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[Momo]

Hello Everyone
a few months ago you were very helpful as I started on my HRT journey, I was using Evorel conti tablets for about 3 months but although the hot flushes went and vaginal dryness improved, my bi monthly migraine started to ramp up to every two weeks, plus I was bleeding every week, more than a light spotting that I sort of expected,  enough to need to wear sanitary towels  daily again and have low grade pain/discomfort, though nowhere near as bad as when I had my real periods - when I would faint from the pain.

Also feeling like I had my old pMT back  so the doc recommended swapping to patches. I started them about 2- 3 weeks ago but since then my PMT feelings - rage, misery, weeping , carb craving seems to be building up plus I have had a headache every day for the last week plus a migraine earlier in the week. Now, do I need to just get through this change over period, or should I just stop the patches and admit that me and HRT don't get on?

I am due to go back to the doc at the end of March for a review, but feeling so bloomin low today , I need to talk to someone about it, Should I soldier on for a few more weeks or stop now and see if the misery subsides?

I just wondered what the general feeling was amongst those who have used these patches for longer? The advice sheet that comes with the patches doesn't mention whether it is safe to stop cold, so I am a bit unsure of the safest approach and of course my GP surgery is now closed until Monday.

all the best

Momo

[Dancinggirl]

Hi Momo
I do wonder if it's the continuous use of progesterone that is making your headaches worse. Some women can tolerate progesterone well but others do find they get too many side effects and end up on a sequential HRT and put up with monthly bleeds - which is at least controllable. Also the dosage with any HRT is ‘average' so for some women the dosage may not work so well and allows a build up of the womb lining that will result in erratic bleeding and spotting.

You could consider a Mirena?  This tends to absorb the progesterone more locally so less is circulated around the body - so, in theory, fewer progesterone side effects.  Once you have a Mirena in place you simply use as little or as much oestrogen as you need (either patch or gel) to control meno symptoms. One of the plusses of the Mirena is that it often reduces and usually stops all bleeding.
You could simply stop using HRT for maybe 4 weeks to see how you cope - this can be a  good idea, as it allows you to reassess whether you really feel HRT is necessary. It's fine to simply stop  - it's not like ADs or SRRIs where you have to slowly reduce - you could try cutting them in half for a week or two but you can simply stop altogether if you wish.  You may find you get some bleeding for a few days when you stop and that will be your womb lining shedding.   
Unless you are under 50 and therefore need the oestrogen, I believe HRT is about the benefits versus the side effects.
DG x

[vickypk]

Hi Momo
I have been using the Evorel conti patches for about 18 months.  In the first few months I didn't really think they were that good, as I had a few side effects.  I just cut them half for a couple of months and built up slowly and I am fine with them now. 
Before I started the patches I used to get very bad headaches that lasted a few days each time and were very frequent.  I can honestly say I haven't had a headache in 18 months since I have been using the patches.
Hope this helps
xx

[sassy44]

Hi, I started on a mirena after surgery to remove cysts,both ovaries and tubes. I felt fab first 2 weeks and also had a patch too. Sadly the coil moved and caused horrendous problems so ha it removed and was put on evorel sequi conti patches. Had headaches first 2 weeks,spottin and a mood that made all my close family t stand clear lol. I'm going to give them a couple of months but may go back on coil if I feel still feel like this. Gosh the joys of a surgical menopause at 44.

[Momo]

Hello Ladies
thanks for the advice ladies, I am under 50 - 47 to be exact and have been going through this menopause malarkey for 4 years but only gave in last year and decided to give HRT a go

I have always had terrible reactions to contraceptives - including Mirena which was one of the worst, with many of the same symptoms I am getting now but magnified. Although not having periods was great! but week long migraines were not. I never found a contraceptive that would work - apart from the not getting pregnant bit. So I got sterilized when I was 37 and put up with the periods - but they stopped when I was 43 so it wasn't too bad.

I get migraines every few months, but they have definitely ramped up since I started taking HRT.  But the daily headaches are a new development, lets hope they pass soon, I will try and put up with them in the hope it all gets better.

