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[scoobylyn]

I have been on the Femseven Conti for 2 months.  My main symptoms have been vaginal atrophy and night sweats/difficulty sleeping. Periods stopped approx 2 yrs ago.

I was on vagifem and then estriol cream and neither on their own did anything significant.  Doctor then stopped the topical and started Femseven which on it's own made no difference and the only difference was I gained breast/nipple pain.  I started using the cream at the same time and there is an improvement albeit small.

Review today the doctor changed to Elleste Duet (white and green pills on a 28 day cycle) and added vagifem twice a week.

My question is what is the main difference between the Femseven Conti and the Elleste? 

[Hurdity]

Why has your doctor changed your prescription? Is this with your consent? Were you happy on the Femseven conti? They are completely different preparations!!

Femseven conti - is a continuous combined HRT transdermal patch with estradiol and a synthetic progestogen levonorgestrel, and Elleste Duet is a continuous combined tablet HRT with estradiol and a synthetic progestogen norethisterone.

It depends what dose you have been given - as Elleste Duet comes in 1 mg or 2 mg. The only reason I could think of for changing ( ie your doc's thinking) is that you have been given Elleste 2 mg because maybe you said that the Femseven had not eliminated your symptoms, or if you didn't do well on the combi patches so perhpas you had side effects from the progestogen? Is this the case? If not there is no reason to change as transdermal HRT is better for you especially as you get older and want to be on HRT for a longer time?

It is possible to increase the oestrogen dose by changing to oestrogen only patches and separate progesterone - either the synthetic one Provera, or progesterone itself - Utrogestan, or you could have a Mirena coil which delivers the progestogen staright to the womb ewhere it keeps the lining thin and minimal absoprtion into the body.

Having said that many women are on Elleste Duet and quite happy with it

Hurdity x

[scoobylyn]

I'd said to him they the femseven patches didn't appear to do anything at all and my symptoms remained the same.  I wanted to try that vagifem alongside so he said to try the elleste 1mg and vagifem together.  The packet says to take all the white first then the green tablets. 

[Mary G]

scoobylyn, I can't understand why you doctor thinks that Elleste Duet will work when the Femseven didn't. 

I can only give you my personal experiences but there is no way that Elleste Duet would work for me.  The oestrogen dose is too low and it contains norethisterone which I cannot take at all because it gives me migraines, breast pain and low mood.  It would not do anything for symptom control either.  When I took a similar type of HRT to Elleste Duet, I might as well not have bothered, it really was that ineffectual.

You could try it, it might work for you and as Hurdity says, many women are happy with it but if it doesn't work out, please don't let it put you off HRT altogether.  Go back to the doctor and get a different type of HRT.  Many of us on here take bio identical transdermal gel or patches with a separate form of progesterone, usually Utrogestan.  Generally speaking, transdermal HRT is far more effective than the oral varieties in every way.

[scoobylyn]

Thank you for the reply.

The problem I am having is finding a doctor at the practice who is a) willing to listen and b) with knowledge.

One female doctor point blank refused to give me HRT end of.  So I went back and saw a different doctor who agreed to let me try it and said he had no experience of prescribing it and looked it up and gave the Femseven first.  Today when I went back I told him I felt the Femseven hadn't done anything at all and it certainly wasn't effective on it's own controlling the Vaginal Atrophy.  He then said to try the Elleste.  Overall he was not happy about prescribing any HRT.

It's really frustrating as I don't have enough knowledge to tell them what I want.