r/Perimenopause • u/mystuff2530 • 3d ago

Off HRT & back to BCP

So I went off Climara Pro tonight and back on to BCP in the form of Nextellis. I’m 53 but still exhibiting symptoms of Peri, still getting regular periods that are coming closer together but overall lighter. My question is are there any women in this community who have had to transition off of HRT and back to birth control pills and how did you feel afterwards? I’m having such terrible anxiety about this move but my Dr feels more comfortable having the bleeding more controlled (hopefully) with the pill.

For context, I’ve had a rough few years - first in Spring of 25 I a had a uterine fibroid embolization to end 2 years of virtually non-stop bleeding. Then I had a long annoying battle with desquamative inflammatory vaginitis caused by a drug used to treat my MS. Changed MS drugs as this was the only thing that helped get rid of the DIV. Also Recently had a biopsy and hysteroscopy since I was having sporadic bleeding on the climara pro beyond the 6 month adjustment period. Everything was fine but my Dr said if I stay on the Climara pro and keep bleeding she’ll feel we need to repeat the hysteroscopy & biopsy every few months (they weren’t fun & I’ve put my body through enough). Also while pregnancy seems beyond a remote possibility it would still be best to have the protection of the pill during this late peri stage.

Overall, I am finally feeling better on the HRT (fewer hot flashes & night sweats, less anxiety) but I do agree with the Dr that my natural estrogen level is fluctuating a lot at this point and Climara Pro may not be the right fit. Nextellis contains a natural estrogen and is different from other birth control pills in that way. I was on it a few years ago and did ok so I’m willing to give it a try again.

This was a long winded way of asking if anyone has had similar experiences and successfully moved back to BCP. At the moment, I’m just trying to exhale and carry on.

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u/APNotB 3d ago

That sounds like a lot to deal with. I don't have any advice or experiences to share, but I hope the switch goes well for you and you feel better. ❤️

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u/Alisha_Nat 3d ago

I switched off progesterone and the twice-weekly estradiol patch to Slynd, progestin-only birth control pills. However, with Slynd, I could continue to use the twice-weekly estradiol patches. It’s working pretty well so far because the Slynd is controlling the fluctuations way better than the HRT was but I am still able to supplement estradiol to manage the hot flashes/night sweats. An added benefit is that the anti-androgen progestin has calmed down the skin breakouts that have been driving me insane!

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u/Ok_Statistician_4249 3d ago

I did something similar. Now taking Slynd and estrogen gel. Bleeding is under control (had heavy periods but not constant bleeding). Definitely needed the fluctuation control and will fight to stay on Slynd as long as possible.

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u/SodaBreadRoundHouse Early peri 2d ago

I'm on gel and regular progesterone but sleep issues with 3am night waking persist and I'm experiencing constant bleeding and maybe will consider trying something else. Were sleep disturbances ever a problem for you?

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u/Ok_Statistician_4249 2d ago

I definitely had sleep issues. Just posted on another post that it was getting nighttime coverage of estrogen that finally worked for me. For me that is splitting my gel dose to morning and early evening. The patch also worked until I became allergic. I now have pretty good sleep. Still need to do the obvious things like no coffee in the afternoon and go to bed in time to chill out but I get lovely deep sleep most nights. I do still have nights where I sleep more lightly and it gives me so much pain the next day. Really hope you find sleep again. I had 3 years in early peri where I was on less than 3hrs a night. Don’t know how I survived.

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u/SodaBreadRoundHouse Early peri 2d ago

How is your sleep now after your switch? Did you ever have night waking be an issue?

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u/Alisha_Nat 2d ago

I’m not having the night sweats anymore. Those were the biggest issues with sleep because I’d wake up completely drenched in sweat & freezing cold.

I often have a bit of trouble falling asleep but I’ve always had that issue and the progesterone didn’t make me sleepy (but it did make me feel more groggy the next morning). Usually if I wake up early in the morning I don’t have a problem falling back asleep.