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[Jellyb]

Hi everyone, I used to be on this forum some time ago, but haven't posted for a while.

I am in my early/mid 40s and have been on HRT for around 8 years due to having my ovaries removed.  I still have my womb.

I was on Evorel 25 patches and Mirena coil.  My Mirena was due to be replaced but, when they came to remove it, it had become stuck in the wall of my womb and they were unable to put a new one in as it seems that my womb has shrunk.  So, I was put on Utolvlan (Norethisterone) and sent home. 

Saw my consultant yesterday and we had a long chat.  Due to the risks associated with Norethisterone (breast cancer/heart attack) he does not want me on that and at the moment, a Mirena is not an option.  So, I have decided to come off of everything and try the herbal remedies.  He is in agreement with this.

I stopped the Norethisterone yesterday and, from 1st Oct, will change my patch every 5 days and finish at the end of November.

In the meantime I'll try Soya Bean products and supplements, and will take Red Clover from the end of November.

I would be grateful to all of you for any advice that you can give as to what I should expect.  And anything else I can do to help myself. I have to say, I think the Norethisterone has done wonders for my skin - it looks so radiant! I hope that doesn't go too quickly!

Thanks in advance.

[Dana]

I wish you well, but so called natural therapies did absolutely nothing to help my symptoms. Personally I would stick with the hrt. There are alternatives to Norethisterone and the mirena.

[Jellyb]

Thanks Dana
Although there are none that would suit me I'm afraid. 

[Dancinggirl]

Oh JellyB - You are very young to be without oestrogen!!! I agree with Dana completely.
I'm really surprised your gynae has said the risks are too high with the progesterone???!!!! At the your age the risks are very, very, very small. The risks of developing osteoporosis, heart disease, vaginal and bladder problems dues to oestrogen deficiency are far higher and do outweigh the risk of BC at your age.
It sounds as though you are not in the UK???  Your progesterone is called a different name?!

I had a premature meno and continued HRT till I was 49 (all the scares came out at that time)  - I was off HRT for 3 years and basically lost 3 years of my life because symptoms were so bad -  I gave in and went back on HRT for another 5 years.  Now 60 I am trying without HRT again but my life is less stressful these days so coping slightly better.  However the damage to my bones is done - I do have some bone loss as a result of those 3 years without HRT despite staying active and having plenty of calcium etc. I should probably try to continue with HRT but I got fed up with the side effects I was getting and, taking HRT in your 60s, the risks do increase slightly.

I would really reconsider this break from HRT - look at different options - there are better progesterones e.g. Utrogestan (micronised progesterone) which carry fewer risks - Provera is another good option.  Have a look at the TREATMENTS section on this site - print off and discuss further with your gynae. 
There are no remedies that will protect your heart, bones and bladder the way HRT does and nothing will reduce flushes, aches, pains, poor sleep etc - I have tried everything and should have saved my money and had a holiday instead.
I'm sorry if I sound 'over the top' about this but I believe it is negligent for a doctor to risk a women's bones, heart and bladder health just because there is a very small risk of BC.
Do let us know how you get on.  DG x

[Jellyb]

Thank you Dancinggirl,
I am in the UK.  I have a further follow up with my consultant in early December to see how I'm getting on, so I will be collating information in the meantime.
There is a small possibility that I could have a Mirena again (and therefore go back on my Evorel patches), but he would need to scan me to look at my womb.  If I am really struggling then I will take that option. 
Thanks again.

[Tinkerbell]

My mother in law was really crippled with osteoporosis through having an early menopause and no HRT.

[vickypk]

Hi Jellyb
I tried everything in Holland and Barrett for the menopause it used to cost me a fortune and nothing worked.   I also used the magnet for a while and didn't notice anything different with that.
I use HRT now and much better.
Good luck
xx

[Jellyb]

Thanks for all of your replies.

