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[violetbat]

I have been taking norithisterone plus 100  everol as a sequi regime for at least a year. I was on utrogestan for years before that and I hated it.
I get on much better with norithisterone. The gps have been useless re dosage. They have decided I haven’t been taking enough- I was taking 6 nori day for 14 days a month.
I was taking what they told me to. They said I should have been on a Conti regime and that’a what they thought I was taking- which I wasn’t.
They have been pushing for me to be on a conti regime- I tried it but it was horrible.
I have a scan booked for the end of this month to see what is happening with my womb lining.
The specialist go in our trust is now suggesting continuous slynd.
I have no idea why. I haven’t got an issue with the regime I am on-
Please can I have you advice as to what to say?
The gp made a useless attempt to phone me today and has since sent a text message saying she can prescribe slynd.
Obviously we all react very differently to different prostins- but I have read awful things about weight gain and hair loss with slynd. I have very few symptoms with norithisterone- bit cramp and a few small spots. On utrogestan I had constant cystic acne/
I m panicking all round.
Last time I spoke to the gp she suggested I simply came of HRT ( because she couldn’t be bothered).
Why can’t I just stay with the regime I am I . I am happy to up the norithisterone if needed.
Thanks so much/

[joziel]

Have you read this guidance? https://thebms.org.uk/wp-content/uploads/2023/04/14-BMS-TfC-Progestogens-and-endometrial-protection-APR2023-A.pdf

It states: "the suggested dose of progestogen given in a continuous
combined HRT regimen would be a minimum of 0.5 mg/day of norethisterone or 2.5 mg/day of
medroxyprogesterone acetate. For low-dose sequential regimens norethisterone a minimum of
1mg/day given for 10 days a month, oral micronised progesterone 200 mg/day for 12 days a month,
medroxyprogesterone acetate 10 mg/day for 10–14 days a month or dydrogesterone 10 mg/day for 14
days a month would be suitable options.11"

Take that to your GP. Print it out.

[violetbat]

Thanks for replying- she is insisting that because I am 57 I MUST now be on a Conti regime and says my cancer risk on the regime I am on is significantly higher because of my age.
She said I was post menopause because I had not had a period for over a year. I told her how would we know as I have had forced bleeds every month on my HRT for the past 6 years didn’t get that at all.
Who knows slynd might be fine.
The thought of possibly losing my hair terrifies me though.
I have agreed to try it out. If it doesn’t work I will go back to the norithisterone.

[joziel]

That's just plain wrong. There was a tiny tiny increased risk (something like 4% more) of endometrial cancer on sequential regimes - but it's so slight as to be negligible.

You might want to look up the videos on estrogen dosing from Dr Felice Gersh on YouTube as she advises sequential HRT for everyone, ongoing. If you take enough estrogen for the health benefits, you WILL get endometrial build up - and that needs to come out. If you don't stop the P to allow it to come out, you will just get random and unpredictable bleeding at weird times which worries everyone. The only way to take P continuously post-menopause, is to take so little E that you are getting no build up - but therefore are also not getting the health benefits of a decent amount of E.

[violetbat]

That's just plain wrong. There was a tiny tiny increased risk (something like 4% more) of endometrial cancer on sequential regimes - but it's so slight as to be negligible.

You might want to look up the videos on estrogen dosing from Dr Felice Gersh on YouTube as she advises sequential HRT for everyone, ongoing. If you take enough estrogen for the health benefits, you WILL get endometrial build up - and that needs to come out. If you don't stop the P to allow it to come out, you will just get random and unpredictable bleeding at weird times which worries everyone. The only way to take P continuously post-menopause, is to take so little E that you are getting no build up - but therefore are also not getting the health benefits of a decent amount of E.

That makes perfect to sense to me thank you.
It feels like such a battle. Most gps know next to nothing and the so called specialists don’t seem to be up to date. I will check those videos out.
What baffles me is her attitude to my upcoming scan. She doesn’t think they will find anything. Ok so if you think my lining will be ok then why the need to change the regime?
She then said that if I didn’t hear from her after the scan to assume that all was ok.
Righty ho then-
When I have my bleed it is extremely light- gone completely after 2 days. To my mind that either means I am not shading enough or it means there is very little to shed.