When should I start HRT?

[Frankbutchersfangs]

Hi everyone,
Some advice would be greatly appreciated.

I have been in peri for roughly 5 years now (am 45). GP did blood tests which showed high FSH levels and prescribed oestrogen (gel) and progesterone (tablets). He said to start the oestrogen as soon as my next period starts. I am now on day 38 of my cycle and no sign of a period (not pregnant). I have messaged the surgery today and they have replied that I can start at any time in my cycle, and to start with progesterone for 14 days. My question is, do I start both for 14 days and then do oestrogen only gel after that?

I am really confused and anxious to start.......

Use gel every day. You don't need to wait for a period- just start it.

Ideally, it' s best to start Utrogestan mid-cycle as it replaces the progesterone you'd normally have at that point in a cycle. But with irregular cycles, that's not always easy.

Bear in mind that when you stop Utrogestan, you will get a fake period about 3 days later (not always but usually , although the first cycle on it you may not.)

A lot of private consultants suggest estrogen only for several weeks in order to get the dose right (when symptoms start to improve) as it's harder to assess this once you're also using utrogestan.

Thanks. So as Utrogestan needs to be taken at night - should I take both the estrogen and then Utrogestan tonight?

No, it makes no difference. Estrogen circulates in your blood stream 24/7, so it's irrelevant when you apply it. Just try not to miss a dose by more than 12 hours.

Utrogestan is taken at night as it can cause slight drowsiness or slight dizziness (it lowers blood pressure). Also, you can ignore the advice about taking on an empty stomach. The reason for this is it's actually more effective when taken with food but the side effects (above) can be increased sometimes.