Confused - When do I take my HRT please?

[LLJETO]

Hi,

I’ve just been prescribed HRT this morning as per the photo. She mentioned about taking the progesterone on day 15 of my cycle..but does she mean my normal menstrual cycle or from when I start using the oestrogen gel?

And do I wait until my period starts to start the oestrogen or do I use it straightaway?

ETA - my last period started on 6th Jan, if relevant, and should be due another one soon.

Thanks in advance.

If you do a search (there are many of the same threads under your post SIMILAR THREADS ) there are lots of threads answering it.

Good luck.

Thanks. I’ve looked at about lots of the ‘similar threads’ and cannot find what I’m looking for.

Never mind.. I’ll see if the pharmacist knows and if not, I’ll ask to speak to the nurse again.

Sequential combined HRT- 3rd other thread at the bottom of the page.

The important thing is to keep to the same DATE each month regardless of your own periods.
You can't coincide your own periods with HRT because eventually your periods will be all over the place and you will go weeks or months without one.
HRT resets a cycle.
If you want to wait till 15 days from now, do that, but whatever that DATE is, start the next progesterone on that DATE.

@JinglingSpringbells JinglingSpringbells

If you do a search (there are many of the same threads under your post SIMILAR THREADS ) there are lots of threads answering it.

Such a pointless, dismissive, unkind reply. Mumsnet is all about asking people things. Do you go on a thread about "How do I cook broccolli?" and go "This has been asked before! Or just Google it!" 🙄Mumsnet is about people coming together to discuss things. And share their experiences with people that it might help.

Having said that, OP, I have no idea to the anser to your question! Because I am just beginning to realise that HRT might help me. (I am 59). And hopefully when I ask about it, and might be looking for some reassurance, I won't be told to "Just search Mumsnet!".

ETA I was so upset with the reply, I didn't do the quote thing properly 😳

Thank you. I did read that thread that Jingling mentioned but there were a couple of posts first that confused me even more so I didn’t get to hers.

OK! But you might want to try to repost the photo? I don't think you can on your first post on Mumsnet. But now you have more posts.

It’s not my first post! I don’t know why it didn’t post. I hadn’t even noticed…the brain fog is strong today.😂

Here’s the picture..fingers crossed it works this time.

I have similar prescribed to me. I take the progesterone on day 15 of my cycle (I track it via the apple health app) and then take it for 14 days. Then stop and start it again on the 15th day of my next cycle.

Thank you for replying..see this is what confused me…do you mean your natural menstrual cycle? Because mine can vary so much so that that wouldn’t work.

I think I get it now from Jingling’s second post. Basically use the oestrogel all the time and take the progesterone for 12 days on the same dates each calendar month. I might wait until February to start that then I know the start date is 15th. My only other question is do I start the oestrogel straightaway still, considering there are just under 3 weeks until the 15th Feb or shall I wait for a week or so?

Im hopig to get prescribed some HRT tomorrow, dont know what type, that sort of instruction above is really going to confuse me.

It doesn't really matter if you add an extra week by starting your gel now. If you prefer to wait a week that's fine too.

It's gel daily and 12 days progesterone every cycle.

You don't need start progesterone on the 15th.
If you do 2 weeks of gel from tomorrow, start progesterone 14 days later.

You create an HRT cycle, which overrides your own.

Gosh I've been doing it wrong then! I didn't have a period for three months and I just waited for it to come so I could get to day 15 again. I didn't take the tablets in all that time! So am I just supposed to take it every calendar month regardless? Or only do that if I don't have a period?

Brilliant, thank you. I will do that then. And then start the progesterone 14 days from tomorrow (10th Feb until 21st, inclusive). And then just to confirm, I will then take that starting on the 10th of every month thereafter?

It's much easier to just start on the first of the month, or the date you get it. My doctor now says take one every ryday instead of two for 14 days it's all the same dose over the month with no bleed which is preferable for me.

I’ve just started on the same regime. Doctor told me to wait until the first day of my period then start the gel then.

I just got told to start taking it straight away regardless. Even when it was changed to continuous hrt I didn't have to wait.

When I first started it I got an annoying 20 day period like which I'm assuming was the hrt taking control anyway.

I understand it that you should take it every calendar month for the 12 days (if that’s how your prescription says to take). This is to protect your uterus lining from becoming too thick.

As Jingling says, this will then create a HRT cycle. I believe you should get a bleed at the end of the 12 days of progesterone. This is with the caveat that it can take a while for things to settle down. So you may get sporadic bleeding for a while and it might not exactly follow the HRT cycle you’ve created at first but it should after a while.

I understand it that you should take it every calendar month for the 12 days (if that’s how your prescription says to take)

Just quoting this - by “if that’s how your prescription says to take”, I mean as opposed to daily which some people are advised to do.

https://www.nhs.uk/medicines/hormone-replacement-therapy-hrt/sequential-combined-hormone-replacement-therapy-hrt-tablets-and-patches/how-and-when-to-take-or-use-sequential-combined-hormone-replacement-therapy-hrt/

HRT trials all used a 28 day cycle.
Day 1 is usually the first day of your period so you could wait until then to start, if you have regular periods and a 28 day cycle this will be your best match timing wise. If your periods are irregular then start whenever you like and the HRT will become your cycle.

As a PP mentioned, using the same date each month helps remember when to start it, that does give a variable 30/ 31 day cycle (28 days in Feb!) but unlikely to be significant.

To a different PP.... yes you should take progesterone each month if you have a uterus.

Can I ask if you take estrogen daily, is that including the days you take the progesterone? Or do you stop it for those 14 days?

I was very confused too. My GP said just do 2 weeks on, 2 weeks off. Gel is everyday.

Yes, oestrogen every day including the progesterone days. There’s no break for that.

You use it for for 12 days every month ( a month can be 30-31 days.)
You don't wait for a period.

I think it's terrible that GPs are not explaining this, which should be telling you that -

Estrogen builds up your womb lining. It need to be shed every month to stop it getting too thick (which in the long term can lead to cancerous changes.)

Progesterone stops the effects of estrogen on the lining.
And each month when you stop the progesterone you will have a withdrawal bleed.

(This is the way for women not yet post menopausal. Women post menopausal use a different way.)

That's ok but GPs were advised (in their training on HRT) to tell women to do that to make it easier for women to remember.

The actual leaflet in the pack of pills says 12 days per cycle.
That's based on a 28 day cycle (but no one ever has a regular 28 day cycle) so using it every calendar month is ok.