bleeding. Never had that problem on bc pills. I wish I could just go back to taking them. I don’t think men would put up with what we are made to endure.
I was taking Combi patch and started bleeding after about eight months, so switch to the higher progesterone Combi patch. Did fine on that patch for another couple of months then started bleeding again. Finally went to an estrogen patch, and an oral progesterone. 🤞 It’s been 10 months .
same for me!!! switched to estrogen patch & 200 mg progesterone it stopped the combo patch bleeding but now bleeding again. They said try & double my progesterone for 5 days. So 400 mg i'll try. 👀
@@helenhernandez2197 I tried the micronized progesterone and I could not take the side effects. I just asked for 2.5 mg of Provera . May be synthetic but I do so poorly on the micronized . I could not do it .Its almost been a year with no bleeding 🤞
I'm on estradot 100mg and mireena coil, had biopsy all clear been on this over a year, I'm 54, I've been spotting and having periods everything month , then I stop for 10 days then I go back spotting😮
I’ve been not taking my progesterone enough. I tend to skip many tablets. That could explain.
Thank you so much
The progesterone protects you from uterine cancer. Keep taking it.
Hi if I'm in perimenopause and I star hormone replacement therapy and I started bleeding again it's normal? I was not have my period for 7 months before the hrt
My experience w biopsy wasn’t too bad. I stopped HRT because of the bleeding. Now I am listening to this and found out whether I need to reevaluate my options. My family doc advised me to stop using HRT as bleeding wasn’t something she thought safe for me.
I am very healthy in my mid 50’s, I used patch. My OBGYN thought I was a perfect candidate for HRT. I did a couple of Ultrasounds and it showed good except last time the thickness of my uterus wall grow a bit (7mm or unit I forgot)
I am post menopausal and on the bioidentical estadiol patch, testosterone cream and progesterone pill. My Dr told me to make sure to take 7 days off a month from the progesterone pill otherwise the receptors get "clogged up" after awhile. Have you heard of this and is that even safe to do?
Evrol patches for 7 months. Post menopause 4 years. Starting bleeding after 2 months. Have been heavy bleeding for 7 months, not spotting even though I have upped progesterone to 200mg and also the mini pill to try and stop it. Private patient and sick to death of no solution. I have stopped taking estrogen patch and continued with progesterone and bleeding has stopped. Going to try again and reintroduce Evrol 25 patch. If it doesn't work I am coming off hrt.
I think you want to bleed which is part of a normal healthy cycle. That way you know you've taken enough estradiol to have healthy growth factors to grow new heart cells, brain cells, remodel bone, grow a uterine lining etc. After two weeks, stop the estradiol and for 2 weeks take a full physiologic dose of bioidentical progesterone so the uterine lining sheds fully.
Oh my gosh. Thank you for making me feel normal. I got started at .075mg and I really should have started out at a lower dose. My lab results showed barely any estrogen so my body had a strong reaction to starting it. I kept being told I shouldn't be having issues with starting the HRT and made to feel like I was being overly anxious, etc. But I thought the same thing. My body has had no estrogen and was like woahhhhhhh....when I suddenly started at such a high dose. Thank you!
Same happened to me! Except I was started at 0.1 mg!! It’s like the doctors have no sense.
I decided to not stay on the patch, I'm just doing the estradiol cream every other night. may still investigate progesterone options, but wasn't comfortable with the patch. I say listen to your own body to do what's best ♡
It is recommended that you start low and dose up to physiologic levels as your body adjusts.
@@edelucia74 really I love the patch, but it is a individual liking, I do the 0.0375 estradiol patch twice a week love it because it’s made with yams, and definitely progesterone 150 mg every day, this is been so great because it helps you sleep at night
Thank you. This was helpful. I started HRT at 59. I had been on herbal estrogen boosters since 55, and progesterone cream. Both helped but eventually i knew they wouldn't be strong enough. So now I have a low dose estradiol patch and progesterone pills. After 5 days, the skin irritation from the patch drives me crazy so i take it off and stopped the matching progesterone until i put it back on. Yep, I have full blown periods. Now, i just move the patch to a new spot with medical tape to avoid skin rash and dont stop the progesterone. But I just wanted to make sure that these periods are not harmful. And to make sure that the low dose 0.0375 estradiol is not too much. I am a small person and told the doctor I wanted a low dose.
