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[flower]

Hi Ladies,
Well, after my femseven conti stopped working this year, I have been stuck in sweat hell with depression etc.,
Today i was lucky to get a female helpful doctor (wonders never cease hey).  She gave me 80g Estradiol get (said use 2 squirts daily) and some Micronor tablets.  I am elated that I have been given something as I am in desperate need of sleep and to stop my wet skin rubbing away to nothing and itching!  Unfortunately, I am so not following things these days (I have tried to read blogs but cant absorb them) BUT what I need to know is Can I use the Gel in the mornings and take the pill at night (I take other pills for pain relief plus vitamins and calcium and magnesium for osteoarthritis in the day).  I want to get the most benefit from this as I can and haven't a clue whether it matters or not so please anyone with this prescription your advice will be very much appreciated.
Ta

[Dancinggirl]

Hi flower
I used gel for many years.  You can use the gel morning or evening - some like to do one dose in the morning and one at night to give an even dosage - I only ever did it first thing in the morning. It's brilliant because of this flexibility - experiment and work out what's best for you.
It really doesn't matter when you take the progesterone tablets - are you doing a sequi or conti regime? If you are meant to take the progesterone sequentially ( to induce a withdrawal bleed which I suspect you are) then I used to simply start it on the first day of every month for the ten days and then get a bleed on about day 12, so roughly 2 days after finishing the 10 days of progesterone -  I'd then know when to expect a bleed - I used to adjust this if I had an event or something important on and I didn't want it to coincide with the bleed.
If you find the progesterone part doesn't suit you (some women don't get on with northeristerone ) then you can try Utrogestan as an alternative or have a Mirena fitted.
I found this regime very good for many years. Good luck  DG x

[Hurdity]

Hi flower

I imagine you are post-menopausal if you were on Femseven conti?

The only think I would say about the micronor is that, although norethisterone is a powerful progestogen (in keeping the uterus lining thin) the dose in micronor (0.35 mg) is lower than in the HRT tablets -(0.5 -1.0 mg depending on the oestrogen dose). Therefore depending on your oestrogen dose I suggest you might be better off on a slightly higher dose of progestogen - to keep your lining thin.

Hurdity  x

[flower]

Gosh, Thanks for that reply. I just took the pill and never noticed they had days of the week on them (so took sundays!) there are 28 in each pack strip and doctor never mentioned taking a break or a bleed.  I havent had a period for years (im 57 and hit meno like a brick wall at 52   So, do you think that means no break per month as i hadn't expected one? All she said was use 2 squirts one on each arm daily and take pill daily.  (I am hoping to be coherent soon....after i get sleep that is) xx

[flower]

Hi dancingirl,
Thanks for the reply.  I hope I am on conti.  My limited knowledge is that sequi is for younger people who never stopped monthly bleeds before HRT.  I just stopped completely and started sweating like I was in the shower 24 hours a day!  I only went to docs as I thought I had a fever after a couple of weeks 

[Hurdity]

Hi flower - yes that's right you take them continuously - still not sure the dose is high enough though to keep the lining thin. Are they 0.35 mg?

Hurdity x

[Dancinggirl]

Hi flower
As Hurdity quite rightly pointed out, I hope the progesterone dose is enough?!!
It's not usual to give this particular progesterone in a continuous dose - Utrogestan would be a better option I think.
I used to apply the gel to my inner thighs as it was easier - I always worried about getting any on my breasts. Make sure you don't get dressed until it has fully dried - about 10 mins. The beauty of the gel is you can up the dose after 3-4 weeks if you are still getting too many flushes. However, as Hurdity points out, if the progesterone dose isn't enough you could get thickening of the uterus so I would check with the doctor first before increasing the oestrogen dose.
What about having a Mirena fitted? You then don't have to worry about progesterone at all - you just use the oestrogen gel amount that you need. I had a Mirena fitted at 53 as I couldn't tolerate progesterone on a continuous basis and it was the best option for me.  Though many think the Mirena is for contraceptive use it is actually very often used as the progesterone part of HRT to protect the uterus as it can reduce the side effects of progesterone.
BTW, many women choose to use sequential HRT and have a withdrawal bleed well beyond post meno as taking progesterone continuously can cause side effects. I believe Hurdity (who is very knowledgable about HRT etc. as she has a science background) is 61 and has chosen to use HRT in a sequential form, though she has found a specific regime that works for her with her doctor's agreement.
I expect you will start to see an improvement in your meno symptoms in about a week or two.  Keep us posted.  DG x

