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[pricey]

Hi Ladies,

I posted a few days ago about my HRT review. I have been doing OK, most symptoms controlled by Elleste Duet 1mg. My very heavy erratic periods had settled into 3-4 days predictable much lighter bleeds. The Dr decided that as I have been on Duet 2 years and may only be having withdrawal bleeds, it was time to try the Conti regime. She has given me 3 months supply with the option to go back to Duet if it doesn't work out. I will be 53 in January, by the way.

I'm slightly apprehensive about upsetting the hormonal apple cart, but have decided to give it a try. Took the first tablet last night. I am currently having my period, whether it's a withdrawal bleed, or not, I cannot possibly know as my periods were erratic before I started Duet 2 years ago. I have felt very tearful and wobbly today. Now I could be reading into what is normal hormonal PMT type low mood (worse some months than others) or could the increase of oestrogen have affected me already? I will admit, the doubling of the oestrogen dose also slightly concerns me. I generally do better on the oestrogen only pills in the Duet, but tolerate the progestin tablets quite well too, apart from an increase in headaches, but this fits with my previous premenstrual phase. I know the general advice is that Conti is for women who have stopped having periods, but my GP tells me that for women of my age who have been on the sequential therapy for 2 years, it is also appropriate to use the Conti regime. The only advantage to me would be the cessation of bleeding and a reduction in breakthrough flushes and other symptoms, but I am worried I will bleed erratically as I may not be truly post menopausal and I also may feel worse emotionally to boot! Have I done the right thing by starting the new pack? Should I run with this?

Thanks for your support!

[Dotty]

Hi

I can't comment on your case but I'm on Elleste Duet Conti too x

[Dancinggirl]

Pricy - I do understand your concern.  The jump in oestrogen was probably not necessary if you were feeling OK on the 1mg Elleste, so your GP could have tried you on Kliovance, which contains the same hormones and a similar dose as the Elleste Duet 1/10 but in a conti regime.
If you were basically OK on the Elleste 1/10, then I would have stuck with this but at least you can go back to it if the conti doesn't suit you.  Break through and erratic bleeding will happen on any conti regime in the first few weeks and months, so do expect this.

It is better to be on the lowest dose possible to get the best overall result with minimum side effects. 
You could keep on with this Elleste conti to see how it goes - it may suit you very well.
OR - you could ask for a telephone consultation and request a new prescription for the Kliovance 1/5 as you feel the Elleste conti version is possibly too high a dose.  DG x

[pricey]

Thank you Dotty and Dancing Girl. To be honest, I feel wretched.  I have taken only 2 of the Conti and feel agitated, restless, anxious and very tearful. I started the new pack on the first day of my period. Hubby thinks I am anxious about the change and the switch could not possibly make me feel this bad so quickly.  My instincts tell me it could.  I told my GP I always feel much better on the oestrogen only pills in the duet and that I am plagued with headaches the second half of the cycle and yet she seemed to think having the progestin constantly would help. Also yesterday my flushes were worse, with horrendous facial flushing and today I have woken up with a very bad headache. However headaches are common during my bleed.  I was at work until late last night and am working today and all weekend. I am dreading feeling like this or worse. I am tempted to just go back to the Duet, but how confused will my body be? But I'm also thinking, hearing more about these other preparations, should I be asking for something else as I don't think really this type of  progestin is the best for me anyway. Hoping to ring GP before work but doubt she will do anything after only two days of the new tablets. Feel so miserable.

[Dancinggirl]

Perhaps try Femoston, either sequi or conti. This has a kinder progesterone that might suit you better. If you get bad headaches with progesterone then you may be sensitive.
I used to get flushed with too high a dose of oestegen and also when on conti hrt.
Why not give yourself a 4-8 week break from HRT to see how you feel and then start fresh. To be honest, if one is getting on ok with a particular type of HRT in a sequi regime, I believe it is often best to stick with this.  Most HRT types will bring some side effects - it's about finding one that gives the most benefits with the least side efffects. DG x

[pricey]

Thanks Dancinggirl. I managed to get an appointment with another doctor.  She seemed to think it was a minefield but talking it through felt Femoston Conti 1mg might be a better option.  Unfortunately she decided to take my BP.  Last week at my review it was "excellent". Knowing that I have a tendency to have BP spikes when anxious, stressy, or with headaches I prewarned her it might be raised.  I had also just walked quickly across town and got called straight in. So the digital monitor had me at 175/84. She went on about this being much higher than last time plus risk of clots and stroke. Lo and behold checked again: even higher. Had I ever had BP meds  recommended? No. Because my BP is only occasionally high. Anyway she said I should perhaps see the nurse in a couple of weeks. I asked if I could do a straight swap from the Elleste Conti (I've only taken 2 tablets). She looked it up. No. I should finish this month. I was frustrated at this point; so given my BP is apparently a worry and I feel lousy after 2 days,  I should take a further 26 days on a higher dose of oestrogen (bad for BP in itself?) Her logic was I would be "doubling up on oestrogen " - surely I would be immediately reducing my oestrogen? Anyway the PIL in the pack says if you're currently on a conti regime you can swap on any convenient day.  I have only been on the Elleste Conti for 2 days. Can I swap to Femoston today?  ☺

[Dancinggirl]

I'm Afraid I don't agree with your GP - I would stop the high  dose HRT right away - perhaps give yourself a couple of weeks without any HRT, if you want to let your body settle, and then start fresh. If you get any bleeding, just wait till that finishes and then start the Femoston.
As you have only had 2 days of the high dose HRT, I'm sure you could simply switch to the Femoston if you want to. There are no benefits to sticking out a whole month with the elleste as this will just throw your body into a roller coaster of hormones which could take longer to settle.
Follow your own instincts. DG x

[pricey]

Thanks DG. As I'm currently having my withdrawal bleed I think I may just switch. I see no logic in what the doctor said. x

[pamb]

It might also be a good idea pricey to buy a blood pressure monitor to use at home to check that your BP was just down to feeling stressed and rushing about.  Mine is always different at the docs and then when I  take it again at home when I'm calm and relaxed its perfect.  Can't be too careful with BP.  Best of luck.

Pamb x

[wombat62]

My BP is always high at the docs! I've got a home machine and over the last couple of months it's come right down, hope the machine is right!

However, what I have discovered lately is that I had a bad night with 3 cycles of heat/loo visits and taking a long time to cool down and get back to sleep, guess what BP was up the next day! I then though, mmmm....every time I visit the doc is when OH is away, I don't sleep well then plus I'm always stressed etc when visiting the doc, rushing there, waiting etc. Also when they take my BP they are chatting and it says on the machine instructions to remain quiet, feel flat on the floor, empty bladder etc for the best results plus because the BP has been higher at the docs, naturally you're stressed before they take it! Even my first reading at home is higher because of the apprehension of the reading!

So, I've got to go this week and really hoping as it's come down at lot at home it will be the same at the docs!

Get a home machine and keep a note of the readings to take to the docs. The last few weeks I've been doing a couple of good short brisk walks a day and also a glass of beetroot juice!

Take care...