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[Indigojo]

Hello!

I'm after some friendly advice and am hoping I've come to the right place.
I am 48 on Sunday and having suffered night sweats for quite some time (as well as a range of other symptoms), I went to the doctors this week to ask for hrt.
I have had 2 periods since October 2014 with my last one being 7 months ago in July 2015 so I was keen to understand the different treatment approaches to perimenopause and menopause. In answer to my question, the doctor responded by saying that the treatments were pretty much the same and that the '12 month from the last period' was guidance put forward for research purposes more than anything else 

Following this brief exchange, he went on to prescribe Evorel Conti yet everything I have read about this patch, including comments on this site, suggests its for women who haven't had a period in over a year.

As much as I am not keen to go back and have regular bleeds again, I also do not want to do myself any harm. Is anyone  able to advise me please?

So you I are aware, I was not blessed with children (not sure if that makes a difference?) and my two sisters went through the menopause at the same age.

Many thanks in advance 

[vickypk]

Hi Indigojo
I've been using Evorel Conti for 6 months.  I am postmenopausal, I suffered from bad sweats, very bad VA, insomnia and anxiety.  All these seem to have settled.  I still have a bit of anxiety, that comes and goes.  I am so much better.  Hope you get on with the patches.

Best wishes
Vickypk

[Kathleen]

Hello Indigojo and welcome to the forum.

 I also use Evorel Conti and am post meno so it may be  unsuitable for those still having periods however I am sure one of the expert ladies will be along to answer your question.

Wishing you a happy birthday for tomorrow and take care.

K.

[Indigojo]

Thanks Kathleen and vickypk for replying 
Its reassuring to hear that Evorel Conti works... I haven't started it yet as I'm going in for a operation next Thursday so I figured it was best to wait; I also want to make sure its right for me. 

What a great forum!

Best wishes 
Jo

[Hurdity]

Hi Indigojo

 

Firstly your doctor is wrong that the 12 months no periods rule to define menopause is just for research purposes! It is set at this because the majority ( but not all) women will not have another period having gone 12 months without one. The medical protocols are such that anyone that does (bleed after 12 months without a period) is automatically referred for investigation - ie scan etc, to check on their womb lining and any abnormalities - so it is an important diagnostic tool really - well the first stage anyway. This ensures that women who might have something like cancer do not fall through the net.

Re the Evorel conti - your periods have been very infrequent so you may well be at menopause. Some docs do prescribe conti HRT in these circumstances. There is absolutely no harm in starting this (after your op) if this is what you want to do. The only disadvantage is that for women who are peri-menopausal - it can lead to irregular breakthrough bleeding as their cycle kicks in, which is frustrating.

Personally though I wouldn't want to start on continuous combined HRT from the ouset so that I could distinguish betwen any side effects from the oestrogen and from the progestogen, so I would start on the cyclical version of this ie Evorel sequi - for a few months and then go onto conti if you got on well with it. You can legitimately go back and ask for this because you are not yet (officially) post-menopausal.

Good luck with your op and keep us  posted

Hurdity x

[Peterspots]

I am still having periods but I am on evorel conti to override my cycle. Is this not the same as taking the pill where ovulation is surpressed. Though I have a period now after using for a month so that maybe my own hormones or things settling

[Indigojo]

Thanks Hurdity, I really appreciate your reply.
I think I may arrange another appointment with a different doctor (the one I saw is new to my practice).. perhaps a female this time (not that I should generalise  ) and go through the points you've raised.
I'll let you know how I get on.
Thanks again!

[Hurdity]

Indigojo - not all female GPs are sympathetic, understanding or knowledgable about menopause and HRT as you will read from this forum but good luck if you do make another appointment

EnglishRose - Evorel conti does not override your cycle. It just gives continuous progestogen so will lessen the bleed from your periods and top up your oestrogen. The dosage is not high enough to suppress ovulation.