That does is the perfect dose, this particular doctor always recommends .05 she thinks that’s best for your bones you could go up and still be safe but if your levels look good, you are just fine. Definitely do not go lower the patches safe it’s made with yams, you definitely need progesterone. Make sure it’s not progestin it has to be progesterone, which is natural you want to get at least 100-200 mg every day if you only do it a few days a month you will have a period, I personally went with 150 mg. Hope this helps.
Got the pellets done in june of 24 and for 3 months everything went great..well, went back in September to restore my pellets , well in the middle of September I started bleeding and in the month of October , i bleed so bad thinking i was going to die ..then had a ultrasound found out i had a fibroid cyst in my uterus ..then kept bleeding until i found out , this provider had me on estrogen pellets almost 5 months without progesterone and me with a uterus ..so now im taking progesterone 200mg at night and still yet when i pee im still bleeding pretty bad..hopefully i can find a better doctor that knows what there doing ..
@Dr. Susan Hardwick-Smith I have come back to this video to rewatch it several times. I started HRT almost 1 yr. ago. Unfortunately, 3 months ago I started having what appears to be a regular monthly cycle. In March after an appointment with my GYN, she increased my progesterone to 200mg & kept my Estradiol patch at 0.1 mg. I am at my whits end bcos this is month 3 of having a full on monthly cycle. Not to mention the increased progesterone has my emotions all over the place as well as increased bloating. Any further advice you can give would be great. Help!
Great video you explained it so well, now I understand
So helpful! I found this at the perfect time.
I had my biopsy under anesthesia 😊
Me too. Same time they took out the polyps. Just got pellets again after being off hormones for 2 years. 200 MG Progesterone. No issues.🙏
I was on HRT for 6 years and started spotting. Got an ultrasound, an MRI and a biopsy. Nothing. My thyroid medicine needed adjustment at this time. The biopsy was fine. My gyno used a local lidocaine and I barely felt it. Increased my progesterone to 400 mg. Bleeding stopped.
Noted!
I am currently on higher dose of pogesterone. After taking it still bleeding a little.. how long it took of higher dose to stop bleeding?
@ about 2-3 days.
Thank you for explaining in such detail!
Thank you so much, Dr. Hardwick-Smith, for the thorough explanation. Just discovered your channel last night and lots of going ons with my body is clearing up :) love how simple your explanations are.
I have been on HRT for years and had bleeding after menopause. My doc discovered it was a benign cyst in my uterus and surgery removed it. No more bleeding.
very helpful, thank you. day 2 cramps and mild bleeding
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 everyday 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. 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. Attaching a picture to show what happened to my face within a week. 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 to Monday. 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.
Also gynecologist prescribed northindrone this week and I have had a migraine everyday.
I’m not an MD, but I had bleeding after many months of no bleeding on .05 estradiol patch and 200 mg nightly bio progesterone . I asked my doc to increase progesterone , so now take 300mg nightly and bleeding stopped. Also had ultrasound after a few months of new dosage and lining thin and healthy, so that worked . However , having breast tenderness and sort of PMS moody … I’m going to try progesterone vaginally and take progesterone cyclically, so u will have a controlled bleed, but I know it’s the hormones and not anything else since ultrasound was fine. If I were you, I’d see how patch with more progesterone works to stop bleeding and symptoms and maybe ultrasound after a bit for peace of mind🤗
Hey I just made a reply just in case it helps, it’s the only other reply forgot to direct it so you see it
You are amazing ♥️
oh that little hysteroscopy and removal of 2 polyps..yeah that was gonna be about $4000 at the facility my doc wanted me to go to, yes outpatient so ask before you go
My experience w biopsy wasn’t too bad. I stopped HRT because of the bleeding. Now I am listening to this and found out whether I need to reevaluate my options. My family doc advised me to stop using HRT as bleeding wasn’t something she thought safe for me.
