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[angela27]

Hi, I have been following the forum for about 3 months now and really hope someone can help with some advice. I am 48 and peri menopausal, I started on evorel sequi patches in March 2016 for hot flushes and night sweats, the year previous to this I had some months with 2 periods maybe missed a month etc.., the longest I went without a period was 3 months. The patches were great and worked pretty quickly in dealing with the flushes and sweats. Then in about January/February this year the flushes, sweats, mood swings returned along with the most horrible anxious feeling in my chest, crying for no reason and low mood, none of these I had experienced before. My doctor tried me on a couple of other hrt's (cant remember which ones) but I didn't realise at the time they can take up to 3 months to work as originally the patch worked pretty quickly, I never stuck with anything for more than a week. I went through a horrendous time for weeks until an hrt clinic appointment.
The clinic got me to wear 2 patches see how I would go. I am now on week 10, I don't get on with the Conti patch at all from what I have learnt on this forum I now understand why. I was due to be on the Conti patch on holiday as it really brings me down the clinic have said I can have a month without and just use the 50 patch.
My problem is this, the really bad anxious feeling and horrendous crying have gone BUT even on the 50 patch my mood is still low, getting mood swings, some nite sweats, headaches, tiredness. I have had a few days were I have felt quite ok, no low mood just like myself but nothing consistent.
if the estrogen is the 'good' hormone what is going on with me? I feel my levels might be too high because of the headaches, tiredness etc.., also there have been a couple of times like today I was extremely late in changing my patches and my low mood had started to ease off a bit?? So confused by all of it, estrogen too high or too low?? I do keep a daily diary but there is no clear picture emerging.
I have 2 small girls of 7 and 6 years whom I love very much and I just so wish they could have the mum back that likes to have a laugh, joke around and play. I am so scared that this is were I am going to be from now on, I know there are lots of other options out there but I think I have rambled on enough never mind going into that now.
I apologise as what I have posted about may seem trivial compared to what some other ladies are going through but this has affected me badly for months now, want to be the mum my girls need me to be and to get back to 'me' for my own sanity.
Thank you to anyone who reads this and hoping for some thoughts and/or advice.
   

[Mbrown001]

It could be that you are not absorbing the hormones from the patch.
Also the progesterone part of this Evorel can cause side effects for some women.

Perhaps the best idea would be to find another delivery method. A gel for the oestrogen part and Urtogestan for the progesterone. A lot of women tolerate Utrogestan well and it can be used as a pessary if you want to minimise side effects.
There is also another patch that you could try. Femseven Sequi I think it's called.

If you look at the menu at the top of the page it will detail out your options.

You are right it can take up to three months to work properly but it's difficult to be patient when you want to feel better yesterday. I do understand that.

Hopefully you have a GP you can work with to find a solution. Browse around and read as much as you can. Ask loads of questions.

We are all here to help if we can.

Oh and 

[angela27]

Hi Mbrown thank you so much for your reply and welcome. Im being seen through an hrt clinic next telephone appointment is in 2 weeks. They are suggesting the mirena coil and gel. I would be very anxious trying the coil as ive read some women suffer badly with depression using it? I have suffered from depression on and off for years and would be worried that i may be affected in this way. Have you heard off this yourself?
With the gel do you know if there would be like a transition period?, like having to start from scratch getting levels built up?, i would hate to return to the really bad anxious feeling and terrible crying again.
I rang the hrt clinic last week to ask if i could get bloods done just to give me a rough idea of my levels but they said no.
Its the physcological end of this i am finding so difficult!!
Thank you so much for your initial reply to me it is a very lonely time all of this.

[Dancinggirl]

angel27 - it is well worth trying the Mirena as it can work very well for many women. progesterone can be the big problem part of HRT for many of us and in my experience of using various hrts over 25 years ( due to premature meno) the Mirena was my best HRT experience. I also think that high doses of oestrogen , particularly in the peri stage, is not a good idea - it can also mess with your head.
If low mood/anxiety are plaguing you then an SRRI alongside HRT may be a good option to try. Many women need an SRRI together with HRT.
Try the MIRENA and either oestrogen patch or Oestrogel alongside - start on a low dose and gradually build till the flushes are under control. Perhaps ask for a SRRI like Citalopram to try for a few weeks to see if that helps with mood etc. Keep us posted DG x

[angela27]

Hi Dancinggirl thank you so much for replying. I read earlier today a lady saying about mood swings with the coil and thats why she wouldnt want to try it. I thought thats it im definitely not trying it!!, its the possibility of depression and mood swings with it that scare me. I asked the hrt clinic about it they said they have never heard of women reacting like that?, thought that was strange. They did say they wouldnt take it out either unless it was for more medical reasons.
Have you heard of high oestrogen levels affecting people mentally? The longer i stay on the 2 patches i feel like im going backwards, low mood still there was nearly crying earlier thats why ive thought could my oestrogen levels be too high and why i feel like this? Does that sound totally ridiculous?? I am also having bad headaches daily which i never had before.
I already take an AD which my doctor got me to increase a while ago believing all this was depression. It did nothing for my mood only took the edge of my anxious feeling.
I have to admit i am very scared at the moment, i read of a lot of people starting to feel better on their hrt and here i am on wk 10 getting nowhere.
Sorry to be so negative, take care.