Hurdity x

[Peterspots]

Thank you. Is there any hrt that will stop bleeding.  My bladder pain is worse when I have a period. Maybe I will go back to Esteogel & urogestan but have a 2 month cycle. It's all so confusing.

[clare663]

Hi I have recently started on evorel conti, im 49 and not had a period for 3 years. Its only been a week and Ive had to cut down to a third of a patch. Still getting night sweats so will go up to half a patch tomorrow when im due to change it. I have had period cramping pains (I think) but no spotting as of yet. It does say one of the side effects is wind so it could be that. If its any help, last time I went onto a conti HRT after no periods for 12 months, I had a monthly bleed every month till I came off it. After speaking to my doctor, your hormones dont just drop gradually but continue to rise and fall for some years. It is possible that you may well have a period again even after 8 months of no bleeding.
 

[Indigojo]

Hello again,
Following my original post, I had went on to experience some break through bleeding on Conti after 5 weeks of use which lasted around 3 weeks. So, following previous suggestions, I went back to the doctors and was swiftly changed to Evorel Sequi. The doctor I saw this time said that I shouldn't have been prescribed Evorel Conti is the first place!
Anyway, I have now been on it for 3 weeks and I can't say I'm feeling great  my mood is quite low, my head fuzzy, concentration isn't brilliant and I keep experiencing bouts of forgetfulness which is a bit scary... oh and on top of that its caused me to get thrush a condition that was always hormone related for me in the past. 
I'm really not sure what to do now for the best? When I was on Evorel Conti, I had no night sweats, slept well and was really happy and upbeat (my hubby said it was like getting the old me back) but on sequi, apart from keeping the night sweats away (just) I am struggling to see any real benefits.
I would be really grateful for any advice you could give me... should I keep going for a while?
Thank you in advance for your help xx

[Mary G]

Indigojo, that is very strange.  I have just looked up both Erovel Conti and Evorel Sequi and they both contain 3.2mg (equivalent to a 50mcg patch) oestrogen and 11.2 mg of progesterone (norethisterone which is very strong) except the Sequi version you are on now only has a progesterone dose on days 15-28.  From what I can see, there is only one dose of oestrogen in this preparation but can you confirm this? 

You say you have been using the Sequi for 3 weeks so presumably you are now on the progesterone phase but obviously the Conti has this dose of progesterone everyday and you got on well with it.  Sorry for all the questions but I am baffled.

[Indigojo]

Hello Mary G,

Thanks for responding. I'm not sure of the dosage but yes, the patches I used for the first 2 weeks (Evorel 50) just had had estradiol in them. The  ones I am on now (started Thursday morning) have both estradiol and norethisterone so it would appear that these have the same ingredients as Conti. Maybe my symptoms will improve again then or am I being too optimistic?
Many thanks!
Jo

[Mary G]

Indigojo, it would appear that you got on better with the continuous progesterone and don't respond well to hormone changes.  Did you have any of these symptoms while on Evorel Conti?

The symptoms you describe are classic progesterone related sensitivity but it is strange if you did not get this while taking it everyday.  It's difficult to know what to suggest but you might want to see this month out and go on from there.  If these symptoms persist then this is not the right HRT for you and it will be time to look at other regimes.  Failing that and if you are reluctant to have periods again and get on really well with the Evorel Conti, then perhaps you could find out if you can go back on them.  Why not email Dr. Currie and get her opinion?

[Noodle]

I don't find it strange that the symptoms have only just appeared.  I started on Elleste Duet Conti - the same progestegen as in the patches Indigojo is using and felt fine mood wise for a couple of months. Then I didn't.

So it might be a red herring that you've felt this after a swap from conti to sequi and it may just be a build up over time from the use of norethisterone.

I've swapped to Femoston  ( oral HRT) and feel great.  Unfortunately, you can't get patches that have the same prog used in Femoston.

I'd suggest going for a different  HRT recipe, avoiding norethisterone.

Good luck.