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[Penguin]

In the HRT section of the NICE guidelines (updated 2022) it says, under the section titled Regimen:

For perimenopausal women, monthly or 3-monthly cyclical regimens may be used.
A 3-monthly regimen may be more suitable for women with infrequent periods or who are intolerant to progestogens. See the section on adverse effects for more information.

Can anyone advise what that means please, as I thought we had to use progesterone every month and couldn't do it over a longer period? They also don't mention which type of progesterone can be used in that way. I'm confused 🤷‍♂️

[Dotty]

A tablet called Tridestra is one that’s used for long cycle hrt.

[Penguin]

A tablet called Tridestra is one that’s used for long cycle hrt.

Thanks Dotty, do you think that's the only one? And that utrogestan can't be used in that way? I had my hopes up there for a minute 🙈

[Dotty]

I believe this is the only tablet available on a long cycle.

I know there are ladies on the forum who use Utrogestan on a long cycle, but I can’t offer any advice on this. Perhaps they’ll be along to help you. x

[Penguin]

I believe this is the only tablet available on a long cycle.

I know there are ladies on the forum who use Utrogestan on a long cycle, but I can’t offer any advice on this. Perhaps they’ll be along to help you. x

Thanks. Just read up on Tridestra, don't fancy that at all, really don't want to take anything orally. Back to the drawing board!

[Hurdity]

Long cycle HRT went out of favour a while ago, due to some adverse research, notwithstanding that Tridestra is commerically available for just this reason. Some women ( myself included) have gone on to longer cycles with the approval of their doc - though mine have never been 3 months. I used to do two monthly cycles but thickened lining means I've now reduced to 5 weeks - and I don't like it!

If you are very late peri or post-meno then you may be able to get your doc to agree to a longer cycle though ideally you should be monitored ( regular scan) to ensure the lining is not overthickening. In practice the NHS will not order a scan unless there is a clinical reason ie abnormal bleeding.

Hurdity x

[joziel]

When we say 'longer cycles' here, what are we meaning? We keep taking the progesterone for longer than 26 days and don't bleed so often? Or there's more time off the progesterone? Which bit is longer...?

[Hurdity]

Sorry joziel I wrongly assumed everyone knew. Longer cycle means a bigger gap between the progesterone part of the cycle so longer time of oestrogen only. The Tridestra tablet has 10 weeks on oestrogen only and then 2 weeks of combi tablets with a progestogen. The longer the cycle the higher dose of progestogen or slightly longer duration - would be necessary to protect the womb because it is dose-dependent ie the progestogen dose/duration is dependent on the dose of oestrogen ( and of course how well you absorb it)

Hope that clarifies

Hurdity x

[Penguin]

Long cycle HRT went out of favour a while ago, due to some adverse research, notwithstanding that Tridestra is commerically available for just this reason. Some women ( myself included) have gone on to longer cycles with the approval of their doc - though mine have never been 3 months. I used to do two monthly cycles but thickened lining means I've now reduced to 5 weeks - and I don't like it!

If you are very late peri or post-meno then you may be able to get your doc to agree to a longer cycle though ideally you should be monitored ( regular scan) to ensure the lining is not overthickening. In practice the NHS will not order a scan unless there is a clinical reason ie abnormal bleeding.

Hurdity x

I don't think I'm late peri. Before starting hrt at the end of last year, my periods were very light lasting only a couple of days and closer together. I guess I will see what happens to them now I'm stopping hrt but I have had regular bleeds like clockwork all year within a couple of days of stopping utrogestan, and last couple of times on the last day of taking utrogestan. I am going to see a private doctor in January as a last ditch attempt to see if they'll let me try a longer cycle with supervision, I can't cope with the current required 200mg for 12 days, so its either a longer cycle or the coil or no hrt I guess.

By late peri do you mean periods few and far between?