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[Quandry]

Last period July 2013.
Saw GP and started HRT 11 months ago on Elleste Duet 1 mg.
It's helped, but when I saw her at 6 month mark she said perhaps I should be on continuous combined, rather than sequential HRT.

My mother had breast cancer so I am worried about risks of continuous therapy, and also Oral route.

Should I be asking for patch/gel and natural progesterone to minimise my risks?

I have an appt tomorrow, so want to discuss with her.

[dazned]

Hi and 

You say your last period was july 2013,but surely on sequential hrt you have had bleeds each month so how would you know ? 
How old are you ?

[Quandry]

Sorry, I didn't explain that very well.
My last 'real' bleed (after 2-3 years of random, irregular, peri-menopause ones) was in July 2013.
I saw my GP at the end of 2014 when it was over a year since my last period and I assumed I was in Menopause. I had horrendous symptoms and had almost reached the end of my tether.
She prescribed elleste duet 1 mg, and I started taking it in Feb 2015. I'm 49.

[dazned]

Oh was probably me being dim ! 

Usually you have conti after 54 or bleed free 12months which you would fit into ,however quite a few ladies choose to stay on sequential hrt as to stop having to use progesterone every day as this usually the part of hrt that causes the most problems re side effects. If you are feeling well on your current regime I personally would not mess with it .

[Hurdity]

Hi Quandry

 

You do not have to be on continuous combined HRT if you would prefer not to. Many of us opt to remain with a cycle either because we are intolerant to or get side effects from progestogens, or because of the possible health risks ( re breast cancer) or because we want to go onto a longer cycle. There is an increased risk of endometrial cancer if you remain on a cycle but this may be easier to detect at an early stage than breast cancer.

Sorry to hear about your mum. I agree that the most natural route/type you can use would be best in your circumstances. Have you been tested for the breast cancer gene? The risks are not even supposed to start until after the average age of natural menopause of around 51/52. However it would be a good time to change.

Many of us swear by that combo ie patch/gel and progesterone. Is your GP sympathetic or knowledgeable? You may have to print out the info from the relevant sections and insist. If you say you want transdermal GP may try you with one of the synthetic progestogens eg Evorel or Femseven patches. However if you say you want to use products that are biologically identical with your own hormones then there is no argument - and especially in your circumstances.

If you need any more help please do ask.

Hurdity x

[Quandry]

If you are feeling well on your current regime I personally would not mess with it .

I'm feeling OK, but there are a couple of things I want to raise with the GP - I think I am getting slightly raised blood pressure on it, and I've recently had a couple of instances of numbness in my left hand and little finger, as well as pain in my wrist 

I also still have problems with needing to wee more frequently than is 'normal' (sometimes every hour, and at least once overnight). Someone told me I might be able to get separate estrogen for that?

[Quandry]

Many of us swear by that combo ie patch/gel and progesterone. Is your GP sympathetic or knowledgeable? You may have to print out the info from the relevant sections and insist. If you say you want transdermal GP may try you with one of the synthetic progestogens eg Evorel or Femseven patches. However if you say you want to use products that are biologically identical with your own hormones then there is no argument - and especially in your circumstances.

Thanks Hurdity. I think my GP is sympathetic, but not sure how knowledgeable. Which are the biologically identical hormones? Is there a section on here about those - I struggled to find it...

[Hurdity]

Hi again Quandry

I presumed you knew about these because you mentioned patch/gel with natural progesterone earlier? These are they! There is no seperate section as they are listed amongst the main HRT types.  Oestrogen patches contain estradiol - the main active oestrogen we produce, and natural progesterone is available in micronised form as utrogestan.  Here are the oestrogen only products - all except Premarin are bio-identical ( ie with estradriol): http://www.menopausematters.co.uk/treatafter.php

Here are the progestogens - you will see there is little choice but utrogestan is there:
http://www.menopausematters.co.uk/to_progestogens.php

Hurdity x