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[Sunnydays]

Almost a year ago to the day I started hrt for the first time.  I was about 2 years post meno, sleep was poor, energy low, skin falling apart, low/nil libido, and generally feeling yuk in myself.
At the time I thought I was taking it with my eyes wide open but only recently I realise I really knew nothing! My gp was helpful but not particularly knowledgeable and this forum has been a brilliant support and a mine of information. I urge any newbys to read the information that is available about the meno and, if interested, hrt.

One thing I do now know for sure is that when taking hrt with an in tact uterus, the demon progesterone is required! And therein lies the problem - for me anyway. Ive had a good look at the info sheets and it appears there's no exact science in the amount of progesterone needed eg in the tablet form of one sequi regime  1mg of Norethisterone is given for both low and medium dose oestrogen; the sequi and conti Evorel patches use the same dose of Norethisterone.

For various reasons I don't feel I've got my hrt right for me so with a range of surplus hrts in my drawer this is my plan...

A quarter patch of Evorel conti 50 patch and half an estradot 25 patch. This makes 25mcg of oestrogen in total   (this is all that I feel I need) but a relatively reduced amount of Norethisterone. My idea is that with this ratio, the benefits of slightly more oestrogen (than in the standard packs)  will outweigh the progesterone negative effects. If I take it as a sequi regime and time the changing of the patches well,  I would only need the 2 patches for 12 days, then apply the estradot 25 patch in full for the remainder of the month. My hope is that the 12 days wouldn't be long enough at such a low dose to build up the progesterone side effects.
The off put is that during the oestrogen only days I would expect to get a bleed (which I don't like) however the information pages suggest that not all women do have one.

In my usual fashion I've most probably made this as clear as mud! If anyone can understand what I'm trying to do, feedback/ cautions etc appreciated! I'm determined there is a right hrt for me and maybe this will be the one!

[Dancinggirl]

Sunnydays - I would like to offer a word of caution.  Mucking around with doses is not the best way to go - I've read so many posts on MM with women chopping and changing their regimes to no real benefit.
You seem to be sticking with just the same type of progesterone which is clearly not right for you!!! I can't remember whether you have tried other HRTs? If so which ones?
The balance of oestrogen to progesterone is very important and if you don't use sufficient progesterone then you run the risk of the womb lining building up and getting erratic or problematic bleeding.
Have you had a good look under HRT TREATMENTS above - which, if any, of the other preparations have you tried?  If you haven't tried Femoston then that's a shame as this has a kinder progesterone that many tolerate very well.  Also I am one of the many now using Utrogestan (with Oestrogel) which is also well tolerated - though I am having to use the highest dose of Utro to prevent breakthrough bleeding/spotting.
If I were you, I would ask for some Oestrogel and just use one pump per day for 2 weeks.  Then have either Utrogestan or Provera alongside the Oestrogel for 12 days after which you would get a withdrawal bleed.  Both these progesterones are well tolerated - maybe try one for 3 months and then the other for 3 months to see how it goes. If you find one of them is working well for you, then you could try it on a continuous basis. Oestrogel gives a better opportunity to adjust the dose and I find one pump per day works really well for me despite being quite a low dose.
I doubt you will achieve the balance you want by cutting things about. You really need to try a regime that you stick with for at least 3 months as this is the only way to allow the body to welcome and adjust to the hormones.  DG x

[dazned]

I too would offer a word of caution ,cutting bits off here and there really isn't the way forward IMHO.
I know what it's like to feel desperate for a solution but really wouldn't advise dabbling like you suggest unless you are going to go for regular scans at least to check on your womb lining 

[Sunnydays]

I appreciate your frank responses; that's the beauty of these forums. Ideas conjured up in the middle of the night might not be quite so sensible as first thought ( although I must admit on this occasion when reflecting I did still think it was a good idea!)

These hormone medications have to be treated with respect however I guess I thought that adding a bit extra Estrogen was a bit like deciding whether to have one or two pumps of the gel.

 Norethisterone only tends to effect me after a buildup hence I thought having it sequentially might alleviate that. Re Provera I completed 12 days of it  after 7 weeks of oestrogen only and I must admit I struggled to get to day 12. I could have lived with that, but I haven't returned to how good I felt with the oestrogen only. I still feel exactly like I did on day 12 of Provera and I can't get rid of it. It sounds absurd but it's as if it's left something in my body that won't go. I can't bear to take it those tablets again in case it's cumulative and gets even worse.  I do have some Utrogestan tablets so I could try that. It would just be nice to get back to how I felt on the 27 November before I took the darned Provera!

Femiston will be my next choice although I had wanted to avoid tablets. 

[Hurdity]

Hi Sunnydays

I would also urge caution - not so much because of the experimentation, although that is a consideration, but cutting patches into such small pieces will not make for consistent dosing anyway - well the Evorel patch might because they are so big, but not the Estradot. They don't tend to stick so well on the cut edges ( I am finding this with my little extra I am adding - cutting a 37.5 mcg out of date patch into 3 to give me a bit more on top of the 50 mcg usual one!). Much better to have a tailor made patch if you are using patches - or switch to gel as Dancinggirl suggests, although depending on how well you absorb it, this might give you much more oestrogen than you are having at the moment.

I can't remember why you decided against long cycle Estradot with say 12 days of utrogestan? I am sure we discussed this in the past? Did you react very badly to it? I know we are all different but I always recover from the 12 days of vag Utro after a few days - once it has cleared my system and I am back to normal on the Oestrogen only. It doesn't seem to accumulate in my body. It may well be that some of the bodily changes due to synthetic progestogens persist longer in some women - a few years ago I seem to remember I read something about this but can't remember where - sorry.

Hopefully you can find a solution without having to take tablets - I think you are mid or late 50's if I remember but maybe younger?

Hurdity x

[Sunnydays]

Yes all makes sense Hurdity. And the Estradot is so small it is hard to handle, yet alone adhere, when smaller! I'm 53.
I think this Provera is stuck in me at the moment!
I must admit that my plan referred to above was implemented a couple of days ago and bang, within 2 days the progesterone headache and so of this evening, I've abandoned Norethisterone once and for all! It looks like Utrogestan .......

[BreadFruit]

Have you tried Kliofem? I am on it for 3/4 weeks now and feel fantastic. I got the tablets as I did not want the patch (skin allergies).

But I would like to caution as well to mucking about with all the hormone stuff you have in your drawer. Try and find a specialist, GP's who have specialised in HRT. Maybe you need a few blood tests to find out how your hormone levels are.

Also some hormones need some time to settle the body into a routine, if changing the drugs all the time the body never gets a chance to settle.

[Sunnydays]

Thanks Breadfruit, I'm grateful for your response. I looked up Kliofem and unfortunately it contains Norethisterone which causes me a problem.  I had also tried to avoid tablets as I am vulnerable to migraines and apparently patches avoid the spikes in hormones. Having said that I might try Femiston tablets in the future.
My husband and I were discussing this whole hrt business this morning and we're thinking of just giving it a complete break and then starting up again later. That'll give me chance to see what support I now need from hrt and also chance for the Provera to vacate my body completely!
I am very much a sun person and winter is a grot time for me. I think this also affects how I feel yet alone putting hormones into the mix!