[Dancinggirl]

HRT is not a cure all. In the peri stage your own hormones will still be fluctuating so I personally feel it is a mistake to use too high a dose in peri for this reason. I think it's about finding a balance.
It is really unwise to use a continuous HRT until well into post meno but the Mirena can give a bleed free HRT regime and give a consistency that is difficult to achieve with any other type of HRT. 
You say you have been chopping and changing various hrts so now your body simply doesn't know what it's doing.
It may sound scary but if I were you I would stop all HRT for 4 weeks and then start fresh and whatever HRT regime you choose to try you should start low and only increase dose after 2-3 months if flushes are not under control.
Keep with the ADs/SRRI and be give things time to work. DG x

[Mbrown001]

Good advice from DG.

When I tried a higher dose of HRT I felt simply awful.

Sometimes it's good to go  back to basics.....have a break and start again.

[angela27]

Hi Dancinggirl and Mbrown, thank you for your replies, much appreciated.

Dancinggirl, i really dont think its something i could do stopping for 4 wks in case the really bad anxious feeling and crying came back. I have 2 small girls of 7 and 6 years who are also off on their summer holidays it would be a disaster.

Mbrown, can i ask you how you were affected when you took a higher dose of hrt?

Would either of you know is it common if i came off the 2 patches and switched to gel would i encounter a return of symptoms possibly i.e. anxiety and crying as i would be lowering oestrogen levels and building back up maybe?

Thanking you in advance for any replies.

[Mbrown001]

I had a sort of internal jittery feeling. As if everything was vibrating, difficult to explain though. I just felt wired I guess. It also made me feel quite sick.

When I cut back down after a few days the feelings went.

I'm only on a half combined patch now but I'm much older than you at almost 57.

You could cut one of the patches in half just to try and see if that helps how you feel.


Mrs Brown

[MIS71MUM]

Hello
I've been on evorel sequi before, am 46 and have 2 small girls of 7 and 8.

My first piece of advice is to change to a separate progesterone! The progesterone in sequi is called notherhisterine and is renowned for causing low mood and depression. You could stay on the evorel patches for Oestrogen and maybe switch to a tablet called provera for the progesterone.

Secondly if you are peri - I would reduce Oestrogen patches to 50mg with a view to increasing at a later date.

I agree that too much oestrogen flattens me a bit, makes me very thinky, irritatable and moody which then increases my anxiety.

I've also tried Mirena.

Just a thought, could you take the ccp pill qlaria or zoely these have bio identical Oestrogen and are in tablet format. This would override your cycle and therefore should stop any of the fluctuations from your own cycle.

Hope this helps.

[Bluebell]

Hi ladies,  does anyone know the difference between Evorel Conti and Evorel Sequi patches?

I was put on Evorel Conti, started at half a patch for a few weeks then up to a full patch.

Like you Mrs Brown the day after putting on the patch I felt totally wired as if I had drunk lots of black coffee, all jittery and having to run to the loo.

I decided to go back to half a patch and the next day I was fine - then today I got up feeling really anxious for no reason?!

I went on HRT because of palpitations but since I've been on it I still don't feel great although the flushes and nightsweats have gone.
 
I'm 63years ...4 years since my last period and beginning to think maybe I'm too old for going on HRT. I've been on it for about four months now.

I just find the whole thing a minefield.  Carol.

[Mbrown001]

Conti is a no bleed HRT and Sequi will give you a monthly cycle.

If you can tolerate constant progesterone then the conti is fine if you can't then a Sequi is much better.

I presume you had been period free for a while before you were put on the Conti ?

[angela27]

Hi Mrs Brown, thanks for replying yet again! About 3 weeks ago i didnt change my patches until pretty late in the day had no night sweats that night and thought could be something in this! So next day i cut a conti patch in half, first couple of days i felt good bit better but by the end of the next week i was back to crying for no reason so went back to the 2 patches again. I dont know if it happened because it was the conti patch.

Thank you for the advice you have given.

[angela27]

Hi MIS71MUM, thanks for your reply. I am going to be switching to a separate progesterone as i dont get on with the conti patch, really low mood etc.. The hrt clinic wanted to use the coil but i really cant take the risk in case i would be affected by depression and or mood swings as ive suffered from depression in the past.

Im assuming provera is a synthetic progesterone would you not get more side effects with this as its a tablet and going through your system? , possibly worse than the patch? I need to read up on it but dont think i have a big pile of options.

The reason my 50 patch was doubled was because my hot flushes, night sweats came back along with terrible anxious feeling in my chest along with lots of crying. Im on my 12th week now, oestrogen only and i feel totally flat, no interest in anything, no laughs or joy going on, not myself at all. This along with daily headaches, bloated, tired is what made me think my oestrogen is maybe too high?

The ccp pills you mentioned are they oestrogen only? When you say about overriding my own cycle, i havent had a natural period since starting the patches last year just the withdrawal bleed during the conti patch. Is this what you mean or just the fact im still peri?

How did you find the mirena? I would love to be brave enough to try it but cant risk it!! How is your hrt journey going?, have you found something that works for you?

Sorry for all the questions!!, would be good to get any of your thoughts/advice if you have the time.

Angela.

[Dancinggirl]

Angela27
I personally don't think you can expect to control all the mood issues with HRT.  In my experience higher doses of oestrogen are not good and I felt very wired and sweaty on a high dose.
Switching to Oestrogel could be an option. It it's the progesterone that can be the hormone that effects mood negatively.
Taking a break from HRT shouldn't effect your mood too badly, especially if you are using an AD or SRRI. You may find you feel better without HRT - so unless you try you don't know.
It could be worth try probers as it is a kinder progesterone than the ones in the patches - many women do really well on Provera - it's all trial and error. You can get side effects whether you take HRT as pills or use trans dermal patches or gel.
You sound so wound up and anxious I really think you need to try and take a step back, rethink what's going on and start fresh. HRT or any medication will bring benefits and side effects - it's about finding a balance. DG x