HRT prescription

[EdinaTheConfessor]

Hi, can someone please help me with this.
I have been prescribed progesterone, one tablet to be taken each day on days 1-25 of cycle, and oestrogen patch to be changed twice a week.

I have only just picked up the prescription but I’m currently on my period, currently day 4.

Does this mean I have to wait until the first day of my next period before starting both progesterone and oestrogen? My periods are pretty erratic so I don’t really know when this is likely to be, I have completely missed a couple lately. Or can I start now? Hoping to get going sooner rather than later tbh.

Also, when would I start taking them again after the 25 days cycle has ended?

It’s unusual to be prescribed 100mg progesterone/day for 25 days, presumably followed by a 5 day break. It is usually either continuous (take 1 tablet every day, no break) or sequential where you take 200mg/2 tablets a day for 12 days a month, the idea being that you have a withdrawal bleed. This should be is set out in the instructions in the box. So I’d check that with your GP.

Otherwise, if your periods are irregular, I wouldn’t worry too much about when you start the patches. Just start tomorrow - eventually the HRT will be what guides any bleeding (if you are on a sequential regime).

Hi, I’m confident you can start today, and then just take the break (is it three days?) after 25 days.

I’m still on the cyclic progesterone but my GP has said I should consider swapping to continuous at some point in the next months and that for continuous it’s either 25 days on, 3 days off or just take continuously and it doesn’t matter which.

Thanks this is what the leaflet says. It doesn’t really elaborate on the 1-25 days cycle option which is what I have been prescribed (pics added but may take a while to appear)

thanks, this is what I was hoping for.

I have tried to speak to my GP but they can’t arrange a call back for over a week 🙄 so I have sent them a message but god knows when they’ll get back to me.

Been looking on line and it seems this type of prescription is usually for post menopause, whereas I am still peri. Hmmm hopefully the GP can clear things up

Can you ask the pharmacist? A prescribing pharmacist might be best placed to give advice immediately and ours can even help get GP calls when she thinks it’s justified.

I’m in peri as well but approaching 50 and my GP is suggesting moving to continuous so it’s not a hard and fast rule that you need to be menopausal (my GP is pretty clued up on this because she’s also going through it).

I’m 45 so only early days really. The GP was a little vague, asked me what treatment I would like, and I’m saying, well your the doctor so you tell me!

Plus he referred to my “lady hormones”

British Menopause Society guidance is that women over 45 should be offered a move to continuous HRT when they’ve been on HRT for 5 years or by age 54, whichever comes first.

That's an average though. Everyone is different. I went on HRT at 55, sequential, because I was still having regular periods.

Eh? Where do you get average from? It has nothing to do with averages. It’s guidance.

@EdinaTheConfessor It sounds as if your GP isn't up to speed and not aware of the 2 types of HRT- for peri meno or post meno.

At 45 and with periods you need the sequential type of hrt with progesterone 12 days a month (or you could have the Mirena coil.)

See this guide.https://www.menopausematters.co.uk/perimeno.php

This is what I’m now thinking. I have sent a message to the GP and awaiting a response, but I’m guessing it’s the same medication anyway, I just take 2 for 15 days rather than 1 per day?

It's 12 days not 15.

2 capsules every day for 12 days.

This is on the leaflet in the pack. It says 200mgs from days 15-26 of a cycle (that's 12 days.)

If your cycles are not regular, you can start on any day of the month but stick with that date every month (eg if you started tomorrow you'd do 4th Dec, then 4thJan and so on. This is what most consultants advise.)

Yes I understand I put the wrong number.

But either way that is not what was prescribed to me. Waiting to hear back from the GP. Hopefully a different doctor will get back to me than the one that did the prescription.

Be prepared to suggest they read the prescribing guidance for GPs because one may not be any more informed than the first.

I'm on 2x 100mg (200mg a day) for 14 days. 14 on, 14 off. Helpful when I can remember sod all and have no idea what day it is.

Just an update, a different doctor got back to me and have changed my prescription to 200mg 14 days on, 14 days off.

You can do 14 days if you want to but that's just so you 'remember it more easily' - that was the reason 14 days was introduced so women didn't forget. Medically, 12 days is enough usually as on the patient leaflet.
Hope you get on okay.

Glad you got sorted OP. I had issues with the first GP I saw who refused to prescribe it agains the menopause clinic guidelines. It’s was so odd. I did a tonne kf research and went back a year later and asked to speak to a specialist menopause GP. It is a good idea to find out if you have one at your surgery.