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[MabelBabel]

Hello all,

I've been on Everol 50 Conti for almost 5 months. FLushes gone. Muscle and joint pain gone. Bleeding seems to have settled down now.
But, I am so tired, I sleep well, but I am so dopey, tired, lifeless, I just want to lay down and close my eyes all the time. Plus I keep having days where my mood stinks, I have this kind of internal anger and a general f*** off attitude which is really bad.
I've got a telephone appointment with a female GP who I don't know this evening.
Any tips or suggestions for HRT tweaking that you think might help that I could raise with her?
TIA

[Wrensong]

Hi, the irritability - it may be that the Norethisterone in your Evorel Conti is not right for you.   It's one of the more androgenic, testosterone-derived progestogens.  If you want to try another combined continuous patch you could ask for FemSeven Conti.  It has a different progestogen (Levonorgestrel), with the same 50mcg oestradiol dose as your current patches.  Other than that if you want to stay transdermal for the oestrogen, it would be separate progestogen & oestrogen products, such as Utrogestan capsules with an oestradiol patch, gel or spray.  Otherwise the Femoston range (tablets) have what's said to be a kinder progestogen (Dydrogesterone) if oral oestradiol is appropriate for you.

The tiredness - I'd ask about having thyroid, iron, B12, Vit D tested if not done recently.
Wx

[MabelBabel]

Hi, the irritability - it may be that the Norethisterone in your Evorel Conti is not right for you.   It's one of the more androgenic, testosterone-derived progestogens.  If you want to try another combined continuous patch you could ask for FemSeven Conti.  It has a different progestogen (Levonorgestrel), with the same 50mcg oestradiol dose as your current patches.  Other than that if you want to stay transdermal for the oestrogen, it would be separate progestogen & oestrogen products, such as Utrogestan capsules with an oestradiol patch, gel or spray.  Otherwise the Femoston range (tablets) have what's said to be a kinder progestogen (Dydrogesterone) if oral oestradiol is appropriate for you.

The tiredness - I'd ask about having thyroid, iron, B12, Vit D tested if not done recently.
Wx

Thank you for your suggestions Wrensong, I appreciate it.
Re tiredness, I'm pretty sure it's not thyroid or low anything, bloods done a few months back and were all good, diet has only got better, plus it comes and goes like huge waves.
I really need to learn more about all this, but feel so lifeless, I just don't have the interest or mental energy atm.

[Wrensong]

Hi again, the Norethisterone in Evorel Conti does have a reputation for making some women feel pretty rotten & the low mood & lack of get up & go could be part of that.  So I think it could be worth trying another type of HRT if you can't put the malaise down to anything else.  Anger & extreme tiredness can be signs of depression too & if the symptoms started before EC I think I'd mention that to the GP when you speak this evening.  Good that your recent bloods all checked out OK, but please make sure if you can, that she understands how bad you're feeling.  I hope the consultation is helpful.
Wx

[MabelBabel]

Oh well, that wasn't very helpful. She said I could have a different kind of HRT, pill form, which I'm not too keen on doing for reasons I can't remember. She also offered antidepressants that can be used for menopause to help with low mood and energy.
I've declined all for now and will hang on for the full 6 months in the vain hope things will pick up.

If anyone else has gone through the same on Everol Conti and found a solution I'd love to know!

[Wrensong]

Oh no, sorry it didn't turn out as you'd hoped.  How disappointing.  What were you hoping she'd suggest?

I was on EC for the best part of 2 years but it didn't resolve my symptoms completely & when they finally tested, turned out I was getting poor absorption - my oestradiol level was less than half what's expected from a 50mcg patch.  I didn't feel as you do on it though.

As 5 months is a pretty good trial & your flushes & joint pain have gone I'd assumed you were absorbing OK & that side effects from the Norethisterone were the most likely reason you've been feeling rough in the ways you describe.  If not, then perhaps some depression for other reasons.  But I wonder whether it might be helpful to have your oestradiol tested in case your levels are not that good & you might feel better swapping to a different product that might give better absorption.  I'm assuming you're postmenopause to be on conti HRT so shouldn't have big, potentially misleading fluctuations from your own hormones to make testing less worthwhile.

Sometimes testosterone is the missing piece of the jigsaw where lethargy is a factor, but as EC already contains an androgenic progestogen it's not usual to supplement with T on top.  Also the fact that you feel angry suggests an overly androgenic effect from the Norethisterone, unless as I mentioned earlier, the anger is a sign of depression not being caused by the HRT.

Hopefully someone else will be along with advice as I can't think of anything else to suggest as next step at the mo.
Wx

[MabelBabel]

Thanks for your thoughts and advice Wrensong, much appreciated.
I've decided to stick another half a patch on to see if that helps. The patch is working so well for flushes and joint and muscle pain.
It is the random mood swings, so like PMS, that come and go but mostly the tiredness, the lack of energy that is driving me crazy and seems constantly there. I get up and I'm tired, despite sleeping well and I can't shake the feeling, I remain in the state of dopeyness all day.

If anyone else is suffering with tiredness, general lack of get up and go I'd love to know how you're managing it.