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[emmab1973]

Good morning all,

Just wondering if I could ask for some much needed advice, I am 44 years old and the last six months been behaving like the Tasmanian devil  without knowing why, it turns out I am peri menopause and have been put on Evorel Conti, I am really really suffering at the moment, constantly feel sick and actually vomited yesterday and the waves of feeling like I am going to pass out is horrendous. But it has stopped my night sweats ( I like I would rather have these than the side effects ) It has only been two week and over the weekend I lost two patches and had to replace. Does this get any better ? I feel just awful 
Also ontop of this, I've been told to I have to stay on my Cerazette pill, no blood pressure taken before being slapped on with this patch either, is this right?!
Any advice would really help
xxx

[Peafizz]

Hi, I am 53 post menopausal and was put on evorel conti in January. Was good for 3 months but then headaches and sleeplessness came back but ‘pmt' like symptoms still absent. But I was nauseous after 3 months on it for months and didn't link it to hormones as had previous stomach problems so had investigations done for that which were all clear. Then last week I had a bleed (3 years without one) and haven't felt as nauseous since then!! Been sent to see a gynaecologist next week to check the bleeding. Going to ask re patch and nausea and see about coming off it. Though I like the fact I am 1.5 stones lighter due to not being up for eating I am fed up of feeling queasy,! Not seen anyone else having nausea on EC patches post menopause but nausea seems to hit a lot of women in perimenopause.

[Dancinggirl]

Hi and welcome to MM emmab1973

Your side effects sound like progesterone overload.  Who is treating you for your meno symptoms? Is it your GP? If so, they don't know what they are doing. I assume blood tests were done to see if your thyroid was working OK? Did they tell you your oestrogen or FHS levels? do stop the patches and ask to be referred to a gynaecologist of meno clinic for specialist advice.
Firstly, you should not be on a continuous HRT.  Evorel patches are also medium dose so probably too high anyway. If you kept replacing the patches you would also be getting extra hits of hormones which wouldn't help.
I assume they want you to keep using the Cerazette for contraceptive reasons?
If your oestrogen levels are low or fluctuating, which is typical in peri, then a low dose of HRt can alleviate the flushes and balance your hormones. Progesterone is needed to protect you womb lining from building up and causing problematic bleeding but in peri you should only have progesterone for 10-12 days each month to produce a withdrawal bleed to shed the lining.  You are having progesterone all the time with this conti patch and you are getting the progesterone from the Cerazette as well - this is a serious overload of progesterone and this will bring the PMT type symptoms you are experiencing .
Your GP should not have prescribed a continuous HRT if you are peri meno!!!!
In peri one can still conceive, so some type of birth control is needed - so you could either:
Try a low dose sequential HRT e.g. Femoston 1/10 and use condoms for contraception. You would get a monthly bleed on this sequi HRT and you would have to be careful not to get pregnant.
OR
Ask to have a Mirena fitted (which would protect your womb and prevent pregnancy) and simply have oestrogen as pills, patch or Oestrogel. The Mirena option is popular with many gynaes as it often gives the fewest side effects and prevents problematic bleeding. If you haven't had a baby then you may need an anaesthetic for the fitting of the Mirena.

emmab1973 - I'm afraid many women can't tolerate continuous HRT because of the progesterone used every day - the bleeding is normal in the first few months on any conti HRT.
Can I suggest you also consider trying the sequential version of HRT ( you would have to put up with monthly bleeds) and also try a low dose to start with - your body has had to cope with a medium dose all of a sudden and is probably struggling to cope. You could also consider the Mirena with separate oestrogen regime, often used in post meno - could well be a good option for you. DG x

[emmab1973]

Thank you so much for your replies! I thought I was going a little crazy. My GP has put me on the patch and had to read a manual before doing so. The cerazette is for contraception reasons and I did find it odd as my last period was only in August? But as I was on the pill my nurse had said that sometimes the pill makes you bleed?
I had to ask for a blood test to check my hormone levels and all she said was that they were low and that I am peri meno.
I have made an appointment with my doctor next week but shes the only one who deals with menopause, are you allowed to ask to be referred to a gynae clinic, my doctor is really abrupt and very rude and actually dreading having to tell her that I may be on the wrong patch.
But I am literally daily feeling like I am going to pass out, I'm a single parent and had to tell my son yesterday what to do if I did pass out. It's not good 

[emmab1973]

Just to add one more thing... I popped into the doctors to get a copy of my bloods taken. Just to be a bit more informed and my FSH level is 33 I did just read peri is between 10-15 and 30-40 FSH is high? Maybe I am not peri?! I don't know how it works but have an appointment next week. Fingers crossed!

