Print

Please login or register.
1 Hour 1 Day 1 Week 1 Month Forever
Login with username, password and session length

[Milliemoo7]

This week I should get the results of my blood tests (aches and pains, poor sleep, hot flushes, anxiety, mood swings) and if they are ok I can go onto HRT.  So, I've been looking on the site to find out about the various different types.

I've pretty much decided I would opt for a patch, as I think that would be a more gentle way for the hormones to enter my system.  Am I correct so far?  As to the differences between the patches, I am wondering if the surgery recommends the cheapest treatments to start with.  I notice that Livial is much more expensive than the rest of them. 

One thing that is worrying me, and putting me off to a certain extent, is that one of the side effects listed is stomach cramps.  I already suffer with stomach pain and I wouldnt want to add to that.  Have others found this to be a particular issue or is it just mentioned in case it happens but in reality doesnt happen to a huge percentage of women on HRT?

[honeybun]

When I first went onto patches (Evorel Sequi)  I had been period free for about eight months. I did have some low grade cramping during the first month and then had a pretty heavy and painful period. That went on for a couple of months. I also felt vaguely sick for about a week. Sore bloobs as well if I remember.
Every thing settled down quickly though.

My sweats and flushes went within three days and I could finally get a good night's sleep.

That was my experience but of course we are all different.


Honeyb
x

[mamakaren]

I'm on the Estradiol 75 patch and I haven't had any cramping as a side effect! I had a hysterectomy before starting HRT though so I'm not sure if that would make a difference to cramping as a side affect? the only thing I really noticed was a bit of breast tenderness.

Karen

[Hurdity]

Hi Milliemoo

I can't remember how far into meno you are?

If you are properly post-meno and especially if two years since last period then your oestrogen will be at an all time low. At first you will notice the difference as your body gets used to it.

Yes patches are a direct way of getting oestrogen into the system and you don't have to worry about it going through the liver or the side effects from metabolic by-products. Re stomach cramps - tablet HRT is more likely to give problems and if you do suffer already with stomach/digestive problems then definitely steer clear of tablet HRT.

It is not clear from the side effects listed whether they actually refer to patches or pills - for example the side effects for Estradot are generic - it says this:

The following adverse drug reactions have been reported from clinical trials and from post-marketing experience with either Estradot or oestrogen therapy in general:

In other words the common side effects listed under gastrointestinal disorders may apply more to tablets than patches:
"Nausea, dyspepsia, diarrhoea, abdominal pain, abdominal distension".

I've never suffered stomach problems at all with HRT - not that I'm aware of or cause me any distress, but of course as honeybun says we are all different.

The thing to do is if you have decided that's what you want - take or apply it with confidence and optimism that it will eliminate (or reduce) the menopausal symptoms that are troubling you. There is no perfect solution as each comes with disadavantages  (which is the lot of us women!) but you want to find whatever makes you feel best, on balance!

I imagine if you are post-meno you will be offered a continuous combined patch - this means you will take progesterone continuously which itself can give rise to adverse side effects in some women.

You may want to consider having a cycle to start with - if you can cope with a bleed - so you can tell if you are OK with the oestrogen and the particular progestogen in the patch. Alternatively you could start straight away on the most "natural" option - the bio-identical oestrogen patch with micronised progesterone (Utrogestan).

Whatever you decide and if you are given a 50 mcg patch to start with, if you are well post-meno I would start with half a patch and gradually build up - to minimise side effects and maximise chance of success!

As for the doctors - I would pre-empt their prescription (of the cheapest tablet) and say you've looked into it and tell them what you have selected, giving your reasons.

Good luck and hope this is helpful

Hurdity x

[Sarah2]

Livial is the name for Tibolone and is a special sort of HRT, quite different from the usual type.

[Milliemoo7]

Thanks all for your replies.

Hurdity I am two years post-meno, have forgotten all about periods - dont want to go through that again particularly.  I'm a bit confused though - is utrogestan just the micronised progesterone? The info I read on here suggests that it is.  Or is it a combination of progesterone and oestrogen, which is how I read your post.

Thanks for the tip about using half a patch.  I assume they still stick ok if you cut them in half?

What does bio-identical mean?  I read that Livial was bio-identical, is that just oestrogen?

