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[SomersetGirl]

Hi, I was told I was in the menopause nearly 2 years ago now aged 43. periods kept end randomly disappearing for months and got endless urine infections. Was put on Elleste Duet 1mg and it made a massive difference and no more urine infections (caused by low oestrogen). Also my quality of sleep improved massively - hadn't realised odd things until the hrt kicked in and felt so much better.  After a year of being on this I was offered Elleste Duet Conti 2mg and the  thought of no more bleeds was tempting so I have now been on this for 2 months. A bit of break through bleeding for a couple of weeks but all fine now.  However, I have noticed that my hair has started to shed terribly - noticed it a bit on the duet but now it's increased, probably because of taking progesterone every day rather than just part of the cycle.  I had a problem with hair shedding and tingly scalp about 5 years ago when put on the POP and my hair has never really been the same since but after coming off that and being on nothing for quite a few years it was a lot better. Now getting those familiar scalp tingles again and the shedding has made me fear that  the daily progesterone is not agreeing with me.  Read on here that Femoston has a more friend,y progesterone and better for hair so saw my GP who has prescribed it he Conti version. However, after actually collecting the prescription the Conti is only 1mg oestrogen whereas my Elleste is 2mg and worrying if I'll start getting other symptoms back with the reduced oestrogen. Also one of the side effects listed is cystitis type symptoms which was my main symptom of the menopause at the start.  I have one month of the Elleste Conti remaining so wondering whether to give it one more month ie, the total 3 they recommend or start Femoston! Sorry for the long post but I'm due to start the third pack of Elleste today 😮

[andius]

Somerset:

After trying the 50 patch and prometrium oral (same as utro but in US) I switched to combipatch which is 50 estradiol and .17 norethisterone (similar to the elleste conti patch) this summer due to the progesterone irritating my bladder.  Six weeks on the new patch, my hair started falling out in droves....really a lot.  I then stopped the combipatch and went back to the 50 estradiol patch and progesterone oral.  This slowed the shedding in about 2 wks but the bladder irritation was back. A month ago, I decided to cut the combipatch in half and am trying that.  So far the shedding is staying the same... still occurring but slowed. I do feel the effects of the lower estrogen though. Maybe I just need to get a permanent curl and wear my hair short like a little old lady. I have lots of hair so no bald spots, but it is coarse and naturally wavy so I look like a brillo pad with hair of all different lengths sticking out everywhere. It is really depressing.    I'm going to discuss the estrogen patch and separate provera pill with my doctor when I have to go back.  Supposedly it is less androgenic and maybe I can use it without either bladder irritation or hair loss.

Something to consider?

A

[Briony]

Hi Somerset, another 43 year old west country girl here! The progesterone in your combined pill could well be the cause of your hair loss. Certainly, I have found it made mine worse. I then switched to Utrogestan vaginally and it was much better whilst I was on it, but shed when I stopped the 12 days. Eventually, I realised I needed something stronger than the HRT I was on (50 mcg patch) and moved to a new, bio identical BCP . Initially (month one) this resulted in even more hair shedding, but by month three it was fine. Better than it has been for ages, in fact.  I would say, at your age, your body expects more estrogen than 1mg (which is why a number of us on here have switched to the pill) hence the reason you're  getting a return of your other symptoms. Perhaps consider a stronger estrogen (patch form, even?)  with a separate, bio identical progesterone, or else an estrogen dominant BCP (google the Avon Pill Ladder to see what I mean).

Good luck x

[Hurdity]

Hi SomersetGirl

  from yet another West Country girl 

Briony is right re the progestogen in Evorel conti (norethisterone). If you look at the different progestogens on the list here, that one is the most tesosterone like and therefore most likley to lead to hair loss:

PERI-MENOPAUSAL SEQUENTIAL COMBINED THERAPY

Used in women with an intact uterus (womb) who are not yet postmenopausal, i.e. have some periods due to continuing ovarian function. Products contain daily estrogen and cyclical progestogen.
Progestogens which can be used cyclically are of 3 main types:

    Testosterone derived - Norgestrel, Norethisterone acetate and Levonorgestrel.
    Less testosterone related - Medroxyprogesterone acetate(MPA).
    Least testosterone related - Dydrogesterone and Micronised progesterone (Utrogestan).

Side effects are often experienced during the progestogen phase of treatment and can be reduced by using a product containing a different type or route of progestogen

http://www.menopausematters.co.uk/perimeno.php

Unfortunately it is really annoying isn't it that Elleste comes in a 2 mg continuous combined dose but Femoston doesn't. I am wondering if this is because norethisterone is much more powerful as a progestogen in keeping the lining thin? However you could ask your doctor if you could double up? Otherwise you could go back to a cyclical HRT with separate oestrogen and progesterone which would enable you to achieve the higher oestrogen levels you would benefit from at your young age. Also if you are sensitive to progestogens then you wouldn't be taking it all the time.

When you start depends on what's important to you - it is very likely you will notice a difference with the reduction in oestrogen going from 2 mg to 1 mg.

Keep us posted!

Hurdity x

[SomersetGirl]

Thank you, I'm staying on the Elleste Conti for now but have made an appointment with my gp next week. What bCp are you on Briony? Funnily enough I used to be on cilest for years and never had any problems and I see that is oestrogen dominant. Hurdity, what do you mean by doubling up? x

[Briony]

I take Qlaira, a new one that's bio identical. It was recommended as I have migraines so shouldn't really take a more potent pill.