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[tra72]

Hi was just diagnosed with the menopause yesterday went to the doctors and have been put on the gel and the tablets the tablets say to take from day one of periods my periods are all over the place. I have called the doctor and asked the pharmacy and they said that I  have got to  wait till day one of period take the 1-25 days then have a 3 day break I have tried contacting them to ask what happens if you don’t get one and how long to leave it for but no one seems to answer the question. Does anyone know please? Thank you making me really upset and anxious

[sheila99]

If it's likely to be a long time til you get a bleed I'd start them now then take the break when it arrives (or after 25 days if it doesn't).

[Dotty]

Hi if you are peri menopausal and still getting periods then the advice should be to take the Utrogestan ( 2 tablets )on days 15-26 of your cycle. Or if you’re not having periods to take 1 Utrogestan every day.

[Konijntje]

If your periods are too much all over the place, sometimes it’s just recommended to just take 2 every 1th-14th of every month. That way it’s easy to remember. Your periods might sync with this schedule or they might not. It doesn’t really matter for endometrial protection, as long as you take the correct amount every month.

So, you can experiment with what works best for you, 1 daily, 1 for 25 days and then a 3 day break, 2 for 14 days a month or 2 for 12-14 days out of 28 days (if you have a clear cycle).

[bombsh3ll]

There are multiple bleed free options that may be better for you than struggling with chaotic bleeding and trying to schedule sequential micronised progesterone, which I would liken to trying to time the stock market.

If you are under 50 a combined oral contraceptive pill taken continuously ie active pills every day can have you bleed free and hormonally stable, with usually a more generous dose of estrogen than MHT.

If this isn't for you, there are also bleed free oral progestins that you could take alongside your estrogen of choice, or the mirena IUS.

If you like having repeated episodes of vaginal bleeding, then I would just start the progesterone now rather than waiting for a particular "cycle day". This can be difficult to identify and risks undertreatment with progesterone.

Note that the dose of micronised progesterone differs between sequential (ie 12-14 days) and continuous (25 out of 28 days is also classed as continuous).

The sequential dose is generally twice as much as if taking continuously, although the overall quantity taken is virtually the same.

[tra72]

Thanks all for your help I am on 1 (1-25 days) I have got up this morning and have a slight light brown on tissue I had similar 25 days ago if you where me would you treat it as first day of period and start hrt?

[bombsh3ll]

The treatment should fit your needs, not you fitting it's needs.

I would just start it now and continue it as prescribed.

Trying to identify a particular "cycle day" can be challenging and can result in undertreatment, particularly with the progestogen as women wait for the "right" day and end up waiting weeks.

What do you think would happen if you took it on the "wrong" day, and is that worth all this angst?

[sheila99]

You can start oestrogen if you want. You can count this as day 1 but sometimes it turns into a proper bleed in a couple of days in which case day 1 is the start of the proper bleeding.