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[sheila99]

If your natural cycle is not 28 days should you adjust HRT to align with your cycle or force your body into a 28 cycle (in peri)?
Age 57, in peri. Natural cycle is anything from 5 - 7 weeks, usually 5.5 - 6. Before HRT I had four 4 week cycles (never had them that short before) then skipped one and stated Everel sequi at the next period. The first month felt as though my body was doing something (changes I would expect during a normal cycle), it hasn't done since. I have had 3 months on everol and am now in wk 6 of 2 pumps oestrogel/utrogeston so I have the opportunity to adjust the cycle length. My theory (which may be wrong!) is that the first cycle was aligned but now it's completely out of sync. I'm not sure if I can re-align it without stopping HRT but in an attempt to do so I am making this a 6 week cycle. Is this a good idea or not? Just wondered if I have enough progesterone with 12 days in 6 weeks instead of 4. The bleed that has just started is lighter than normal.
  It's possible my periods would have stopped without the HRT but the timing seems too much of a coincidence.

[CLKD]

Sorry can't help.  Really surprised that someone with HRT knowledge hasn't replied 

Is there any hint in the leaflet in the box or could you speak with a local Pharmacist? they have private rooms now.

[sheila99]

Good idea CLKD, I hadn't thought of asking a pharmacist. I suspect there aren't many women in my position as everything seems to be geared to a 28 day cycle. I think I'm just abnormal!

[Dancinggirl]

Hi sheila99
Sorry yo didn't get responses sooner.

At your age you are likely to be well on your way to post menopause - your own hormones will be fluctuating and declining so no true cycle going on. Evirel sequi would control the hormone levels and gave you a withdrawal bleed every month and this is not a true period but an induced bleed to shed the lining - this is very important as a thickened lining will result in erratic bleeding and a small chance of womb cancer.
I am doubtful that you own hormones will be having any big influence now but there may still be some fluctuations in oestrogen.

A pharmacist can be very helpful with many drug treatment but in this case they will simply look at the standard recommended dosage and cycle that is recommended by NICE so they are unlikely to be of help with your queries - they are not specialist gynaecologists. You can see the licensed recommendations on this site under TREATMENTS in the progesterone section. You are wanting to go off license so should really take professional advice.
When you switched to this new hrt regime you would have noticed some changes as it is different hormones and delivery. Some women  do successfully do a longer cycle in post meno - so 4 weeks of oestrogen only and then add 12-14 days of the Utrogestan. How heavy a bleed there will be will often depend on the amount of oestrogen you use or simply how much the lining builds up - we are all different. A longer cycle should be monitored really - so perhaps pay to have a scan annually.
It is early days with this new regime so you need at least 3 months for things to settle. I would advise you stick with a 4 week cycle for 3 months before trying a longer cycle or you may get some erratic  bleeding. Allow the body to adjust to this new regime with a standard 4 week cycle and maybe gradually increase the time between bleeds over several months.
12-14 days of Utrogestan is usually enough for a longer cycle(I was advised at least 12 days by my specialist gynae) to ensure a proper shedding of the lining but many women use Utrogestan vaginally to ensure it delivers the progesterone more locally, which can be more effective and can reduce side effects.
Most women doing non standard hrt regimes eg long cycle, are under the supervision of a private gynae.
Hopefully Hurdity will be along soon as she has long experience this regime so can advice you better.
DG x