My cycles have changed since I?m on progesterone.

My cycles have changed since I?m on progesterone, and I do not know where I should be taking my breaks.

This is very common. Cycles have been known to lengthen or shorten while on progesterone treatment. We generalise with women and state that as long as there is a regular cycle occurring with a rhythmic break from cream, then your periods will come and go according to your unique profile, varying slightly by a day or two, here and there.

One woman in her early fifties - we’ll call her Frances - used to have a 28 day cycle. She stops her progesterone cream at day 26 and has a 5 day break because she suffers very high PMS.

Frances has found that when she recommences using cream on day 5 her period arrives on day 6, which ultimately means her cycle has lengthened. Nonetheless, this works for her, and she has maintained asymptomatic (symptom free) estrogen dominance. Frances is reluctant to take a longer break purely because she really does feel different when she is not on the progesterone cream.

This woman has come to understand her body’s rhythms and that she will have her period the day after she starts the cream. When it’s all said and done, your body will find it’s own cycle. You just need to make sure you have a rest from progesterone cream 5-7 days every month (12 days break is ideal if you can cope, as it is true to nature’s rhythmic pattern).

In Frances’s case, the break from cream is not bringing on her period as she believes. What’s really happening here is a 32 day cycle. But this lady has a mind set of a 28 day cycle, and that’s the way she wants it to stay. It’s also why she suffers from PMS. Given her real cycle of 32 days, breaking from cream at day 26 when she needs progesterone cream the most to counteract estrogen dominance, makes treating PMS very difficult. If she took her break 5 days later, say day 31, 1-2 days before her period appears, she would be able to cope with a longer break from cream, and perhaps suffer less from PMS.

And she needs to take into account the fact she is probably entering menopause, and periods will lengthen or shorten until they disappear altogether. Bringing us back to the fact that every’s woman’s bio rhythms and cycles is unique. You would be very surprised to learn that this lady is a registered nurse, which might explain the rigid belief that her cycles cannot be anything other than 28 days!

Another woman, in her thirties, whose periods had stopped altogether, established a regular cycle with progesterone therapy after years of irregularity and heavy bleeding. There was no underlying problem. Her body just needed progesterone.

For those women who find it hard to chart a regular cycle - periods are all over the place or not arriving at all for months on end - we suggest you use your cream 3 weeks out of 4, taking a break from cream for at least 5 days. Longer if you feel up to it (12 days ideal).

Stopping progesterone cream is not necessarily going to bring on a period if it’s not ready to come. However, if your body is primed for a period, it will arrive within 24-36 hrs. Breaks are important - it keeps your cycle mimicking nature, and allows the receptors to up-regulate (refresh).

For women who no longer ovulate or perhaps their periods are winding down, or they are battling severe diseases like painful endometriosis, severe migraines and/or PMS, polycystic ovary syndrome, or fibroids, need to use higher doses or stay on cream longer.

These high doses will not down regulate providing you break from cream each month to stimulate cell receptors and you body is, in fact, utilising these levels. If you do not take even short breaks (3 days minimum) it will render progesterone’s work in the body ineffective.