Cyclical Progesterone - keep forgetting

[nutellacrumpets]

I never really got of to a good steer with progesterone as I take it for day 14-28 and had to wait for a period.

But it has really affected cycles and I have wild and unpredictable bleeding. Sometimes at the end of 14 days sometimes just randomly. It’s quite annoying

But the main issues is keep for getting to take it. I know how important it is to take it.

I haven’t taken it for ages now. And need to restart it. But I agent had anything like a period in months too.

I know the IUD is an alternate. Or continuous.

Another question is how do you know when to switch from cyclical to continuous? Does the withdrawal bleed stop?

I was told not to time it with periods but to take from 14th to 28th of the month

Thanks- does this mean you have a withdrawal bleed and a period?

You need to talk to your GP.
How many months have gone by without using it? Is it more than 3-4 months of just oestrogen? What dose and type of estrogen are you using? Or have you stopped that as well?

You should maybe have an ultrasound scan because without using it the womb lining can build up and lead to irregular cells.

When you do start taking it you have to stick to the same dates each month not follow own periods. So if you started 14 days of it today, you'd start the next 14 days on 21 September (use your phone or whatever helps to remind you.) This sets an HRT cycle and a withdrawal bleed.

You can't use continuous until you're over 54, been on sequential for 12 months at least or no periods for 12 months.

Get a mirena!

Your cycle is likely to go a bit haywire when you are in peri so trying to time taking pills with it is never going to go well.

I was younger than 54 and had only been on the tablets for a few months when I had a mirena coil fitted. They are used for contraception in younger women, so not sure why @JinglingSpringbells says there is an age limit. After some spotting I haven’t had a period for about 8 years. Why would you want to persist with them or having to take pills every day if you didn’t have to?!

I think they try and time the insertion with a period but I think that is because it makes it a bit easier and less uncomfortable for you but it’s not essential AFAIK.

You're talking about something different. It's tablets and patches that have various guidelines

Having the mirena coil is not the same as taking tablets as continuous hrt.
The Mirena is available at any age.

Not all women want one.
I don't and have been offered it. Lots of reasons why but mainly dont want synthetic progestogen continuously and would rather stay with body identical.

In peri many women use sequential HRT and the packs of tablets or patches or gel/ tablets are used as an HRT cycle, not varied each month around your own periods.

I was the same as you - kept forgetting and had awful bleeding. As I'd been on hrt for a while, the GP said I could take the progesterone continously. I never forget now and no more bleeding at all

Pick a date - the first of the month this easiest to remember. Always take it from that date. Set a calender reminder if you need to.

And as PP said, if you've carried in with oestrogen while forgetting progesterone, check with your GP if you need a scan.

Use your phone calendar and put a recurring 14 day appointment in to remind you when you take them! I do 14 days of pills and 14 days of no pills so it’s easy to know when to change. But as I’ve you’ve not taken it for so long I’d speak to your GP or practice nurse first.

I'm on continuous, which is so much better. My menopause GP suggested it because I felt quite ill on my progesterone days.
This has been absolutely fine for me. I don't have any side effects and it's much easier to remember!!
I'm 47 and I've been on HRT since January.

Thanks @JinglingSpringbells I’m fem 7 50mg patches

I don’t really want a mirena as heard horror stories about getting access to have them removed can be problematic. I also don’t want continuous synthetic hormones in my blood and I want body identical- this stems from some awful experiences on the pill. Finally I think the insertion without pain relief is barbaric!

It sounds as though you may have misunderstood the instructions. You should be taking progesterone for 14 days of every 29 irrespective of whether you have a bleed. Eventually you may stop having bleeds and that's when you switch to continuous HRT.

I'm not a doctor so that isn't medical advice, you should check your NHS app to see if that clarifies the instructions for taking your HRT or speak to the pharmacist.

You should probably ask your GP if you should have any investigation as a result of going without progesterone for so long as is can be dangerous.

Just to champion the Mirena (obvs from my own experiences). I've just had my 4th or 5th Mirena inserted - originally I had them for contraception, now it's as the progesterone element of my HRT. I think it's the best thing ever - I can't remember the last time I had a period, I get absolutely no side effects (however, the grim side effects for a short period of taking oral progesterone had me hammering down the door to get the Mirena re-inserted). The hormone dose is less than oral, as it is localised, hence fewer side effects, and likewise, shouldn't replicate your experience from the pill. I always request local anesthetic for insertion, and it makes it so much better - in fact when the dr asked me at my recent fitting and I queried why anyone wouldn't have it, she said the same (seems barbaric not to), but she's obliged to ask.

Removal is easier than insertion, but yes, medical assistance would be advised. I was told that to have a Mirena inserted by the sexual health clinic in my area currently has a 12 month wait. That's insane!

@WorriedRelative

Eventually you may stop having bleeds and that's when you switch to continuous HRT.

Withdrawal bleeds continue on sequential HRT as long as you take it whether to age 49 or 79. (some women do choose to carry on with sequential as daily progesterone can produce too many side effects.)

Estrogen makes the womb lining grow, progesterone reduces the effects on the days it's used, and when it's withdrawn, the lining sheds.

So, the answer is to take Utrogestan each cycle.

I've not read all your updates here but if you've missed progesterone for months you do need a scan so see your GP.

Has the info here about when to start progesterone and carry on with a regular cycle helped?

Yes fantastic thanks. I’m a bit embarrassed and feel a bit dim! but I have made an appointments at the menopause clinic next week.

I knew how to take it but it was confusing with my cycle and random bleeds and it never synced so I’d have a bleed and then a whithdrawal bleed anns sometimes no withdrawal bleed and end up terribly confused. I should have started on the first of the month and take it for 14 days that would have been much easier.

Having thought all this through and going to the GP will confess to my sins and then ask for a TVUS and then I will consider a mirena.

I’m on continuous at 42 with a mirena also. Didn’t know you should be older to be on continuous but I do have endometriosis

Don’t expect your bleeding to fall in line with the progesterone cycle, even if you start taking it in line with it! My cycles vary from 21 days to 35 despite sticking religiously to 14 days on/off.

@triile I did reply to another poster that this doesn't apply to the Mirena. Only tablets or patches for the progesterone.

Do you get a withdrawal bleed as well?

Yes, that’s where I get the cycle lengths from!

Hi op.

You can get a mirena withdrawn in any GP appt. My GP promised to take mine out immediately if I didn't like it. you literally cough while they pull.

And Re having it put in, you can get it down at private GPs for around £350 which is what I did last time. Some gynaes will do it in private hospitals too.

After a year of sequential I was told I could move to continuous, despite still having periods. Much easier.

Oh I meant I’m on continuous progesterone AND the mirena. Probably wasn’t clear!

Because you have endo, that' s why.