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[Jogawne]

Hello all

I'm just after some advice. I've been on evorel conti about 16 months, after oestrogel and utrogestan stopped working for me.
I like it, I feel more balanced and felt like I had slightly more energy. I thought the progesterone part (norethisterone) was better suited.
However for about the last 2 months my hair loss seems to have increased. I have naturally white hair that us past my shoulders so I tried to tell myself it was just because I could see the hairs. But it us continuing. When I wash my hair or add product the hairs are tangled in my fingers and all day long I have hairs falling out.
I have no bald patches, have had thick hair up to now, but I feel it's now a problem.
I had covid in February ( I know that has affected some people with hair loss) .
So I know evorel conti can cause hair loss, would it be this over a year after starting on patches and if I wanted to try another patch, what would be a good one to request. I'm better going with an idea, rather than waiting for a Dr to suggest one.
Thanks for reading what turned out to be a long post x

[Wrensong]

Hi Jogawne, I'm sorry to hear about your hair loss which I know can be very distressing.  It's difficult to say whether Evorel Conti is the cause but it does have a rather androgenic progestogen in the Norethisterone, so it does seem possible.  If you wanted a straight swap, i.e. another combined continuous patch, FemSeven Conti has the same 50mcg dose of oestradiol, but a different progestogen - Levonorgestrel.  While that's also androgen derived, from memory I believe it's said to be a little less androgenic & you may get on better with it.  I've just checked the BMS website for availability, updated yesterday & it's showing as fully available so hopefully you'd have no probs getting hold of it.
Wx

[Jogawne]

Fabulous, thank you, I'll contact Dr's tomorrow and see if they can swap without an appointment.
Thanks again x

[Wrensong]

No problem.  I hope the hair loss stops soon.
Wx

[Lily102]

Hi Jogawne, I'm sorry to hear about your hair loss. I'm in the same boat so understand how upsetting it is it is.

Replying here to share my experience in case it provides some answers and/or provides answers for me.

I started to have hair loss about 6 weeks ago and it feels like I have lost 50% of my hair.  I'm 54 and had lots of hair - both parents had lots of hair. Hairdressers used to moan about the volume!

I contacted the doctor today and she said it might be due to low ferritin. Mine is 27. She said for hair loss purposes it should be 70. I track my blood results and I can see it was also 27 3 years ago and 33 6 years ago.

My HRT background is:
 
Fem 2/10 (with dydrogesterone, a synthetic form of progesterone) for about 4 years until it stopped working last year.
Switched to oestrogel (2 -3 pumps per day) and utrogestan (taking the 100 tablets vaginally 25 days per month). The new regime of oestrogel and utrogestan took about 5 months to settle in though after 3 months I went on mirtazapine 15mg as my mood was low and I wasn't sleeping. In hindsight, I think the low mood was caused by 4 months of little sleep. My sleep is brilliant now thanks to mitrazipine. I tried coming off it 5 months ago - first not taking a table and then taking half a tablet. On both occasions, I woke up a 3am in the morning as I used to. I can't cope without sleep so went straight back on.

I initially thought mitzrapine was causing the loss as there are lots of articles and forums online saying it causes hair loss. Having read comments on here today I realise it could also be oestrogel,  utrogestan, low iron or something else. I'll update in here if my situation improves after taking iron tablets.

[Wrensong]

Hi Jogawne.  How are you?

[Wrensong]

Hi Lily102, I'm sorry you've also been dealing with hair loss.   I'm another with low ferritin (20 earlier this year) & it can be associated with hair loss, as you say.  Also with thyroid conditions, among other causes.  I'm assuming your thyroid is OK as you don't mention it?

Interesting your doctor's advice about aiming for ferritin of 70+.  Can I ask is that a GP?  Because my haemoglobin was still in range, my GP was not concerned about the low ferritin, which I first discovered with private testing as I suspected I was becoming anaemic with a background of long, v heavy periods & progestogen withdrawal bleeds.  A gynae I mentioned the low ferritin to advised supplementing with iron, which I'd already started, on learning ferritin was deficient according to NICE guidelines. 

Adequate ferritin levels are also important for optimal thyroid function & I'm long term hypothyroid so it's doubly important to me to try to improve iron status.  To avoid adverse effects on digestive transit I've only been taking a v low dose of iron citrate & my GP has since agreed to retest for me.  So far no improvement in the hair shedding but last ferritin result was still <30.

Can you point me at any articles on Mirtzapine's effects on hair loss please?  I'm not on it, but interested to know whether it's because Mirtazapine can affect thyroid levels.  I'm glad to know it's been so helpful for your sleep & it is renowned for that.  What a Godsend for you  .

I hope you manage to stop the hair shedding.  Like yours, mine was always exceptionally thick, in fact a nuisance for styling.  I took it for granted & never imagined I'd be in this situation  .
Wx

[Gnatty]

In case it helps, I took Mirtazapine for about twelve months a while back and had no problems with hair loss. It's far more likely I would say to be hormonal or low iron. Or... Have you had a nasty virus lately as that can course hair shedding too although I would imagine not as much as you would from hormone problems x

[Lily102]

@wrensong thanks for all that info.
 I've started tracking my blood tests and I'm close to hypothyroidism. I actually had blood tests to check for that. By the time the blood test came round I had recovered from what seemed like hypothyroidism symptoms.. Aunts had thyroid issues but I don't have their diagnosis.. My white blood count is always on the low side so that could trigger a lot of stuff. I was fortunate in  that pre menopause I had light periods and no pain. I have a getting my iron levels were also below 30 and not an issue for me. My knowledge on vitamins and nutrition is limited but I know you have to be careful with not having too. Much iron. My pottasium is towards the high side, mentioning that in case useful info for you.

Here are a few of the links I found
https://www.psychiatrist.com/jcp/case-mirtazapine-associated-hair-loss/#:~:text=The%20patient's%20hair%20loss%20occurred,diagnosis%20of%20drug%2Dinduced%20alopecia.


https://www.reddit.com/r/Mirtazapine_Remeron/comments/10fehj9/hair_loss_from_mirtazapine/

[Lily102]

@Gnatty thanks for the feedback on your experience with mitzrapine. All bits of info help. It really is trial and error. Hopefully increasing iron and pasting now attention to my diet will help. I'm pretty good but I can improve more.

[Wrensong]

Lily102, thank you for the links  , I'll  read those later.

Oh yes, very sensible to keep a close eye on the thyroid situation with that history & your recent results.  There are quite a few hypothyroid women on here if you want to run anything past us.

Yes, important not not have too much iron, so needs careful monitoring when we are trying to get ferritin levels up.  I'm doing this with v low doses, so it's taking a while.

Good luck with the thyroid & halting the hair loss
Wx