Stupidly took norethisterone on top of HRT, now what?

[RunVelma]

Started HRT for peri-symptoms back in Nov. (Evorel Sequi). I still get regular periods. My period was due to arrive last Friday but as we were going away for a few days I wanted to delay it so took norethisterone. I usually keep a stock in the bathroom cupboard incase me or my daughters need it for holidays etc.

Took my last tablet on Sunday night and expected my period to arrive on Monday or Tuesday as it usually would. Still nothing today though and a quick google informs me that I shouldn’t have taken it as I’m on HRT.

Now what? I am due to apply my next patch (progesterone) on Sat, then on Tuesday start a new box. My cycle was out of cync with my patches (partly because I occasionally forgot to change my patch, and also because I have a shorter cycle. GP said this didn’t matter as long as the HRT was working for me).

Any idea when my cycle will return to normal?

And why am I not supposed to take norethisterone as well as HRT?

Hi there, it isn’t recommended as—it’s a strong synthetic progestogen that can interfere with your HRT balance and result in too higher dose of progesterone which can cause side effects. It may cause mood swings, bloating, headaches, and even increase the risk of blood clots.Always check before combining hormone treatments—you deserve the right balance for “you”.

Be careful, and your body will return to its “new” normal in time. Don’t forget me trial cycles eventually stop anyway. But unless you get any severe cramping or unusual bleeding or new symptoms please see your gp. X

@RunVelma It's not going to do you masses of harm taking more Norethisterone for a few days but if you even want to delay the withdrawal bleed there are easier ways to do that. The amount in HRT is tiny so adding a bit more isn't a huge risk.

If you want to delay your bleed, you can either use the estrogen only patches for a bit longer or take more of the combined patches for a few more days, so you're getting the Norethisterone in those.

You might be confused over what HRT does- you're no longer having your own periods. The bleed you get is the withdrawal bleed created by HRT and this will continue as long as you're on that type. If you're not getting the bleed at roughly the same time each HRT cycle, talk to your GP.

You aren't supposed to use patches to follow your own periods.
HRT creates a new HRT cycle and you should have the withdrawal bleed at the same time every 4 weeks, usually 2-4 days after the last patch with progesterone in it (it might be out by a day or so but not much more.)

If you forget to change the patches on time you may get spotting when you don't expect it, especially if you've missed a patch containing progesterone.

Now, you need to restart the patches, with the estrogen only ones and complete the 4 weeks in the box in the order they come in.

Thank you both for your input. It’s very much appreciated.

My period arrived today, which is a relief.

I am getting my bleed at roughly the same time each cycle, as it’s usually 26 days give or take a day or two. Have never had any spotting.

However, my bleed isn’t happening a few days after the last progesterone patch. In fact, if I hadn’t taken norethisterone, my period would have arrived on day 4 of progesterone patches with another 11 days to go.

@RunVelma It’s good to hear your period has arrived and that your cycle usually remains fairly regular! Accidentally taking norethisterone on top of your HRT shouldn’t cause long-term issues as I said, but it might have temporarily influenced your cycle timing.

As long as your cycle remains roughly predictable (26 days, give or take) which you said it usually is and not excessively heavy or prolonged, it’s likely just a sign of ongoing hormonal adjustment.

Some women find their own cycle still overrides the HRT-induced cycle for a while before settling.

If bleeding becomes erratic, prolonged, or very heavy, it might be worth discussing with your GP to review your progesterone dose/type.

If your cycle keeps arriving too early during your progesterone phase, you might need a tweak in your HRT regimen.

But since your period has come and things seem to be ok, there’s no urgent concern—unless anything changes as I said before or if it keeps shifting unpredictably, a GP review might help fine-tune things. Hope that reassures you a bit! X