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[Mandylou]

 :Hi, I am Mandy, 46 years old and need your advice. I had blood tests about 2 years ago because of ridiculous hot sweats and I was peri menopausal. The female Dr was great and put me on Pempac C which stopped the hot sweats. Unfortunately Prempac C were discontinued by the supplier and the great Dr had left my GPS surgery. I phoned up and another Dr said they would write me a prescription for alternative HRT. When I got the prescription I realised that the type of HRT (can't remember name) they gave me was for someone who has had a hysterectomy,  I hadn't and was still having regular periods. I telephoned the Dr only to be told I would have to tell them which one I wanted as they "are not well up on HRT" so I quickly googled one, not knowing anything about HRT and said Elleste Duet Conti, which is a continuous one, the Dr prescribed it and I have been on the elleste duet coni since March 2017 and not had a breakthrough bleed since then.  I noticed my hot flushes came creeping back while on them. Anyway I have changed Drs and I  had to have  a review today before they would issue my repeat prescription. The Doctor seemed to know less than me about HRT. He said all HRT is the same and if I want to change just pick one from a list he had on his computer screen! Or better still go and ask the pharmacy what they have in stock and pick those, come back and tell him and he will write the prescription. I asked him why the prempac c stopped my hot sweats but the elleste duet didnt? He said again they are all the same and that they should both have done the same job. He eventually just picked one from a list and prescribed Tridesra. I said I liked not having a bleed because i have Fibromyalgia and ME and a bleed gives me a flare up of symptoms. He assured me that I wouldn't have a bleed on these because any HRT with progesterone in stops bleeding!! Now I know this is wrong because I will have a bleed every 3 months, it says it in black and white on the packet! I have also read that i should not have been on a continuous one in the first place. I ended up crying in the car because I am fed up of everything. I don't know if the elleste duet conti has done any harm or if this new one is a good one? I need to know if not having progesterone everyday like I have been having on the elleste conti will cause any problems? Because I am reading I just take the oestrogen for many weeks and then add in the progesterone at the end of the 3 month cycle. 2 different Drs surgerys and different Drs why don't Drs know about HRT? This was a review and he didn't even take my blood pressure or anything!  I would appreciate any help you can give me so much xxx

[CLKD]

 :Hi, I am Mandy, 46 years old and need your advice. I had blood tests about 2 years ago because of ridiculous hot sweats and I was peri menopausal. The female Dr was great and put me on Pempac C which stopped the hot sweats. Unfortunately Prempac C were discontinued by the supplier and the great Dr had left my GPS surgery.

I phoned up and another Dr said they would write me a prescription for alternative HRT. When I got the prescription I realised that the type of HRT (can't remember name) they gave me was for someone who has had a hysterectomy,  I hadn't and was still having regular periods. I telephoned the Dr only to be told I would have to tell them which one I wanted as they "are not well up on HRT" so I quickly googled one, not knowing anything about HRT and said Elleste Duet Conti, which is a continuous one, the Dr prescribed it and I have been on the elleste duet coni since March 2017 and not had a breakthrough bleed since then. 

I noticed my hot flushes came creeping back while on them. Anyway I have changed Drs and I  had to have  a review today before they would issue my repeat prescription. The Doctor seemed to know less than me about HRT. He said all HRT is the same and if I want to change just pick one from a list he had on his computer screen!

Or better still go and ask the pharmacy what they have in stock and pick those, come back and tell him and he will write the prescription. I asked him why the prempac c stopped my hot sweats but the elleste duet didnt? He said again they are all the same and that they should both have done the same job. He eventually just picked one from a list and prescribed Tridesra.

I said I liked not having a bleed because i have Fibromyalgia and ME and a bleed gives me a flare up of symptoms. He assured me that I wouldn't have a bleed on these because any HRT with progesterone in stops bleeding!! Now I know this is wrong because I will have a bleed every 3 months, it says it in black and white on the packet! I have also read that i should not have been on a continuous one in the first place. I ended up crying in the car because I am fed up of everything.

I don't know if the elleste duet conti has done any harm or if this new one is a good one? I need to know if not having progesterone everyday like I have been having on the elleste conti will cause any problems? Because I am reading I just take the oestrogen for many weeks and then add in the progesterone at the end of the 3 month cycle.

2 different Drs surgerys and different Drs why don't Drs know about HRT? This was a review and he didn't even take my blood pressure or anything!  I would appreciate any help you can give me so much xxx

Welcome to the wonderful muddle of menopause and the fact that GPs really aren't up to knowledge! nor do they understand how The Change affects many women.  Nor do many seem interested in finding out the ins and outs  !

There's nowt wrong with asking a Pharmacist for advice.  It doesn't appear that the Surgery you attend has GPs interested in womens' problems! 

I am sure that there will be someone along with HRT info later.