I have been a week off the Norethisterone and seem ok.  Will start to wind down my Evorel patches during Oct and see how I do.

I have a follow up in early December so can speak to my gynae consultant then if I have any concerns.

[Taz2]

Hi Jellyb - good to hear from you again.

I am with Dancinggirl on this. You should not be without oestrogen at your age and this can lead to all sorts of problems. I can understand the reason why you can't have another Mirena but I'm not sure why you can't use Evorel sequi or one of the other combination HRT's?

Taz x 

[Dancinggirl]

Jellyb - I'm afraid you should probably not be still using the Evorel as this will build up your womb lining without progesterone.  What you may need to do is take 10-12 days of progesterone alongside your last doses of oestrogen to ensure you get a final shedding of the womb (withdrawal bleed)  - in other words do a womb clean out after you finish using oestrogen.   

I still think you are unwise to stop HRT so early - but it is your body and you need to do what you feel is right for you.

Don't waste money on alternatives that won't protect your heart and bones and are unlikely to reduce flushes etc.
BTW - it's the oestrogen that is good for your skin - not progesterone and you may notice your skin becomes dry and less resilient when you stop the oestrogen.  Also do  look after your ‘lady bits' - local oestrogen is a good idea, when low on oestrogen, whether you are on full HRT or not.
Do keep us posted about who you get on. DG x

[Jellyb]

Thanks

Hi Taz2, good to "see" you again!

Once I stop all HRT, how soon will I see any symptoms, if I am going to have any?  I want to have enough time to completely evaluate how I feel so that I can make a decision when I see him in Dec.

[Taz2]

I found that it was around two months before my flushes really started in earnest again and by the end of month three all of my symptoms had returned. You are on a low dose though - I've always been on 50 not 25.

Taz x

[Dancinggirl]

JellyB - meno symptoms will usually return within 2-4 weeks in my experience but as the time wears on it's the effects on the skin, joints, muscle strength etc. that gradually become an issue and these will emerge over several months.

Stellajane - you are so right - it's the hidden damage that oestrogen deficiency does that is so worrying.  It's not until you break a bone or start to get UTI infections that the real consequences are felt. Though I've always found HRT challenging due to side effects I've stuck it out mainly to gain the long term benefits. Now I'm 60 I am trying to do without systemic but I am still using Vagifem at least 2 times a week - wouldn't want to be without that. What's really horrid is how the weight is gathering around my hips and tummy (but loosing muscles in my legs and arms) despite eating less and doing lots of exercise. DG x

[Jellyb]

Hi all

Ok, I've been looking at the list of HRT available so that I can arm myself with the relevant info when I see my consultant in December. Ideally I would like to go back on the Mirena plus my low dose Evorel patches. 

However, he is going to scan my womb and, if another Mirena is not possible, from what i can see, the most suitable patches for me would be the Femseven Conti.

I assume I am post menopause (have been on hrt for 8 years, both ovaries removed, no bleeds), I would prefer a patch to a pill (he seems to think there is a higher risk for me with tablets).

The Femseven Conti contains estradiol, which I know I can tolerate as I've been on that with Evorel patches and also levonorgestrel, which was in the Mirena.  The only issue I can see is that the estradiol dose is higher than my lose dose patches, which were 25mcg and this one is 50mcg.

Have I missed anything?  Any other suggestions would be most welcome.

Thanks.

[Dancinggirl]

You could have separate oestrogen as patches or gel and then progesterone in pill form e.g Utrogestan or Provera.
It is often a good idea to use the sequential version of any HRT first to gage whether a particular progesterone suits you - this will mean a monthly bleed but you can then change to a conti regime if all seems fine.  The different types of oestrogen are rarely a problem so I'm sure you could use any oestrogen - as you are young you may need to have a slightly higher dose of oestrogen to protect your heart and bones - the very low dose you were on before may well have not been enough so you could have been getting meno symptoms and other side effects because your oestrogen levels were too low.
DG x