I mistakenly went through two "cycles" (pellet insertions ~18 months apart) because a friend recommended it and I didn't know any better until I encountered Dr. Jen on We Can Do Hard Things and then bought & read the book.... I ran out of the progesterone pills a few months ago, and haven't slept well since: waking up hot, but mainly much lighter sleep without that pill. I'm 52.5-- can I start MHT correctly now with transdermal estrogen and oral progesterone... Or is it safe to just have the progesterone because of the SLEEEEEEEP that I need? No heart conditions, but 80y.o. dad had a clot in his leg.
Do you use the same considerations if a patient wants to initiate BC at a later age say 45 or 50 due to mood swings…or opt for estrogen patch+ prog pill instead at a certain age?
If someone is low risk you can start the pill or patch anytime before 55, but I think it would be unusual to start at 53. Then again, if someone is having regular periods and is at risk of pregnancy then it could be done. For mood swings it depends. If someone is still getting regular periods or their periods are a little closer together I would go for the pill, because that is more likely PMS worsened or starting due to short cycles than menopause and you want ovulation suppression. If someone's periods have started to space out then it would be reasonable to try an estrogen patch/lotion etc with a progestogen of choice, understanding that it could create bleeding issues. One way around the bleeding issues is a levonorgestrel IUD.
I mistakenly went through two "cycles" (pellet insertions ~18 months apart) because a friend recommended it and I didn't know any better until I encountered Dr. Jen on We Can Do Hard Things and then bought & read the book.... I ran out of the progesterone pills a few months ago, and haven't slept well since: waking up hot, but mainly much lighter sleep without that pill. I'm 52.5-- can I start MHT correctly now with transdermal estrogen and oral progesterone... Or is it safe to just have the progesterone because of the SLEEEEEEEP that I need? No heart conditions, but 80y.o. dad had a clot in his leg.
If you have an IUD, how will you know when you're in menopause if you're not getting regular periods?
Do you use the same considerations if a patient wants to initiate BC at a later age say 45 or 50 due to mood swings…or opt for estrogen patch+ prog pill instead at a certain age?
If someone is low risk you can start the pill or patch anytime before 55, but I think it would be unusual to start at 53. Then again, if someone is having regular periods and is at risk of pregnancy then it could be done. For mood swings it depends. If someone is still getting regular periods or their periods are a little closer together I would go for the pill, because that is more likely PMS worsened or starting due to short cycles than menopause and you want ovulation suppression. If someone's periods have started to space out then it would be reasonable to try an estrogen patch/lotion etc with a progestogen of choice, understanding that it could create bleeding issues. One way around the bleeding issues is a levonorgestrel IUD.
Thank you so much. That’s very helpful