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[Kathleen]

Hello ladies.

After a reasonable day yesterday I spent the evening flushing and panicky for no particular reason and then couldn't sleep! So today I decided to look over my diaries to review my HRT history as it were.

I discovered that I have been using Evorel 50 mcg patches since December 2014, firstly with separate Utrogestan and then a combined patch however I have continued to feel flushy and jittery every single day. I wake feeling on edge and quivery but it usually subsides as the day goes on. I also often get an anxiety surge in the late afternoon but around 9 PM I start to feel 'normal'.

My question is ladies should the HRT have completely eradicated these problems and do others find that these symptoms persist inspite of HRT or is putting up with an ineffectual dose for so long a really silly thing to do and some sort of record? I would add that I am post meno and I  did increase to 75 mcg for a while but that caused spotting and tender breasts.

I look forward to any comments ladies and I wish you all well.

K.

[Lizab]

I'm interested in the responses, as I'm battling the increase from .375 to .50 and wondering if the whole hrt route is pointless.

[dazned]

I did well for 5/6years on hrt whilst peri but year 7 had horrendous anxiety,palps,etc and nausea,tried lots of different hrt including seperate utrogeston and decided to take a break from it all see where I was at so to speak. I felt that trying this ,that and other was consuming my whole life 
4 months on Im okay so far so we shall see as they say 

[Smokey]

Well I was on everol sequil patches for about 5 years 50mg and doing well, then I started getting hot again, so I rang doc and she said I could add an additional 25 patch making 75 in total. I had a bleed same time on patch 6/7
Every month. So far so good I then started to feel panicky and scared for no reason and presumed hormones playing up. After about 4 weeks wait got doc appointment and discussed, she agreed to prescribe me everol Conti patches
50mg and the Ad Mirtazapine and said I don't need another increase in oestrogen. I now have burning tounge and hot menthol feeling in my mouth constantly, low oestrogen I presume as I'm sure I had these before I even had Hrt 5 years ago, I've never had really hot flushes just warm glows, so I'm just waiting for them to return, dry eyes are much worse too.  I have no to call menopause clinic this week, but it could be 45 day wait.

To complicate things I also have ms, I really just want to feel well!

The Mirtazapine is helping my sleep, but seriously I just need more hormones
And maybe then I wouldn't need these Ads.

Ann x

[Kathleen]

Hello ladies.

Many thanks for your responses. It seems at least some of us are struggling in similar ways.

Lizab - I have also wondered if HRT is pointless but my moods were terrible before using it.

Smokey - Yep, feeling well is the goal. When I tried an increase to 75 mcg I had very tender breasts and lots if spotting which resolved when I went back to 50 mcg. As I am post meno I have been cutting a corner off my 50 mcg patch but now I wonder if I should return to the full 50 mcg.

I'm sitting here flushy and anxious with low mood and could cry with the frustration of it all.

I should probably make an appointment with my GP but he knows next to nothing about the menopause and HRT which is why talking to the ladies on the forum is so helpful.

Wishing you all well and hoping for a better day today.

K.

[Lizab]

Yes, I am certainly improved some since before starting hrt, but it's been months of up and down. I'm crediting the hrt for the improvements, but can't help but wonder if I would have come through those months of turmoil the same without hrt. I'm sticking with it, but it might be stupidly blind faith.

[linz57]

I'm also finding that after 14 months on a 50mg combined conti patch I'm not getting the same results as I did in the first year. The heat is starting to creep back, along with the anxiety and bladder problems. I wonder if our bodies are just getting used to the amount of hrt or whether external influences such as stress etc are affecting the efficacy of the product?
If we keep increasing our doses what happens when we get used to those amounts? It's a tricky one this.

[Dancinggirl]

Kathleen - are you eating small amounts often.  The symptoms you are describing could partly be due to low blood sugar levels. I don't think hormone levels fluctuate that much through the day when on HRT.
I will often feel shakey first thing in the morning until I've had my breakfast and I always get a dip around 5 ish in the afternoon and have to eat some seeds or a piece of fruit to get me through till dinner.
Chopping and changing dosage is not the best way to go. 

linz57 - I find that higher doses of oestrogen give me flushes and when I took 200mg of Utro daily for a month I felt really hot all morning!!!.
I have been back using Oestrogel for the last 10 days, just used one pump per day and my flushes and nights sweats have gone!! - I have no intention of increasing dose - I'm going to do Utro on a sequi basis again for 12 days each month.  I have just turned 60, have been post meno for around 18 years now and I think my body just needs a small amount of oestrogen to keep things ticking over nicely. Sometimes less is more.  Dg x

[linz57]

Yes, it's a case of trial and error I think. I'm loathe to increase my dose but wondering whether changing to a different hrt might help. I do feel that estrogen levels are still declining though as shortly after starting hrt, hair started growing back profusely on my legs. Now it's practically non existent again. Just when you think you've got it sorted.......

[Hurdity]

Hi Kathleen

When you were on the oestrogen patch and Utrogestan - did you use these continuously or on a cycle? I think we have discussed before that sometimes progestogens seem to interfere with the beneficial effects of oestrogen such that some women eg using HRT cyclically get flushes on the progestogen part, and even some women  start to get flushes in the second half of their cycle just before peri-menopause - which is when oestrogen drops and progesterone rises.

Also in your case - the jitters etc could be due to the norethisterone in the continuous patch - I'm sure I mentioned this before when you started a thread about jitters? 50 mcg patch should be enough really at your age/stage - although conceivably you might not be absorbing it.

Personally - in  your case -  I would think about a separate oestrogen and progesterone again and maybe even bite the bullet and try a cycle if you could face the bleeding? However if not - it might be something that you have to put up with. With continuous combined HRT - combi patches and pills - there is no way to increase the oestrogen without also increasing the progesterone - which could be causing the problems. Also Estradot are really good small oestrogen patches and I think absorb really well. You haven;t been on it that long so possibly still worth experimenting?

I have never had jitters or any problems on that score - although I do have t cope with the progesterone side effects every couple of months - so there is no ideal solution - whichever is the least worst really and makes you feel best overall - as Stellajane says!

linz57 - I don't think we habituate to the oestrogen dose - it's a question of finding the sweet spot by slowly increasing (over a matter of weeks/months) until you find a dose that eliminates flushes and sweats and makes you feel good. Of course when you are peri-menopausal this may need adjustment as you get into later post-menopause and your levels drop finally - but not necessarily. I have never had to increase my dose despite being late peri when I started and now well post-meno at 62.

Hurdity  x

[linz57]

To be honest Hurdity, I don't really know what's going on now. My hrt patch is still keeping the hot flushes at bay but I just don't feel great on it like I did for the first six months. I'm not depressed, just feeling more like I did before I started on the patch... Aching joints, lower energy, anxiety, increased urinary frequency etc. I've started supplementing with Vagifem to see if this controls my increased frequency  rather than upping the patch dose.
Sorry Kathleen, I seem to have hijacked your thread...

[Kathleen]

Hello ladies and many thanks for your comments.

Hurdity - thank you for your considered response. I may ask my GP if I can try a different HRT, one that doesn't contain Norethisterone and see if that helps. I agree that at my age and stage you would have thought 50 mcg would eliminate the flushes etc but it has not! So frustrating!

Linz57 - Don't worry about hijacking my thread lol! We are all in this together.

Wishing you well ladies.

K.