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[Sunnydays]

Hi,
I started Evorel conti patch 3 weeks ago and due to headaches from other patches was advised to start with just quarter patch and build up as needed. This past week I increased to just over a quarter and it's been great - I actually slept through the night! Yes! I fell asleep at bedtime and woke around 6am. It was strange as I've not had a complete sleep for years and to wake in the morning without having laid awake all night was wonderful! And from Tues to Thurs I felt really good.
I changed the patch on Friday during the day and this weekend has been the opposite. I've reverted to poor sleeping, I've felt lightheaded and anxious. I sweated buckets. I know hrt can increase blood pressure and I have had raised readings in the past but I was so worried, I purchased a home use one. Pre hrt my bp was 90/60, now it's 138/78; not brilliant but just ok so that's good. My tummy has felt like a period pain, although not so low down as proper periods pains, and it's almost like a burning/bloating discomfort. I just feel strange. About 3/4 years ago, a year before my periods stopped I had an 'episode'! We were on holiday abroad and I was overcome by a terrible feeling, I don't know if it was anxiety or what, it felt like I might die.  It happened a few times and lasted over a couple of  months. A good friend said it was likely to be hormone related, but the GP said it was most probably a virus, and I wasn't menopause. This is the kind of feeling I have at the moment, but not so strong.
So maybe last week's 4 days of wonderfulness might have been just down to coincidence or maybe the good bits about hrt, but the not so good element is taking over.
I know that the progesterone part of this particular hrt is not supposed to be so kind from what I've read on this site.
Has anyone felt like this, but then got through it? Did it raise your blood pressure but then settle down? Any comments gratefully received as I feel really strange. Thank you

[Greenfields]

Hi Sunnydays

I'm into the second cycle of using Evorel 50 (patch) and Utrogestan (100mg oral) and the first cycle (ie the first 4 weeks) I had a lot of side effects that came and went. These included period pain like you describe.  I also had good sleeping experiences at the beginning as well.

In the second cycle I've had periods of early morning anxiety and nausea. I've also had issues with poor sleep - trouble getting off to sleep and waking up frequently.

I've not had sweating though.

I've also had periods where I've felt fine and even upbeat.

I've not noticed a change in my blood pressure but I haven't been monitoring it -
however when I've checked it at the Drs surgery its been fine.

I currently have hives on my neck and I don't know whether that's HRT related.

I've been told by others on this board and my Dr that it can take up to 3 months for the body to get used to HRT and if you are perimenopausal then your own hormones will be fluctuating as well - so that can impact moods and symptoms etc.

I wish I could offer you more hope but it does seem to be a rocky journey in terms of finding an HRT that works and then staying on HRT for a while to see whether the body can adjust to it.  I'm better than I was - I have no hot sweats now and my anxiety (when I'm not impacted by early morning anxiety) has diminished.  But it's not a medication that makes you feel better and better over time necessarily - things fluctuate.

Hugs xx

[Briony]

Took me months rather than weeks to get used to HRT. One day it just dawned on me that I was getting more good days and fewer bad ones. Eventually I moved to the pill as I realised that, far from having too much estrogen, I actually needed more.

Hang in there for at least three months if you can - in fact, someone on here advised me to wait at least six months (I think I was expecting miracles after six days!!)  xxx

PS I don't get hives but I do get itching as a side effect of both HRT and the pill. Weirdly, it's always the first week of the month only. 

[GypsyRoseLee]

Does the Pill give your more oestrogen than an HRT patch then Briony? That really surprises me!

[Hurdity]

Patch doses go up to 100 mcg and Qlaira gives on average just under 2 mg estradiol valerate so less than a 2mg tablet.  if you were on 100 mcg patch then you would likely be getting more oestrogen than on Qlara. However for two days (on Qlara) you have 3 mg (although two other days you have 1 mg and 2 days you have nothing). Of course you can't really compare directly because it depends on how much you absorb from tablet vs patch HRT. However 2 mg estradiol is classed as medium dose and 100mcg patch is higher than high ( looking at the doses on here).

Hurdity x

[Briony]

Doctor described it as the pill being more 'controlling', though based on what Hurdity says, sounds like Qlaira is at the lowest end of the pill scale? (Low dose pills are classed as 30mg or less). She said Qaveraged as equivalent of 100 mcg patch over the month. I would have stayed with HRT if I could have had more frequent progesterone, but I really suffered when the Utrogestan stopped - the no. of non progesterone days with qlaira is less than with 200mg Utrogestan for half month, as I took previously, meaning I don't get the dip I used to get . So complicated , isn't it?!! Xx

[GypsyRoseLee]

Thanks Briony

If you really disliked the withdrawl from the Utrogestan, couldn't you have taken 100mg every day rather than 200mg for just the 12 days?

[GypsyRoseLee]

Hi Hurdity

If you needed something stronger and more controlling to even out your hormones would you be better off then taking a more mainstream version of the Pill like Loestrin (I remember being on that one I think?) rather than Qlaira?

