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[peacemakerukuk]

Hi all,
I hate making my first post a questions, questions, questions post but I'm desperate so I'm diving in.
I'm 49 and my GP put me on Evorel Conti 50 patches a month ago, I literally put the last patch of the box on last night.  So far the only thing the patches have helped with is the hot flushes/night sweats.  My mood is still very low / feeling angry / want to cry all the time, feeling tired with no energy and no period for three months.  I had until today thought my worst problem now was the mood swings but today I am SOOOO bloated I look 9 months pregnant.  I'm not slim at the best of times but this is ridiculous.  Today I've spent the bulk of the day crying and feeling so down.  I can't get an appointment with my GP until 4th November and I'm going on holiday next week to Corfu so I'm not sure what to do.  Question is, should I carry on with the next patch on Sunday and hope the bloating will get better or should I cut now and not start a new box on Sunday? Am I being too previous in wanting to stop the patches, can things get better or is this it? Also I gather I'll get a withdrawal bleed when I put a fresh Conti patch on on Sunday – how bad will this be and how long does it last roughly?
Thank you all for any help you can give me.
Sue
 

[dazned]

Hi and 

I'm not sure you should be on a conti regime if you've only been 3months since a bleed ,hopefully someone with more knowledge will be along soon to help just wanted to say your not on your own now you found us all here.

[peacemakerukuk]

Could it be because I had a DVT during my last pregnancy 8 years ago - she didn't want to put me on tablets

[Hurdity]

Hi peacemakerukuk

 

Don't apologise - that's not long - you should see some new member's first posts   

Dazned is right - if you have only just been put onto HRT and you were still having periods you should have been put onto cyclical HRT which causes a withdrawal bleed. You are only supposed to be given conti HRT when you have been 12 months without a period. Nothing to do with tablets - you can still use transdermal HRT (patches or gel). What were your periods doing in the year or so leading up to starting HRT?

The problem for some women with that particular one is that the progestogen (norethisterone) which you need to prevent the womb lining thickening ( from the oestrogen - which helps with the symptoms) is notorious for causing side effects in some women - and you are taking it all the time -  which could partly explain your symptoms.

The side effects may settle - it is usually recommended to try an HRT type for 3 months before settling or changing it, but in your cases you may have been given the wrong type anyway - although if you were not post-menopausal and still having a cycle of sorts you would expect more breakthrough bleeding. Perhaps you are near menopause?

If you have been given Evorel conti you will not get a withdrawal bleed. There is often some bleeding or spotting within the first few months and this is more likely as I said above, if you are given this type before you have reached menopause. Most post-menopausal women do not bleed on this HRT after the first 6 months.

The other thing is it could be that the oestrogen dose is not high enough for you to improve your mood, although as it has dealt with hight sweats and flushes this implies it is working.

"Previous"? Not sure what this means in this context?! Typo??? If you stop now you may well feel worse while you are away as the hormones leave your system so personally I would leave it on - but up to you - only you know how bad you look/feel now and whether you are happy to go on holiday like that!

Hurdity  x

[peacemakerukuk]

sorry everyone, brain fog - I am on Evorel Sequi.  I put the last patch on yesterday from the first box.  Its since week 3 I've felt even worse than before with the mood swings, tears, bloating.  I think I'm due a bleed on Sunday when I put on a new patch from a new box???  Sorry for the confusion

[peacemakerukuk]

me again, when I said previous I meant is it too soon

[Hurdity]

Hi again - oh I haven't come across that expression!!!

Ah - Evorel sequi - that explains it! The comments I made about norethisterone still stand - during the third and 4th weeks you are taking the combi patches so could expect pmt symptoms that you describe.

Unfortunately you should still expect "normal" pms when you stop the conti patches ( ie the combi ones that you are using now) as this is part of what happens in a normal menstrual cycle - so you may feel irritable. headachey, tense etc on Mon/Tues and yes you will expect a bleed at some point (usually a day or two after changing back to the oestrogen only patches)  and you won't know how heavy it's going to be.

The other alternative is to take the conti patches from the second box for another week (or two) which will delay your bleed. (although you could possibily get some spotting sometime during the week). You might like to speak to your doc about this - but this wouldn't do any harm. Problem is you would have the wrong number of patches as you would then have too many oestrogen only ones and probably wouldn't want to go 4 weeks on these. Your doc might say this is OK though?

You will either have to put up with a bleed or the side effects of the Evorel conti! A few women don't get a bleed though....

Hurdity x

[peacemakerukuk]

I don't normally get PMT, I'm pretty even tempered all the time to be honest

[CLKD]

HORMONES    .

I would have a talk with either your Practice Nurse, GP (who can give you a ring-back) or visit a Pharmacist, most of private rooms.  Bloating is awful  ………. I had it prior to each bleed.  It made me asthmatic.

[peacemakerukuk]

I managed to get an emergency appointment in the end after crying down the phone.  The GP (male) told me to stop taking the HRT patches and has put me on Sertraline 25mg. Don't know how much good they will do but I've got to try something.  I've now got the bleeding to worry about which I'm guessing will happen tomorrow

[Hurdity]

Sorry to hear this peacemaker - your doc is doing the standard thing of trying to fob you off with ADs after only trying one HRT type! I despair! I have no experience of these but from what others have said there may well be initial side effects anyway which you certainly don't want just before going on holiday on Sunday. If it was me I would change the patch to the oestrogen only one tomorrow (saturday), take all the sanitary protection with you on hol, and fingers crossed you don't get pms or cramping.

Remember whether you stop the HRT completely before you go away, or change to the oestrogen only ones, you may get side effects from the withdrawal of progesterone and a bleed -  hopefully the bloating will subside though once you've stopped the combi patches?

You just have my sympathies for having to think about this just when you are going on holiday! Hopefully the sunshine will make it all OK and you will be able to relax!!!

I think a different HRT type is in order for you and at your age you could try Femoston (tablets starting with 1/10 which are well tolerated by many women)

Whatever you decide to do - make sure you enjoy your holiday even if you are not feeling 100 % - try not to dwell on this and sort it out when you get back!

Hurdity x

[CLKD]

I agree!  Your GP is treating your symptoms.  The most obvious one being 'depressed' because you were crying, not crying because you are frustrated and feeling below par due to HORMONES  .

I would continue with the HRT without a break - another 1/2 weeks are unlikely to do any harm.  Leave taking the AD until I  returned [or you won't know if you are flying a bike or riding a kite]! 

[Suzyq]

I also agree I'm afraid - keep up with the hrt for now and I think your low mood will pass. Every ad I tried made me feel absolutely terrible with out of control anxiety - I definitely wouldn't risk it just before a holiday! Plus you will likely have a return of flushes and sweats if you stop the hrt now xxx

[peacemakerukuk]

Thank you all for your replies.  When I got back the doctors yesterday I took the patch off I'd put on Thursday.  After a lot of thoughts going round and round and around in my head overnight I've come to the same conclusion as you all and have put a patch back on today.  I go back on the single hormone one on Sunday (I change mine Sunday's and Thursday) and hopefully things will settle back down again.  I did take 25mg Sertraline when I got back from the doctors yesterday but I don't plan on taking anymore.  I'll try to struggle on until i see my female GP on 4th.  Tampax and ibuprofen are packed.  I normally have heavy periods anyway - would it be ok to take the Tranexamic Acid as normal?  Why does everything go awry before a holiday???  We fly this evening - me and two children, I can't be feeling unwell / sad for them.

[CLKD]

If required take the Tranexamic Acid?  Pack plenty of sanitary protection in case.  Let us know how you get on when you are back!  Rest, rest, rest ;-)