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[owenlana]

Just found out there are none to be found!  my doc has let me know.  I realized there was a shortage but it all seems sudden now.  Not sure what to do, they have offered me femoston tablet form but I am not happy with concerns about blood clots.  I dont think my circulation is the best as have raynauds. 
doctor said my options are to take the tablet, or alternatively to try weaning off patches.  I agreed to this but a bit unsure, she suggested to extend the length of time I wear 1 patch so instead of my usual 2 patches a week to wean off by using 1 a week for a month, then extend to each patch thereafter for 10 days a patch.  I have 8 patches left so figure I make these last a couple of months instead of the usual month for 8 patches. 
Very confused, as I have read that some people cut their patches.  Perhaps I would be better to cut them half?? and space them out that way rather than extending each patch.
HELP!!  I have been on these patches for over 10 years, early menopause.  Panicking.  as heard that evorel sequi may not be available till later in 2020
So my question is cut in half or extend the wear of each patch??  I figure cutting in half keeps things in a better sequence as 4 evorel sequi and 4 conti patches.  I think my body would be out of sorts if I take docs advice by extending each patch, I am now thinking this is poor advice and cutting them makes more sense.  What do you think?  Anyone help or advice would be so appreciated. 

[Hurdity]

No need to stop using patches or cut them. Your doc can prescribe oestrogen only patches (you will need to find out from your local dispensary or pharmacies which they have available), together with a separate progestogen. The two available and licensed separately for HRT are Provera or Utrogestan. The one that's the same as in Evorel sequi is norethisterone so the doc could prescribe you this one as it is available separately - but prescribed as part of combi HRT types. The dose for sequi HRT is 1 mg per day but in tablet form. It might not be available at this dose though.  https://www.menopausematters.co.uk/perimeno.php .

Also the BMS has produced a table:
https://thebms.org.uk/2019/11/hrt-preparations-and-equivalent-alternatives/

This might go straight to it:

https://thebms.org.uk/wp-content/uploads/2019/11/HRT-alternatives-04.11.2019.pdf

Hurdity x

Edited to correct the link

[owenlana]

Thanks for your reply
The message from my doctor was that there was no patches in any form available at all
I have been left with just 2 options to take tablet form femoston or to wean off my patches.  I am naturally really confused. 
When I put in for my repeat prescription I got the telephone call first from pharmacist and then later from my doctor surgery both telling me same info that no evorel patches or any substitute patches available at all in my area in Scotland.

[sheila99]

I think your doctor is wrong. Maybe take the list to the pharmacist to check then you can tell the doc what they can get. I haven't had a problem getting oestrogel if you want to stick to transdermal.

[owenlana]

I asked if there was an alternative and they told me on 2 occassions a firm no! 
I really would have been happy with any alternative patch I told them this but they said nothing was available!
Not sure what oestrogel is, is it a patch? 
I have no idea what to do

[sheila99]

Oestrogel is a gel. IMO it's a better option as it's transdermal which is safer than oral. Many doctors are clueless when it comes to meno and I'd put your doc in that category. Keeping a patch on for a week at a time will give you a normal dose for 4 days followed by next to nothing for 3 ( I tried to increase my dose by leaving the patch on for extra days so I know it doesn't work). Just because your doc told you nothing else is available doesn't make it true. It's very, very unlikely she knows better than the bms.

[owenlana]

Thankyou, the oestrogel may be an option however not sure about the conti part of the evorel?  the progesterone, seems to be in tablet form.   Really want to avoid tablets. 
I think I am left with no option but to cut my patches in half to make what I have left go further. 

[Hurdity]

owenlana - if you look at my post I explained this - about the separate progestogen, and gave you some links which will give you the alternatvies and also gave them in my post. Utrogestan can be used vaginally if you don't want to take anything orally (same product same dose - but no need to tell your doc this - just get it prescribed 200 mg x 12 days). What your doc will be referring to is situation re the combi patches. Quite true that there are none available ie both Femseven sequi and Evorel sequi have manufacturing issues. However as I said and as per the links I gave you will be able to get oestrogen only patches. Do your research and then be persistent with them! Just realised I missed off the "h" from the link so will edit my post....