I have had a terrible time with bleeding while on HRT. I have had a pelvic ultrasound and 2 endometrial biopsies. The ultrasound revealed many fibroids but none within the endometrium. My doctor recommended an IUD. I now have an IUD and taking progesterone pill each day and still having bleeding (more than spotting). I think I will ask my doctor about the hysteroscopy. Thank you for this information. I am at my wits end with the bleeding on one hand and feel so much better from the menopausal symptoms with the hormones on the other hand.
Hi Stacy how are you doing? I hope all is well your right the hrt helps us with so many things but the bleeding is so annoying.
I hope your well and let us know the out come so we can learn. Thank you Stacy!💞
Same exact story here. My OBGYN is lowering my estrogen dosage patch and hoping for the best. I’m still having bad tummy issues and feeling the progesterone is to blame but it could be that I already had these problems and they’re just coming to a head.
I’m fasting and changing my diet drastically hoping for change.
I doubled my P after bleeding for 3 months , its stopped overnight
Seems like you don’t have enough estrogen.
@@cindybrown1398how did you get your doctor to double up your progesterone? To what amount if you don’t mind me asking. I am having spotting a lot it’s driving me crazy. I never went a whole year without a cycle so I think I am still pre menopausal so my doctor has me on progesterone and estrogen every day which I am wondering if taking the progesterone and estrogen every day to early might have caused this. How are you doing now?
What should a woman in perimenopause who is still regularly ovulating and cycling expect when starting hrt treatment for peri symptoms? I've started a .05 estradiol patch and daily oral 100mg progesterone tab which has done wonders for my symptoms. BUT Didnt ovulate this month (unusual for me, I track mucus signs and basal temps to confirm ovulation) but had a light to medium 3 day bleed around day 32-34.
I am also ovulating and in perimenopause, I just turned 50. I started 0.5 estradiol gel 8 days ago, and I have been bleeding ever since, soon to see a doctor about ot. I have a cyclic regimen, meaning I should be adding a progestin (Provera 10mg) from day 11-21, then 1 weeek off from both, and then restart. My symptoms are bad sleep, low mood and libido, brain fog, dry eyes. One doctor says it is normal to bleed, other says to stop the gel… hard to know who is right
I had a full period 18 months after I thought I was in menopause. I have been on estradiol 2 mg and progesterone 50 mg. I'm thinking it may be because the progesterone is too low? I had an ultrasound and am awaiting the result. I'm a little worried. 😔
Thank you so much for this. It is so helpful.
W have the Climara pro patch which is a combination patch. It’s supposed to stay on 7 days but yesterday it was basically off and I put it back on. Only the outer edges were really in contact with my skin, now I’m spotting. I’m gonna try a different route because the patch is just not working for me.
I use this patch and sauna daily what you can ise is those stickers that go over a Continuosus glucose
This happened to me. Ended up with a DNC then did oral est/prog.
Thanks - I needed this info. Now I know how my doctor ought to approach fixing this. Was on Premarin (oral) and progestin for 5 years. Switched to estrogen patch and a different progesterone and began getting a full period every three weeks.
I suppose I could always go back to taking the Premarin orally...I only changed to patches because I didn't want my liver filtering the estrogen and thought transdermal would be a better delivery system. I think I may have been wrong about that. Time will tell.
I'll see if the progesterone can be increased because these patches have sorted out my hot flashes and vaginal atrophy perfectly. They're a bit of a pain but they work well.
Hi Susan. I take my progesterone at bedtime which for me is at 11:30. I stop eating at 6 pm. I was never told by my doctor to take it with food. So, since that is the case, I would think it is too early to take it as I need it also for sleep. Any suggestions you may have would be helpful. Thanks for your informative content.
I also have read that taking it with food may INCREASE the strength of the pro pill. I go to bed at 9:30pm and sometimes eating dinner at 7pm. I don’t think this time frame is working for me. Started experiencing dizziness. After taking it and still have the symptoms before driving to work… not good. I sleep better though.
