Many women find the continuous therapy method difficult to follow when it is explained to them, and an illustration showing the days when the hormones are taken is helpful.
Oestrogen is given continuously, and progestogen is added every month for ten days. A bleed may occur in the week following the completion of the progestogen course. Any bleeding at any other time must be reported to the patients doctor.
Although some writers believe that the production of periods has a psychologically beneficial effect on the patient, it was initially found difficult to persuade our group. Few Australian women wish to return to menstrual periods; however, since the publicity on the increase of cancer of the uterus with long-term oestrogen therapy alone, this attitude has altered.
I emphasise that women can choose when to have the bleed. If they have a heavy social programme or family commitments one week, they may have their bleed before or after this. They take the progestogen pills at the time they wish and a period usually follows within a week. If no bleed occurs, it simply means there is not enough build-up in the lining of the uterus to come away.
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