Cyclic vs continuous HRT

[ChocolateTruffleCake]

Hi all,
I am confused about the benefits and risks of cyclic vs continuous HRT. My OB has me on Estrogel (3 pumps) and Progesterone (200 mg) continuous. But have been reading that I should be cycling Progesterone every 12 days.

Anyone have any advice?

The dose for continuous is 100mgs daily.
The dose for cyclical is 20mgs x 12 days per month.

This is on the leaflet in the pack of Utrogestan.

Cyclic versions are for women who are not post menopause OR for women who choose to remain on a cycle.

There is a slightly lower risk (according to research) of about 1% less breast cancer on cyclic.

typo-

200mgs for 12 days a cycle.

Thank you @JinglingHellsBells

I've seen your many very knowledegable posts, and appreciate your opinion.

In Canada, the pharmacy gave me my prescription of 100mg progesterone in a capsule bottle, with no information or leaflet.

I have a phone consult with my OB on Tuesday and will ask her about cyclic instead. It is tough, however, as I feel she is not very knowledgeable about menopause and HRT.

Thank you again!

Sorry - I do have one other question.

My OB raised my Estrogel dosage from 2 pumps to 3 pumps as I was still having hot flashes and insomnia. She therefore said she was going to raise my Progesterone dosage from 100 mg to 200 mg continuous.

Is this correct? Does the Progesterone dosage increase with Estrogel dosage?

Thank you for any advice!!

varying the dose has not been something I have come across. I can see the logic but you need to ask.

Thanks so much @JinglingHellsBells. My OB is a sweet, soft-spoken and very thoughtful woman, but I have real concerns about her knowledge of menopause.

Hi @JinglingHellsBells - quick query, as I am considering asking my OB (I have a phone consult next week) about moving to cyclic progesterone. How many days is the bleed and how heavy? Is it like a light period or much heavier?

Thanks very much!

To be honest @ChocolateTruffleCake I don't see why you can't do this yourself without asking permission. Especially when she seems to be prescribing the wrong amount for you anyway! :)
The patient leaflet gives the dose and...she's not working within that guidance.
Hard to say how long the bleed is as everyone is different. Mine isn't a good guide because I go longer than the usual 4 week cycle. But I get a couple of heavyish days and then maybe 3 days of light bleeding. The bleed depends on how much estrogen you use.
If you go to cyclic and stop the huge amount of progesterone you use, you may well be able to use only 2 pumps of gel.

Thank you for your reply @JinglingHellsBells! I wish you were a doctor because I trust your opinion more than my own gyne!! LOL.

I have asked for a referral to a NAMS menopause specialist gyne now, so will get this sorted.

Still shocking as to how many doctors do not know much about menopause or how to treat. SMH.

Thank you again my dear; you are such an invaluable resource on this forum.

Can anyone help. I’m 63, my periods didn’t stop until I was 56 which was quite late. Prior to periods stopping I got hot flushes and some night sweats - my doctor recommended HRT which I tried on and off but didn’t really want to be on them so came off. About 5 years ago the night sweats came on really bad - wet through in the night, couldn’t sleep and low mood. I went to the doctors and was given HRT in patch form - a life transformer! A couple of years ago I tried to come off the patch and doctor recommended antidepressants or blood pressure tablets which I didn’t want to take. Tried to come off the patches but my goodness the night sweats were horrendous. I went back on the patches and then about 9 months ago was advised to come off the patches due to time I’d been on them. Anyway 3 months ago I started weaning myself off the patches to the point that a month ago I was totally off them. 2 weeks later - here I am, night sweats and low mood - I feel terrible. I’ve been trying a herbal supplement called Menopause 73 but this has no effect whatsoever. Can anyone help - please??

Wondering why you are going off HRT? Clearly it works for you.

@charli126 Why have you stopped the HRT? It's clear you aren't coping without them so the question is are you worried about the risks? You didn't use HRT that long if you started in your early 60s.

Hi, been on the HRT on an off for over 5 years and doctor not keen to prescribe any more.

I suggest you find a new doctor. There are plenty of menopause specialist doctors on the NAMS website.

Also I urge you to educate yourself by watching YouTube videos by:
Menopause Taylor (an ob/gyne in the US), Dr Louise Newson (a specialist menopause GP in the UK) and Dr Heather Hirsch (an internist at Brigham & Women's in the UK) about HRT. And read "Estrogen Matters" by Dr Avrum Bluming! All excellent resources.

OOps - Dr Heather Hirsch is an internist in the US, not UK

Thankyou so much for that - it’s so helpful. I feel there’s hope now

Absolutely!! I suggest starting with Dr Newson's Youtube channel. She also has an excellent podcast (My Menopause Doctor). I just listened to a podcast she did with her mum, who has never stopped HRT.

Dr Taylor (Menopause Taylor on YouTube) has over 200 videos - very detailed, science-based and she goes over EVERYTHING including HRT and the misleading fears about it. You can also schedule a consultation with her. Her website is menopausetaylor.me

I have a consult with her in December!

@charli126 the guidance on duration on HRT changed 5 years ago. It's in the NICE guidance that there is no time limit. Your dr is out of date. As long as you have annual reviews of your hrt and no added risk factors, you can stay on it as long as you choose, once your dr explains risks and benefits.

Thankyou so much you have been so helpful. Looks like my doctor is in the dark ages!!

It is honestly extremely frustrating and disheartening that so many doctors are uneducated about HRT and menopause. My ob/gyne has made so many mistakes that I have decided to switch to a menopause specialist.

I was upset today because I just figured out that the dosage of ethinyl estradiol in the birth control pill that I was taking for two years was too low a dose to help with osteoporosis. Two wasted years of potential treatment. Grrrr.