I've been on hormone replacement 5 yrs without problems except for when I first started had some spotting did biopsy all was clear since then over 4 yrs.2 months ago I switched compound pharmacy started getting cramping on and off that then became intense Then today gushed pretty good for about an hour brown thick yucky old blood. I had already went to GP with the cramping and I have an ultrasound scheduled for the 18th ..now I'm really worried and stressing out. Will call my GP in morning see if I can get moved up for ultrasound tell her I'm now bleeding. I'm wondering if this new compound pharmacy would have anything to do with it? I never had problems before or just a coincidence ? I hate procedures etc the biopsy was brutal I had 5 yrs ago. Thanks in advance for any thoughts on this
A friend said as she aged, her dosage had to be changed as her body changed.
So glad I found your channel Dr Smith. I have been on HRT - continuous, now for two and a half years and every now and then I start spotting. Is this normal? I can go for months being ok then back spotting again for few days at a time. Thank you for your helpful videos 🙏
Is low progesterone the cause for breast discomfort on hrt?
Estrogen may be too high. Tell your MD.
This information is super informative and I truly appreciate this. I’ve been dealing with breakthrough bleeding for months, and my doctor appears to not be as first in this topic so now I have a starting point to either allow my doctor to better assist me or shop for a more equipped position.
Thank you very much for this video.
Started with CombiPatch with the low progesterone first. Started bleeding after a few months . Then went to the CombiPatch with higher P was fine for a few months then it started again . Now will try estradiol, patch and progesterone at night. 😐 Hoping this works 🤞 ( had ultrasound and all was well there luckily )
This sounds exactly like me. Did you figure out the right regimine?
Try Lyllana patch
Thank God for doctors like you. Thank you for sharing your knowledge.
I have had two experiences of bleeding on hrt , I was sent to the hospital to get checked out the fist time it was discovered that I had polyps on my cervix the second time I had a large ectropion on the cervix. I would still encourage women to get checked as there are several other reasons for bleeding when taking hrt .
How well does progesterone cream absorb through the skin?
DR. Susan, I am thankful for the information. I have a question about fibroids and HRT. Unfortunately, due to a delay in my compound progesterone being delayed, I went about 2 1/2 months without progesterone. I have gained 8 pounds around my middle, have uncomfortable pain in my belly and severe bloating. I was on a very low dose of estradiol for 8 months and went off for about 7 months. Went i went back on I asked to be pushed up to 0.075 and no progesterone. I am a little concerned about the pain, bloating and bleeding. Can you please provide me information on what I should do.
I started Estradiol patch and topical progesterone compound cream 7 months ago. I started bleeding. My doctor put me on a progesterone pill higher than the cream and bleeding stopped. She still ordered a vaginal ultrasound. She said the limo was a bit thick and even though I’m still not bleeding she is ordering me for an endometrial biopsy. :( Meanwhile- hot flashes have resumed along with the WORST night sweats! 😢😮 At this point I’m worried. And wondering what is after this if that is okay. 🤷♀️ I’m really wanting the Mirena IUD or give up. To go through this for every minor bleed at 54 Not interested. This is why women give up. What a hassle.
How are you doing now?
I started a hormone cream 5 of estrogen 200 of progesterone. After one week I started spotting. I was like ok my body needs to adjust. By Second week I was having a full on heavy period that would not stop. After 10 days of bleeding heavily I was done. I quit the cream. It’s been 5 days since I stopped using the cream and I am still spotting daily. I know I have 2 small uterine fibroids was diagnosed with those last year. Previous to starting hormone therapy I had not had a period for 8 months.
Same situation but my Dr said I must stop for a week but after a week and a half of having blood I am now spotting! Then he said I need to halve my progesterone. I don't think he knows what he's doing. 😢😢Time to change Dr!
So helpful! Thanks!
