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[NightNurse]

Hi everyone,
I'm 53 and have been using oral combi conti HRT for one year with excellent results until about 3-4 months ago. 

Within a week of starting in April 2016 many of my symptoms (hot flushes, night sweats, mood changes, joint pains, energy levels etc) had all resolved.  Very satisfied customer!  And happy family/co-workers too!

However about 3 or 4 months ago I felt as if the effect was wearing off.  Thats the only way I can describe it.  Night sweats started up again and disturbed sleep and low mood/irritability/anxiety.  I discussed this with the practice nurse who seemed rather puzzled by my description, as if she hadn't heard of this sort of thing.  I asked for a higher oral dose but as I was on top whack that wasn't an option.  To be fair, she did say she would seek expert advice and get back to me.  As promised she did and the GP phoned me and suggested changing to transdermal patches.  I'm now on two patches Evorel Conti and Evorel 50 at the same time.

Has anyone else experience of their HRT "wearing off" or am I imagining this?     I read this may happen with HRT implants (tachyphylaxis) but the scientific evidence is weak.  If it does happen, and is not my imagination, will it happen with the patches?  Or is it just my oestrogen levels have fallen off a cliff again and I need more to "top up" to my functioning level?  If I need more in the future how many patches can a girl use at one time?!?

Thanks for any advice you may have xx

[Annie0710]

Hi nightnurse and welcome

Yes I was on max dose oestrogen for 13 years when suddenly (and I mean suddenly) it stopped working.  The only difference was my symptoms were completely different to my original ones

[Hurdity]

Hi Nightnurse

 

Sorry to hear you are feeling rough again. Oestrogen levels fall pretty dramatically for the two years following the last period - although some weak follicular activity may continue for a few years - so it could be that you are noticing the effect of this. Some women also find that continuous progestogen ( like you are taking) is associated with side effects - not sure whether these would become apparent after some time though  .

If you are on a 50 mcg patch in addition to the combi patch (ie 100 mcg) the doc who prescribed this will need to ensure that the progestogen dose (which is deemed sufficient for the 50 mcg patch) is also sufficient to keep your womb lining thin, otherwise you could get sporadic abnormal bleeding if your lining overthickens.

Assuming you are absorbing oestrogen from the patches I think it would be unusual for someone who still had a womb to need more than 100 mcg to eliminate symptoms.

Another alternative is to return to a cycle ie have a withdrawal bleed now and again - which many of us do even into our 60's - which may give you better control of symptoms - perhaps worth a try anyway?

Hurdity x

[CLKD]

 

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