When is day 1 of cycle on hrt?

[PollyIndia]

I have patches all through the month and utrogestan pessaries days 15-26. I have been starting my day 1 the day I get my bleed. Is this correct or is it better to start day 1 the day after I finish the progesterone? I haven’t been able to find this out online. Gp
wasn’t sure. Thank you!

HRT cycles are the same as our own without HRT.
Day 1 is the first day of a period/ HRT bleed.

Presumably you're starting Utrogestan on day 15, and having a withdrawal bleed around 3 days after the last tablet.

I take mine from the first to the 12 th if the month, and then my period is after us that right? Doctor said not to worry about cycle days go with the calendar @JinglingSpringbells

Yes bleed a few days after last pessary. Cycle doesn’t fit with calendar month at all though so not sure how that would work. Thanks for responses

The nurse told me to start on the 1st of the month when I changed HRT types but I kept to my cycle and just write on the box the dates I need to take the progesterone.

@Doggymummar @MiddleAgedDread @PollyIndia

Yes, starting on the same day each month is the best way to do it.

I was answering what @PollyIndia asked which was 'which is Day 1 ' of a cycle.

@PollyIndia I wasn't sure if you needed more info about when to start. It IS better to choose the same date each month. This is because eventually your own cycles won't be regular and you could go months without your own natural cycle.

HRT establishes an HRT cycle, which replaces your own cycles.

So whatever you've done this month it would be best to start Utrogestan next on ! February, then 1 March etc. It doesn't matter as a one-off if this is sooner or later than a month.

Thanks all. I'm currently waiting for my bleed (with HORRENDOUS pmt mood stuff - just feel so low and depressed!), so in theory take progesterone again in about 12 days. But you are saying I could just start it again 1st feb (which is only a couple of days off), then do same each month and the cycle would vary depending on the length of the month? I've been writing it down in my notes as things stand to track day 1.

Also wondering if the coil would get rid of the pre bleed awful mood stuff

Now that your bleed is due any day, wait till 1 March to start Utrogestan.

The cycle length will only vary by a day as all months have 30 or 31 days (except February.) This is not a problem.

An HRT cycle is 28 days. The numbering of the days is arbitrary, but its useful to start your HRT (the first time you begin taking it) at about the right time if you are still having periods, this minimises breakthrough bleeding by trying to follow your existing cycle. So when you first begin, you start patches on day 1 of your period and start Utrogestan on the 15th day of that cycle. After that it's continuous oestrogen with Utrogestan 12 days on/ 16 days off, over and over.

So if you take Utrogestan on days 15-26 then days 27, 28 of that cycle and then days 1-14 of the next cycle you don't take any... then repeat. The HRT will override your existing cycle, you can get some breakthrough bleeds while it's settling. Use every 28 days (4 weeks) not the calendar months or the next cycle's bleed to work out the day numbers.

There is an element of choice on this and what someone finds easiest.

Using Utrogestan on the same day each month is suggested by many medical specialists. It makes it easier to remember and the extra 2 days isn't relevant. If someone chooses to do a 30 day cycle they can take Utrogestan for 14 days not 12.

The 28 day cycle is based on the 'average' 28 day menstrual cycle that very few women have in real life.

With estrogen and Utrogestan, many doctors advise using the first day of the month for the Utrogestan. The extra day making it a 30/31 day cycle isn't important.

There are lots of posts on here where women have been advised to do this, by drs. (including me and my consultant.)

It's also possible to create a longer cycle with less Utrogestan with medical advice.

@JinglingSpringbells I agree there are all kinds of ways you can personalise your HRT... but it doesn't sound fron the question she asked as if OP is intentionally trying to tweak her HRT or is being advised to do so, rather that she's confused by what is meant by day 1 etc.

I agree, it's an artifical cycle (same as with cyclical combined contraception) but a reasonable starting point for most people. By varying each HRT cycle length as she was doing by making a new 'day 1' every time, it's less likely to settle into a regular pattern.

Thank you! I'm on about month 4 but I ended up just starting it as I didn't have a period for a few months. I was waiting when I got the prescription. So I have settled into a cycle. I just wasn't sure if I started day 1 the day after I finished progesterone pessaries or if I waited until the bleed came a couple of days later. I agree easier to track to the calendar month! I could do that. But also thinking about the mirena now just as I did not feel good at all with the progesterone pmt...

I started on cyclical Utrogestan like you but my periods had already been becoming very irregular for the last 18 months (as much as 4 months apart) and I have (last couple of months) gone to taking Utrogestan one capsule every day (instead of 2 for 12 (or 14) days) and it's pretty much eliminated the PMT feeling. I also haven't had a period during this time but I suspect they were on the way out anyway.

https://www.balance-menopause.com/menopause-library/utrogestan-micronised-progesterone-explained/

This is helpful explaining the different ways it can be taken.

I was told to start the HRT on day 1 (1st bleed) but then to continue taking it regardless of how my period cycle coordinated.