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[Shannonplussed]

I'm switching from continuous no-bleed estrogel & prometrium/micronized progesterone/utrogestan (exact same medicine, different trade name) to cyclical because I have been getting bleeds. Does everyone who uses utrogestan take it for 12 days, cycle day 15-26? And you always get a bleed? I have read that if you bleed before all 12 daily capsules have been taken, you're to continue to take all 12 days, and then count from the day you started bleeding and begin again at cycle day 15. And if early flow continues, then a higher progesterone and/or lower estrogen dose is needed. Now if you don't bleed, or bleed quite a bit later, do you adjust when you start taking it? At what point do you opt for long cycle? I've been searching the forum and all over the net really, and so many recommendations are super basic like "take for 12 continuous days in a 28-day cycle"...presuming everyone has a 28 day cycle. I'm in Canada, and Merck, the manufacturer, states in their product monograph to take it for 14 days, days 8-21, which seems completely out to lunch. Same product in Australia says 12 days days 15-26, same as UK. I'm apparently peri, and went 7 months without a period (I think a crazy long anovulatory cycle), so I'm trying to align this with my natural cycle which seems to have resurfaced with the progesterone. I have so many questions, but my dr doesn't know a fraction of what you ladies do!

[sheila99]

I have some experience of this as I have a natural 6 week cycle. My cycle is stronger than the hrt one so trying to fit it into a 28 day cycle results in bleeding at any time of the month, sometimes twice. So I use hrt to fit in with my cycle rather than the other way round. I can tell when I ovulate so I start 12 days utro a day or 2 after. If it's an anovulatory cycle I take it at 4 weeks. Could you do something similar? If you're bleeding at the wrong time it's probably because the hrt cycle is out of step with your own. Since doing it this way I haven't bled early, but I did a couple of times before getting it in step. I don't know if I was doing the right thing but I stopped the utro, my theory was that I'd produced enough prog of my own to cause a bleed (both times it was a proper bleed) and this way the hrt cycle would align to my own. Some people who are intolerant only take utro for 7 days but if you do it this way you should go for scans to make sure your lining isn't building up. I take a more relaxed view of a long cycle than some as my body has been doing it for 40 years and lining still thin before starting hrt. I think the  more important factor is that you have a proper bleed. But for me the most important thing was to get the hrt cycle to be the same as my own.

[Shannonplussed]

Thanks, this is great to hear. I don't think I've ovulated in a long time (I recall the signs, and continue to check for them). I'm not sure what my natural cycle is going to do, so I will start day 15 (which happens to be tomorrow) and go to day 26 and figure things out from there. I'm fortunate in that progesterone really agrees with me. Since stopping the continuous, I've been feeling terrible without progesterone, I'm literally losing my mind. I can't wait to take it again. One of the worst days of my life was the day after I stopped the mini pill to prepare for baby #2. The crash left me feeling like my blood was boiling, I was so full of rage. Scary. I have also struggled with PMDD in the past, the days just before a period. The last two weeks without progesterone have felt similar, so I can't wait to have a full cycle to hopefully get things running smoothly...as much as they can be during perimenopause