Hi there pearl59
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The average age of menopause is 51/52 and 80% of women will have gone through menopause by age 54 ( if IiI'm remebering the stats correctly) - not sure if that just means in the western woorld? However that means 20 % will experience it in the years following - and you are one of them!
It is usually to prescribe continuouis combined HRT to women who have reached menopause - but as you probably know that means having not had a natural period for 12 months so strictly speaking you have not got there yet!
As your menopause is late, have you had any checks to ensure everything is OK in terms of uterus lining? I am sure your doctor will have thought of this already.
When you say you have just finished the Evorel sequi - do you mean the whole of the first packet or the first month? Some women do react badly to the progestogen part of HRT especially the synthetic ones as in Evorel sequi ( which is norethisterone). Also some women also react badly to the changeover - the progesterone withdrawal phase which occurs after stopping the combi patches and going back to oestrogen only.
It is usual to try each HRT type for 3 months before deciding it's not for you so you could find the side effects settle although if it is the progestogen you are sensitive to then maybe it would be bad each month?
You have been given a very low dose of tablet HRT now and this may not be enough - but perhaps good idea to try it and see how you get on. However as your last period was in June you don't know if you are post-menopausal so if your hormones do breakthrough you could experience the odd bit of spotting or bleeding. It is unlikely to stop your periods if your cycle is still strong but it depends how far into peri-menopause you were eg if your periods until last June had been very occasional then you might well be at or very near the end!
Re when to start - if you had a small bleed - I presume this was after stopping the end of the Evorel sequi for one cycle? This would be a normal withdrawal bleed so you could start them straight away. but as I said if your periods are still fairly regular then anything could happen re bleeding!
If you find you can tolerate the progestgoen then there is a higher dose available ( 1 mg) but some women do find continuous combined HRT is not good in terms of mood since if you are sensitive to synthetic progestogens (even the ones closest to our own as with the Femoston), they can experience continuous low grade side effects.
You won't know till you try so why not give it a go?
Let us know how you get on
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Hurdity