Got HRT but nervous/unsure/confused about starting

[lechatnoir]

I've been prescribed HRT but not yet started: 2 pumps of Estadiol and 2 x 100mg capsules of Utrogestan for first two week of the month.

Am I right in thinking first 2 weeks of the month can literally be 1st-14th of each month (which will be much easier to remember) or do I need to wait until day 1 of my cycle?

Is it normal to feel apprehensive about starting? I'm in one of the easier stages of my cycle so currently I'm questioning whether it's really bad enough to warrant/worth the risks - give it a few more days I'll be feeling dreadful again I'm sure. Any words or advice or encouragement greatly received.

You can choose the start date for Utrogestan and stick to it each month.
BTW the leaflet/ dose says 12 days and the 14 days is usually for women who find they bleed too heavily on 12 days.

(Not sure why GPs are saying 14 days except to follow the same regime as for patches or tablet form.)

I don't think anyone can answer about your anxiety. It depends on what your symptoms are and how unbearable. You mention 'early stages of a cycle' which implies your symptoms are like PMS rather than millions of flushes are insomnia.

Be reassured that the research shows that Utrogestan is one of the safest forms of HRT and there is no added risk of breast cancer for at least 5 years.

You can stop at any time if you aren't finding it helps.

Thanks @JinglingHellsBells . I definitely don't want to take more than is necessary but dr instructions says 2 weeks which I took to be 14 days - will have a read of the leaflet which I haven't yet done .

Symptoms are similar to pms in that they follow my cycle but I'm increasingly having less and less good days and the bad days are awful with main issues awful brain fog, general lethargy, really low moods/flat feeling and lack of libido. I definitely don't want to carry on like this. i don't recognise myself - once life and soul of the party and now I just can't be arsed with anything and have become a short tempered and miserable old cow.

I felt the same about starting OP. Like you, my symptoms were like terrible PMS but getting worse and worse and taking up more and more days of each month. HRT has worked well for me so I would say it's worth a go. You can always stop if you decide it's not helping.

I think you may be on the same regime I’m on, 2 weeks on and 2 weeks off Utrogestan? You start this on day 15 of your next cycle.

I felt like you and was constantly fatigued. It made so much difference; the pain I was experiencing was 75% less on the first day.

I was due a period (they were v light) and felt so awful I just wacked it on. I skipped that period so ended taking the utrogestan about 2 weeks later. As I had no idea where my cycle was I followed the regime below which has worked well.

The point is to keep things memorable and simple afaik. www.liverpoolwomens.nhs.uk/media/3548/taking-utrogestan-patient-information-leaflet.pdf

So do you start the estrogen on Day 1 then add in the progesterone for 12 days from Day 15. That takes you to Day 26. Then what do you do? Do you keep the estrogen the same? When does Day 1 start again? Do you have to wait for a bleed?

Estrogen isn’t typically different dosages, it’s just a continuous thing, for me I have patches. Utrogestan you need to take a minimum of 12 in every 28 day cycle but some doctors prefer to prescribe 2 weeks on, starting on day 25, and 2 weeks off for ease.

Shit I can’t edit, DAY 15!!! Not 25!!!

See pic. This is via weeks, the other way is calendar month.

You have to forget your own cycle (but can start synched if you know where you are) but it can take a few months to properly sync. My cycle was thrown off course by hrt and then took 3 months to sync again.

I find it takes 7 days after stopping utro for my own bleed to arrive. So technically start the utro again on "day 11" of my "cycle" iirc.

My cycle is completely out of step with my HRT, so I am sticking to the starting on a fixed day every month, for 14 days. My actual cycle has settled down to something like every 35 days, so I find I am taking progesterone during my period at the moment!

@BigWoollyJumpers yes mine is late for the second time, not in a row, just odd times it goes 35+ days. I’m due to start Utrogestan Saturday and will do so regardless. I wish they just stopped and that’s it! At a set age 😂 this is annoying being all over the show

I attempted to move to continuous but also upped patches which was clearly too early. Too much constant spotting and bleeding So am back to cyclically but it's Alllll out of sync. Think I will
Be bleeding as I start utro next week!

Well a shit night's sleep, DS sending me to tears & shouted at my poor mum over some tough decisions all before midday so no question I won't be starting it - oh that blissful few days where you think you can muddle along and then BOOM it hits you again 😩

Unless I've misunderstood, the oestrogen/estadiol is a daily 2 pump no breaks and I start that the day I start the progesterone capsules. Still a bit confused about when to start those! I'm on day 20 of my cycle so due a period at some point in the next 5-10 day so should I wait for that or just start today and that will presumably reset my cycle.
I do prefer the idea of a set date each month and had planned on going with the 1st-12th of each month but what happens if I'm mid-period? And is it then ok to always do 1st-12th of each month regardless or should it be 2 weeks on 2 weeks off?

Got it I think, thanks all! I got the patches and utrogestan prescribed a couple of months ago but have been putting off starting it but think I need to now.

OP when you start it, you can start Estrogen at any time, then the first time you start Utrogestan if still menstruating regularly-ish, day 15 of the next period. Two weeks on, two weeks off thereafter, regardless of when you bleed. Your doctor will ask you at 3 month review how it’s going and once periods stop I think they do an ultrasound just to be sure your uterus lining is all good.

I do one pump in the morning and one before bed, otherwise that's a lot of gel to spread around.
I start my tablets on the same day of the month, each month and take them for 12 days. By day 11 my bleed starts.
It took at least three months for the bleeds to settle down - at first they were long and heavy, but now they are fine.
There are various schools of thought on the best way to do the tablets, but this works best for me.

The issue is, you can't tell when your periods stop, as you still get a bleed from the HRT. My GP has recommended 2 years on the cyclical before I can go to continuous.
Having periods again is the only real downside I've found with HRT, than goodness for period pants.

My doc has told me to take the utrogestan for 15 days and use the calendar to make it easy. So I take it 1st to 15th of the month.
My dose is only 100mg per day though - I wonder why I’m on half of what the rest of you are on.
This month has been weird. I had a bleed that seemed linked to the HRT but a few days later I seem to have regular period symptoms - sore breasts, low mood. My body is a mystery !!
But OP my sleep is almost normal and I have no hot flushes.

as you still get a bleed from the HRT

No, not always. People will still finish their menstruation years, you don’t bleed for all the years you’re on it necessarily. But once you’ve started HRT, in the OPs case it’s 2 weeks on, 2 off, from when you started.

@Sellorkeep so you are only on 100 but take it cyclically? Are you on a low dose of Estrogen? Were you still menstruating when you started HRT?

Thanks for your questions!
My periods were becoming increasingly irregular.
I’m on two pumps.

Have just started HRT after 7 years of no periods, am on 2 pumps estrogen and continuous dose of 200mg utrogestan daily ( day 1 - day 30). Is this OK? Or should I be doing 2 weeks on 2 weeks off?