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[Bobbins]

Hi

I'm new to the site and learning slowly about HRT.

I've been on the pill for most of my adult life, and at 49, have been told to stop the pill because of my age. I have additionally got heart problems that seem to get worse with a drop in Oestrogen. My doctor suggested stopping the pill and moving to Evorel Conti 50 patches. I stopped the last pack of pills and the following day tried half a patch. The following day, I felt like I was in orbit! I felt like I'd eaten 6 bags of haribo. It was like I could feel the blood in my veins! After three days I had to stop the patches to have a week-long ECG. Then I went to see my GP to see if the effects of the patch was normal, and he advised me to stay off the patches until he's consulted with an endocrinologist. I'm now 10 days with no pill or patch and have had nasty headaches and felt rough. Questions - anyone else had the 'hyper' reaction to the patches? Should o stick it out or try a different one? What are pill withdrawal symptoms?

Thanks
Bobbins

[Dancinggirl]

Hi and welcome Bobbins
I'm a bit baffled as to why your doctor put you straight onto a continuous HRT!!??? If you have been on the pill it would probably be difficult to know where you are in the your menopause journey and I suspect you may still be in peri meno. If you are peri then a continuous HRT would be the wrong thing to have and also the patches are medium dose ( so too high a dose) and possibly given you a big surge from the outset. A sequential HRT would be far better and it's always a good idea to start on a low dose.
Peri meno will bring a fluctuation of hormones as the ovaries start to fail and produce less hormones. These fluctuations can cause surges.  I'm wondering if coming off the Pill made your body produce a big surge of your own hormones and unbalance things???  Then adding in the HRT could have increased that surge.  Whenever I came off the BCP I would get 7-10 days of headaches so I think that is quite normal.  It's good to have this break and hopefully your GP will do some blood tests to see what's going on.
I am surprised they didn't ask you to stop the BCP for a month first and then do blood tests to look at FSH and oestrogen to see where you are in the menopause!?
It's good they are getting some advice from an Endocrinologist as it could be a combination of things going on.
You might do better with some Oestrogel applied each day with separate progesterone for 10-12 days each month and this way you can gage what suits you and how much oestrogen you actually need.  You can start with just one pump per day and then increase slowly over several week if need be.  If you are peri you may find that one pump per day would be enough for the time being until your own hormones decline.
In the mean time, I would stay off everything to see if your periods return. At 49, the periods can come and go over several years, so it's useful to know where you are in the meno journey. Once you have allowed your own hormones to settle without the BCP than you can start with HRT. DG x

[vickypk]

Hi Bobbins
Sorry to hear you are having a rough time.  I've been on the those patches for 18 months.  It did take a few months to get used to them, the side effects were stomach cramps and slight headaches, but all stopped within a few months.  I did stop and start the patches a few times, it wasn't easy. 
You may still have periods, I had my last period at 54, I am 59 now.
Hope you are okay and get things sort soon.
xx

[Bobbins]

Thank you dancing girl and Vicky.
Dancing girl - my case is complicated by my heart problem. In the pill-free week, my heart problem got worse so the reason for conti patches, was not to have any rise and fall in hormones to upset my heart. Since stopping the OCP, it's made everything worse, so worse heart problem plus headaches and stomach (womb?) cramps, and generally feeling unwell. I ideally want a constant flow of hormones to keep everything steady.

Evorel Conti 50 are the lowest dose patches you can get yes? If you half, or quarter them, is there a risk if not getting enough progesterone to protect the womb?

After the initial panic of coming off the Pill and being synthetic hormone-free for the first time in my adult life, I've come round to the fact that it's probably a good idea. I had a hepatic adenoma, which went after dropping to a lower dose OCP. I'm also very 'natural' in other areas of my life being clean eating and into complementary therapies. If it wasn't for the heart problem, I'd be happy to wing it and see what my natural hormones do, but already struggling with being chronically ill, fatigued and in pain, I'm struggling to add another de-stabilizing and uncontrollable factor to the mix!

Why wasn't I born a man!?!

[Hurdity]

Hi bobbins

 

When you say the pill do you mean the combined one or the mini pill? If the combined one then presumably you will have had a sudden drop in oestrogen despite the Evorel because the doses are much higher usually in the CCP (mostly stronger synthetic oestrogens).

This could account for your symptoms. They could also be due to the progestogen in the Evorel conti - and depends on which progestogen was in the pill you took? Also this particular progestogen in Evorel can give some women continuous side effects like headaches, irritability etc.

It's difficult to know what to suggest expect I agree with Dancinggirl that separate oestrogen and progestogen may be the way to go and to take these cyclically. I can see that if you are still peri-menopausal then your own hormones may well be surging. Most HRT contains bio-identical oestrogen ie estradiol which is the same as your own body makes and Evorel or any oestrogen patch contain this.  There is a regime whereby you can take Utrogestan ( progesterone) for 25 days out of 28 along with oestrogen ( patch or gel) and this might help even out your hormones a little - rather than stop completely.  You might then still get a bleed at some point depending on your own cycle. Some women find the Utrogestan too sedating though.

Alternatively you could try a mild tablet HRT like Femoston 1/10 which is very well tolerated,  although probably transdermal is preferable if you have heart problems.

By the way yes you can cut Evorel conti in half off licence - Dr Heather Currie has said this is OK - because you are reducing the progestogen along with the oestrogen and they should be approximately balanced for most women.

Have you had your thyroid tested re fatigue as well as possible vitamins re deficiency - although if you are into healthy eating I expect you are unlikely to be deficient as you will be focusing on a good diet?

Hope this helps and let us know what you decide

Hurdity x

[Bobbins]

Thanks Hurdity

I was on the combined pill.
Loestrin 20
Ethinylestridiol - 20mcg
Norethisterone - 1000mcg

The Endocrinologist suggested Evorel Conti 50
Estridiol - 50mcg
Norethisterone - 170mcg
(Estridiol hemihydrate 3.2mg
Norethisterone acetate 11.2mg) because the progesterone was the same but
My GP said they are actually different chemicals.

Using separate Oestrogen and Progesterone sounds good but I'd still have the 'period! Gap week which we were trying to avoid, hence the Conti patches. You say these can be cut in half - is there a limit? Can you do thirds or quarters?

The fatigue is part of my heart problem. I have had all the Thyroid, vitamin D and other tests and they are all ok.

Thanks

[vickypk]

Hello Bobbins
I started on a quarter of a conti patch, even now I don't use the full patch and feel fine.
You might be okay with separate oestrogen and progesterone. I did try that regime initially for a few months and felt terrible. I went to a private HRT specialist in Harley St and he prescribed that.
It cost me at least a £1000.
I had to stop that regime and went to my GP and asked for the patch. Better with that.
Hope you feel better
xx

[Bobbins]

Thanks Vicky x