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[Annidav]

hi- I started on HRT in April and was on FemSeven Conti patches; however after a few weeks of the patches not sticking properly I went back to my GP and was prescribed EvorelConti patches and these are much better at sticking; last week after a couple of weeks of feeling very low and anxious again I went back to my GP and he has doubled the dosage and I am now on Evorel 100.  Eager to feel a bit better I stuck on a new patch as soon as I could; had a lovely sleep that night - undisturbed and woke next morning feeling wonderful, like I had had a "proper night's sleep" really restful - I later realised I still had my previous patch on too so maybe that's why I slept so well...!!

Anyway, on reading information this morning about Evorel it appears it is not a combined HRT - as I still have womb I understood I should have a combined HRT, otherwise I run the risk of increased risk of womb cancer...

I am going to telephone my GP surgery to check but thought I would ask on here too as I feel like a nuisance contacting the surgery again   

[CLKD]

If your GP has given you an incorrect prescription then they need to know!

How did you get on?

[Taz2]

Yes - if you are using Evorel 100 patches you will need to add in a progesterone.

Taz x

[Annidav]

Thanks CLKD and Taz2 - waiting on a call back from GP "later today"....

[CLKD]

Feet up with a cuppa then, phone in hand?

[Annidav]

Spoke to my GP who asked if I would prefer to be on combined HRT; said yes as understood I SHOULD be on combined; he asked if I was still bleeding and I said not for several years as had thermal ablation and this had stopped my periods (surely this is in my notes?!?!?); he said he would call be back after he had been able to look up an appropriate patch for me.  He has just rung back to tell me that he has spoken to a couple of specialists and there is no higher dose combined patch so it will have to be tablets....I had preferred patches because of the worry of possible heart/liver problems if taking tablets... feel on the verge of tears again (been in tears most of the morning) as I feel "why me"

[Taz2]

I feel for you fiftygirl but you can still have Evorel 100 patches but with a separate progesterone. Other members are on a regime which uses Utrogestan and some use the Mirena coil I believe.  If you use the search button in the blue bar top left of the screen it will bring up others posts on this. You can also use gel for the oestrogen plus a progesterone added separately.

On a different note - the progesterone in Evorel is Norethisterone which is notorious for making some women feel anxious, on edge, and weepy especially when you are receiving a continuous dose as you would have been with the conti patches.  Are you sure that you do need a higher dose of oestrogen and that it wasn't just the norethisterone making you feel that way?

Taz x

[Mary G]

fiftygirl, if I were you, I would simply add Utrogestan for a few days each month but make sure you use it vaginally because it works better when used in that way and has fewer side effects.  Because you have had an ablation, I would not have a Mirena coil or use heavy duty norethisterone which is notorious for side effects.  I would take 100mg Utrogestan for 7 days each month and then have a scan a few months later to make sure your lining measurement is OK and the dose is right.  You probably won't get a bleed but apparently you do need to have the thinning effect of the progesterone even after an ablation. 

One other thought... why not change to Oestrogel?  I can well believe you need to go up to the 100mcg patch because it's so darn difficult to get enough oestrogen out of the patches.  I didn't find patches effective at all and it was only when I changed to the gel that I felt completely normal again.  The gel is also flexible and you can adjust the dose to suit your needs.

[Annidav]

   woke up this morning worrying about taking the tablets; rang surgery first thing as I wanted to talk it through with GP; both GP's I have been seeing are not in today (one not in all week and the other not until Thursday); I asked if I could see another GP to be told that all appointments today are for emergencies only-do I have an emergency (in my head yes but obviously not really) so end up having to settle for  a telephone appointment with another GP. She has just rung - I gave her my background and recent events; I asked if I could use the Evorel 100 patches but have a gel for the progesterone - she informs me that she is not aware that there are any gels but even if there are, they would not be an effective dose; the only way I could get an effective dose is to have  a Mirena coil fitted - do I want her to book me an appointment with a GP who can discuss fitting a Mirena coil? NO!!! I want to discuss all other options in full, face to face, with someone who understands what I am going through!!! She said I oult think about taking the tablets for a while to see how I get on, or  go back to the Evorel Conti patches (which were a lower dose and cannot go higher on them) -and then I started to cry - OMG what a wreck I am    so embarrassing - like a child crying when they can't have sweets!!!!   so I have a telephone appointment for next Monday with a GP to talk about Mirena coil......got to  log on and try and work now....  

[Mary G]

fiftygirl, sorry if I was confusing but I meant micronised Utrogestan capsules (used vaginally) for the progesterone part of your HRT and Oestrogel to replace the patches you are currently using.  I suggested the Oestrogel because I think it works far better than the patches and you mentioned that you have worked your way up to the 100mcg patches which is exactly what I did when I couldn't get enough oestrogen out of them. 

Why not ring your doctor back and ask for Oestrogel and Utrogestan?  I have had two Mirena coils and would not recommend them for someone who does not have problematic bleeding because it does have side effects.  In theory, the progesterone in the Mirena is supposed to mostly stay in the womb but I found that enough of it got into my system to cause breast pain, low mood, low libido and (latterly) migraines.  I would not have thought a Mirena would be suitable for someone who has had an ablation anyway.  You should be able to take a 100mg Utrogestan capsule vaginally for 7 days each month without getting a bleed. 

[Annidav]

Thanks. MaryG - it was a very frustrating phone conversation tbh as I got the impression the GP didn't really know too much; I did say that I thought there were issues with Myrena and fact I had ablation but she didn't think that  was an issue - hopefully I can have a better discussion next week but I would much prefer to do so face to face; in the meantime I have taken a tablet .......

[Taz2]

I just wonder whether the oestrogen dose was high enough for you and that it was the norethisterone which was causing you to feel so anxious and horrible.

What tablets have you been given?

Taz x