Standard hormone replacement therapy (HRT) schedule
Hormone replacement therapy (HRT) can be taken on a continuous or cyclic schedule and in a higher or lower dose. Typical schedules include the following:
Cyclic HRT
- Take estrogen for 25 days each month and progestin for 10 to 12 days each month. No medication is used for 3 to 6 days per month. Menstrual-like bleeding (withdrawal bleeding) is expected during the period when no medication is taken.
- Take estrogen daily and add progestin for 10 to 14 days per month.
OR
Continuous HRT
- Take estrogen and progestin daily.
- Apply a transdermal patch twice per week to an area of the body not exposed directly to the sun.
Women experience different bleeding patterns with continuous HRT than with cyclic HRT. If one schedule causes unpleasant side effects, trying another schedule may improve symptoms.
- Irregular bleeding is more common with continuous HRT during the first year.
- With continuous HRT, one-third of women do not experience bleeding, many women stop monthly bleeding after 2 to 3 months, and most women stop monthly bleeding after 1 year of therapy.
- Continuous HRT causes fewer premenstrual-like symptoms than cyclic HRT.
- Continuous HRT causes fewer side effects in women who are several years beyond menopause than in younger women.
- With continuous HRT, women who are treated with higher doses of progesterone (5.0 mg) have the fewest episodes of bleeding.1
- Cyclic HRT causes most women to have predictable withdrawal bleeding, which can continue for years. Perimenopausal women may tolerate cyclic HRT better than continuous HRT.
| Author: | Kathe Gallagher, MSW Carrie Henley | Last Updated: August 4, 2006 |
| Medical Review: | Joy Melnikow, MD, MPH - Family Medicine Tom Bailey, MD - Family Medicine Carla J. Herman, MD, MPH - Internal Medicine | |
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