Question: I am 43 years old and I am having irregular periods. This has been happening over the last 2 years but got worse this year. I have been to numerous doctors and have had numerous workups done. All my blood work is normal. They have done-CBC,CMP, Hormone Panel, Saliva Test and everything. I am using pharmaceutical grade of Progesterone Cream 1 pump at night. My bio-identical hormone doctor advised me to use it continuously without any break but the directions says to not use it more than 3 weeks out of the month and so does the pharmacist. The doctor also stated if I do not get a period he would refer me back to my gynecologist who wants me to take birth control pills which I am trying to avoid. Here are the results from my test: Test Low Normal High Reference Range Units triiodothyronine,free,serum 2.8 2.0-4.4 pg/mL thyroxine (t4) free, direct, s Test Low Normal High Reference Range Units t4,free(direct) 1.68 0.82-1.77 ng/dL Test Low Normal High Reference Range Units tsh 1.750 0.450-4.500 uIU/mL Test Low Normal High Reference Range Units vitamin d, 25-hydroxy 42.9 30.0-100.0 ng/mL I have had extensive test done:Colonscopy, endoscopy, transvaginal ultrasound, abdominal ultrasound, extensive lab work and even Hormonal Saliva test. Here are the results from Saliva Test: Cortisol load was 20. (the range is 22-46) DHEA was 4 (the range is 3-10) Estrone was 31 (Depressed) Normal range is 40-49:38-68 pg/ml Estradiol was 8 Normal range is 2-10 So I am stumped on what to do. My hormone levels appear to be normal and I have no menstrual cycle. So now that I wrote you a book lol here are my questions: 1) Can I use Progesterone Cream daily without a break? 2) Should I even worry about having a menstrual cycle at my age? 3) I was taking a supplement called Brevail WWW.WWWW.WW and it seem to help with hot flashes and my bio-identical hormone doctor advise me just to use progesterone and to stop taking this and now I am having hot flashes really bad without it. 4) If I choose not to try to regulate my menstrual cycle what type of maintenance test should I do and how often to make sure there are no adverse effects of not having a period? Again I am 43. I also paid and had done a thermography test of breast and body and they showed I was a T4 which showed high estrogen in the breast tissue by the heat. So that is why I was taking Brevail to support the breast tissue. My hormone doctor stated maybe it was lowering the estrogen too much and it was affecting my cycles but now he is unsure if that was even the case. We are both lost. Any help would be great!

So if I am not having a menstrual cycle I do not have to worry as long as I do annual pelvic examination, ultrasound of pelvis and pap smear correct?