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[Squashcat]

Hi ladies

I'm new to posting and looking for some guidance on hrt. I'm 8 weeks into combined conti, elleste duo 2mg. I've tried for four years (am 2 years since last period) to manage hot flushes, lack of sleep, no energy etc and finally gave in and accepted a prescription from my GP. The first two weeks were great, I felt so much better, flushes gone, sleeping better, more energy. I though I'd cracked it! Then slowly I started to notice sore and swollen breasts, mood fluctuation and today have had a tiny bit of breakthrough bleed.
Is it the progesterone?
I've got a GP appt on Friday and am thinking to ask for a change of tablet or maybe patches?
Any thoughts would be greatly appreciated!

Thanks

[Taz2]

Hi Squashcat 

It must be really disappointing to find these side effects happening after feeling so good for a few weeks but they are really common for the first three months of any HRT especially the breakthrough bleeding which can take six months to settle on a conti HRT. It may be worthwhile using this one for another month to see how you feel. If, after this time, you are still experiencing problems then go back to the GP and ask for a change of HRT type having given this one a good try.  I've never used the one you are on but I'm sure someone else will be along soon to give their advice and share their experiences of Elleste.

Taz x 

[Squashcat]

Hi Taz
Thanks, I did wonder if another 4 weeks may make a difference, I've just started  month three tablet card tonight, I always take it with my evening meal. The side effects are similar to PMS, thought I was well rid of that delight, I've even got the nasty 'blind' hard spot on my chin, not had one for years!
Thanks for replying, it sounds like giving it a bit longer could be helpful  X

[Taz2]

If you can last another month you can at least say that you gave it the recommended three months. Those hard on-your-chin spots are so annoying!!

Taz x

[Hurdity]

Hi Squashcat

  from me too!

Yes the progestogen in Elleste ( norethisterone) does cause pms type sympotms in some women but as Taz says just give it another month and see if this settles. I didn't get on with it when I had it on a combi patch ( Evorel sequi)

There are many other types to try if you have to end up changing though. Some of us never like progesterones and so opt to remain on a cycle even though we are post-menopausal  - which means we have to have a withdrawal bleed so that we can benefit from the period of time on oestrogen alone

Hurdity x

[Squashcat]

Hi Hurdity
Thanks for your reply, I've read quite a lot that the norethisterone isn't always well tolerated hence wondered about the progesterone being the problem.

I'll give it the next 4 weeks, ironically I have far less PMS symptoms today than yesterday. If I do opt for a change later on which progesterone do you think could be more tolerable than the norethisterone? I'd quite like to stay on a combined continuous if possible

Thanks!
Squashcat xx

[Squashcat]

Hi Ladies

I thought an update may be helpful for others interested in Elleste duet conti 2mg.

I kept my GP appt yesterday, it was a different GP, who seemed more knowledgable about hrt and was very willing to discuss it. She suggested I switch to femoston conti 1 mg, she said she no longer prescribes elleste duet and hasn't done for some time. She seemed keen on the patches as a 3rd option if I don't get on with femoston conti. She was happy to try them now however I am keen to go with a less testosterone derived progesterone as I am fearful of hair loss, it's bad enough having skin that's trying its best to turn into crepe paper, losing my hair would be the outside of enough!!
Fingers crossed the femoston works out ok, I'll post an update in a few weeks 
Squashcat X

[Hurdity]

Thanks for the update Squashcat. Hopefully as you've only been taking the Elleste for 8 weeks your body may not notice the change from 2 mg to 1 mg of Femoston ( unless she prescribed double?). The progesterone in Femoston is very close to our own progesterone and is the best tolerated of the synthetic progestogens.

I presume you've seen this about which progestogens are testosterone derived?:

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).

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

Let us know how you get on

Hurdity x

[Squashcat]

Hi Hurdity
Thanks, yes I found that information about the progesterones, it's very helpful to know!

I asked the GP about the difference from 2 mg to 1, she didn't think it would be too much of an issue and said she can supplement the estrogen if need be. She wanted to be a bit careful about it though as she said if there is too much it blocks the receptors and the availability is diminished.

I've only had 3 tablets, feeling ok but a little nauseous, I'm assuming that will pass.

I'll post again soon with an update 

Squashcat X

[Squashcat]

Hi Hurdity

I know it's very early days but I'm wondering about what you said about had the GP suggested I double the dose . I've had 5 tablets up to now, the nausea has gone but what I have noticed the last four nights is the return of the dreaded insomnia! I'm getting very little sleep, possibly worse than pre any hrt at all. I'm a bit puzzled by this, maybe not enough estrogen?? I thought it was progesterone more that regulated sleep? No PMS symptoms so far which is great, but I'm not sure how many more nights I can do on so little sleep, think I should ring the GP and ask about doubling the dose?

Sorry to be back so soon with another issue, hormones! Wouldn't it be great if there was a genuine one size fits all!!

Thanks for your support


Squashcat X

[Hurdity]

The thing is you have halved the dose of oestrogen so this could be the reason for feeling as you do - the body is often sensitive to a reduction in oestrogen as well as low oestrogen if you see what I mean? Also you have changed the prog type - but Femoston is better tolerated.

I would see how you go with this one as it will take a while for your body to adjust (we are supposed to give each type three months) but if you get a return of symptoms like flushes and sweats (with associated insomnia) then what I was suggesting was doubling the dose which would give you the same amount of oestrogen as before or giving you the 1mg and then the ultra low dose (0.5 mg oestrogen) - which would be a happy medium at 1.5 mcg. ( I have no idea if any docs do this though!). You will see it's the first one listed:
http://www.menopausematters.co.uk/postmeno.php

I don't think you've said how old you are? Once you're over 60 docs like to try to get women to reduce the oestrogen dose a bit but otherwise there should be no problem - although it might cost a bit more to take extra!

Hurdity

[Squashcat]

Hi Hurdity

Thanks, again, your response is very much appreciated. I'm 51, 2 years post menopause.
I see what you mean re the estrogen being halved and its poss impact, I think the progesterone in femoston is suiting me better though, I know it's early days but I'm not getting any PMS type side effects at all.
I'll be patient and see how it goes!!
Good idea to try the extra .5 if I do get any flushes, night sweats etc returning. That's assuming my GP is agreeable 
Thanks once more, your knowledge is invaluable. I'm reading what I can find, I'm sure I'll piece it all together eventually 
Squashcat X