[Dancinggirl]

Milliemoo
Livial is a HRT that contains testosterone as well as oestrogen and progesterone. Many find it very good, paticualry fro the libido!!! - I tried it and got few side effects except I got acne because of the testosterone, so came off and tried other HRTs.
As you are post meno you can take continuous HRT which will means you would eventually have no bleeding.  Most Conti HRTs will bring some bleeding for the first few weeks or months but it is unusual to get any pain.
I'd try a continuous patch and see how it goes.  You may have to kiss a few HRT frogs before you find the 'prince'.  DG x

[Sarah2]

Livial is also a bit more than that- its doesn't have any effect on the uterine lining. It's often used for women who need HRT but have fibroids which bleed with too much oestrogen or endometriosis which still exists even after a hysterectomy. It can make some women have hot flushes- it's not so great at stopping those- or can make you feel hot. A friend of mine takes it due to heavy bleeding and trouble with fibroids when on other HRT.

[Milliemoo7]

Thanks you two, I'll cross Livial off my list as I am already troubled with spots from time to time 

I am still confused about Utrogestan because of the following on the site:

"Tailored continuous combined effect allows flexibility but is less convenient to take. Use any continuous  tablet or non-tablet estrogen with one of the following:-

UTROGESTAN    Micronised progesterone    100mg at bedtime from day 1 to 25 of each 28 day cycle"

This suggests (to me anyway) that the Utrogestan patch only contains progesterone AND that I would also need to take an oestrogen with it, in either tablet or patch form.

Also, if you are taking 100mg at bedtime that suggests that Utrogestan is a tablet, not a patch.  I am so confused.

Is it me, am I missing something (or adding something even!)?

[Sarah2]

Utrogestan is not a patch- it's only available as tablets either 100mgs or 200mgs.



Can you say where you found that quote then I could put it into context? It's not clear if the first line 'Tailored......' is talking about oestrogen, progestogens or combined HRT.

Utrogestan is as you'll know micronised, bioidentical progesterone. Bioidentical means the molecular structure- of either oestrogen or porgestogens- is the same as we make ourselves- as opposed to synthetic types of hormones such as those made from mares' urine ( conjugated equine oestrogens - CEE)

Utrogestan -The dosage varies. Some women take 100mgs continuously so it's a continuous-combined regime where there is no withdrawal bleed. Others take it for 25 days then would possibly have a light bleed. Others take 200mgs for as little as 7 or 10 days in a month (this is usually under the care of a consultant) or even every 2 months on long-cycle HRT.

Does this help?

[honeybun]

You can also use utrogestan as a pessary although it's not licenced for that in this country. That's how I used it but found it gave me bladder pain so went back to my combined patches.


Honeyb
x

[Milliemoo7]

Hi Sarah

I got the quote from the menu on left of the screen - HRT preparations, then Postmenopause.  It gave me a list of drugs and patches suitable for post-meno women.  I found the wording confusing as well.

The reason I thought that Utrogestan was a combi patch was because on the above mentioned menu it is listed under the heading Transdermal Patch.  Also, I read this by Hurdity:  " Alternatively you could start straight away on the most "natural" option - the bio-identical oestrogen patch with micronised progesterone (Utrogestan)."

HB, thanks for the info re. using it as a pessary, I definitely wont take that route.

It's a patch I would like, a combi patch, one with the least side effects (so presumably bio-identical would be best).

Off to study what's on offer again.

[Sarah2]

Yes I've looked at that too ow Millie and it doesn't make sense to me! I don't know why it says a combined continuous regime is less convenient- it actually seems it should say the opposite! maybe some typos going on there.

I've never wanted a patch simply because I don't like the idea of something stuck on my skin all the time, and visible to me and other people.
My dr offered me gel straight off, I agreed to try and it's been brilliant.
I know not everyone wants to be bothered with gel but I like it.

[Dancinggirl]

Milliemoo
I'm afraid there isn't a patch with bio-identical progesterone yet - which is a great shame - I hope a scientist is working to create that one a.s.a.p..  The Oestrogen in the patches is bio-identical.
The only truly bio-identical route is: Either Oestrogel with Utrogestan or Oestrogen Patches with Utrogestan.  DG x

[Milliemoo7]

Thank you Sarah and Dancing Girl for clarifying things.

So, my patch options are just the two:


EVOREL CONTI*    2 x Weekly    M    Transdermal estradiol 50mcg & transdermal norethisterone 170 mcg

FEMSEVEN CONTI    Weekly    M    50mcg estradiol and 7mcg levonorgestrel p   



I'm wondering what the difference is between norethisterone and levonorgestrel, from what I've read so far levonogestrel has fewer side effects.  But will a patch stay on for a whole week?!

Sarah, I didnt see a gel listed in the preparations.  Did I miss it?