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[lottieheaven]

Hi all, Im new to the forum and would like to ask a question.  Im 54 and was on femoston 1/10 a sequential tablet for about 18months but have been changed to a 50mg patch and utrogestran on a conti regime [because of my age I think as I was peri before I started the tablets)  as I was starting to experience breakthrough bleeding and a worsening of flushes and breast tenderness.  My question is although the delivery is different will different dosages cause problems? what are other peoples experiences? my doctor said she wanted to start me off on lower doses and see how it went but I would have thought that I needed higher oestrogen rather than lower?  i know itll take a while to see what changes need to be made but it seems to be quite confusing to figure out what symptoms indicate high or low levels

many thanks

[Hurdity]

Hi lottieheaven

 

Firstly you cannot compare tablet HRT with transdermal HRT from the dosage quoted especially with patches. With oral HRT the amount of oestrogen given is the total amount in the tablet, much of which is lost to digestion and after metabolism through the liver so eg with a 1 mg tablet you don;t get that amount into your body.

With patch HRT the dose given is the average amount absorbed from the patch per day - ie the amount of estradiol the patch is designed to deliver so 50 mcg patch is designed to deliver 50 mcg estradiol per day through the skin.

The general rule is to go by what is approximately low, medium and high dsoes and you can find this here on the menu: https://www.menopausematters.co.uk/treatafter.php

You will see therefore that you are going from what is classed as a low dose to a medium one.

Secondly, having said that women differ greatly in how much oestrogen they absorb from the different methods so it is not a precise measurement - so what is medium for one woman may be low or high for another.

The other things - your comment "because of my age I think as I was peri before I started the tablets" - the onset of peri-menopause has nothing to do with age - although obviously after a certain age it is more likely! For most women who still have a uterus and are not on the mini pill or Mirena coil - it is cyclical changes combined with age and symptoms which determine whether a woman is peri-menopausal. So ref your comment - if your cycle was irregular and you were skipping periods consistently, and over 45 and experiencing menopausal symptoms then you were peri-menopausal. If your periods were still regular, despite your age - you may not have been.

In your position actually I would continue with a cyclical regime as you are changing regime, and see if these products suit you and what happens to your symptoms. Then if all is well on both parts of the cycle then try a conti regime?

Good luck with it and hope this helps

Hurdity  x

[lottieheaven]

thanks very helpful