[Dancinggirl]

I'm afraid the blood tests are not reliable - diagnosis should be based on symptoms really.
Do stop using the patches until you see the doctor - if you feel dizzy and faint that is dangerous.
How awful that you GP is abrupt and rude - of course you can ask for a referral.   
Can I suggest you print off some info from this site for her to see (particularly from the TREATMENTS section) -  write down all your questions to give her and, as she has given you the wrong HRT, ask very firmly "if you could please have a referral to a gynaecologist or menopause clinic as, at my age, there are long term risks to your heart and bones if I don't get the right HRT treatment”.
Why not tell her about this site - Menopause Matters is linked to the NHS Choices website and is run by an NHS Gynaecologist, so is absolutely the right place for you to get help and advice - she needs to get clued up by visiting this site. Good luck. DG x

[Hurdity]

Hi emmab1973

  from me too.

Just to add that even though blood tests cannot be relied upon to say where you are in menopause - in the absence of an obvious cycle (due to the pill and HRT), a raised FSH level (such as you have) does indicate that you are at least peri-menopausal.

I agree with Dancinggirl that if you still need contraception then a Mirena coil is a good option so that you can add oestrogen to suit your needs and symptoms.

The other alternative is that you could have the CCP - and there are two types which contain the gentler oestrogen - estradiol (as found in HRT) rather than the strong synthetic oestrogens. They are called Qlaire and Zoely. Qlaira only has 2 tablet free dyas ( I think Zoely has four) so they would control your cycle, give you contraception and added oestrogen. There is some info on this website but do have a google about these: https://www.menopausematters.co.uk/contra2.php

Hurdity x

[emmab1973]

I would like to thank you all so much for the information, I will be going to the doctors next week with written notes and questions ready!! I'll come back on with the results next Wednesday!

[emmab1973]

Hi well I went to the doctors and been prescribed Tibone 2.5mg does this one sound good? I'm unsure already as it says in instructions only to take 12months without a period. But I bled only in August. But this could of been just a hormone realease from my pill?! I could cry nothing Is straight forward!!! X

[Dancinggirl]

Give the Tibolone a try - many women find it good. It's very good for libido!!!! DG x

[Hurdity]

Hi emmab1973

Have you been recommended to stay with the Cerazette as well? The thing is Tibolone is not for peri-menopause so you should not be prescribed this due to potential for endometrial thickening and random bleeding. If you are still taking the Cerazette - well I've no idea how this will interact with Tibolone in terms of how you feel but maybe it will continue to provide contraception.....It doesn't sound like the right combo to me....

Did you think about Dancinggirl's suggestion of a Mirena coil? This may well be a better solution as it will provide contraception as well as protecting your womb lining when you add oestrogen. Also my suggestions for the CCP listed below ( Qlaira or Zoely)??

Hurdity x

[Hezzalady67!]

Just been prescribed this. Worried about acne, as suffered from it all my life and only got rid since post-meno. Anyone had acne with this? Still, at stage where ANYTHING is worth a bash...will let you know!

[emmab1973]

Hello there, thank you for all your replies! To be fair the doctor did offer the mirena coil but I have heard such horror stories regarding this it puts me off, I did mention Qlaira  and Zoely but she has never come across them before so couldn't recommend them. I am still taking the Cerazette as well, so I don't know how I will fare. I had my first one this morning and also have a urine infection so on antibiotics for this also, so having a wonderful time of late!

I have had a search and there is no menopause clinic near me, still no blood pressure taken, I just find it very odd, but I'll try it and see and hoping I do not have a repeat of my dizzy spells!

Can I please just ask another question, I purchased some Menopace tablets, are these OK to still take? Any extra vitamins surely can't harm or will I be overloading?!

Hezzalady  I hope everything works out for you on this pill!


Many thanks!

[Hezzalady67!]

Just an update. Was changed from estradiol pessaries to evorel conti a few weeks back. Have just begun to notice, my skin feels lovely and my tummy has decreased. Not sure if it's from this, or from getting more exercise.

[Hezzalady67!]

Sorry to double-post...my fears about acne seem to gave begun to materialise as I have now begun to get break-outs for the first time in several years post meno.

Otherwise, still getting on well with the patches and more comfortable overall. Definitely less bloating than with estradiol pessaries, less getting up in the night and sleeping better.