Hi and welcome to MM Purplemushroomfairy
Hopefully someone like ''Hurdity will be along soon with advice - she has a science background so is good on these things.
What you have been given is great - a shame they didn't tell you how to use it!!!!
The patches should be used all the time (follow the instructions in the leaflet) and then the Utrogestan tablets are meant to taken orally for 12-14 days each month while still using the patches. You should get a bleed after you have finished the Utrogestan capsules phase. Here is the section on this site that explains how to use it:
http://www.menopausematters.co.uk/to_progestogens.phpYou don't tell us what your oestrogen levels are? What strength patches have they given you?
Some local oestrogen like Vagifem would be advisable alongside the systemic HRT to help with the VA - I'd definitely ask for this if you are uncomfortable down below.
I really think you need to be seeing a specialist gynae for advice on this. Regular checks on your hormone levels may be necessary. Do you get spotting or erratic bleeding?
Utrogestan should be used for at least 12 days (dose 200mg per day) to ensure the lining will shed properly. Under the guidance of a specialist gynae you may be able to use less but if you womb lining is building up so much, using less may not do the trick. Many women do use Utrogestan vaginally and find they tolerate it better that way.
Hopefully others wil be along with advice. Do read up all the info on this site to get clued up.DG xxx