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[NightNurse]

Dear All, following your excellent advice early last year (thank you all xxx) I eventually found the best combo for me: Evorel 100mcg with 12 days uterogestan.  All was well until this damn supply issue started. I was prescribed Estradot 100mcg which I started last week.  Since then I've felt awful with loads of hot flushes, night sweats,and dreadful emotional and psychological symptoms.  I had a bit of a meltdown two nights ago and poor husband and daughter got the full force   I feel hideous and it's like the Estradot isn't working.

Today I had a thought: am I using the Estradot incorrectly?  I have been using the Evorel patches on my bottom - out of sight, out of mind and very acceptable and convenient to me - and continued to do that with the Estradot.  But is that right?  I've checked the leaflet and it says to put the patch on the lower abdomen.  Nothing about putting it on the buttocks.  Do you think this could be the cause of my symptoms?

If the abdomen is the right place, and I know this sounds silly, where exactly should I put it?  By the tummy button or hip?  Is it safe to put above the pubic area or is this too close to the ovary? It does say not on the breasts.  I've got a bit of a belly so there is plenty of space.

Thank you all for just being there xx

[Hurdity]

Hi NightNurse

Well I would give anything to get back my Estradot patches which are unobtainable at my local dispensary! However I guess it's what you're used to - and sounds like you are absorbing differently from the Evorel. I've had to go the other way - from Estradot to Estraderm ( searate thread) which I'm not happy with - symptom wise OK but not because of the size of the patches. I continue to stick to my butt cheeks though.

By lower abdomen it means anywhere below the waist front or back so whichever suits you best and is less likely to come unstuck. I don't stick to my front abdomen because of my loose baby skin (which is still a bit wrinkly from stretch marks all those years later!) there even though no belly as such!

Yes it's fine to put anywhere there but probably choose somewhere the skin is thinner so increased absorption. Also make sure you don't use shower creams etc or other products on the skin where you are going to apply the patch. As they are so small this is more crucial for good absorption so maybe in your case elsewhere than butt cheeks might work better?

How long have you been on that combo of HRT and how long since menopause if you know? It might just be coincidence if you feel like that so quickly? Are you due to take the Utro soon? If you are peri could your own cycle have kicked in and making you feel like this? Just trying to think of other explanations but do try shifting position of the patches first!

Hope you feel better soon. If it doesn't improve maybe increase the dose by cutting one into 4 and trying 125 mg?

Hurdity x

[Jennijx]

I had the exact same experience last month - within a couple of days my mood had dipped, hot flushes and migraines increasingly worsened. I had thought about putting the patches on my hips (where I normally put my everol patches) but have issues not following rules so never braved it 😆

Fortunately I managed to get an out of date months supply of everol. Instantly felt better. My doctor said she would try me on estraderm next. This shortage is awful

I hope you find a solution that works for you soon XXX

[shrosphirelass]

I changed the position of my evorel patches from  butt cheeks to thigh and I felt awful, return of headaches, heat, dizziness and nausea. When I changed back things settled down. So it seems to me that positioning can make a difference.

[NightNurse]

Thank you all so much for this advice and info.

I'm age 55 so guessing I'm post-menop.  I was taking the combined pill continuously until age 51 years so no bleeding for ages, then went onto 2mg Elleste Duet Conti for about 18 months.  No bleeding at all during that time but started to become symptomatic again around a year of use. So I then changed to patches and messed about with different Evorel Conti patches until I hit upon Evorel 100 with cyclical 200mg uterogestan. I had got that really well balanced with patch change every 3 days and monthly utero. I didn't mind the bleeding at all as my symptoms, mood, mental function, libido and migraine all seemed stable and minimal.

The change to Estradot was as I mentioned below. I've taken your advice Hurdity and put them just around the hip line, to one side of the lower abdomen where the skin is thinner and there is not too much sag! I've just finished this month's utero so let's see how it all goes for the next month or so.  I'll keep hold of the thought of cutting a patch to raise the dose if necessary. Is there a dose upper limit in terms of safety or side effects?

I feel so ashamed at being so shrieky and crying last week.  Poor husband and daughter. He came home with flowers the following day xx

This whole HRT supply issue is extraordinary - but I know the supply of loads of other medicines is problematic. But how come I can get Estradot when other ladies can't - this doesn't make sense. Also I would be OK to buy Evorel 100 via online pharmacy - but those are not available. Why are 25 and 50 available but 75 and 100 are not? Is it that the patches not being manufactured, or are they not being distributed to UK?  I've seen what the BMS have said but Janssen (the drug company which makes Evorel) has not explained the reason(s) for the supply issue or made clear when they expect to resolve the issues.  Is this going on in other countries too?

Thanks again xx   

[KatyB]

Yes, positioning definitely makes a difference - I'm on Everol 100mcg, didn't get on well with Estradot due to not sticking, although I absorbed ok, but I needed to put them just below belly button.....normally I'm adorned with black sticky marks on upper thighs and buttocks!

[julie55]

Hi can I cut a evorol conti patch in four to increase dose as I am still getting hot flashes and palpitations I was on elleste duet conti and evorol conti is a lover dose been on it two weeks but not getting any improvement ATM

[shrosphirelass]

I had a menopause clinic appointment last week and I'm changing from sequi to evorel conti, when supplies improve. My symptoms have returned recently so I asked about increasing dose. She wanted me to go on to the gel and untrogeston, as this gives more flexibility, but I'm not keen. She said the only way to increase with evorel conti was as you suggest to add another half (or I guess a quarter) though she didn't recommend this, as with the increase in progesterone there would may be more side effects.

[Sickntired]

Just caught a bit of this, been put on Estrodot because i was on Evorel sequi which now cant get.   Am in Perthshire , Scotland.  Wonder if postcode lottery...  maybe not but ?

[julie55]

Ty for your reply Shropshirelass XXX much appreciated I will give them another week then I will add a quarter to see if it helps more if not looks like yet another trip to doctors don't want to take tablets anymore prefer the patches if I can get it to work for me finger's crossed and Ty once again for your reply 🌹🌹

[Hurdity]

Sickntired - lucky you to be given Estradot! I presume you have been given a progestogen to take alongside?

Good luck with that julie55 - I'm always cutting patches but mine are oestrogen only so there is no problem in principle with cutting them! With the combi ones like Evorel conti this would be off-licence but Dr Currie said it was OK to do this a while back on here and in the magazine - for that product. As always report any abnormal bleeding.

Hurdity x

[julie55]

Thank you hurry x I am going to do it today just add a quarter and hope it helps I will let you know if I have any improvement thank you all for your help what a fabulous group this is god send xx

[julie55]

Sorry hurdity spelling mistake on your name xx♥️♥️🌹

[Hurdity]

Lol! No problem - it's the rude ones I might take exception to  . All the best

Hurdity x