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[Angela11]

I tried to post this yesterday so apologies if it is already on the forum (I can't find it.)
I have suffered with the menopause for 3 1/2 years. Having tried just about every alternative method I resorted to HRT. Tibolone saw my mood plummet, I was then prescribed Premique, brilliant my flushes stopped but my mood more than plummeted and I had to stop taking it. My GP has prescribed Evorel Conti patches but I am worried as it appears to have the same ingredients in as the two I have already tried. I haven't been to work since the 22nd of December after breaking down in a blubbering mess!!! What on earth should I do? my flushes are every 30 mins and sometimes come in clusters. Help!!!!!

[bramble]

Not sure where you are looking but all 3 of these have totally different ingredients!

Bramble

[Hurdity]

Hi Angela11

 

In fact all the hRT types you have tried have been completely different.

Tibolone is a synthetic preparation which has properties of oestrogen progesterone and testosterone but is not actually a hormone as such - although relieves menopausal symptoms, with minimal effect on the uterus and is supposed to help with libido.

Premique contains a mix of horse oestrogens and a synthetic progestogen

Evorel contains a bio-identical oestrogen ( ie the same compound as found in our own bodies) and a different synthetic progestogen and is a transdermal (thought the skin) preparation rather than tablet HRT

Depending on how old you are and where in menopause ( eg had you been 12 months without periods before starting HRT?), you might find a sequential HRT  - ie one that gives a withdrawal bleed similar to your natural cycle, better - because it allows you to have oestrogen only for a while and then the oestrogen and progesterone combined.

Sounds also like none of these are dealing with your symptoms either (re flushes) - and again this takes time?

Once you have told us something about yourself we can advise you properly but maybe you are progesterone intolerant - or at least to synthetic progestogens (which all of these types have been to a certain extent)? If so then you would be beter of with separate oestrogen ( patch or gel) with progesterone  (micronised progesterone ie utrogestan) - and as I said perhaps as a cycle which would enable you to feel the benefits of oestrogen alone.

Also depending on your age and what doses you were given before and how long you tried them - you might need a higher dose of oestrogen.

It is recommended to try each HRT type for at least 3 months to let the side effects settle before rejecting it and trying another - sometimes there are undesirable effects for the first few weeks - but obviously you need to be able to function!!

In the meantime read as much as you can from the drop down menus above

Hope this helps

Hurdity x

[Sunnydays]

Angela11 maybe you meant that all three had a content that were more testosterone based, hence more likely to cause low mood and PMS type symptoms. When I started on Evorel it was recommended to me that I cut the patch down to a quarter just to build up getting used to it. You might like to give that a go. As Hurdity says you need to give it 3 months ( I'm afraid I don't practice what I preach on this last point but in hindsight I should do!) good luck

[Angela11]

Thanks very much for your informative replies.
I thought they all had progesterone in and maybe that was causing my low mood (understatement of the year as I was either just about mute or crying.) I was on Premique for five weeks and it did stop my flushes (which was great) but my mood plummeted. My GP advised I come of them and try the patch. I haven't dared to try the patch as I am worried that the low mood will return. I am hoping to return to work very soon so I'm not certain what to do!.
I am 54 and haven't had a period for 20 months. The worst of my symptoms has got to be the flushes but poor memory is also a problem. I usually have a happy and positive nature.
Oh! the strength of the meds were Tiblone 2.5mg. Premique 0.625mg/5mg. I have the prescription for the patch but it does not give the strength it says apply one patch twice weekly. 
Thanks again for you feedback and I hope you are all well.
Regards Angela

[Sunnydays]

Hi Angela. As you are post meno and presumably have a uterus you will be on the continuous regime which means you have to have he progesterone part to keep the lining of the uterus from thickening. The patch you have been give is likely to be the Evorel which at post meno comes in one dose only 50 mcg. Everyone reacts differently to the progesterone element - some are fine some unable to tolerate it.
I was advised to start wth a quarter patch for say a couple of weeks. See how you go then increase to half a patch etc. You can then tell how it's affecting you. I don't get on with progesterone but at a quarter patch, I didn't get the low moods on this particular patch.

[Mary G]

Angela11, welcome to MM!

I agree with everything that Hurdity has said and I can relate to your problems.

I have been around the block on this one and from what you have said, it sounds as though you might be like me, intolerant to synthetic progestins and if that is the case, Evorel is unlikely to work for you.  It has taken me a long time to find an HRT formula that works and to cut a very long story short, the only type that works for me is two pumps of oestrogen gel daily with 100mg Utrogestan taken vaginally for 7 days each month although some women may be prescribed more - I also take a pea sized dose of testosterone every day.  This type of HRT does mean having the dreaded periods again but it is a small price to pay for getting back to normal.  The problem with continuous combined HRT preparations is they contain synthetic progestins which will often lower your mood and can undermine the good work that the oestrogen does. 

I am also 54 but 9 years post menopause so I've had plenty of time to try different HRT preparations, all of which were completely wrong.  My current regime is the one recommended by Professor Studd and not only is it tried and tested, it is also the most effective for symptom control and also the safest type of HRT i.e. transdermal and bio identical. 

It might be worth running this past your GP.

Hope that helps.

[Sunnydays]

Mary, can I quickly ask a couple of things. How much don2 pumps equate to in terms of a transdermal patch roughly and do you have to have scans every so often to check the Utrogestan has done its job?
I totally agree that the regime you have suggested seems the only way forward if intolerant to progesterone plus reduces the various risks etc. As I think you've said in one of your other posts it's just such a nuisance having to have periods!!! But, it can be a small price to pay for better quality life.

[Mary G]

Sunnydays, it's difficult to be exact on this one but off the top of my head, 2 pumps of gel is about the equivalent of a 50mg patch BUT that depends on how well you absorb it and everyone is different.  I was previously on the 100mg patch but it was nowhere near as effective as 2 pumps of gel because I seem to absorb the gel like a sponge!  Because of my severe intolerance to synthetic progestins, Professor Studd precribed 3 pumps of gel every day and 7 days of 100mg Utrogestan per month (which I take vaginally) for me originally but I was having very heavy periods so I reduced the gel dose to 2 pumps and they have become a bit lighter and last about 5 days so I can just about live with that.

I do have regular scans to check the lining and so far all has been OK but with the periods I have, it's not surprising!  It's also worth noting that Utrogestan taken vaginally will be much more effective at clearing the lining each month because most of it hits the womb and does not get lost in your digestive system. 

[Angela11]

Thank you everyone but especially Mary G. It all points to me not getting on with progesterone I plan to seek specialist advice but for the present time I will not but taking or using anything. I prefer the sweats and foggy brain to the depression.