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[alexia123400]

Hi there, new here. I’ve been started on 2 pumps of oestrogel continuously and 200mg of progesterone to take on cycle day 15 to 28. I have always had a regular 25 day cycle until i hit perimenopause and now my period comes anywhere between 21 and 26 days, still below the usual 28 day cycle. I made my gp aware of my short cycle however she still advised me to take progesterone on day 15 for 14 days. I have been having my period start on day 26 so i’m still taking progesterone when my period comes and a new day one of my cycle begins before i have completed the 14 day course. My question is do i continue to take the progesterone on day 15 as advised or should i start it on day 12 or 13. There’s no information i can find for women who have a short cycle. Any advice appreciated, hope this makes sense 🫨

I should add i am 44 and have been on hrt for 2 months.

[Hurdity]

Hi alexia

 

The 28 day HRT cycle is designed to bring the cycle back to the natural (avergae) 28 day cycle experienced by most women pre-menopause. Because the clinical definition of peri-menopause is when the cycle varies by ay least 7 days each cycle ie from one cycle to the next, HRT is intended to regulate that and ensure progesterone is taken regularly and the womb lining doesn't thicken, since many cycles at this point will be longer than 28 days.

So when women start HRT while still having more or less regular periods - ie before peri-menopause proper it seems to make sense to tie it in with your cycles - if shorter, and maybe even when longer, since HRT generally does not suppress ovulation and the natural cycle.

It sounds like you are almost there ie your natural cycle is beginning to vary though one of the features of the last stage before peri-menopause is for cycles to become shorter, which they seem to be doing in your case. This is called the late reproductive phase ( or stage?).

The thing is your periods won't stay like this - because after that stage you will start to skip ovulations and at that point it is important to take the progesterone on a 28 day cycle as recommended - but you may not necessarily know when this occurs.

AS you've only been taking it for two months your body hasn't settled into a pattern yet and you won't know what will happen to your cycle in future. It's only a couple of days difference so personally I would probably continue as advised . However if you do decide to shorten your HRT cycle to say 26 days then you would still take it for the required length of time ( the licensed dose is in fact 12 days), then you would start on day 13 instead of day 15.

Hope this makes sense but as I said - everything will change as you becone properly peri-menopausal with skipped cycles.

Hurdity x

[sheila99]

I had a natural cycle longer than 28 days so I  had the same dilemma. For me the 28 day hrt cycle just didn't work. My own cycle was always stronger than the hrt one though sometimes I had an additional hrt induced bleed as well. The medical advice is to stick to the hrt regime regardless but IMO it's given by someone who doesn't have to live with the consequences. It's fine once your own cycle is disappearing but I've found it very much better to alter the hrt cycle to be in sync with my own. My advice would be to stick to your own cycle length but you still need the 12 days utro so start it a bit sooner. My boobs get sore on prog so I was able to start utro when this happened and the two cycles remained in sync.

[GraceM]

If you cycle is not the same length each month then there is no sense trying to tie your utrogestan in with it.  Take it for 2 weeks on and then take a break for 2 weeks and continue this pattern.