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[anartistatheart]

That's great news! Good luck with the HRT and I hope it soon begins to make you feel better. The general advice is that it takes up to three months before you can really tell whether it is the right one for you. Your withdrawal bleeds for the first couple of months might be a bit painful or heavier than usual but, in my experience, this soon settles down.

It is very worrying that women are still being given the wrong HRT when it can have such a detrimental effect on their health. It just shows how important it is to read up on the medications etc. we are given and not just take what we are told is right for us actually IS right.

Taz x 

Thanks Taz 

[Hurdity]

Hi anartistatheart

Good to hear your persistence has paid off, but if you are in UK then with reference to the title of your thread they have still got it wrong, in that the pharmacist and nurse have prescribed you an off-licence regime. Desogestrel is the active ingredient of the mini pill cerazette and is not available as part of hRT nor has it been tested in this respect. Rather, the only study I could find (quick look only!) was from 1993 where a trial investigated using Desogestrel separately with oestrogen as part of hRT but at twice the concentration.

As far as I know there have been no recent trials using this or at least it is not licesned, nor even recommended to be used off-licnece although I know one member who was prescribed two mini pills ( giving 150 mcg) as she was already on Cerazette.

The problem is that this may not be sufficient to protect your endometrium so if the prescribing nurse and pharmacist came up with this one - well there are other licensed progestogens available which are listed on this website here: https://www.menopausematters.co.uk/to_progestogens.php and which they should know about. These are Provera, Utrogestan or the Mirena coil, (occasionally norethsterone on its own as it is already part of some combi HRT types). Do you know if there was a particular reason why they chose a) this particular one as opposed to the licensed ones) b) this dose?

Sorry for dampening your enthusiasm but it is important to be given the right products in order to protect your womb lining. If there is a god reason for this combo then fine - otherwise it's wrong again!

Hurdity x

[anartistatheart]

Hi anartistatheart

Good to hear your persistence has paid off, but if you are in UK then with reference to the title of your thread they have still got it wrong, in that the pharmacist and nurse have prescribed you an off-licence regime. Desogestrel is the active ingredient of the mini pill cerazette and is not available as part of hRT nor has it been tested in this respect. Rather, the only study I could find (quick look only!) was from 1993 where a trial investigated using Desogestrel separately with oestrogen as part of hRT but at twice the concentration.

As far as I know there have been no recent trials using this or at least it is not licesned, nor even recommended to be used off-licnece although I know one member who was prescribed two mini pills ( giving 150 mcg) as she was already on Cerazette.

The problem is that this may not be sufficient to protect your endometrium so if the prescribing nurse and pharmacist came up with this one - well there are other licensed progestogens available which are listed on this website here: https://www.menopausematters.co.uk/to_progestogens.php and which they should know about. These are Provera, Utrogestan or the Mirena coil, (occasionally norethsterone on its own as it is already part of some combi HRT types). Do you know if there was a particular reason why they chose a) this particular one as opposed to the licensed ones) b) this dose?

Sorry for dampening your enthusiasm but it is important to be given the right products in order to protect your womb lining. If there is a god reason for this combo then fine - otherwise it's wrong again!

Hurdity x

thanks Hurdity, yes I have since noted that and did a bit of research myself - I did find a few references to it being used such as the one below
https://link.springer.com/chapter/10.1007/978-1-4899-1268-8_50
but Im not convinced that their decision hwas made from a well considered and knowledgable point of view or the complete opposite.
Im conflicted now as to whatt to do. I have been given a 3 month supply, so I am considering taking it for the 3 months and then raising the issue after the review in August. Its either that or move GP surgeries. I have been with this surgery for 22 years and this is the first time I have been so bitterly disappointed by the seemingly lack of specialist knowledge. I have lost confidence in them I have to say but during these times I think its might be wise to stay where I am.

[Dotty]

Hi .. I agree with Hurdity that you have been given an incorrect prescription again . There is not enough progesterone in what you have been prescribed to be used in HRT.

