Continuous HRT

[mrsnjw]

I have just switched from a tablet hrt to gel and progesterone tablet. I have now just got my period eleven days early. My last period was also about two weeks early. Is this normal? I thought I would go for longer between periods in the perimenopause! I just wished they'd bugger off now!!!

Are you post menopausal? Continuous is only for women aged over 54 or who have gone 12 months with no natural period.

Do you mean you are using continuous? That's a progesterone every day.

If you are in peri you should still be using a sequential type- estrogen daily and a progesterone (either in the tablet, patch) for 12 days per month.

Continuous HRT is not suitable for peri when you still have periods as it won't control the bleeding/ periods- the dose of progesterone in it is for women with no natural periods.

Did your GP suggest you changed?

I still get regular periods albeit a few days adrift early or late each month! I'm 50. Yes the gp said to take the progesterone tablet for 25 days and then have a 3 day break. I was under the impression that this regime would end my periods. Moods are much better on the gel I must say.

That regime is for women who do not have periods of their own, or very few (maybe 2/3 in a year.)

You may find that in time it will get into a reliable no bleed pattern, but what your GP has told you is contrary to the directions on the products, and also how they work.

Continuous is known to cause erratic bleeding for 6 months even when it's given to post-meno women.

Continuous HRT works when there is a fine balance between estrogen +progesterone (as in a prescribed form of hrt.

If you add to this balance, your own hormones (that are raging between low and high in peri) that's why odd bleeding occurs - because the amount of progesterone in 1 capsule of Utrogestan is not enough to keep the lining thin.

You can persevere if you want to, but the best way to get a predictable bleed is the sequential regime, using it for 12 days a month (2 capsules each of those days.)

Also, most women using it as continuous do not leave a 3 day gap each month as they rarely have any blood loss. The way it's used now for post meno women is every day (no break.)

Back to the gp I go then. This was the menopause gp x

On the plus side I'm not getting any cramping or migraines mid month.

I've got a similar issue as you I think, in that I've been on HRT for a year (I'm 49) and I've have had very regular cycle of approx 28 days for years, so taking progesterone on days 15-26 of the cycle was easy. And now my last 2 cycles have been 2-3 weeks apart.

So the thing is, if I keep taking progesterone on days 15-26 of every 28 days, it won't match up with the 2nd half of my cycle at all. I asked my GP last week and she had no idea, and suggested I start taking 1 tab 25 days out of every 30, regardless of cycle.

Jingling, since I'm still having periods and probably still ovulating, then do you think we should do 12 out of 28 according to calendar, not paying attention to now-erratic cycle? You always seem really well informed compared to my kind but not HRT-expert GP.

I think I'm going to go back to taking gel everyday and tablet day 14-28 and see if my cycle settles down x