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[Sheri]

Currently I'm on everol sequi 50 patches. I'm seeing gynae Wed & want to see if i can go lower as i don't feel great on the estrogen 50 patches?
I don't want to sound silly if I'm already on the lowest patch. I think if i can go lower & then see how i go & increase gradually if need to or stay on the lower patch if it suits me better.
I've read you can cut the patches in half, even though its not recommended, louise newsome says you can. This would mean cutting the progesterone patches aswell, I'm guessing?
I won't do anything until I've seen gynae but want to go well prepared.
I've also come down with a chest infection, so really not feeling great.

[McPeri]

Hi - the instructions say not to cut them, but you can. Some people cut them diagonally rather than across, not sure why but probably to do with the way the delivery system is made.

As you say, you can cut the oestrogen only patched and then, in the second half of the month, cut the oestrogen+progestin patch.

You can also get a 25mcg Evorel patch but would need a separate progestin because it is oestrogen only. The progestin in Evorel Sequi is norethisterone and you can also get it in tablet form to take alongside a 25mcg patch. In case your doctor doesn't like the patch-cutting, it is another option.

[joziel]

You can't cut combined estrogen and progesterone patches because you will mess up the amount of progesterone you're getting then - it doesn't always work that you can just half both.

But really, why do you want to go lower? It would be best to get a blood test done and check your levels before you do that. Because low and high estrogen can often give the same symptoms and if you really need more estrogen, you're just making things worse by trying to go lower.

[ATB]

When I suspected I was too high after the full 3 months on that dose, I tested first and spoke to my specialist at Newson. I didn’t cut patches I just ordered new ones. If you haven’t been on it for 3 months, you are guessing and risking making yourself worse or the questions harder to answer by not seeing out the 3 months. It depends on your symptoms. Symptoms can happen from fluctuating hormones and raising a low level of estrogen can increase symptoms temporarily. It’s really best to wait to your appointment IMO.

[Sheri]

I won't do anything until i speak to gynae. I'm hoping he will do bloods as i didn't get them before i started HRT.
What is the protocol when you see gynae after starting HRT? And can i ask for bloods?
Only thing i had before starting HRT was a scan & an internal examination.
I have painful, quite severe bloating today & wind in belly. I haven't managed to eat anything as my stomach is so swollen & uncomfortable.
Can estrogen cause this? As i do get swollen belly as i have CF but if it was CF related, I'd have griping pains. This feels like the heavivess/bloating you'd get before a period.

[McPeri]

The hormones in an Evorel Sequi patch are evenly distributed across the patch so, in theory, you definitely can cut it in half and many people do this to titrate up. My own menopause specialist said it was perfectly fine and it saves wasting a perfectly good patch.

However, I guess the question is whether you want to faff about doing so when there are 25mcg patches available with separate norethisterone tablets.

It is such a small amount but there are some of us who do have to work up gradually from a small amount and 50mcg is too much to begin with. There is also a 37.5mcg patch, Sheri, which is Estradot. Estradot are nice and small so feel less like a plaster on your backside/thigh. Again, you can take the progestin in tablet form. Sometimes it is good to separate the oestrogen and progestin elements to see how your body is on oestrogen alone and then progestin alone.

It is all a lot of trial and error unless you are one of the fortunate ones who hits jackpot first time.

See what your doctor thinks but there are lots of options.

[NicolaJ]

I am now on 25mg patches after cutting Evorel Sequi in half as an attempt to see if u could manage. It worked and I now have Estradot as a 25 patch and separate progesterone (Utrogestan) My GP was more than happy for me to do this. Good luck

[Hurdity]

As I understand cutting Evorel sequi patches (both phases) can be done but its off-licence. I think Dr C answered a question on this some years ago. Not sure if she was jus referring to Evorel conti. Theroetically if you are redicng the oestrogen by half then it may well be OK to reduce the progestogen too - but no trials, hene being off-licence under medical superivision.

I cut my Evorel 75 mcg patches to give approx 62.5. The best way to cut them is parallel to the join where you normlly peel the oatch and then it can be peeled in the same way. I would not cut diagonally - first because you then have two sharp points that may become unstuck more easily, and second because you have a longer cut edge for the hormone potentially to leak out or moisture etc to leak in....

Hurdity x

[Sheri]

Thank you for the advice.
Today is the first day, I've felt no painful bloating. Still aching muscles but its now controlled through paracetamol.
Less anxiety today & mood is lighter. Not courting my chickens but i feel hopeful.
Will still ask for bloods to check estrogen level...just incase i am high...& that way if i am ok then i will try to see the 3 months out.
I think maybe i was asking for too much regarding feeling normal & energised so quickly as i still have my own hormones & I'm about to have fluctuations in levels.
But the aches over the past week plus sore throat & anxiety was horrid & when your feeling bad & down, you don't see clearly.
Today, i feel like i can see the house through the woods & may it continue.
Many thanks for your patience.

[joziel]

Sheri, I'm having my own battles at the moment with heart palpitations and feeling jittery and occasional high blood pressure as I start estrogen and increase it. I totally get wanting to stop or reduce or change something. But really I think we have to give things a really long run to see if they settle down in our bodies. As long as things don't get unbearable...

[Sheri]

I agree with you joziel, i have to give HRT a fair chance. If i stop now & i start to feel really ill mentally, i will be devastated & can't expect my gynae to put me back on HRT.
I think i expected to feel 100% better instantaneously like the likes of Davinia McCall or Lorraine Kelly said they did. But i kniw it doesn't work that way inreality.
I looked through my mood diary from before starting HRT & i can see how bad i really was. Like struggling to function on days, wanting morning not to come or even not wanting to wake up ever again. I haven't been that drastic these past few weeks. Just abit down, a day or two of health anxiety - that was new to me & grumbling anxiety in the background.
I hope the increased dose of HRT helps you. All we want is a peaceful & easy life....not much to ask is it? 🤨

[joziel]

As I understand it, the anxiety and feeling jittery can be a result of the estrogen and should settle with time.

I have definitely spent a lot of time feeling like I've had 8 Red Bulls the last couple months and I can't say the heart palps and pulsing hands and high blood pressure help    I also suffer from health anxiety (I tend not to be concerned at all about my health or I get v anxious about it).

There are some great apps you can download to help. One is called Headspace (mindfulness/meditation) and one is called Breathwrk (breathing/focussing on the breath) and I use both these when I'm feeling anxious and want to calm down. I'm not sure if they help but at least they make me feel like I'm doing something about it!

[Sheri]

Didn't want to start a new thread again but was wondering if you can take replense for dryness?
I can't take lube as i was allergic to it. Thought maybe replense might help.

[joziel]

Replens isn't a great one for ingredients. It has some dodgy ingredients I wouldn't even want to put on my skin, let alone up my vejayjay  and it also is known to cause a weird discharge when it comes out.

Instead, try using YES OB or Olive and Bee. They have all natural ingredients and YES OB is organic as well. Of course it depends what you are allergic to...

[Sheri]

Ok, thanks I'll give it a miss then thanks.