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[Witchinghour]

Oh cripes!

I started HRT 8 days ago. (Estrogen patches and utrogestan). I'm on cycle day 21 and I've started my period this evening.

What do I do now?! Do I carry on taking utrogestan until I've completed 2 weeks?

[joziel]

Yes, you carry on until you've taken the required amount BUT (this is how I do it) you count today as Day 1 and you re-start the utrogestan on day 16, even if that is sooner...

That's how I do it to get it to match up with my cycle anyway.

[sheila99]

I start counting again at day 1 but I stop utro. It's the withdrawal of progesterone that causes the bleed (presumably of your own this time) so I don't see any reason to continue with it now the bleed has started. You might want to if it helps you sleep but it gives me fatigue.

[GraceM]

I wouldn't be switching up the days to tie in with periods.  You need a certain dose per month to keep the womb lining healthy.  If you are prescribed it for 12 days, then take them all, take a 16 day break and start again for 12 days.  Or if prescribed for 14 days, take for 14 and then take a 14 day break.  Trying to match it to periods wont necessarily work, as periods can become erratic during perimenopause, and may end up with you taking less than you should be.  Even if you start a period while taking the utrogestan you should continue taking the utrogestan if your prescribed number of days isn't completed.

[joziel]

You should for sure take the amount prescribed for the duration prescribed, but there is no risk to taking more than this... Which is how you get it to fit with your own cycle again.

Think about it: Your body naturally produces progesterone after ovulation, in the second half of your cycle. This is what taking the progesterone in the second half of your cycle is mimicking, day 16-26.

If things get off and you start to bleed during that, you can't stop the utrogestan or you might end up taking less than prescribed. (It's use is not just to trigger a bleed, we can't assume that, or you could end up taking less cycle after cycle if you keep bleeding early.) Instead, continue taking it but take it again from day 16 of your next cycle. This might mean much less time off it than usual but after a few cycles your body will sync if you keep following that.

This advice is also what is given by Prof Prior, see the diagrams: https://www.cemcor.ubc.ca/resources/cyclic-progesterone-therapy

[Hurdity]

I agree take the whole cycle of utro as prescribed. Bleeding can be caused by all sorts of reasons, not just the withdrawal of progesterone. For example if your lining was thickening then you may well start to bleed much earlier in the cycle, because the lining becomes more sensitive and unstable when thickened. If you are taking it orally then it is easier to complete the cycle. Taking it vaginally while bleeding is challenging because it may not be absorbed.

Hurdity x