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[optisight]

Hello everyone, long time lurker and first time poster
I have gained some really valuable advice from reading this forum and just wonder if anyone can help me a little further

After reading the menopause matters website I decided enough was enough and my psychological symptoms were too much for me to manage and I wanted to try HRT. I was sceptical as to how my GP would be about this having read some of your posts on here, but I requested an appointment with a Dr who had a "special interest in the menopause or HRT" when I rang to book an appointment.The receptionist booked me in with one of the part-time GP's who I know is very empathetic and to be fair I have found all the GP's at my Surgery to be very good....I guess I am lucky there and I go VERY rarely!

I guess I have been peri-menopausal for about 2yrs ( but didn't really realise it until especially the last 6 months) I am 50 and have previously been very regular with my cycle every 26 days without fail. But had my last period in Oct 2016 and visited the GP in early Nov, so only really missed 1 maybe 2 periods. As I said my symptoms have been mainly psychological, anxiety, tiredness, irritability etc and associated with my cycle. Had a few hot flushes this Summer, but mainly when I got hot I got VERY hot, dripping sweat hot!

So I approached the appointment with a bit of dread, but happily report it went really well  GP was lovely, I just told her I was having peri-menopausal symptoms which I could no-longer manage and I wanted to go on HRT. She asked about them and said that sounded all fine and going on HRT not a problem...result!! She went through all the advantages and disadvantages, weighed me and took Blood Pressure etc.
Because I am severely overweight ( chocolate is my anti-depressant of choice!) she recommended patches. Now this is all going swimmingly well so far isn't it....
Then she said "ummmm I used to do a lot of HRT prescriptions, but since all the scares etc I don't do many these days" She prescribed  FemSeven sequi patches as she'd had good results with these in the past and I have a review in 3 months. I sort of got the impression she was a bit out of touch with what was the current HRT patch of choice and picked what she'd used maybe a few years ago ( I am in the healthcare profession and sort of could read the situation) I don't criticise her for that, as sometimes the old things work the best

I'm coming to the end of the first 2 months and on the whole I feel blooming marvellous!! Almost immediately I felt better in mood, less anxiety, less aches and pains, more rational in my thinking and generally much more able to cope with life and more energy...yipeeeee
My only issue so far is that I am having a period at the end of the 2 weeks oestrogen cycle, rather than at the end of the two week progesterone/oestrogen cycle, and we're back to heavy periods, but no other side effects of note and that's a small price to pay for feeling so much better. I'm assuming that eventually my cycle may change to align with what it should be??

So my question is...if you've managed to stay with me so far! My Gp is excellent I have no complaints and I feel she is willing to listen to any suggestions I have, but I just have  a little niggling feeling that Femseven maybe an "old HRT" and there are "better" ones out there ie more modern/natural formulations of the progesterone? FemSeven doesn't seem to come up much on the chat on here and I wonder if it has been superseded by more modern drugs?

I am happy to stay on FemSeven as it is certainly doing the job it seems, but does anyone know of anything "better" ( I realise in medicine it's certainly not that simple and not everything suits everyone, but would be grateful of any knowledge anyone has)
Many Thanks in advance Xx

[Hurdity]

Hi optisight

 

So glad to hear you are feeling well on the hRT you are using .

Femseven is not old-fashioned as far as I know - it is one of two standard combi HRT patches as I expect you know? http://www.menopausematters.co.uk/perimeno.php . Also the progestogen in that one is probably better tolerated than the other one - Evorel - which contains norethisterone - used in a lot of the tablet HRT types.

The only more modern one I suppose is progesterone itself - the licensed formulation of this - micronised progesterone (Utrogestan) has only been around for a few years although enlightened (knowledgeable?) doctors and gynaes have been prescribing Cyclogest pessaries (a different preparation normally used for fertility) for years before. http://www.menopausematters.co.uk/to_progestogens.php

However because it is unstable progesterone has to be taken in larger doses and so is associated with different side effects from the synthetic progestogens. Some ( like me) use it vaginally (off licence in UK) to prevent metabolism/digestion that occurs from oral use.

You could try to reset your cycle so that the bleed counts as Day 1 and see what happens - but in peri-menopause and with irregular cycles this can be tricky.

Hurdity x

[menomummy]

Hi I have posted something similar this week (http://www.menopausematters.co.uk/forum/index.php/topic,34706.0.html)

However I am on evorel sequi patches for 3 years now, and my cycle has just gone out of sync with the patches, so I had a bleed after stopping the progesterone patches and then another bleed two weeks later as just finishing the estrogen only patches.

On the link Hurdity posted ([[http://www.menopausematters.co.uk/to_progestogens.php]])  it says :
Careful explanation is required as to the timing of administration of the separate progestogen, in order to synchronise it with the existing cycle.

In the Postmenopause, progestogen is given every day along with the estrogen. This is known as "Continuous Combined" or "Period-free" HRT.

