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[pb42]

I posted on here a couple of months back as wanted advice about evorel conti sequi 50.  Had been working great for about 5-6 months but then symptoms came creeping back, although not as bad as before taking them. Visits to doctor were a waste of time hoping for incresed dosage but they said you can't just increase but that was explained better on here by a couple of ladies as I never realised that the evorel cs 75 wasn't just a higher dose which I orignally thought it was.  Two visits to doctors later i'm still on same so asked for specialist referral but unfortunately, due to new job starting next week, i'm 250 miles from home so not only did I have to cancel specialist appointment I have the time delay of registering with new doctor here and wonder if they will be more helpful or not.  The query I have is I have 6 months supply of evorel conti sequi 50.  Has anyone cut some in 1/3 so you have a whole patch plus a 1/3 so slightly increase dose?  If so, it is ok to do this and would I have to do for both sets os patches (1 set for first fortnight then second lot for 3rd and 4th week).  Any advice would be greatly appreciated.

[Taz2]

Hi pb - I'm a little confused. Are you on a conti HRT (Evorel conti) or a sequi HRT (Evorel sequi)? The Evorel sequi pack contains two sets of patches - oestrogen only for the first two weeks (which may be labelled Evorel 50) then oestrogen plus progesterone for the second two weeks.

Taz x

[pb42]

I have two different patches for month so fortnight for each.

[Taz2]

That's a sequi HRT and should give you a bleed each month? If you add extra patches in the first half of the month then I would think that you will need to do the same for the second half of the month too in order to get enough progesterone to keep your womb lining thin and so prevent the risk of endometrial cancer.

Hopefully you will get more replies tomorrow. What a shame you had to cancel your appointment. Hope the new job is going well?

Taz x

[pb42]

Thank you for reply.  I never did get a bleed apart from a few spots once or twice.  I did again just this week.  Had no side effects from evorel so just thought i could get higher of same but apparantly not and two different doctors i saw even didnt know to suggest or didnt want to give me more of somethiing hence DIY idea but would like to know if anyone had done this. New job starts Monday!

[Hurdity]

Hi there pb42

Because the patches in the second half of the month are Evorel conti - the same as the patches for continuous combined HRT - then this means that the amount of progestogen you are taking for cyclical HRT is the same as you would be taking for continuous combined ie 170 mcg. This being the case it may be possilbe to increase the oestrogen only patches so that you could add a third of oestrogen only all the way through the month.

In the past this question has come up for Evorel conti and cutting the patch and Dr Currie herself has said this is fine off licence - and even wrotie in the magazine to say so in the queries section.

My advice would be to have an e-mail consultation with Dr Currie specifically asking this ie is it possible to increase the oestrogen dose throughout the month but not the Evorel conti ( in view of what I said above re doses) or would it be preferable ( if indeed advisable) to increase all the patches by one third.

You might be OK with this option anyway if you react well to the conti patches?

The other possibility is to go for separate oestrogen and progesterone (patches and either Provera or utrogestan) so that you can vary the oestrogen dose accordingly.

Good luck with the new job!

Hurdity  x

[pb42]

Thank you very much for that. I may try this and see how it goes.