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[sheila99]

Hello, I'm so glad I found this forum, there seem to be some very knowledgeable people here. Went to the doctors this morning and prescibed Everel patches (50 micrograms estradiol 170 norethisterone). It says it is for those who haven't had a period for 18months. I am still having them so think this may not suitable. Age 57, periods a bit irregular, disturbed sleep, permanently tired, fed up, emotional and short-tempered, zero libido, not interested in doing the things I used to enjoy (I mean non-libido related things!). I am normally quite cheerful and even-tempered - or at least I was.
 Should I take the Everal now as I am still cycling? I suggested estrogel/utrogestan/testim as suggested by Prof Studd but was prescribed HRT anyway.
 I have an appointment in a month with a GP who apparently knows more about it than the one I saw, and I have the option then to be referred to a menopause clinic at the local hospital. What treatment should I ask for?
 I need to wee more often and sometimes leak - is this Peri related?

[Dotty]

If you are still having periods then you need Evorel Sequi.

Why wouldn't your doc prescribe gel and utrogestan?

[sheila99]

I didn't ask, but as it's NHS they usually start with the cheapest option. He did say he didn't know much about it which is why he told me to book with other doctor next time.

[sheila99]

Thanks Dotty, I've read the leaflet for Everel and it seems this is the one I should have been prescibed. Might stick Evarel on OH so he knows how I feel  but I'm not going to use it myself!
  Any thoughts on testosterone? GP said it isn't prescribed for women so take it up the other doctor.

[sheila99]

Oops, that should have read 'I've read the leaflet for Everel Sequi' ...  Add Brain function deficient to the list of symptoms.

[Hurdity]

Hi sheila99



Yes that's right - if you've been given EVOREL SEQUI this is correct! When was your last period and the one before that? If they are still heavy at your age you might want to ask the doc to scan your uterus lining to check all is OK and for fibroids etc - as you are well past the average age.

I expect you are fairly near menopause by now! .....there is a late menopause thread in the Personal Experiences board if you want to have a look - it's here: https://www.menopausematters.co.uk/forum/index.php/topic,36765.0.html

It's best to get oestrogen levels up before adding testosterone and also probably better to take this with progesterone rather than the synthetic progestogens especially the testosterone derived ones like norethisterone (in Evorle sequi) - not sure how they would affect the androgen receptors and the effectiveness of the T replacement? Not sure how much if any research has been done on this!

For the vaginal/bladder  problems - pelvic floor exercises and local oestrogen! Many women need this as well as systemtic HRT ( ie the patches). Vagifem is the one most commonly prescribed. All the preparations can be found listed at the above tabs...

Hope this  helps

Hurdity x

[sheila99]

Hi Hurdity, I was prescribed Everel Conti which seems to be the wrong one, so I'm not going to use it & have booked another appointment with the GP. I don't know yet what she will prescribe but it may well be Everel Sequi. They have already done various blood tests & a uterus scan, all normal. LH is 9.9, FSH is 20.5, they don't seem to have measured oestrogen. Periods are normally 5-6 weeks and have always been a bit irregular. Had 4 at 4 week intervals but seem to have skipped the last one. Bleeding is mostly normal.
  Should I try whatever she prescibes and see how it goes or is there anything specific I should ask for? 
  Does local oestrogen help with bladder problems or just vaginal ones? Had my daughter aged 42 which may be a contributing factor.

[Hurdity]

Hi sheila99

re the Evorel conti - just to say that Evorel sequi contains two types of patches - there are 4 Evorel 50  (oestrogen only) used for the first two weeks, and 4 Evorel conti (the combi patches which contain the oestrogen and progestogen) for the second two weeks. This can confuse women because the sequi pack has conti patches in it. If it is sequi on the pack then it's the right one. Sorry if that sounds like I am doubting you - just that this has caused difficulties before!

Have you been having flushes and sweats at all? You do not need oestrogen levels measured and doctors go by symptoms. The fact that you are still having pretty regular periods means you are still producing oestrogen. Interesting they are still fairly frequent at your age but glad that there is nothing wrong. Although you must be fed up with bleeding it is great to have the benefits of your own oestrogen for a lot longer than most women!!!

No problem with trying Evorel sequi and seeing if you find it OK and then take it from there.

There can be bladder problems which are nothing to do with oestrogen but the sorts of problems that occur peri-menopausally which used to be called Vaginal Atrophy ( VA for short) - a term which most of us still use, is now known medically by the snappy name of "Genito-urinary Syndrome of the Menopause (GSM for short) although this name hasn't caught on in common parlance!

There is information here:
https://www.menopausematters.co.uk/vaginalsymptoms.php

and magazine articles here:

https://www.menopausematters.co.uk/article-vaginal-atrophy.php
https://www.menopausematters.co.uk/pdf/article-gsm-issue44.pdf

and blog posts here:
https://www.menopausematters.co.uk/blogpost-vaginal-dryness.php
https://www.menopausematters.co.uk/blogpost-lube-or-hormones.php

Some of the info is probably the same!

Also do read the long-running thread in Personal Experiences known as "The Burning Club"! which has lots of info and advice on this problem! Here it is but I've "bumped" it so that you and others can find it more easily:
https://www.menopausematters.co.uk/forum/index.php/topic,22886.0.html

Let us know how you get on

Hurdity x

[sheila99]

Thanks for the links Hurdity. I have been prescribed Everel Sequi and put the first patch on this morning. No instant cure yet but here's hoping...

[Machair]

Hi Shella99,
So lovely to hear from another 57 year old still having periods! I am in the same boat though they are getting much lighter shorter and less frequent. I know people think it is odd but it isn't as odd as I used to think. There are more of us than I first thought and it causes anxiety, so sharing experiences is so helpful. When did you first notice a change in your cycle?

[sheila99]

Hi Machair, it wasn't on my radar at all. I've always been a bit irregular, they're usually 5-6 weeks but can be anything from 4-7. I thought it was a bit odd when I had 4 at 4 week intervals but the last one was 8 so presumably skipped one. If it wasn't for everything that's been in the media about menopause I might still be oblivious! Main symptoms are disturbed sleep, permanently tired and emotional, all very non-specific. Day 3 of Everel Sequi now and not much change so far, but probably a bit soon to expect it yet. I did wonder if the longer cycle length contributed to the late menopause. Do you have any theories?

[Machair]

Well yes I do. My cycle was always 35 days so maybe this is why I am having a later than the average menopause. Most of my friends were 28 days and they finished at 50, and the ones who had even shorter cycles finished late forties. I know it isn't always the case but it does seem to be that way a lot of the time.

[Hurdity]

I'll just be an awkward one! My cycle was annoyingly 24 days for most of my menstruating life but I had 4 pregnanices and associated break from periods due to breastfeeding - but I was still having periods at 53 (albeit rarely) - not sure when I would have reached menopause as I started HRT at just under 54!! Hope the patches work for you sheila99 - give them time   

Hurdity x

[Machair]

I think pregnancies affect this too as I had 5, so although one ended in miscarriage,  so that was a lot of time spent without ovulating when you add in breast feeding months too!

[sheila99]

Not in my case. One pregnancy, 2 early miscarriages, 3 cycles of IVF which I would think used more eggs than the pregnancy saved. Perhaps I'm just odd!