Hi lucysavill
and the wild and wonderful world of menopausal women, symptoms, sweat, tears and laughter!
If your periods are only just starting to become irregular then you are still in early peri-menopause so this phase may last another few years yet - or maybe only a couple.
Yes as directed, if you start HRT you should have sequential preparations which give you a withdrawal bleed. 15 % of women do not get a bleed on sequi preparation according to the stats on this site but if you are early peri then you will most likely do so. If you stay on sequi HRT then you may always get a withdrawal bleed ( as I do in my 60's - unwillingly though - but because I don't like taking the progestgoen part all the time).
If you have been on HRT for some time, because 80 % of women have gone through menopause by age 54 (again according to stats on this site), then if you have started sequi HRT well before this age, once you reach 54 your doc can put you on a trial of continuous combined (no bleed - once it's settled) HRT to see if this suits you. You may well naturally go on to have periods until 55 anyway.
Combi tabs that are well tolerated are Femoston 1/10 or higher dose 2/10. If you want to have Evorel sequi then if the Evorel 50 patches are available then you can be prescribed Evorel 50 mcg together with Evorel conti and do two weeks of each. That's all Evorel sequi is anyway. You doc should know this.
Vagifem should not bring on a period - it's not that strong although with advanced VA (vaginal atrophy) the insertion can cause trauma and light spotting, although in your case if you are still having periods then unlikely. It wouldn't be a proper period if this happened anyway.
If you continue to have bleeding in between period or are worried about abnormal bleeding then do consult the doctor to get checked out further although this is a common occurrence during peri-menopause. In the meantime read as much as you can - on the menus on this website - and have a look at this article about peri-menopause too:
https://www.menopausematters.co.uk/magazine/pdf/Article%20-%20Perils%20of%20the%20Perimenopause.pdf The British Menopause Society has also produced some videos which are on Youtube now.
Hope this helps
Hurdity x