[Hurdity]

Hi again

Just to point out that giving Micronor continuously (ie the norethisterone) is just the same as when it is part of conti HRT tablets that contain norethisterone, (eg Elleste Duet conti, Kliofem etc). It's just the dose I was concerned about.

Hurdity x

[flower]

Hi Ladies,
Thank you so much for the info and advice.  I unfortunately can't do anything about the micronor 35mg dose as I was lucky to get a Dr that bothered to give me gel and pills...others just ignored me! So far the wet sweats have cut down dramatically (even tho here in uk its unusually hot and humid just now) and the depression has gone...I had got to the point where I just didn't give a damn and all the mundane chores of life were just that ! a bloody painful chore so I was angry but now I feel so much lighter and like the usual me who just gets on with it.  So I will keep fingers crossed as I slept really good last night (tho I did take 2 Co-codamol )
I will keep you up to date and I am doing the gel one squirt on my early morning wakes (4 or 5am) and the other late morning like suggested.
Thanks again xx

[Dancinggirl]

Flower - you shouldn't need to use the gel that way - applying some at 4am seems odd - why wake yourself up to do that!!!!?.  You can just use 2 squirts either morning or evening after showering.  Some women like to use one dose before bed and one dose in the morning though.  I never found it made much difference.  DG x

[flower]

 :)oh dancingirl, you made me laugh...if only I did wake myself up!  Getting to sleep and staying asleep went out the window with meno   my whole body feels heavy and like pressure at the moment also, but I think its my body getting used to gel and tablet I am pleased the depression has gone tho. I split the gel application as I thought it might be easier for the body not to have a 'big hit' all in one go. Than you x

[Dancinggirl]

Hi flower
I always did my gel application in one go - it shouldn't make much difference when you apply really.  If you use more than two squirts of gel I think it is recommended to apply some in the morning and some at night.
I do know what you mean about sleep though. I haven't slept a whole night through since having my children - I get up at least twice a night to have a pee and now I've come off HRT my sleep is even more disturbed. The recent humid weather is driving me nuts!!!! I had far better quality sleep when I was on HRT. I just thought that doing an application in the small hours might wake you up more(it could become a habit) when it's best to relax and try to go back to sleep when you wake in the night. I do find I wake around 4am because of the dawn light so recently I made some blackout blinds from thermal fabric and used velcro to stick them up and this makes the room darker and helps me to go back to sleep if I wake.  I do think we are programmed to wake with the light.
I believe the body does store oestrogen, so 2 squirts in one application should easily last through one day. You should find your sleep improves as your body builds up it's oestrogen stores.
BTW it won't be the oestrogen causing you to feel heavy etc. it may well be the continuous progesterone. That's why I was suggesting either the Mirena or perhaps try Utrogestan.  Utrogestan actually makes many women sleep better so you have to take it last thing at night.  DG x

[flower]

Thank you. I have noted your advice for when I go back to docs. They are not that helpful so I will continue for a month or so and then make my requests based on your info. Hope you get  a decent nights sleep x

[charliegirl]

Hi all, not been on here for a while, messaging about HRT, am on Evorel Conti 3.2mg and 11.2 mg, twice weekly patch, everything fine till last few weeks, when my body is trying to have period, brown discharge and period pain, any suggestions as to whats happening, especially you Hurdity as you know so much. Thanks
Charliexx

[honeybun]

It's really not unusual to have spotting on a conti HRT to start with. It can take up to six months to settle.
It did with me on the same patches that you are using.


Honeyb
x