HRT and me: I finally feel good – but why am I bleeding and spotting so much?

One of the best things about menopause (yes, there are more than one) is the end of your periods. But bleeding has been a major part of my menopause journey this year and it’s lead to a worrying couple of months.

It began with a GP appointment. It had been almost six months since I’d been given Evorel Conti as a make-do hormone replacement therapy (HRT) after Covid-19 precautions stopped me getting a coil fitted and I needed a new prescription.

However, I was a bit concerned because I was bleeding. Often. Every couple of weeks I would have a “period”, sometimes as heavy (and almost as painful) as my true ones, and in between I would rarely go more than a couple of days without spotting. I’d had to put away my nice knickers and wear the old faithfuls, the sort your mam would warn you about not having a road accident in.

Obviously I did what everyone in this situation does and turned to Google and read:

Most women do not have a regular monthly period with Evorel Conti. However, bleeding or spotting does often occur in the first few months until treatment settles down.

Closer googling unearthed forums on Mumsnet where other women were also having bleeding, so I took a deep breath and accepted it.

But then Mr 50Sense said: “Again?” when I told him about a new round and I realised I was bleeding or spotting more days than not. And six months did seem more than “the first few months”.

Fast-track to Worryville

When I told the doctor – a locum, covering during the pandemic – he said he would recommend I changed over to the coil and inform Dr B, who does the fitting.

However, Dr B was not so happy and before I knew it, she was talking about getting me fast-tracked for ultrasounds and seeing gynaecologists and checking for cancer.

I’d been brushing my teeth when she called and I sank down onto the edge of bath in disbelief. No one on Mumsnet had mentioned cancer.

Dr B was wonderful, calmly discussing her concerns and why she thought this was the best action. We needed to get anything serious ruled out, she said. But then she called back straight away and said: “I’ve been thinking and perhaps you should stop taking your HRT,” and my heart did a little flutter. (We compromised on a half as I was scared of going cold turkey.)

Sitting there, I came to a decision: cancer has struck several members of my family and my in-laws, so I wouldn’t tell them about this until there was something to tell, either good or bad. I didn’t even want to tell Mr 50Sense, but then he was off ill when I had to go for the scan and I had to explain why I was suddenly drinking gallons of water!

Ah, yes. The great How Much Water to Drink for an Ultrasound debate! The clinic told me to drink two litres, but a quick chat on Twitter found this was a much-disputed number. Some women had been told a pint, others that they’d drank too much and had to wee some of it off… In the end, I compromised on a pint and a half and crossed my legs and fingers.

At the women’s health centre, where motherhood rules

Medical procedures fascinate me and I lay there enthralled as she read off numbers and discussed my “fast asleep” left ovary compared to my “very young-looking” right, where a follicle was “11”.

I raced back home to tell Mr 50Sense. “What does all that mean?” he asked. “Haven’t the foggiest,” I replied, and then promptly took to social media to boast about my “young-looking” right ovary.

As time went on, however, that C word kept coming back to my mind and I googled facts about ovaries and follicles, looking for reassurance that the internet couldn’t provide.

Off to the women’s health centre

A couple of weeks later, I found myself sitting in the nearest women’s health centre to see the gynaecologist. Why they call it a “women’s health centre”, however, I have no idea as there wasn’t one piece of literature or poster or pamphlet for women’s health that didn’t relate to pregnancy and childcare. Images of babies and happy families were spread wall to ceiling. “Motherhood health centre” would be a more appropriate term.

My internal rant waylaid some of my fears.

You see, I’d been blasé when talking about the tests, saying it was nothing to be concerned about, but a niggling part of my brain kept saying: “What if…?” After all, I’d started bleeding yet again that morning…

In fact, I was so nervous that when they told me to undress and wrap a paper blanket around me “like a sarong”, I did a full strip and walked out tightly holding on to as much decency as possible.

“Noooo,” laughed the gynaecologist. “Just your bottom half!”

Well, it broke the ice.

Next, I was stirruped up, discussing the weather in a very British way as bits and pieces were stuck up my vagina and wiggled around.

