Hi again pb42, Hurdity's post will have been helpful as always, but I just want to add a couple of thoughts. If you had gone a year without periods when you started HRT, did you opt for a sequential regime (that would presumably mean you started to have bleeds again) or were you not given the choice of a bleed-free (combi conti) regime? Many women do prefer to continue to have bleeds because this means they only have to take a form of progesterone for part of the cycle & as it's usually progesterone that brings the worst side effects they want to minimize exposure to it. If, as you say, you had no side effects from the Evorel Conti, this suggests you are not progesterone intolerant as such, so if you have continued to put up with bleeds & would prefer not to, you might want to consider trying a continuous regime i.e. one where you take both hormones at the same dose every day. That said, be warned that combi conti regimes are not always bleed-free, especially in the first months while the body adapts.
As the progestogen part of HRT is also thought to be the element that carries the risks (albeit small), some ladies understandably prefer to stick with a sequi regime to keep any risks to a minimum. You didn't mention dissatisfaction with being on a sequi regime, so my suggesting a combi conti regime may be unnecessarily complicating the decision, but if you are about to change regimes I just thought you might want to consider a bleed-free option.
As for your question about adding oestradiol gel to your existing Evorel Sequi regime - I wouldn't do this personally (certainly not without approval of a gynae) as this might increase your oestrogen levels beyond the capacity of the progestogen to protect the uterine lining. That said, Sandrena gel was added to my Evorel Conti regime for a few months, but this was prescribed by a well-respected gynae & I later stopped it in agreement with my GP, as I continued to have bleeds beyond the "acceptable" initial 6 months.
As Hurdity says, if you simply add another half of the Evorel patches, this would give you rather a high dose of progestogen during the second phase & if the progestogen in the Evorel Conti patches is perhaps already preventing you getting full benefits from the oestradiol, this probably won't make you feel any better than you already do!
Hurdity & I both use Estradot patches with Utrogestan, but as Hurdity says, she prefers a sequential regime, whereas I take Utrogestan continuously. It's a matter of how progesterone makes you feel & whether you mind having a bleed. The Utrogestan is the most natural form of progesterone btw & as such is thought to be more "breast-friendly". Not everyone gets on well with it though & I have twice had to abandon trials of it in the past! As Hurdity suggests, have a look at the list of preparations available - the Estradot & Utrogestan combination is only one choice.
Sorry this is rather long - I hope it doesn't make things even more confusing!
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Topic: Do I need a higher HRT dosage-help! (Read 47484 times)