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[wendy68]

I’ve very new to this forum but would really appreciate some support and guidance having received very little from my GP surgery.
I’m 55, fit and healthy and have been on Everol sequi for about 3 years, 50 patches.  Periods sporadic had about 4 in last 12 months. So I don’t think I’ve hit menopause.  After a terrible bout of insomnia and brain fog I asked if I could increase the patches to 75. 
I had a consult with a pharmacist and he told me I was on the wrong regime, that it put me at high risk of thickening and changed me to combined continuous Everol  75mg plus 100mg of progesterone nightly.
I’ve been on this new regime for a week and feel dreadful.  Extreme fatigue to the point I can’t  work or drive and a headache. I started bleeding the day after I began taking the new meds and am still going now.
I had a consult with a doctor yesterday who knew very little about HRT.  Her advice was to either go cold turkey and stop meds, or reduce.  She questioned why I was on the new meds as I still have periods occasionally. There was little offer of support.
The new regime definitely helped sleeping at night.  Night sweats disappeared completely and no waking periods.  But I felt drugged the following day.
My questions are - should I be on combined continuous if I still have periods?  Was the estradiol patch too high at 75mg?  Am I intolerant to progesterone? Should I battle on?
I really don’t want to come off HRT as it helped me with so many issues.
We do not have a menopause specialist at the surgery so my only option is to pay £200 to see one privately.
I just would like to feel normal again as I have a lovely life, a job I adore but hating the way I feel
Thanks so much in advance for anyone who reads this
Wend

[sheila99]

Perhaps he's another one who believes the fable that everyone is meno by 54. At this stage you could try conti if you want to but there's no need to if you prefer sequi. I'm on sequi at 63 because utro makes me dopey all day too. They told me there's a slightly higher risk of endometrial cancer this way. As you know you get on with evorel you could use 1.5 patches. Some gps are happy to prescribe this, others aren't. Or you could use utro with a sequi regime so you'll know if it's utro causing the problem (pretty sure it will be). 2x 12 days (days 15-26), might be worth trying vaginally though it makes no difference to me. Bleeding can be expected in the first 3-6 months of a new conti regime. And if you're not meno it's likely you'll get breakthrough bleeding.

[wendy68]

Many thanks Sheila for your reply. It’s such a minefield isn’t it. Feeling drugged all day is not a price worth paying for a good nights sleep and I’m definitely hankering after the old patches. Last night I whipped off the new 75mg patch and just took the progesterone tablet. Had a poor nights sleep but ironically feel
Less drugged today although headache still there. And feeling quite low. I think I’ll research the risks of being on the sequi regime at my age and go back to the GP. I’m amazed surgeries still haven’t allocated a specialist for meno. Bonkers

[sheila99]

If you find any research on it could you let me know? I couldn't find any so just going on what they told me. I can't imagine there's a vast number of post meno women on sequi to do research on. I came to the conclusion I'd rather take the risk than be permanently doped. I may try a mirena though.

[CarolineM]

Hi Wendy,

This sounds familiar! I was made to transfer from Evorel sequi to Evorel conti when I hit 55, even though I couldn't tell them when my last natural period was because I'd been on HRT for quite a while. Excessive bleeding on Evorel conti, switched to Evorel + Utrogestan and am now nicely settled into 2 periods every 28 days. Been scanned twice, other than fibroids all OK. So it would seem I'm still having my own periods but my surgery said it's standard policy that everyone should be post-meno by 55 (!) - sounds like your pharmacist believes the same.

Just checking you're waiting at least 2 hours after finishing eating before taking the Utro at night? I got my timings wrong once and took one 90 mins after eating and was like a zombie the next day, couldn't drive.

You might not necessarily be intolerant to progesterone - maybe try it vaginally if timings are an issue (although it's not licensed for vaginal use in the UK). I alternate oral and vaginal.

I can't comment on the dosage of estrogen as never been on more than 50. I wouldn't advise going cold turkey as the symptoms you get back could be quite intense.

Good luck.

[wendy68]

Thanks Caroline.
Good shout about the 2 hours post food. I’m guessing this means any calories going in including tea etc? My pharmacist couldn’t advise on that. I’m guessing it hits the nighttime munchies tho!!
Re two periods every 28 days. That sounds pretty tough. Is that a full on one with all the pmt to go with? Are they heavy bleeds? I’ve read that on this regime if you’re still bleeding at 6 months that can become a worry.
I’m guessing putting up with periods could be worth it if the other issues come under control a bit?
Thanks so much for the reply x

[bombsh3ll]

Hi Wendy, it sounds like you really need some individualised advice from a menopause literate specialist.

I'm sorry you're not getting the help you need from your GP - what about asking for a referral to your local NHS menopause clinic?

Sadly the waiting lists are very long and FWIW if at all possible, I would consider paying for an appointment to get the treatment you need.

We shouldn't have to, but in my case I do pay for my treatment because my health and quality of life are my absolute priority. I am disabled and on a low income but I would rather spend the money on feeling and functioning as well as I can rather than going untreated/inappropriately treated and living a miserable half life.

[CarolineM]

Hi Wendy,

Drinks are OK - I never drink tea in the evening so don't know about that one but wine was fine :-) And yes, night-time munchies are definitely a thing of the past :-(

Never really had problems before periods much but usually get two full-on quite heavy periods with moderate cramps, feeling shattered for a day and a lovely upset stomach on occasion. But the no-HRT version of waking up every hour with a hot flush, crawling skin, total mental instability and feeling like I want to kill everyone isn't much fun! Feel 90% normal atm and I'll take that. The last two periods have been slightly lighter so maybe my bits are getting the message?!

I've 4 friends who tried Evorel Conti and all have been bleeding irregularly at 6 months, all had the same investigations I have and three of us have small fibroids and the others were normal. So, I'd say to anyone on Evorel Conti - if you're bleeding at 6 months don't bother worrying unduly until you know there's a problem!

:-)

[Kathleen]

Hello ladies.


Your comments about not eating two hours before bedtime when taking Utrogestan has resonated with me today.

I was previously using Cyclogest pessaries as prescribed by Newson Health however this became was very expensive and I am not convinced that the doctors were as clued up as I hoped ( although they were very familiar with the HRT products ).   

While I was a patient of NH my surgery started a meno service run by a Senior Nurse Practitioner and I reverted to their care for HRT in January of this year. The surgery would not prescribe Cyclogest or an alternative that my NHS Consultant had suggested and instead I was given Utrogestan to be taken orally only. My Oestrogen continues to be Sandrena gel.

After reading this thread I will ask for a review of my HRT because I was assured that snacking just before taking Utrogestan was fine ( and it may be of course) however I would like to have this clarified because I am still struggling with some meno symptoms that my HRT is not controlling.

I will try to get an appointment asap and I will report back when I can.

Take care ladies.

K.