Hasty -  I got confused earlier, I think I was on Elleste Duet Conti - my tiny mind is easily confused

 I guess I just need to be patient with these patches. Thanks for the support ladies, just reading the replies made me feel better, it is always great to know I am not alone sending positive vibes to you Sassy44 - you sound like you have been through a lot more than me, puts it all in perspective, take care.


Momo

[Dancinggirl]

Momo - It definitely sounds as thought progesterone is not agreeing with you.  I would try a sequential HRT regimeand possibly go for oestrogen as patch or gel everyday and a separate progesterone in pill form for 10-12 days each month (either Utrogeston or Provera - which are both kinder progesterones) - this might reduce the progesterone side effects.  There is sometimes a possibility to do a longer cycle which might also suit you.
I get these horrid headaches that last 24-72 hours and I found they were better when on HRT - now I'm off systemic HRT my headaches have got a lot worse - almost weekly!!!   WE are all different so it's about trial and error till you find the HRt that gives the most benefits and the fewest side effects.
I would say that at your age HRT is a very good idea to protect your heart and bones for the longer term. Once you find a regime that suits you, then you should feel better overall. 

Sassy44 - same advice for you - the spotting may well settle but many women, well into post meno, stick with a sequential HRt regime to reduce side effects like erratic bleeding and spotting.  DG x

[sassy44]

So now on 3rd patch of everol conti and first bleed, only slightly! Is this the norm as only just started on the whole patch as coil etc was removed. Feel fine on this conti patch but the evorel you take before im not so good. Feel cheated as only had ovaries removed and now on a bleed! I have heard it's best to bleed as less likely of womb lining build up? Thank you xx

[Hurdity]

Hi saffy44

Some bleeding is common during the first 6 months of continuous combined HRT but hang on - are you on Evorel sequi (2 weeks of Evorel 50 then 2 weeks of Evorel conti)? In this case a withdrawal bleed is normal. Most women get this towards the end of the prcombi (conti) patch or just after changing back to the oestrogen only ones.

If you are on this combo - it is normal to feel rough during the first few days or so of the oestrogen only ones ( after you stop the combi ones) due to the effects of progestogen withdrawal - which gives pms symptoms. However these should settle making you feel OK for most of the oestrogen only patches. Good that you can tolerate the progestogen in these patches.

Also if you are still peri-menopausal ( presumably you don't know where you are in meno due to Mirena?) then your own cycle will kick in and you can also feel the effects of hormonal changes due to that - HRT does not control your cycle as such.

Hurdity x

[sassy44]

Sorry,yes on the sequi.no idea about my own cycle as no ovaries so no periods now. Just the withdrawl bleed, im confused as to what is in what patch? Thank you for advice it's so much appreciated, it's hard finding advice on just no ovaries and tubes. Also the mirena coil was removed as it had moved and caused problems so now only on the patches of evorel conti seaui. X

[Hurdity]

Hi again - sorry I didn't read back along the thread and just answered your latest post. My apologies. I see you've had ovaries removed in which case you won't have a cycle any more!

The constituents of the patch should be given in the leaflet that comes in the box and on this website here:
http://www.menopausematters.co.uk/perimeno.php ( scroll down to transdermal)

Transdermal estradiol 50mcg/24hrs
Trandsermal norethisterone 170mcg/24hrs for 14 days/28

This means you have two weeks of oestrogen only patches and two weeks of combi patches (the Evorel conti ones) which contain oestrogen and progestogen ( in this case the type of progestogen is norethisterone) - and this is why you get a withdrawal bleed - it is an artificial period caused by the HRT and is needed to protect the lining from over-thickening due to the oestrogen.

Hopefully the side effects will settle after a few weeks but if not there are other alternatives to try

Hurdity x

[sassy44]

Thank you so much,makes sense now. X

[Mary G]

momo, from what you have said, it sounds as though you are severely intolerant to progesterone and Norethisterone is one of the strongest.  I am also severely intolerant to all forms of progesterone (except my own) and having tried many different types of HRT, I have finally settled on Oestrogel and a very, very low dose of Utrogestan but I was told that I should have a hysterectomy long term.

You might want to try limiting the amount of progesterone you take and go on from there.  Why not try taking a separate oestrogen and then use Utrogestan (micronised progesterone) vaginally, it has fewer side effects when taken in that way and it works better too.