Also here is the latest situation ( end Nov) re all the HRT prodicts available although this will have changed a bit and will vary locally depending on wholesalers and demand.
https://thebms.org.uk/2019/11/british-menopause-society-further-update-on-hrt-supply-shortages-26-november-2019/

Good luck and don't give up or be fobbed off by your docs!

Hurdity x

[owenlana]

Thankyou. I did check through the alternatives very carefully previously and researched in detail came to conclusion utrogestan didn't sound like an option either,
cutting the patches does seems to be my only option

[sheila99]

Why is utrogeston not an option? If you want to keep away from oral you can use it vaginally, you use the same product and dose. HRT is one of those things where you have to try it. You can't tell in advance what will suit you and what won't.

[Katejo]

Just found out there are none to be found!  my doc has let me know.  I realized there was a shortage but it all seems sudden now.  Not sure what to do, they have offered me femoston tablet form but I am not happy with concerns about blood clots.  I dont think my circulation is the best as have raynauds. 
doctor said my options are to take the tablet, or alternatively to try weaning off patches.  I agreed to this but a bit unsure, she suggested to extend the length of time I wear 1 patch so instead of my usual 2 patches a week to wean off by using 1 a week for a month, then extend to each patch thereafter for 10 days a patch.  I have 8 patches left so figure I make these last a couple of months instead of the usual month for 8 patches. 
Very confused, as I have read that some people cut their patches.  Perhaps I would be better to cut them half?? and space them out that way rather than extending each patch.
HELP!!  I have been on these patches for over 10 years, early menopause.  Panicking.  as heard that evorel sequi may not be available till later in 2020
So my question is cut in half or extend the wear of each patch??  I figure cutting in half keeps things in a better sequence as 4 evorel sequi and 4 conti patches.  I think my body would be out of sorts if I take docs advice by extending each patch, I am now thinking this is poor advice and cutting them makes more sense.  What do you think?  Anyone help or advice would be so appreciated.

  You can still get Evorel Sequi by posting your NHS prescription to the independent Pharmacy https://www.theindependentpharmacy.co.uk/menopause-hrt/evorel-sequi    You will only be charged for an NHS prescription (assuming you usually have to pay). I have obtained Evorel Conti this way. I keep a photocopy of the prescription just in case it goes missing in the post but it hasn't happened yet.

[owenlana]

Thanks Katejo I did already purchase from independant pharmacy at a very high cost £69 for 3 months as in Scotland I dont pay for prescription.  Was unsure if I could get on my free prescription
No way I am changing to try something completely different, not after 10 yrs on evorel.  Chopping and changing will not suit me. 
Pleased I have found some evorel for now anyway at rather a high cost!

[Katejo]

Thanks Katejo I did already purchase from independant pharmacy at a very high cost £69 for 3 months as in Scotland I dont pay for prescription.  Was unsure if I could get on my free prescription
No way I am changing to try something completely different, not after 10 yrs on evorel.  Chopping and changing will not suit me. 
Pleased I have found some evorel for now anyway at rather a high cost!

You definitely don't need to pay the £69 or complete their online order form if you have a prescription. I didn't pay anything because I have exemption and had completed the back of the prescription.

[owenlana]

Thanks but I dont think I qualify in Scotland
first question
Are you registered with a GP surgery based in England? Unfortunately you may not be eligible for this service, please contact our support team for further information about how we can fulfil your NHS prescriptions
Going to cut the patches to make them last longer and see how I go
Anyone had any success cutting patches or did you suffer side effects by doing so?
Also is it actually ok to cut these patches?

[Katejo]

Thanks but I dont think I qualify in Scotland
first question
Are you registered with a GP surgery based in England? Unfortunately you may not be eligible for this service, please contact our support team for further information about how we can fulfil your NHS prescriptions
Going to cut the patches to make them last longer and see how I go
Anyone had any success cutting patches or did you suffer side effects by doing so?
Also is it actually ok to cut these patches?

Yes I am in London. Try sending an email to ask about this. I emailed originally before making my first request.