Where the **** is my period?

[WearsMeJumper]

Am 51. On HRT (Evorel 75, progesterone 200mg two weeks/month) for around 3 years.

Fibroids, uterine lining 8mm (four weeks after LMP) at recent scan. Generally nothing of concern identified, though will have follow up in a few months.

But my periods are all over the place. Cycles can be 11 days or 53 (and counting).

I can cope just about with the unpredictability of bleeding, though it’s a nuisance, but not with feeling like my period is just about to start for three or more weeks in a row. I’m tearful, lethargic, anxious, exhausted; I have sore boobs, heaviness in my thighs and abdomen, generally feel like shit. Struggling badly in a job that needs me to be on top of my game all the time.

Is my HRT not right? Is it just age? Terrified that this somehow will end up being my post-menopausal self. A few days of this a month used to be countered by a phase of “normal” and a few days of shiny happy energy :-(

Perhaps time to move to continual hrt?

The usual reason is it's not enough progesterone.

On sequential HRT you should have a regular withdrawal bleed. You don't normally have 'periods' as such as HRT should override those and give you a withdrawal bleed roughly 2-4 days after finishing progesterone.

Has this never been the case?

A 75mcg patch is classed as 'higher'. So if you're not post menopausal and still have your own estrogen, you probably need to up the progesterone to 300mgs x 14 days.

This is guidance and explained in the British Menopause Society report 'Endometrial protection/ HRT'.

The other option is to have a Mirena coil.

You definitely aren't ready for continuous HRT because that's for women 12 months post menopause or age 54+. 100mgs of progesterone day isn't going to stop the bleeding- quite the opposite.

Has your GP not offered advice?
Are they aware of the guidance to increase progesterone? It's online- you can read it.

Thanks both.

HRT has never given me regular bleeds, so it’s really hard to work out what’s going on.

I was originally on Evorel Sequi, and changed to the higher dose oestrogen patch and progestorone tablets about a year ago because I was finding peri symptoms were creeping back in.

GP is pretty hands off. The recent scan and blood tests were scheduled without an appt after I submitted an econsult about the irregularity. It’s good that there’s nothing sinister going on, but after a lifetime of being pretty tuned in to my own cycles, I’m struggling with even knowing what to ask for.

I find it really hard to map the guidance to my own circs @JinglingSpringbellsbut that is a helpful gloss- I’ll ask specifically if prog should be increased.

There is info GP can access about irregular bleeding on HRT. The first is changing the dose or type of the hormones, which hasn't happened yet.

https://thebms.org.uk/wp-content/uploads/2026/06/01-NEW-BMS-GUIDELINE-Management-of-unscheduled-bleeding-HRT-MAY2026-D.pdf

Page 4 - 6 sets out the first steps of what to do.