I had pellets put in December. On January 19-25, I had a period. Now it looks like it is coming again almost a month later. I am confused as another doctor on YT said having a period on HRT is normal, but spotting should be looked at. I' m confused.
Thank you so much you are amazing ♥️
Thank you soooooo much for this info. I've had breakrhru bleeding everytime. Even with a small amount of estrogen. But now I understand the how/why of the progesterone! I'll be making the adjustments starting today. Hopefully I can get it figured out. Thank you. sincerely, Karla vae
Brilliant. Thank you.
Thank You for this information
I started hrt pellet therapy while I was premenopausal so I never went a whole year without a period. I think that’s why I still have a cycle. This is all so confusing.
Is there anything unsafe about taking progesterone 1/2 the month and opting for a predictable period? Thank you so much for all the helpful information. Very much appreciated....💗💗💗
I am wondering the same thing. Because of severe pms. Hope someone knows the answer
Dr. Felice Gersh Answers this on TH-cam ,
@@CJDane-rf1je thanks for the reply. What is the title of the video?
Im 47, haven’t had a period for 4 months, but was having symptoms of insomnia, vaginal dryness, low libido, and night sweats. Labs were at post menopausal levels. Testosterone was also in the toilet. Dr, prescribed compounded estradiol 2mg/Testosterone 2 mg cream (4 clicks/1 gram in AM and 100 mg progesterone. In just the first few days, symptoms improved. But on day 10, I started spotting and now have a full blown period with cramps and related loose bowels. I was told bleeding could happen when starting BHRT. But this soon? Could this be a true blue period stimulated by the hormones? Or a coincidence?
I'M only on my 2nd week. I'm on 0.1 mg estradiol patch and I take 200mg progesterone pill at night. I'm hoping not having enough food in my stomach and maybe not absorbing enough of the hormone.
I had a break through small bleed l am on evorol Conti patches post menopause 😭😭♥️
Great info, however what if you have no uterus (hysterectomy) and are still spotting using HRT!
Thank you so much for the information ❤
Thank you for the info
I’m perimenopausal extremely light period with crazy symptoms on .50 mg patch and 100mg of progesterone all month is ok not to shed the lining? Also just got on the mirena 3months ago is it ok?
Thank you, this video is so important. Unfortunately I have a gyn who refuses to raise the progesterone so I'm just shedding. Can you recommend an HRT-literate gyn in NYC?
@@rfr64 OK thanks!
Dr Susan,
When is the right time of day for progesterone? Estrogen? Testosterone?
Ha spotting!? I was 2 weeks in and was bleeding through everything for 9 days. I was cycling 2 weeks on 2 weeks off. I was expecting spotting not full on period. Now started taking est and progesterone both daily. Not my preference but at 51 I definitely don't want to be like a 12 yr old again.
Exactly!!!
Hi Dr. Susan, I emailed you awhile ago about post menopausal bleeding on HRT and you were so kind to answer a lot of questions.
My problem is that I'm still bleeding. I'm 53 post menopausal for 3 years and on HRT 2 yrs and bleeding/ spotting a good amt. We've tried adjusting everything (on 0.1 estradiol patch 200 mg progesterone also tried .05 patch and 100/200 mg progesterone) nothing stops it. My gyn is scheduling another endoscopy with D&C and says if that doesn't work that I should consider a hysterectomy or maybe an ablation. What do you think? Should a post menopausal women have an ablation? During our earlier correspondence I thought you said a post menopausal woman shouldn't get an ablation. What would you suggest a hysterectomy or ablation? Thanks, I am absolutely at my wits end!
Mirena coil is the best option if micronised progesterone doesn’t keep the womb lining thin.
@@cj705 I thought this too and my doctor was going to place a mirena coil during my hysteroscopy but couldn't because I have a very small, arcuate shaped uterus that wouldn't accommodate it.
Any updates? How are you doing now?
Iris been 4 weeks now. I think I’m getting progesterone reaction (dizziness, anxiety).
I'm on evorel conti patches, both estrogen and progesterone. After 4 months started bleeding/spotting. Should I take extra progesterone ?
Thank you