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[Pixie]

I've been on Everol Sequi 50 for 4 months. I clearly need the full amount and possibly more. On the odd occasion a patch starts to lift I know about it! Awful hot flush with pounding heart, lightheaded, weak and shaky for example comes back.

I was just wondering if I ask my GP to increase to 75 how is that usually done as there's no progesterone patch with any other doses but the 50. I'm doing great on them and don't want to switch to any other type.
Do GP's just give you an additional 25 estrogen patch alongside the everol sequi 50 that would be my preferred option, a pump of gel in addition to everol sequi 50 or is it a complete change with utrogestan and estrogen patch or gel? I don't think I can take utrogestan due to another med I take which would counteract it's effects. Plus I don't want pills. I like patches.

I can't find anything about this anywhere.

[Dotty]

Hi you would need to move to a 75 patch or gel and a separate progesterone (Utrogestan).

[CarolineM]

Hi Pixie,

I might be wrong here, but could you ask your GP if it was OK to use an additional half a patch? That way you'd be on the same hormones and not have to worry about changing to something that doesn't suit you.

As for the patches lifting, I put a big wodge of micropore tape over the patch to make sure it doesn't lift off. The first ever patch I tried fell off after a day! Either micropore tape or that brightly coloured tape athletes use on their calves or knees. When you take the patch + tape off it's a bit of a job to scrub the fluffy bits round the edges off (I usually just use my nails) and it hurts a bit to rip them off, but I'll take a few seconds of pain for a full dose of hormones any day!

Caroline

[MrsE!]

Re patches falling off, I was told to put a new one on as soon as possible   . Also depending on where you put them, try to make sure skin is relaxed and clean clean

[Nas]

Hi
You would need a separate 75 patch and progesterone. The sequi progesterone works with the sequi oestrogen only.

By adding an additional half patch, you wouldn’t be getting enough progesterone ( I don’t think).

[Pixie]

To clarify I don't have a problem with patches not sticking, only twice in four months. I use alcohol wipe first, then a quick blast of hairdryer and rub patch all over. I have it down to a fine art. They stick very well that way but clearly some aren't as sticky and lift at the edges after 12-24hrs but it's only happened twice in four months. You should not be covering them with tape! This is against advice.
Baby oil gets any black marks off in seconds.
That's not my question!

I need to know what GP's typically do to increase dose on patches. As I already said, I can't take utrogestan due to conflict with a long-term  med I'm on nor do I want pills as I already said, I am on a cocktail of pills for other conditions. I don't see why the progesterone isn't enough as northisterone is strong and no matter how much oestrogen someone's on 200mg utrogestan is supposed to cover it despite that utrogestan is known to have poor control of bleeding.
I can't have mirena due to a medical condition as it has a high risk of perforating my uterus.

I'm looking for a definitive answer to increasing patch dose only. Is there no medical answer to this as I can't find it anywhere online and why on earth don't they make the other patch doses with progesterone. It's so limiting.

[Nas]

Hope you find an answer soon.
We are not medics or patch manufacturers either!

[Wrensong]

Pixie I agree, it is frustrating that the combi patch products don't come in a range of doses, but I also agree with the other ladies that the amount of progestogen in them is said to be proportionate to the oestradiol dose.  So if you supplement the product with an additional oestradiol source (an oestrogen-only patch/part-patch/oestradiol gel/spray/tablet), you risk getting insufficient protection for the endometrium from an inadequate progestogen dose, which over time could cause potentially harmful proliferation. 

Utrogestan was also not a tolerable option for me, nor could I risk an IUD, but there are other progestogens you could perhaps try with standalone oestradiol, such as oral MPA/Provera, Norethisterone tablets & the Dydrogesterone in the combi oral Femoston range.  If it's taking Utrogestan orally that could be problematic for you, some women do use it vaginally (off licence) & I believe a few on here are using Cyclogest pessaries as an alternative source of micronised progesterone. 

I'm sorry if this isn't what you were hoping to hear as I understand you would prefer to avoid oral progestogens & I think many, many of us sympathise, given the currently inadequate range of options for progesterone & its synthetic variants & the very great problems some of us have with progesterone intolerance.

I hope you manage to find an acceptable solution.

[sheila99]

Some GPs will prescribe a patch and a half (also of conti), others won't. Worth asking them though if you will have problems finding an alternative prog.

[Pixie]

Thought I'd update this just in case anyone else has the same issue.

I have ehlers danlos syndrome, I cannot take ANY oral progesterones. They all relax my ligaments more and cause me horrendous agonising muscle and joint pain all over. No mirena either as higher risk of perforation because of EDS.

Patches are my only option. So far I'm fine with progesterone through the skin at least on a sequential basis. Continous combined is yet to be tried! Been on everol sequi for a year. Night sweats have been coming back here and there. I just had my annual review and the GP said it's no problem to use 1 and a half everol sequi to increase it and even two patches if necessary. This GP has additional menopause training and specialises in womens issues.

Hooray!