“Your cervix is a bit…”

“Wonky?” I proffered. “That’s what they told me in Spain during a smear test once. They said it was more difficult because my cervix was wonky.”

Well,” said the gynaecologist. “I wouldn’t be so rude. It’s… playful. Likes to hide.”

See? That’s the difference between the Spanish and the British NHS.

Wonky or not, it turns out I have a cervix that really doesn’t like people poking around in it. Especially people trying to do smears or biopsies. I closed my eyes and concentrated on mindfulness techniques, focussing on my breathing and trying not to imagine John Hurt with a Baby Alien moving around his stomach.

After what felt like an age, the gynaecologist said: “You’ve done really well. I’m waiting for your scans to come through, but I’m getting the biopsy sent off straight away. I think it’s HRT related, but if it is cancer, we can hit it running.”

Fistula fistbumps

I thought I would feel more nervous after the gynae appointment, but her words made me feel much, much better. The matter-of-fact way she explained what she was doing and why brought about an almost Zen-like calmness: if there was something there, I was in the best hands so better to find out.

Straight out of the clinic

Not long later, I coincidentally received a DM on Twitter from someone going through a similar situation. Through our conversation, I explained what was happening to me – she was the only person apart from Mr 50Sense and my Pausitivity colleague Clare that I had told.

And it felt good.

By telling her what I had gone through, I was not only able to prepare her a little more, but also reassure myself. There was a process here and experts behind it.

More importantly, though, I was able to lift a little of the load I’d been mentally carrying by keeping it secret. By shining a light on it, I could put things into perspective and look at the facts, which were that it was more likely to be the HRT than anything else.

I still had a huge sigh of relief when my letter came through agreeing with me and saying everything looked good. It also gave me lots of medical details to geek out on and I know fine well my new party piece will be telling people the size of my uterus.

I also heard from my DM Pal, telling me she had fistulas.

“Fistula fistbump,” I proudly replied!

Wonder if she knows the size of hers…

Looking to the future

So now it looks as if I may finally get to my holy grail of HRT – a Mirena coil and oestrogen gel – 20 months after I was recommended it by the now-head of the British Menopause Society.

The ironic thing is, emotionally, I’m actually feeling really well on the Evorel Conti! I’m taking it with Sertraline, which seems to be counter-acting the effects of progesterone on me, and except for one bad episode of menopause depression, I’ve been more emotionally stable than for a long time. I’ve still had a few bleeds, however.

Any advice?

Finally, if you are experiencing bleeding after menopause, please go see your GP straight away. In fact, let’s make that an order – GO AND SEE YOUR GP.

And share your medical facts with me afterwards.

What are your experiences of Evorel Conti? Has it made you bleed? Please let me know in the comments below and tell me what happened to you.

17 thoughts on “HRT and me: I finally feel good – but why am I bleeding and spotting so much?”

  1. Gosh I just stumbled across your post while googling why am i bleeding on ‘everol conti’. Your whole scenerio could have been written by myself! I too have had an ultrasound and an internal , plus an internal ultrasound, didint know that was a thing! After calling my doctor to tell her I was bleeding, 3 weeks after starting on the patches. After my ultrasound I too got a call from my doctor to come off my HRT ‘immediately’ – eek! Waiting on a gynae appointment, bleeding again this morning and quite sore. Little clots coming away too. Called doctor and now apparently a letter has been sent by the gyne dept at the hospital with ‘advice’ – not seeing them?? Still waiting on my doc calling me. I know I have a cyst on one of my ovaries. But i hadnt had a period for 2 years now bleeding more than I did when I had my periods. Boo!

    1. Some of my GP phone calls seemed to have got lost, so if you haven’t heard from your GP soon, give them a call iand inquire. For what it’s worth, I was told I could remain on the Conti but with regular scans to check my womb lining wasn’t getting too thick. I didn’t want to put that cost on the NHS so I came off it. Let me know how you get on xxx

  2. Same here – 18 months of bliss on oestrogen patch and utrogestan and then bam! Ten weeks of spotting, biopsy, scan, the waiting was horrific. The first option (reduce oestrogen dose) brought all the symptoms back but stopped the bleed. I’ve upped the patch now and feel ok but I expect I’ll bleed in a week or so. Seems like have to have one or the other and bleeding is the least bad.

