When to begin HRT patches?

[Jott]

I got a prescription for Evorel patches yesterday, still having periods but am perimenopausal so GP has agreed this will help manage the symptoms I'm having.

The instruction leaflet says if still having period then to start the patches within five days of the start of bleeding.

Does this mean five days before my period starts/is due or five days after my period starts?

Tried ringing the GP and they're closed for staff training.

I would read that as after. Surely, especially if perimenopausal, a woman may not be able to predict with certainty that her period would start within five days.

Well that's it, it's now always 3-5 days early or 3-5 days late so I can predict roughly when it'll arrive but not within a five day accuracy.

Within 5 days of starting bleeding.

So within five days of my period actually arriving is the general consensus. Flipping leaflet is clear as mud.

@Jott can I ask what symptoms you've been having?

Periods going a bit wonky, as above. They're always 3-5 days early or 3-5 days late and they now last 5-8 days instead of 4-5 days.

Mood swings and anxiety, especially in the run up to my period where every little thing triggers off an anxiety response.

Heart palpitations around ovulation and in the week leading up to my period.

Hot flushes. They're not spectacularly bad but still unpleasant, usually happen just as I'm going to bed where I'll feel like I'm burning for 10-30 minutes and then I'm normal again. DH will feel my skin and tells me I feel normal temperature even though I feel like I'm on fire.

Hair loss, its getting thin on top and if I shave my legs it's a good 3-4 days before I start feeling prickly as it's slow to grow back.

Aching breasts, especially around my period, and mild digestive issues.

Low emotional tolerance, I've got no patience for anything, I get touched out and overloaded much faster than I used to, as soon as I start to feel stressed I go from zero to sixty with very little in-between.

Muscle aches and pains especially around my hips, ribs, shoulders, and back. Costochondritis. Low energy.

Hair on my top fucking lip because the universe is a shit show.

Dry skin and itching. Moisturising is now a nightly ritual otherwise I end up raking my arms and legs to pieces.

Forgetfulness. I go to the shop for one thing and come back with everything but, go into a room and forget why I'm there, go to tell DH something and forget what it was. I get brain fog anyway as I'm hypermobile but it's like it's levelled up.

GP was very thorough as I'm only 41. Referred me to the breast clinic for the boob pain, cardiac clinic for the palpitations, gastro clinic for rhe digestive issues, and did prettyuch every blood test you can think of including a CA125 antigen test. All came back normal. Thyroid normal, blood pressure normal, all smears up to date and normal, blood sugar normal. She said its very likely perimenopause and can last 10-15 years. She said its hormones waning and reconfiguring ready for menopause, much like they do in the run up to puberty. She recommended the patches to top my levels up and see if it eases the symptoms. I took Norihisterone last year for a week to delay my period and honestly felt the best I'd felt in ages while I was on it so she thinks that supports the theory that I need a top up. I have one type of patch that I use for two weeks and then another type that I use for two weeks, one has two hormones in it and the other has one.

Thank you @Jott that's really helpful.

It's so hard sometimes with peri to know one way or the other but your GP sounds like they've been very thorough.

I hope you get on ok with the patches, my GP is prescribing for me also although I don't have as many symptoms.

As a heads up, the chemist will charge you for two prescriptions even though its only one item. Apparently because they have two hormones in them, it counts as two prescriptions.

I've just been prescribed Evorel 50 and Utrogestan and was also confused about when to start the patches.

My GP definitely mentioned the Ultrogestan being day 14/15 of my cycle (I have regular periods) but I'm confused about when to start the patch as I've missed day 5. I only realised about this timing after scouring the leaflet and reading this thread.

I don't remember my GP mentioning anything particular about the timing of patches, I'm not sure if I have to delay the whole thing till day 5 of my next cycle. Presumably I shouldn't start the Utrogestan until I'm on the patches, I feel like I'm making lots of assumptions!

I can't speak to the GP for another 2 weeks.
Any advice would be gratefully received