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[lisa789]

Was prescribed Evorel 50 patch & norethisterone for bad PMS & peri menopause.

Was ok with the oestrogen patch but only managed 2 days of the progesterone tablet and I can't take anymore I felt that ill - intense nausea (couldn't eat anything), crying & panic attacks.

Any ideas anyone on what I should ask my GP. The HRT was prescribed by gynae outpatients but my review is not until the end of May. Is it ok to keep the oestrogen patch until I sort something else out with regards to the progesterone?

[Cassie]

PErhaps ask for Utrogestan and use vaginally so less side effects....

[lisa789]

Thanks Cassie. Are GPS ok with prescribing this or is it best to go private?

[limpy]

You may feel better with a transdermal route for the progesterone. I think Evorel Sequi has the same oestrogen patch that you are currently using, with the progesterone component being supplied by Evorel Conti patches. Have a look at the info in treatments http://www.menopausematters.co.uk/perimeno.php.
and have a chat with your GP.

Just seen Cassie's post - like she says, perhaps ask for Utrogestan.  Some ladies find it hard to get on with the progestogen in Evorel Conti. See what your GP says.

[lisa789]

I was prescribed the meds for severe PMS & peri. My periods have been regular for the last year.

I was told to take continuous oestrogen via the patch and 12 days of the norethisterone commencing day 17. I was given 5mg tablets and to take one twice a day so 10mg per day in total. Felt awful, like my stomach had been turned inside out and was having panic attacks.

I've sent an email to DR Currie and rang my GP but they told me to ring the outpatients as they prescribed the meds, I've left a message for them to call me back

Definitely can't handle more of the norethisterone I was physically shaking I felt that ill

[Hurdity]

Hi lisa789

If you have been prescribed the norethisterone to help protect the endometrium from the extra oestrogen from the patch then that is a ridiculously high dose! If you look at the medium dose tablets ( 2 mg oestrogen), then the dose is 1 mg for 12 days, not 10 mg!!!! That is a very strange way of dealing with pms - but gyane must have reasons - perhaps you can ask when they ring? If you are having regular periods and have never skipped on nor had irregular or skipped cycles then you are most likely not yet peri-menopausal although there must be a reason you have been diagnosed as this?

Utrogestan would not be prescribed vaginally by your GP but you can use it like this. However a normal dose of progestogen may well not affect you in this way! I would either go with Limpy's suggestion of Evorel sequi and see if a lower, transdermal dose would suit you better, or try utrogestan - (it may be in the doc's book as "micronised progesterone").

Print off the info from the link Limpy gave (scroll down for utrogestan) to take with you in case the doc queries what you are asking for. If you have no joy with the outpatients then you should go back to your doc but hopefully if you tell gynae they don't agree with you they will prescribe something else.

Hurdity x

[lisa789]

Thanks for your reply Hurdity.

To be honest I think the doctor I saw at outpatients was a bit clueless, he was one of the consultants underlings. When I went for the prescription the pharmacy they wouldn't give me it until they'd spoken to him as he'd put I had to change everyday not twice a week.

The last year my periods have been pretty much normal but the 3 years before that I was missing periods and went 4 months without one at one point. Bloods taken then suggested menopause but I've since found out they were taken at the wrong time of the month. I changed GPs and had my bloods done on day 2 of my cycle and my levels came back ok.

I was diagnosed with severe PMS and possible peri menopause because of all the physical and mental/emotional symptoms I have. I was given zoladex in September to stop my periods to see if this helped with my moods and anxiety but it made things worse. I've since read you're supposed to be given HRT alongside zoladex or else you get instant cold turkey menopause, I wasn't given HRT. I went through hell for a month and honestly thought I was going mad.

I went back to outpatients in February and said I wouldn't have the zoladex again and he gave me the HRT combo. Must admit I don't have much faith in them after how he prescribed the patches and what you've said about the norethisterone.

I've left a message with the consultants secretary so hopefully he'll suggest something more suitable.

Isn't it a sad state of affairs when people on a forum know more than people who are paid to know this stuff

[CLKD]

 

[lisa789]

THANK YOU!!

I'm new to all this and so confused. Seems the doctor I saw was pretty much useless and has caused me unnecessary suffering by giving me way too much progesterone

[Mary G]

Lisa789, I had the most evil side effects imaginable from taking norethisterone and I wouldn't touch it with a barge pole now.   Definitely get hold of some Utrogestan, it has far fewer side effects as long as you don't take too much of it and works much better when taken vaginally.

[lisa789]

Thank you for your replies ladies I appreciate it so much xx

Waiting for the hospital to call me back, if I get nowhere with then I think I might see a consultant privately.

Mary G, yes taking it vaginally might be the best thing for me.

Stellajane I can't tell you how bad I felt yesterday. I last took a tablet yesterday at 1pm so hopefully it'll be out of my system. My stomach still feels rough, bloated and I have awful acid reflux. Managed to eat a bit today which is good. Teatime onwards yesterday I was sat rocking on the floor with horrendous nausea and my teeth were clenched and anxiety sky high.

Stupid doctor I'm so angry!

[Taz2]

Hi Lisa - are you saying that you were prescribed norethisterone to stop you having PMS? If so I find this incredible given that so many women experience PMS symptoms while using it.   I agree with Hurdity that 10mg seems a really high dose although if you scroll down to 4.2 (2) on this site https://www.medicines.org.uk/emc/medicine/7257 you will see that the prescription is correct in terms of treating PMS symptoms.

Taz x 

[lisa789]

Hi Taz the doctor said he was prescribing HRT in the form of Evorel 50 patch & norethisterone for the treatment of severe PMS & peri menopause. I'm not sure if I am peri. When I was 38-40 my periods stopped for 4 months on two occasions and I had really long cycles then over the last year there become pretty much normal.

I'm even more confused now! I'll just have to hope the hospital do call me back tomorrow.

I've still got the oestrogen patch on do you think it's ok to leave it on when I'm supposed to be on the norethisterone for another 10 days?

I always thought progesterone intolerance was the main cause of PMS. As I've already said think I got a clueless doctor so hoping it's the consultant that rings and not one of his juniors.

Just had a look on the NHS site and it says oestrogen treatment for PMS should be accompanied by low dose progesterone. 10mg for 12 days isn't a low dose is it

[CLKD]

For ladies with a womb progesterone is essential in order to cleanse the womb as 'usual'.  It is known that many do suffer at this stage of HRT ……….  .  It can be Trial and Error at a time when ladies would like to feel better sooner rather than later!

Make a list of symptoms to take with you.  You shouldn't need to see anyone privately.  Sometimes it is necessary ….. browse round, make notes ;-)

[Trufflecat]

Hi Lisa. I have a history of appalling pms. I think (and I am self diagnosing here) that I have what prof Studd calls 'reproductive depression' . Have you seen this?
http://www.studd.co.uk/reproductivedepression.php