The only thing which would bother me was that I still used to get PMS when I was on the Pill years ago, so not sure if taking the Pill now would control my hormones. But at least the PMS was completely predictable and was only for a few days prior to my period and would disappear as soon as my bleed arrived.

[Sunnydays]

I'm continuous regime as no period for nearly 2 years. I've had 3 days of my tummy feeling like is in turmoil; as I type it's  feels so uncomfortable. Is this progersterone 'ripping' away at the womb lining? If so, I thought it would have been lower down. As I'm on continuous am I likely to have this all the time does anyone know? And this is just quarter of a patch!

[Greenfields]

Sunnydays when I had symptoms like that, they did go - so I would give it a few more days.  Every treatment has different side effects on the individual. 

[Briony]

Thanks Briony

If you really disliked the withdrawl from the Utrogestan, couldn't you have taken 100mg every day rather than 200mg for just the 12 days?

GP wouldn't let me as I still had regular periods 

Hi Hurdity

If you needed something stronger and more controlling to even out your hormones would you be better off then taking a more mainstream version of the Pill like Loestrin (I remember being on that one I think?) rather than Qlaira?

The only thing which would bother me was that I still used to get PMS when I was on the Pill years ago, so not sure if taking the Pill now would control my hormones. But at least the PMS was completely predictable and was only for a few days prior to my period and would disappear as soon as my bleed arrived.

I would have opted for something a little stronger if I could, but I liked the fact that Qlaira is bio identical, combined with the fact that it's best for someone higher risk like me (have migraines with aura and Dad had a serious stroke at 50). I also liked the fact it has so few 'estrogen free' days. My GP mentioned Microgynon to me too, as it has one of the lowest risks of blood clots, compared with other C O pills. All my life I have been anti COPs, so it's quite ironic that now I no longer need contraception, I am so dependent on them!!

[GypsyRoseLee]

I didn't realise that about having regular periods means you can't take it continuously. Worrying too, as the locum gynaecologist I saw prescribed me Evorel Conti, eben though he kne I still had regular periods! I never tried it. And my own consultant frowned when she saw he had recommended it and said 'Hmm perhaps not a very wise choice' which is the closest professional come to slagging ach other off.

I think I have taken Micronogyn in the past and a few other brands, but they were all much of a muchness. Though I still always got PMS while taking them. But I'd happily swap, as the PMS was no where as severe as the low mood/anxiety that I am getting now.

Right now I'd drink washing up liquid if it would raise my low mood and stop this awful anxiety.

[Briony]

I know, the anxiety (and palpitations) are the worst. I felt  that others ie colleagues/family would  think I should 'pull myself together' so I tended not to mention it and just withdraw myself from normal life. Us women are our own worst enemies!! My partner is the only one who knows how much I suffered (and, if I am honest, he has suffered because of it  ). I think he's relieved that things are beginning to look up as I refused to plan anything out of my comfort  zone in case 'it struck'.  Even shopping became an ordeal at one point. Now I am being 'slightly' more daring again (with the exception of yesterday which was , to be frank, a pants 'I am about to have a heart attack/blood clot/anxiety explosion'  day)!

I do have a thing about posting on here too, as at least three times I have been very positive about something, only for it all to go wrong the next day!

  x

[Hurdity]

GypsyRoseLee - it won't actually do you any harm to be prescribed conti HRT when you are having periods - after all that is in effect what the Mirena does (locally), but most HRT types do not contain sufficient progestogen to completely stop the bleeding and so you can get unpredictable bleeding while you are still peri (and if your cycle is still strong), or even bleeding all the time sometimes! I don't know anything about CCP apart from the fact that most types are completely synthetic - v large doses of synthetic oestrogen and progestogens so can't be compared to HRT at all ie women's experience of CCP in the past.

As Bryony says Qlaira is bio-identical oestrogen and doesn't have the 7 pill free days of most of the other CCP types so should even out your mood dips because the oestrogen is almost continuous.

As I've said before personally I would not want to be on conti HRT because I don't think continuous progestogen is particularly good for you and especially not synthetic progestogens - but as always it's a case of balancing one set of symptoms vs others vs short and possible long term effects - and is all a compromise about quality of life!

If you are a woman who has suffered very bad progesterone withdrawal symptoms as part of pms (in addition to the oestrogen dip!) but is generally OK when on the progesterone part of your cycle (it goes without saying that women are at their best during the first half of their cycle when oestrogen levels rise - excluding peri-madness which plays havoc!) - then I can see that continuous progesterone could prevent the few days withdrawal while your body reverses the physiological changes caused by the prog.

Hurdity  x

[GypsyRoseLee]

Very informative as ever Hurdity, thank you.

I'm intrigued with what you say about the Pill evening out mood dips because the oestrogen is almost continuous? My GP told me that wearing an oestrogen patch every day would have the same effect of evening out my mood dips and making the dips much less severe. But so far, even on a higher 50mg dose patch for over 3 weeks I am 9 days into a very low mood dip. As low as anything I have felt either before HRT, or since.

So would being back on the Pill be any better at controlling my mood dips? Is the oestrogen in it really that much stronger than HRT?