Hi Lucyjo
Glad you've got some HRT but pity you had to go privately though
![Sad :(](https://www.menopausematters.co.uk/forum/Smileys/extended/sad.gif)
especially as apart from the testosterone cream the other hormones are available on NHS. Also surely your gyane must have given you some guidance as to how/when to take it? I am amazed if not!! How remiss of them!
Anyhoo - if you are post-menopausal and you don't want a bleed then probably start both at once. However if you are peri-menopausal you would start with the oestrogen only for 2-3 weeks and then introduce the utrogestan for however long ( licensed dose is 12 days x 200 mg). You can still do it this way if post-meno and don't want to take the prog all the time or if you want to see how your body copes with oestrogen only. Yes progesterone receptors are only activated in the presence of oestrogen as I understand but no problem with starting both at once.
If you intend to take both all the time ie no bleed continuous combined HRT for post-menopause, then if you started oestrogen only then your womb lining will build up a bit so when you start the prog - if you carry on without a break you might get some spotting until it settles - but you might get this anyway as spotting and bleeding is common within the first few months of taking conti HRT.
If you can make head or tail of that ramble then good luck and hope it works for you!
Hurdity x