    One thing two docs have suggested – increase the utrogestan dose to stop the bleeding (although no one has told me for how long or how often, or after how long a time does it become a concern again). This isn’t a one size fits all and it’s so difficult to find someone accesible who knows their stuff. Grrrr

    1. Hi Cat. It is frustrating, isn’t it. You think you’ve found the answer and then bloody Mother Nature screws it up again. All we can do is keep going back to the GP. The more we let them know they’re advice isn’t good enough, the more they’ll have to learn! Good luck x

  3. Hey ladies ,
    Reading a few diff things online ,have been on the conti for a month and have just started bleeding for 2nd time ,heavy and painful like I used to have .normal body getting used to it or consult my doctor??

  4. Mrs vicky saka

    Hello all,Started evrol conti may10th 2021,2weeks later aching boobs and belly ache then a period like bleed 7 days later no bleeding for 4 days then spotting and now today my second appointment with Dr about patches im bleeding again like a period ,Dr gave me another 3 months of patches and of bleeding hasn’t stopped by then it needs looking onto so I suppose that means a lot of prodding and poking down there ohhhhh isn’t being a woman fucking fabulous 😀

    1. It is a bloody trial at times – figuratively and literally!!!!! Evorel conti can cause intermittent bleeding for the first few months. Keep tracking it and if it doesn’t settle, go back and see your GP. Good luck and keep in touch x

  5. Hi.I’ve been on evorel conti for 8 weeks now and have been bleeding for 10 days now. Should I contact my gp or is it just breakthrough bleeding? Thanks Mandy.

  6. I’m 55, been taking EC for last 6 weeks and on that time I’ve had 2 heavy and cramping bleeds with only 9 days between each one, currently bleeding for the second time. I am still waiting to hear back from my GP (will be phoning them again tomorrow). I haven’t had a period for over 10 years and it’s horrible. In between I feel like I’ve been born again…. But this bleeding is getting me down, I’m not accepting that the bleeding is ok. Now I’m having to buy sanitary wear and take pain relief for the cramps…. That doesn’t seem right.

    1. Hi Julie. I hear ya. I’m on utrogestan now and the pain from the bleeding this time is just like my period pain of old. What did your GP say? x

  7. Hi
    I have been on EC for just over 2months I am 58 and was feeling horrific before .i am a new woman on these but am so surprised with the bleeding . I haven’t had a period for well over 9 years going back to sanitary products and periods oh gosh . Also my breasts are constantly painful,big and my nipples are so so sensitive. I feel so much better in myself but do I have to endure this for long or will it stop .

    1. Hi Angela. Thanks for stopping by. It may be intermittent bleeding from the start of the HRT (happens to a lot of women), but any post-menopausal bleeding should be investigated, so give your GP a quick ring to ask. Always best to check x

  8. Hi I have been on EC for 3 years with no signs off any spotting or problems from day one , however on a long car journey recently and felt lower back/period pain and realised I’d had a short but heavy bleed…. Been to doctors and had an examination , she says everything feels look fine but to come off EC and if don’t bleed in next 6 weeks can go back on …. But if I get another bleed whilst off it then I’ll get ‘referred’ . I’m scared to come off it ‘cold turkey so might halve the patches for the next few times but I’m confused …. Could it be the EC that caused it … after 3 years with no problems I wonder? Or something more sinister in which case I’m worried about waiting 6 weeks …. Help!

    1. Hi Debs. I wish I could help. For the majority of women, post-menopausal bleeding is usually for a non-cancerous reason, such as polyps or a thinning vagina wall, but it’s something we always have to get checked out in case. You shouldn’t be left worrying, however. I would ask to see another GP and explain your fears to them. You’re entitled to have full reassurance. Go make the call today and let me know how you do xxx

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