Print

Please login or register.
1 Hour 1 Day 1 Week 1 Month Forever
Login with username, password and session length

[Me]

Has anyone here used only the evorel 50 patches or Estrogel without progestogen?

[Peri2022]

Hello, it’s my understanding that if you have a uterus, you need progesterone along with your oestrogen to prevent the womb lining getting too thick. If you’ve had a hysterectomy though, there are likely to be many others on here in the same boat who can advise. Good luck!

[Suza]

I'm currently using the evorel 50 patches, but had a hysterectomy 1999 so don't need any progesterone. No problems except a bit weight round the tummy, and a slight reaction to the glue on the patches

[Me]

apparently only in the UK ( I think) is progestogen advised.  I got this straight from my HRT specialist.  The biggest risk, she told me, to the lining of the womb is obesity not oestrogen.  She said that, in France, for example, people are regularly prescribed the gel without the progestogen. 
I wondered if, in that case I could have the patches instead of the gel because of the even release.
The reason I stopped the combined hrt was the extreme bloating and sore boobs.  With oestrogel only, it hasn't happened.  Yet!  But so far, after a couple of months I haven't even had a twinge. And of course no annoying 'pretend' period.

[GraceM]

I'm surprised a specialist told you that.  The reason we need progesterone is to prevent the womb lining from thickening - oestrogen causes it to thicken.  If we are without progesterone there is a higher risk of uterine cancer.  And its not just the UK who advise progesterone use.

[sheila99]

As above, you have a greater risk of cancer if the lining is too thick though I thought it was endometrial cancer rather than uterine. IMO it's extremely risky not to use progesterone and I would strongly advise you to have regular scans so at least you know when you're at risk.
There was someone on here who took oestrogen only for 9 months  (she'd been prescribed utrogeston but didn't take it) then ended up in A&E because of excessive bleeding. After that her gp refused to prescribe oestrogen unless she had a mirena.

[Nas]

It would be madness to take oestrogen only hrt. Your womb lining will soon build up and potentially cause issues later down the line.

Unless you’ve had a hysterectomy, you definitely need a progesterone in the mix.

[sammy828]

I am in the USA and progesterone of some form is required as part of HRT if you still have a womb.  Otherwise it is dangerous.

[Me]

Yes I was surprised too but apparently the risk is extremely low unlike obesity, smoking and consuming alcohol.  They are apparently well known to be of greater risk.
I exercise a lot, eat well and don't smoke or drink. 

[Jillyboo]

Yikes - never heard that before. Did she also advise very regular scans of your endometrium? 

[Zoe]

In some women the risk can be lower than in others, but the only way you will ever know what your risk is would be by having very regular scans. Which the NHS will not do so you would need to pay for yourself.

The reason obesity increases the risk is because women who are overweight tend to produce more oestrogen but, again, this is not a one-to-one correlation. There are different reasons why women are overweight, not just calories in/calories out.

Risk also depends on how much oestrogen you are taking. Unless you can afford scans every 3 to 6 months, I would be very wary of the advice given. Wish it were different for those who really struggle with the progesterone part.

The other possibility is to settle on a longer cycle like some other women on this forum have done, so you don't need to take progesterone as often. Or have a hysterectomy (but this has its own risks).

[Me]

Hi Zoe - could you explain the 'longer cycle'?
Just to clarify I still have periods but they are all over the place.  I recently discussed all this with a clued up GP who has given me Evorel 25 patches and some more Utrogestan.  She suggested that my sensitivity/intolerance to progesterone is probably because I am small (never heard that before) but I suppose it could be the case.  Just been reading the Professor Studd regime of a really low dose of progesterone of just 7 days in the cycle; I would be taking the Utrogestan vaginally - often advised every other night although I can't figure out if that is the 100mg or 200mg tablets.
I would quite like to start with it on the first March but keep it very low.  Having said, when I ran out of Estrogel a few days ago, all I had while waiting for my appointment was once old patch of Evorel Conti which I put on and literally the next day I had some bloating. 

[Zoe]

Hi, some women on this forum take 200mg vaginal utrogestan for 12 nights every six to eight weeks. This is with medical supervision, of course, but it reduces the frequency of the utrogestan phase. If you search for 'longer cycle' you will find reference to it. Not sure if this would work in perimenopause because the natural cycle might break through, but you could ask your doctor.

Utrogestan intolerance due to being small - maybe? Who knows?!

I can't comment on the Prof Studd regime of 7 days. For me, that seems too short. My own doctor has said that the 'transformation dose', ie the amount needed to thin the endometrium, is 2000mg utrogestan per cycle as a minimum. So, 12 days x 200mg gives 2400mg or 28 days x 100mg gives 2800mg.

However, we are all different and if you can be monitored very closely and have scans then you can afford to try less utrogestan.

You have said you are only using 25mcg patches so that is a low dose. Taking utrogestan vaginally every other night continuously may work for you. Again, another option to discuss with your doctor.

Perimenopause is just such a difficult/random time. Whatever you decide, in my experience it is important to keep it as simple and consistent as possible, sticking with one approach for at least 12 weeks to assess it. I hope you soon find something you can work with. X