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[Friend of lhasaapso]

Hello Ladies ,
                     I'm currently 3 years since last period &have tried various types of hrt ,patches and oral tablets .
At the moment, I have an evorel 25 patch and utrogestan 200mg for 12 days a month . The problem for me is I just start to feel good on the first 2 weeks of the month ,but when I have the utro it just feels as though all the good is being undone & feel awful again with nausea and fatigue &pmt symptoms. 
      Last month I tried upping the patch to 50 but couldn't tolerate it so had to go back to the 25  as I felt very hyper and anxious ,as though I'd had too much caffeine.
   I just feel I have the choice of two evils at the moment,  stay on current regime &see if things improve or come off it completely ,which I'm frightened to do as the last time I tried I could hardly climb the stairs was so achey and exhausted.
  I just want to get back to some kind of normality and to have the energy to live my life without feeling miserable all the time . I've also developed a sore tingly scalp &noticed some hair thinning around my hair line which is new &worrying .
  I know a lot of people won't have the answers,but it does help to talk to others going through a similar thing ,as hubby tries to be sympathetic but,he doesn't really understand.

[sheila99]

It seems 25 is the right oestrogen dose but the problem is utro? Are you on a sequi regime by choice or is it possible you aren't meno yet? What about half an evorel conti patch if you're OK with the prog in it? Have you tried utro vaginally? I use it on a 6 week cycle to get more 'good' time, I get fatigue on it.

[Hurdity]

Hi friend of lh...

To me it sounds like your progesterone dose is quite high for your oestrogen dose or vice versa ie oestrogn low. In other words you are taking a low oestrogen dose but the standard licensed progesterone. Also you mention not feeling good on 50 mcg oestrogen but maybe as you are on a low dose, then 37.5 mcg would do the job? Could you try one and a half patches? I found that 50 mcg oestrogen was not sufficient, after many years and increased to 62.5 which is what I now take (I am prescribed 75 mcg and cut a bit off).

Also for some reason, anecdotally some women feel that their low oestrogen symptoms return during the progesterone phase of their cycle, and certainly we have had women on here who use gel and regularly incressed their dose during the progesterone phase.

Maybe you could try this to start with ie try 37.5 mcg during the prog part and then perhaps extend to having this dose all month? As you are taking the standard prog dose there is not likely to be any danger to your womb lining but increasing the oestrogen dose slightly - but if it works then hopefully you can get your doc on board to prescribe this slightly higher dose? Estradot actually make a 37.5 mcg patch but after years of taking HRT and trying several of the patches I can confidently say that Evorel is the best one I have tried - even though I used Estradot for years and loved them because they were so small. So I would "stick" (!) with that one if it is working for you generally.

Hurdity x

[Floradora]

I agree definitely try 1.5 of your 25 patches (or 3/4 of a 50 if you have any of those left). It’s quite a big jump just doubling straight from 25 to 50. You may be able to creep up even further just by tiny increments each couple of weeks.  It might help to balance the huge dose of progesterone in the second half of the month. I believe some ladies take progesterone vaginally which I think can sometimes help too so that might be worth a shot. X

[Friend of lhasaapso]

Thank you do much for your replies ladies, I'll give your advice a go .
       I wasn't sure about cutting the patches,but as I only had the 50s I had to for a while until got new prescription &it seemed OK.
         I wish the utro could be cut down as it really zonks me &not sure If gp would agree to 6 week cycle,but I'll ask .
          I just want to feel like a normalish?human being again  with a bit of enthusiasm for life, which I don't have at the moment, it's such an effort to do anything &I really want to get back to work .
       Wish me luck ! thanks for making me feel less alone xx

[sheila99]

According to Louise newson but not besins you can halve the dose if you use it vaginally, so 100mg x 12 days.

[ange63]

I've just started Everol 50 (but on 1/4 patch to see if i tolerate it).    Dreading the progesterone phase and doctor has agreed vaginal use due to stomach issues i have.   Interesting the last comment about Newson view that can reduce to 100mg if used vaginally.   Will follow the updates and this is giving me so much information - thank you...   Please let us know how you get on with things....  take care x

[Catcc]

Totally agree re the suggestion of half patches.  I felt just like you every time I tried to increase my patch. I needed more as I don't absorb well.  My Dr at newson clinic suggested increasing by using half 25mcg patches.   That got me from evorel 75 to 100 with none of the jitteriness.  I'm now in process of gradually going up to 150!!!  I really am bad at absorbing :-). Levels are increasing but very slowly.
 Good luck!!

[ange63]

Thanks Catcc.   I ended up with terrible anxiety even on the 1/4 patch.   So off it again at the mo.   Don't know what to do now!  Having a think about it and lots going on so not going to start again until I have a quiet few weeks .    Do you have to use progestrone as well - if so how are you tolerating it?