Not at all thick! Perfectly reasonable question - we all babble on about stuff we've been talking about and doing and it's only when someone comes and asks that we quite rightly need to explain!
The average normal menstrual cycle is 28 days usually described as a month but actually 4 weeks. This cycle is counted from the first day of the bleed which counts as Day 1 and the cycle lasts until the start of the next bleed ( a new Day 1) - so especially when peri-menopausal can be very variable in length. As I said the start of the cycle is determined when your bleed starts.
When you get to post-menopause you don't have a menstrual cycle, but when you take HRT you have an artificial one if you take cyclical or sequential HRT (ie oestrogen only for part of the month and then oestrogen and progestogen for the rest). The cycle length is the total time for one round of HRT ie the oestrogen only followed by the combi pills. Most combi cyclical HRT maintains the 28 day ( "monthly") cycle apart from Tridestra which is 12 weeks I think.
Many of us who do not like taking progestogens and are post-menopausal ( so random bleeds don't keep getting in the way!) opt to have a longer cycle - under supervision from the doc as there can be a danger of the womb lining over-thickening on these regimes - depending on the oestrogen and progestogen doses. Women who do this commonly take oestrogen and a progestogen separately so as they can tweak the cycle themselves (with doc approval!).
So - a 3 month cycle is the total time you take oestrogen only + the combi pills. For those few who do a 3 month - or more usually - a 12 weeks cycle - it would be 10 weeks of oestrogen only followed by 2 weeks of the combi oestrogen + the progestogen. That's it!
In fact most women who vary their cycle usually date the start of the cycle from the first day of taking the progestogen and the total cycle length would be from this date until the first date you start the next course of progestogen - irrespective of when you bleed. In my case for example I do a 6-8 week cycle or even a 2 month cycle (depending on what commitments I have). So - for a two month cycle - if I take my progesterone for 12 days starting 1st April, then I next start taking it on 1st June. A 6 weeks cycle is correspondingly shorter. The full 3 months would be very easy - just pick a date in the month to start the prog and then 3 months later you start the next course. Not many women will be doing this though I doubt unless on very low doses of oestrogen.
However in terms of monthly bleeding, irrespective of what the actual date it is, Day 1 is always the start of the bleed.
Hope this helps and is not too long-winded?!!!
Hurdity x
