How worried do I need to be:pregnancy risk

[Airconismyking]

I’m in peri, aged 52 on continuous combined but still having fairly regular periods.
last cycles have been 32, 49, 56, 46, 38 and currently day 25 in this cycle.

Contraception is condoms but it came off last night. We are abroad without access to medical care for MAP and not home for another three weeks so too late for an IUD.

How much risk is this at 52? I feel like it’s potentially the worst part of my cycle.

can anyone reassure me that it’s low risk for a one off at my age?

I previously conceived easily with this partner but 20+ years ago.

Very low risk

Thank you! I’m really panicking but can’t actually do anything about it

Very low risk I think. But not impossible. However you clearly can't do anything about it at this point so no point in worrying really. Perhaps take a pregnancy test if next period isn't as expected and think about another method of contraception for the future.

Very low risk and even more unlikely you'd carry till full term if it occurred @Airconismyking

But...
I’m in peri, aged 52 on continuous combined but still having fairly regular periods.
last cycles have been 32, 49, 56, 46, 38 and currently day 25 in this cycle.

If you're in peri why has your GP prescribed continuous combined HRT? Is there a reason?

This is for women who are post menopause or who maybe have had a couple of periods in a year and are over 54. See this link.https://www.menopausematters.co.uk/postmeno.php

POST MENOPAUSAL -
Continuous combined therapies.
"Period free" or continuous combined therapy can be used by women who are 54 + yrs, or more than one year since last period at any age. The criteria should be fulfilled in order to offer such treatment to women who no longer have a continuing ovarian cycle, so that steady levels of both estrogen and progestogen can be achieved.

When there are steady levels of estrogen and progestogen from daily administration of both, the womb lining stays thin.

Although some bleeding in the first 6 months of therapy is common, there should not be bleeding after that and the lining does not go through the stages of stimulation and then shedding as it does during a normal cycle and with sequential therapy. Start with low dose preparations and increase as necessary for symptom control.

Your GP would normally prescribe sequential HRT which gives you a regular bleed each month (not a period- it's withdrawal bleed.)

@JinglingSpringbells my understanding is that CC is the safest regime but usually not tolerated by women having regular periods as it can send a cycle haywire. But that over 51 or after a year on HRT it’s worth a trial to see if it can be tolerated. If not you can just switch back to sequential.

The link I left and the quote is by Dr Heather Currie, consultant gynaecologist, NHS.

Continuous combined HRT has a higher risk of breast cancer compared to sequential. There is hardly any difference in endometrial protection if sequential is used as prescribed.

Continuous combined is the 'bleed free type' and doesn't send a cycle haywire. It just doesn't control your normal cycle if you still have periods.
This is because the amount of progestogen is too low. After 6 months on continuous combined, if you're still bleeding the advice is to use sequential.

The 'over 51' is more for women in late peri (see above where it says over 54.)
The 'year on HRT' applies if women have very few periods ( 2 or 3 in 12 months) before using HRT.

You're not getting any benefits of continuous, which is a choice for women who want a no-bleed type.

@JinglingSpringbells

I believe it is more nuanced than that and the increased breast cancer risk is very minimal given the overall doses of both hormones are the same on either regime (I have no additional risk factors) whilst the increased risk of endometrial proliferation with sequential increases over time.

i am 52 but had been on HRT over four years when we decided to try and switch to continuous and I have tolerated this fine with no irregular bleeding.

https://www.drlouisenewson.co.uk/knowledge/sequential-and-continuous-hrt-whats-the-difference

It's not to do with the dose, but that sequential reduces proliferation as the breasts get a 2-week 'rest' from the progesterone.

i am 52 but had been on HRT over four years when we decided to try and switch to continuous and I have tolerated this fine with no irregular bleeding.

last cycles have been 32, 49, 56, 46, 38 and currently day 25 in this cycle.
On combined continuous there is supposed to be no bleeding at all.
Would it not be better to do a 4 week cycle with sequential so you get a predictable withdrawal bleed?

Anyway, this wasn't your question so I'll back out now!