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[Belladonna]

Is it possible to add extra estrogen (in the form of gel) when you are on a combination patch or pill? Or will that wreck the balance and cause thickening of the endometrium and cancer?

I think I read that someone here did this successfully but can't remember who it was.

The patch I am planning to go back on does not have enough estrogen for me as I'm only 34 (used it before and got lots of estrogen deficiency symptoms). But it is the only combination patch available where I live. It has 50 mcg estradiol and 250 mcg norethiserone acetate.

I am trying to find a hormone specialist who can help me but that will take some time and I need to get off my current HRT (which is actually BCP Yasmin) immediately as I feel horrible. And the only option I have at home are the patches.

IF it is possible to add estrogen I could call my gyn and ask for estrogen gel. If it's not possible my plan is to try to find a gyn who specialises in meno and until then be on two patches. 100 mcg/500 mcg total. I know that my gyn/onc thinks this is fine as we talked about two patches before and I tried it for a while. I did however feel bloated and swollen but not as bad as on the Yasmin. And I am worried that only one patch will plunge me into estrogen deficiency again straight away. Or maybe I could try 1.5 patches?
 Does that sound ok or really stupid?

[Belladonna]

http://www.medsafe.govt.nz/profs/datasheet/e/estalispatch.pdf

I found this, apparently Estalis is available in a 50/140 strength in other countries. That should mean there is room for adding extra estrogen to the 50/250 right?

Say that I had used two 50/140 which is 100/280. So if I add about 50 mcg estradiol gel to my 50/250 patch that will be a total of 100/250.

[Hurdity]

Yes some medications have progestogens in two strengths to cater for women for whom a lower dose is insufficient when given continuously - to keep the endometrium thin. This is well recognised. There is a tablet HRT Indivina which comes in two prog strengths. So yes there is room to add in extra oestrogen - but you may find that you get spotting/irregular bleeding on conti regime on this.

Thickening of the endometrium does not automatically lead to cancer! However it puts women at greater risk from developing it and as with all these things there is no knowing if you are that person.

I'm sure we've said why don't you have a Mirena fitted? Sorry if you've already explained - can't keep looking at different threads! This would be so much better for someone of your young age and then you could have as much oestrogen as you needed - and hopefully a bit of testosterone too).

Hurdity x

[Belladonna]

I don't think I am a good candidate for a mirena. Doctors always say it's only for women who have been pregnant. And I have a really tiny uterus that's also tilted backwards. Every gynecologist I've had, which are tons as I had gyn cancer, have commented on how tiny it is.