Our expert says:
Climen consists of estradiol ( a type of oestrogen) 2mg for the first 11 tablets and oestradiol plus cyproterone in the next ten tablets. This combination is designed to have effects on the endometrium which, in the majority of women, will result in regular periods. In some women, however, breakthrough bleeding occurs as in your case. The problem with this is that irregular bleeding may indicate other problems and it is difficult to distinguish between a problem wiht the uterus or cervix or just the homonal effects of HRT. At your age, there is always a worry about cancer,. so you would need constant tests and checking if the bleeding persists. It is therefore better for you to take a pill which does not cause irregular bleeding. I am not familiar with Perfesta and it is not in the Drug Reference manual. Is this a generic? In any event, your gynaecologist is correct that it is the effects of the oestrogen dose as well as the progesterone/ cyproterone component which has effects on the uterine lining. The type of oestrogen also differs in different preparations. It is not as simple as looking at the dose of oestrogen.
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