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[birdlady]

I posted here a while ago that I was on Elleste Duet for three months, which was ok apart from giving me horrible flu-like symptoms when taking just the estrogen tablets. These lasted for about the first week, peaking at day7.

I went to the GP, not my usual doctor, who suggested Evorel Conti, but just one patch a week rather than the usual dose of two. TBH I felt like she wanted to prescribe and get me out of the door ASAP, it was 5.45pm on a Friday. So, I started on these a few weeks ago but I feel dreadful. Constantly grumpy and irritable, not sleeping again, headaches, worse then on Elleste Duet as I was at least sleeping better then. I suffer from CfS so need my sleep.  Is this because the dose isn't strong enough? Is it the effect of continuous progesterone? I am confused as I can't find anywhere online where a doctor has prescribed just one patch a week when the usual dose is 2. I can't work out how the patch will last a week??

I am nearly 47, blood tests show perimenopause.

[Hurdity]

Hi birdlady

 


Sorry to hear about your problems.

Firstly - whereabouts are you in menopause ie cycle and periods before starting on HRT? Have you skipped many - longer cycles, longer  or heavier periods etc? This gives more of an indication than blood tests at your age, as well as symptoms. What drove you to seek out help from HRT from the doc?

If you are peri-menopausal (was it Elleste Duet cyclical or conti that you were given initially?) then your own hormones will be fluctuating and giving rise to symptoms which are not necessarily completely controlled by HRT. Also as you say synthetic progestogens like norethisterone (in the Elleste and the Evorel) can cause side effects in some women.

You should only be on Evorel conti if you are post-menopausal ie been without a period for 12 months before starting HRT. Otherwise you are likely to get unpredictable bleeding.

As you are under 50 you might want to consider something like QLAIRA a CCP which controls the cycle but only has 2 tablet free days and has oestrogen in it the same as in the Elleste ie bio-identical to the one in our bodies.

Depending on where you are in menopause mu suggestion would be something like Femoston if you want to stay on HRT and go for the 1/10 or 2/10 cyclical. Otherwise separate oestrogen (patch or gel) and progesterone (Utrogestan) may be preferable. Utrogestan has a sedative effect so it might be helpful for you (some of us find it too depressing though!).

Hope this helps

Hurdity x

[birdlady]

Thanks Hurdity,
I had only missed one period but had terrible hot flushes and insomnia etc. I actually asked to go on the BCP to regulate but the GP said HRT would give me bone protection plus other things so better than BCP. I was given Elleste cyclical.

I was surprised to be given Evorel conti - it's a patch of continuous oestrogen and progesterone, but she said it might have with the progesterone withdrawal I was having causing the symptoms. It's a low dose of progesterone so not supposed to have any bleeds, and I haven't as yet. I did have a lot of bleeding the first month on Elleste Duet but the second month it was more like a normal period.

Thankyou for your advice. I have been thinking about asking to try the oestrogen-only plus utrogestan option which might suit me x