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How to get hormone therapy done?

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Practicing since : 1999
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I am premenopausal. In XXXXXXX 2013 I had a 15 day period with severe bleeding after not having a period since January 2013. To regulate my cycle and prevent the heavy bleeding, my doctor prescribed Premarin .625 mg for 21 days followed by Provera 10 mg for 7 days. I had to wait for another period to start the HRT, which did not happen until December 2013. I have now finished the first 28 days of pills, but my period has not started. Do I wait to have a period before starting the next 28 day cycle of pills, or do I start up with the Premarin again?
Posted Fri, 14 Feb 2014 in Menstruation and Miscarriage
Answered by Dr. Timothy Raichle 1 hour later
Brief Answer: Hello, I would be happy to help... Detailed Answer: Okay, first of all, your doctor is giving you a course of hormone therapy that is usually reserved for women who are POST-menopausal. They are making some assumptions about your hormonal status and this is not necessarily the best thing for you. Here is my impression and what should happen: 1. You had a last period in 1/2013 2. 6 months later, you had 15 days of bleeding 3. 6 months later, you had a "period" 4. You then completed a month of estrogen / progesterone with no bleeding 5. You are presuming that you are PRE-menopausal because the definition of POSTmenopause is 12 months without any bleeding Here is the workup that should happen (before throwing more hormones at your uterus): 1. Any woman over the age of 40 with abnormal / irregular bleeding needs to see an OB/GYN 2. At that visit, you need an exam, an endometrial biopsy, and eventually an ultrasound 3. Once pre-cancerous or cancer related changes have been ruled out, then it is worth talking about ways to regulate your cycle 4. One of the simplest ways is to just put you on a low-dose birth control pill. 5. In most cases, this might be continued until the average age of menopause (51-52) and then stopped. I hope that this helps! Let me know.
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