So from what I can guess is that even though I am out of sync it won't do any harm, and I am guessing that I will get my natural cycle back into sync eventually, just by the very nature of it being erratic, while the patches stay constant!!!!

I too work as a health care professional, and find myself looking for answers that the best way to go, but I have to say that having taking cyclogest progesterone for fertility reasons previously, I am tempted to stay with the patches only!!!!!

[optisight]

Thank you so much for your replies and very reassuring they are too 
I guess I need another few months on the patch then Rockhopper, before I loose all signs of menopausal indecision and questioning things I know are logically correct!
I feel so much more reassured now that yes I am doing so much better on HRT ( and still find it amazing that putting a plaster on my bottom once a week has improved my life so much ) It is such a shame that there is so much false information and belief about, that most women feel they won't even consider trying HRT when they could feel so much better. My rationale is, if I had Blood Pressure or Thyroid issues etc etc I would have to take medication to stay well and HRT is no different. There are side effects and risks from everything....even toast it seems. However feeling so much happier and contented with my life out-ways any small risk from HRT, merely being alive is a risk!

As for the bleeding, I'll wait and see if I realign to end of progesterone/oestrogen cycle with time, but I suppose as long as I have a bleed is all that matters as that's the whole point of sequi to keep the womb healthy

I shall declare myself a true FemSeven fan and be happy
Thanks all for taking time to reply X

[Jaki T]

I couldn't get FemSeven to stick on so had to have something else!

[atalanta]

I didn't get on with femoston and agreed to try femseven sequi patches. I have to say I've found them really good. I was sceptical as to whether they would stay on (I swim and runs lot) but they do and my tiredness and aching joints have gone. ive been on them for 6months and only had one bleed...which I don't mind as I spent years taking the pill continuously to stop my periods. I'm wondering though if this is a problem. Is the point of this patch that you should have a bleed?

[Hurdity]

Hi atalanta

It depends where you are in menopause? The fact that you are not having a bleed despite the progestogen from the patch, implies that the lining is just not building up sufficiently on this dose - or even if it is a bit then the combi patches are providing enough progestogen to thin it down to the extent that after the two weeks ( combi patches) there is nothing to shed. Sounds like you must be post-menopausal I would think. Great to hear they not only stick well but are doing the job and you feel better. I would certainly recommended them over Evorel (the other combi patches) - although I haven't tried them myself - but women seem to tolerate the progestogen in this one better than in Evorel (the latter gave me migraines!).

Hurdity x

[atalanta]

Thanks for posting. I've only been on HRT for a little over a year so wasn't sure if I could be post yet. Can My GP test my hormone levels to find out whether I am or does the absence of a bleed provide sufficient evidence?

[Glass.half.full]

I've been on FemSeven Sequi for 3 years now and they have completely transformed my life.  I too was scared to use hrt in the beginning but the anxiety I was suffering was through the roof so in the end I thought I would give them a go and I'm glad I did.

fir the first 6 months I too had bleeding just as I started patch 1 of a new pack but my cycle soon switched round.  I do find occasionally that I have a small show at the end of patch 2 but apart from that all is well.

[Hurdity]

Hi atalanta

The doctor is unlikely to do blood tests - firstly because they are unreliable and also if you are taking HRT they are especially not a reflection of your underlying status re menopause!

If you are happy on these patches then its best to carry on - despite the lack of bleed. Personally I would always choose to remain on cyclical HRT than continuous combined (as many of us on here) because I would not want to take the progestogen component all the time, and therefore you don't get the build up (of progestogen) in the system nor the ongoing side effects.

Unless you have extra bleeding at the "wrong" time then it sounds like it is doing its job. If you are concerned then havbe a word with your doctor in case they want to scan you - but the doc may well suggest you change to Femseven conti in the circumstances. However if you are not quite post-menopause then this can lead to breakthrough bleeding....

Hurdity x

[atalanta]

Hi I'm 50 and after 9 months on FemSeven Sequi patches and feeling generally good (although still no libido whatsoever), in the last couple of weeks I've started to get flushes again - not as many as before but one or two a day, the lethargy seems to have returned too and my skin feels dryer and my mood seems to be more up and down again.

I'm feeling a bit dismayed as the patches did seem to be keeping the worst of the symptoms at bay and me ticking over. I've still only had one bleed since taking the patches and none this year. I went to my GP who did some blood tests that all came back fine (thyroid, iron) but beyond that she didn't suggest anything. 

Does anyone have any advice or suggestions about what to try? If I'm heading out of the peri phase and into post, is it that the dose in the patch isn't enough? Would supplementing the patches with extra oestrogen be a solution? Is it possible to do that? Or should I take black cohosh or something alongside the patch? The lack of libido is also starting to be an issue with my other half, everything in that department ground to a halt last year when the worst of the symptoms hit.