I would advise you to contact yr GP surgery and ask for Utrogestan or a Sequi HRT tablet .... Evorel Sequi or Femoston x

[Kathleen]

Hello anartistatheart and welcome to the forum.

I'm pleased to see that you have been helped with your query.

 I  wanted to add that when you have been dealing with medics as long as some of us here you lose all fear of them lol. Obviously it's important to be polite and respectful but you will soon get the hang of asserting yourself so that you can obtain the right treatment.

Wishing you well.

K.

[anartistatheart]

Im losing the will on this one now. I have evorel 50 and im supposed to take the progesterone pill daily.
If i go back again I need to be just telling them what i expect to receive.... if i stick to the evorel 50 patch, what strength, type and regime should I be on for the progesterone?

Thank you everyone...im just so tired and its taken so long for me to pluck up the courage to go get hrt in the first place. 

[Taz2]

There are quite a few members on here using Utrogestan mentioned in Hurditys post or some go for the Merina coil.

Don't give up! I'm sorry I didn't notice the one you've been given wasn't string enough to protect your uterus by the way 

Taz x

[anartistatheart]

There are quite a few members on here using Utrogestan mentioned in Hurditys post or some go for the Merina coil.

Don't give up! I'm sorry I didn't notice the one you've been given wasn't string enough to protect your uterus by the way 

Taz x

Hey Taz, you shouldnt been apologising... this group is a godsend and you have been nothing but helpful.
The surgery that im dealing with isnt easy. Getting past reception is hard enough, then the first line of defence is a pharmacist who doesnt seem to really know what hes doing, he then passes me to the nurse who seems to be trying very very hard but just isnt getting it right. She then defers to the gp who obviously isnt getting it right either. In the current situation I am feeling worn down by it because its taking so much effort and time when working full time too..... so I've looked online and I can buy the utrogestan via oxford pharmacy. Have you heard of this place? X

[Taz2]

No I haven't but others may have. You really shouldn't have to do this though. 

Taz x 

[anartistatheart]

I know I shouldn't but just dont feel I have the fight in me this week to sort it out.  Its really not my usual personality! Ill sleep on it... maybe if i get a good nights sleep I'll feel different in the morning. Fingers crossed. X

[anartistatheart]

No I haven't but others may have. You really shouldn't have to do this though. 

Taz x 

I had these words ringing in my ears all night and woke up with determination!  i spoke to the pharmacy first and checked that they had the standard stuff in stock and gauged her opinion on the prescription. She said it wasnt right basically, pointed me to this site  and she advised to call the surgery back ...exactly what I was hoping for. The conversation felt a bit easier then because I started it with "your pharmacist has concerns and pointed me to...". Its still been a farce and not yet sorted. Apparently a doctor is going to call me in the morning. Still..... progress! 

[Taz2]

That's good news! Well done! Waiting to hear the next instalment 

Taz x 

[anartistatheart]

Maybe this saga has come to an end! There has obviously been some frantic reading up being done in the surgery since yesterday - they all suddely seem to know what I should be on now! . I now have the correct regime with the Utrogestan added for 12 days at 200mg. The pharmacist has now completed his CPD in HRT 

I will be eternally grateful for everyone who has helped me with this - I really just felt like giving up and despite losing my confidence in the specialists in my surgery, I feel well equipped now to be assertive with the medics as Kathleen said.

thank you for the expert advice and hand holding everyone

[Taz2]

That's great news and will also help other women who approach your doctor's surgery with the same problem!

Looking forward to hearing how you are getting on with the HRT.

Taz x 

[CLKD]

Well done    tell your Pharmacist your result too.

Maybe he would like to run a menopause group ;-).  Or the Nurse Practitioner at your Surgery, it's a learning curve but we shouldn't be educating the medical profession.  Sadly though .......

Do read the threads on vaginal atrophy and bladder issues