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[strozzi]

Hello 

I'm new here and been reading lots of stories on here and other groups, but I'm struggling to get an answer on this issue...

I got a prescription of Evorel Sequi patches and started them on Saturday. The GP wasn't very knowledgeable about HRT, was actually googling it during the appointment! I am also currently on the mini pill, which I am taking to control heavy periods (not as contraception). I asked if I needed to keep taking it and she didn't really know, but said I could if I wanted to.

The leaflet with the patches states that the amount of progesterone in the patches is less than in contraceptives, so I don't really understand why I need it in the patches aswell - doesn't the mini pill cover it?
If not, then I will need the combined patches, but will this then give me 'too much' progesterone. i.e. will I be more likely to get unpleasant side effects? (I had the mirena coil a few years ago and it gave me horrific mood swings)
If it will, then maybe I will stop taking the mini pill. But will I then get the heavy periods back again? (I stopped it earlier this year to check if I was still having periods and I most definitely was!)

I have made an appointment to speak to another GP who is more experienced with HRT, but that isn't for another couple of weeks.

Would be interested in hearing anyone else's views/experiences on this.

Thanks

[Hurdity]

Hi strozzi

 

You haven't said how old you are but I presume you know you are peri-menopausal due to blood tests (FSH) combined with symptoms such as flushes and sweats, because being on the mini pill you have no cycle to go by.

You're right that you might have too much progestogen with the mini pill and HRT but the amount of progestogen in the mini pill is not sufficient to protect the uterus when taking oestrogen too hence the need for a proprietary combi HRT like you have been given.

Which mini pill are you taking? Ideally the Mirena coil would do both jobs - ie prevent the bleeding as well as protect the womb lining as part of HRT. I wonder if you tried the Mirena again with a reasonable dose of oestrogen you might be OK this time?

It also might be that you are fine with the extra progestogen - some women are - especially if you are OK taking the mini pill which is pure progestogen.  There are some women who do take both....

The other alternative is the contraceptive pill - there is one ( or two) that are similar to HRT and would provide oestrogen as well as control the bleeding. Qlaira is one such and I think can be taken up to age 50.

Hurdity x

[shrosphirelass]

Several years I ago I went to the Dr with bad premenstrual headaches and very heavy bleeding. He prescribed mefanemic acid tablets (which are NSIAD's), to be taken for a few days premenstrually and during menstruation. Didn't touch the headaches, but worked wonderfully well for the heavy periods. Since being on evorel sequi I don't need this any more, though it could be that I am finally approaching menopause at 57!

[pants46]

Strozzi, if you are peri, you defo need Evorel Sequi. The minipill is not enough progesterone.
I started on Evorel Sequi patches 8 weeks ago. I too was on the minipill for heavy periods. Been on it for 12 years.
My Dr suggested staying on it, then I wouldn't get my bleeds back on the HRT. So I stayed on it for the first month. I didn't get a bleed at the end of the first month. After that I stopped the minipill. My main issue is anxiety, and I thought it may be too much progesterone. I have now gone a month without and have just got a bleed. It's very light right now. But who knows what it will be like a few months down the line. It will be predictable, at least.
So it's up to you. If you get on with taking both, keep going. If you struggle on the Conti part of the month, you can try stopping the minipill. Just remember that the hrt on its own is not a contraceptive. And if your periods become heavy, you can always go back on the minipill. You can take the minipill up to age 55.
It's really up to you. We just have to try things and learn. Do keep a diary though,  so that you can work out what works for you.
Good luck and let us know how it goes.

[strozzi]

Thanks pants46 that is really helpful. So it doesn't sound like I should get anything this month and I'll take it from there.

Just to clarify - I'm nearly 50 and on the mini pill so blood tests would be pointless. And as I said, I have no need to contraception - I would love to, but I'm single! 

Mirena coil is a definite no from me from past experience and knowing that if I was to get bad side effects I would have to wait for an appointment to get it removed.