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[SophiaG]

Hi everyone, I posted on here a few months ago re Evorel Conti patch which I have been using for 6 months now.  I am 58 and hadn't used HRT since my last period 12 years ago however my symptoms, flushes, palpitations, mood swings etc had got so bad I gave in and started the patches which pretty much stopped all of my symptoms.

1 month ago I had that dreadful flu bug and was laid up for 3 weeks – I started spotting, only for a couple of days but it freaked me out a bit. As I had also had some very uncomfortable breast tenderness I decided to cut the patch in half to see if that changed things.  Well, just over 4 weeks on from the flu, I am now having hot flushes at night, more low moods and an increase in palpitations.  The skin irritation, itching dry skin, I had tolerated before has now spread and become more irritating, I'm not sleeping so well…overall I feel nearly as bad as when I wasn't on the patch at all!

I wondered if anyone has tried to reduce their patch and had similar results – I'm contemplating using a whole patch again but I really don't want to start spotting again…I did wonder if having flu may have affected things as well?? Any advice would be gratefully received and might make me feel a bit more sane too! 

Many thanks, Sofia

[Salad]

I'm an Oestrogen only user -I used to trim bits off my patches with success.

Im assuming you're on the lowest dose?

[Aileenf]

Hi Sofia

I've just came off everol conti after 6 months, I was fine for about the first six weeks, started spotting then started having a period every two weeks, I have been post menopausal almost 4 years, I also couldn't cope with the depression and anxiety either which seemed to get worse every month.  I did cut the patch in half for the last few weeks but didn't feel much of a difference to be honest.  I am currently on Angeliq which I have been on for 3 weeks now and feeling so much better mentally, no flushes and I am sleeping, but still in very early stages, trying to take one day at a time,

[SophiaG]

Hi Salad and Aileen, thank you so much for your responses.

Salad – the Evorel Conti patches seem to only come in one dose which according to the leaflet “delivers 50 micrograms of estradiol and 170 micrograms of norethisterone acetate a day”.  Tell me does an oestrogen only patch still mean no-bleed? 

Aileen – it sounds like you've had a bit of a time of it on Evorel Conti…glad to see you've found something that works. I can't do the tablets as I get a reaction to the binding agents they use.

To be honest I felt really good on Evorel Conti until the spotting, I haven't had a period thank goodness and I'm now just wondering if I overreacted to the spotting because I am 12 years post-menopausal and not used to it! I'm seeing my gp in 2 weeks for a review and maybe should go back to the full patch.  I wondered if dropping to half a patch and then going back to the full patch is going to mess things up any more – anyone with experience of doing this out there?

[Hurdity]

SophiaG - women who use oestrogen only and do not need progesterone have had a hysterectomy so no need for womb protection.

Although spotting and bleeding is normal on any continuous combined HRT for the first 6 months, any bleeding that continues after this or is new onset should be checked out just to make sure nothing is amiss - even though it is likely due to an imbalance between oestrogen and progesterone - if you are post-menopausal. As you say you can only get the two ingredients together on this patch which means if the balance is wrong - you can't alter one without also altering the other. Too much of the progestogen can cause endometrial atrophy or over-thinning of the womb lining whihc can lead to spotting. To much oestrogen can lead to over-thickening and sporadic shedding of excess womb lining. Rarely if the lining continued to thicken - a condition callled endometrial hyperplasia can happen which if untreated could in a small proportion of cases lead to cacner. Hence the checking - which in most cases turns out to be not due to anything sinister.

I'm sure flu will have affected you overall  and how you feel - it takes some time to recover fully. if you had a high temeprature then this could have caused the patch to come a bit unstuck ( I know th9is happens to me in the summer sometimes when out in the sun and getting v hot!) which would have caused a lowering of levels and led to the spotting?

re changing dose - I've done this several times. I was on 50 mcg for several years and then gave up for 3 months so had nothing When I resumed hRT doc suggested a lower dose of 25 mcg to see if it worked - but it did for a bit and then flushes came back so i went back to 50 mcg. A few years ago again I had some spotting and doc suggested reducing so tried 37.5 mcg for a few months but still flushes came back so went back up to 50 mcg which is clearly my sweet spot dose - and actullay now I am on 62.5 by snipping an extra bit - becase I also take testosterone and didn't want to shift the balance too much towards T.

Breast tenderness can sometimes be caused by the prog if it's ongoing....

Hurdity x

[SophiaG]

Thank you Hurdity for taking the time to give such a comprehensive reply - its made it all a lot clearer for me re spotting.  I think I'm going to wait until I see my gp, armed with a bit more understanding  and then, if I'm still feeling the same increase in symptoms, I'll go back on the full patch. Thanks again for explaining it so well.