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[doolou]

Hi. I am due to start again with a combined patch.  After having a hysterectomy January 2016 mostly due to endometriosis,  my GP prescribed Premarin which I took for 4 months.  I questioned them regarding oestrogen only in July and they changed it to Elleste duet conti.  Suffered with aching in armpits so phased onto Kliovance in October.  Constant headaches so weaned myself off them.  Eventually started on Oestrogel in February,  skin rash! Swapped to Evorel 50 for a month all good . Then surgery for anterior and posterior repair so cold turkey, no HRT for the last 3 weeks! Surgeon wants me on combined again as found a couple of endo spots during surgery.  Anyone know Evorel conti comes in different strengths please?  Really nervous about a combined again,  as felt dreadful last time,  but am willing to give the patch a go. Any advice would be much appreciated.  Thank you.

[doolou]

Thank you Hasty.  From what I've read,  the strength is 3.2mg of estradiol and 11.2 mg of progesterone which seems high? I'll try and speak to the menopause clinic I think,  see if there is a minimum combination to give some relief. 

[Hurdity]

Hi doolou

You can't go on the total amount of oestrogen on the patch - which is what you are quoting - this patch is designed to last for at around a week but for optimal absorption is changed after 3.5 days and delivers estradiol at 50 mcg per day - hence the Evorel 50. To compare with tablets you just have to go on whether they are low, medium or high - but women also vary in how much of each type they absorb - and different women also absorb different amounts from the same dose/type!

You could take an oral progestogen - like Provera - along with the patch, or try a tablet HRT like Femoston conti which contains a better tolerated progestogen?

Hurdity x

[Mbrown001]

If your uncertain of the strength then why don't you cut the patch in half and see how you get on. These patches are really quite big so it's easy to trim some off.
I've been using half a patch for a couple of years now with good symptom control.

Mrs Brown

[doolou]

Thank you Hurdity and Mbrown for your information.  I was ok on the evorel 50, it's the progesterone level that seems high. I felt awful on combined tablets,  but as the surgeon found a couple more endo spots,  wants me back on combined.  I think I'll give the patches a go,  and see how I get on. At least if it doesn't suit,  I now thanks to you both have information to try other options or reduce the dose of the patch.   I appreciate your comments,  thank you.    x