Hrt advice please!

[tackytriceratops]

Started in October 37.5 patches and cyclical utrogestan.

When I started I skipped a period. Felt a lot better, a few symptoms still lingering.

Booster brought in a period and then I seemed to be roughly regular with the fortnightly on and off use of utrogestan.

Then I caught covid and really struggled with the aftermath for 4 months. At My 3 month review (about a month after covid) I went to a 50 patch.

I couldn't get 50s so did an alternating mix of 2 25s and one and a half 37.5s. So either 50 or 56 in total each patch change.

The period before last was barely there and this one is now 2 weeks late thought I've felt like I've had period paints on and off. So I'll be starting utrogestan on Tuesday.

Is this an indication to move to continuous utrogestan? Or could it be to do with the fluctuating 50 / 56 dose in patches? I definitely felt better on 56! Prior to hrt I was having a period every month, it's just it could vary between 25 and 30 days and was getting lighter and lighter.

I've hat hot flushes, night sweats and joint pains too so I want to go up or try testosterone.

Bumping for you.

Thanks - personally I think I just need to go up and see what happens 😆

I think when I go up for some reason it stops my periods anyway. I suppose if they're still being irregular it's whether continuous progesterone is actually safer.

If you are using Utrogestan on a cycle, the bleeding is not your own period, it's a withdrawal bleed that comes when you stop the Utrogestan.

Not all women have a withdrawal bleed every cycle. Most do, but something like 20025% don't.

It also depends on how much estrogen you are absorbing. Also, using Utro for 14 days is a lot (the leaflet says 12 days) and the more you take, the less build up to the lining= light bleed or no bleed.

I think you have to forget about your own periods and now think of them being controlled by the HRT cycle. You should be on a cyclical regime for at least a year before trying continuous as otherwise you might get bleeding at odd times.

Sequential /cyclical is actually safer re. breast cancer as the risk increases the more progesterone is used.

• 20-25% don't bleed on the cyclical sort.

Ah ok thanks Jingling.

Gp originally said to do day 1-14 per month or mid month for 14 days. I'd been doing 12 days over 4 weeks as I found it easier to the and my normal cycle was always 25/26 days. but it was still taking a week or more before a bleed so I switched to what she'd originally said when the 1st of the month happened to line up.

I've actually started my period today. Id doesn't seem heavy. And should be starting utrogestan on Tuesday if following calendar or today if following fortnightly, so not really sure what to do.

(This will sound bonkers but when I tried seed cycling for a year my cycle skipped two weeks to match the mood cycles which is what it's done. Yes that sounds bonkers!)

What would be the purpose or result of going to a continuous regime?

I'll do 12 days from now on though.

I also don't know if there'd still issues from covid - I've only started to feel the symptoms from that lift in the last two weeks, after 4 months.

I know Dr Panay says that covid can affect both own cycles and hrt for 3-6 cycles.

(Moon cycles that should say above. )

That's very interesting, I'm also on cyclical hrt and my previously very regular monthly bleed has been all over the place since I had covid in March. In his opinion should I just stick with cycle and hope it returns to normal?

Sorry quote function fail, Dr panays covid comment very interesting.

Yes I'll find the link.

For me though I don't know if this is me getting worse or after effects of covid.

Either way I do feel I need patches increasing which from experience may knock it all again.

I've just read the leaflet again and will go back to the 28 day regime.

Im just not sure whether to wait a week from today (day 1) before re starting utrogestan. I have a review in a week where I hope to raise a patch. Would feel happier if utrogestan was later in cycle.

Diane did a video with Nick Panay that covers covid:

m.youtube.com/watch?v=POpIyVB49wQ