[Hurdity]

Hi Mandylou

 

Heavens above what ignorant doctors!

OK so you were peri-menopausal two years ago - what was your cycle doing then ie did you miss many periods, were there long gaps between them?

As you have found yourself of course the HRT types are not all the same -  some of them contain different oestrogens, different progestogens, some are tablets, some are patches, some are cyclical ( to give a withdrawal bleed) and some are continuouis combined (no-bleed).

First thing - Elleste Duet conti differs both in oestrogen and progestogen and is a continuous combined type so no wonder you feel different. I am assuming this the the 2 mg one (I think the 1 mg one has been discontinued)? Which dose of Prempak C - was it the 0.625? This contains a mix of horse oestrogens so different from all the other types which contain estradiol - bio-identical to the oestrogen in our own bodies, so better to have HRT containing this one really. I think the PRE horse oestrogens are being phased out as they are now old-fashioned.

Some women find that having continuous progestogens does not completely suppress hot flushes and anecdotally (from posts on here) norethisterone (the progestogen in Elleste Duet) seems to be the type that causes a greater resurgence of hot flushes.

If you are not post-menopausal then you should not be on a continuous combined HRT. Here are all the types for peri-menopause: https://www.menopausematters.co.uk/perimeno.php but if you don't want a bleed - then how about a Mirena coil? This delivers progestogen directly to the uterus where it is needed and then you can add oestrogen as a patch or gel until your symptoms subside.

If you have Fibro and ME it may be the reduction in hormones causing the symptoms flare-up. Have you had these for long? Also have you had thyroid function checked. There is a link between hormones and all of these conditions women get diagnosed with in mid-life - fibro, ME, CFS and HRT at the right dose (or thyroxine if thyroid problems) can eliminate or control them.

Why not try the Tridestra and see what sort of bleed you get? However if you are not near menopause then it's pointless because you could get breakthrough bleeding before the 10 weeks is up - but maybe give it a try?

Hope this helps

CLKD I couldn't understand your post as it seemd to be a repeat of Mandylou's and I couldn't make out which bits were your responses - so I'm confused and didn't read it all through to try to work out which was new! 

Hurdity x

[Emerald2017]

:Hi, I am Mandy, 46 years old and need your advice. I had blood tests about 2 years ago because of ridiculous hot sweats and I was peri menopausal. The female Dr was great and put me on Pempac C which stopped the hot sweats. Unfortunately Prempac C were discontinued by the supplier and the great Dr had left my GPS surgery. I phoned up and another Dr said they would write me a prescription for alternative HRT. When I got the prescription I realised that the type of HRT (can't remember name) they gave me was for someone who has had a hysterectomy,  I hadn't and was still having regular periods. I telephoned the Dr only to be told I would have to tell them which one I wanted as they "are not well up on HRT" so I quickly googled one, not knowing anything about HRT and said Elleste Duet Conti, which is a continuous one, the Dr prescribed it and I have been on the elleste duet coni since March 2017 and not had a breakthrough bleed since then.  I noticed my hot flushes came creeping back while on them. Anyway I have changed Drs and I  had to have  a review today before they would issue my repeat prescription. The Doctor seemed to know less than me about HRT. He said all HRT is the same and if I want to change just pick one from a list he had on his computer screen! Or better still go and ask the pharmacy what they have in stock and pick those, come back and tell him and he will write the prescription. I asked him why the prempac c stopped my hot sweats but the elleste duet didnt? He said again they are all the same and that they should both have done the same job. He eventually just picked one from a list and prescribed Tridesra. I said I liked not having a bleed because i have Fibromyalgia and ME and a bleed gives me a flare up of symptoms. He assured me that I wouldn't have a bleed on these because any HRT with progesterone in stops bleeding!! Now I know this is wrong because I will have a bleed every 3 months, it says it in black and white on the packet! I have also read that i should not have been on a continuous one in the first place. I ended up crying in the car because I am fed up of everything. I don't know if the elleste duet conti has done any harm or if this new one is a good one? I need to know if not having progesterone everyday like I have been having on the elleste conti will cause any problems? Because I am reading I just take the oestrogen for many weeks and then add in the progesterone at the end of the 3 month cycle. 2 different Drs surgerys and different Drs why don't Drs know about HRT? This was a review and he didn't even take my blood pressure or anything!  I would appreciate any help you can give me so much xxx

Hi! They don't know because they don't care! I'm 42 and peri.
My first gyn said that meno is something natural and to just accept it! I told him that I needed to work and I had too severe symptoms and he said to stay home! Absolutely wrong cause he had to treat early meno according the new guidelines.
My second gyn prescribed livial and it caused me bleeding and headaches. Completely wrong cause livial is suitable for post meno ladies.
Fortunately my last gyn gave me a cyclical prescription, cyclo progynova that suits me more. Don't give up, try to get informed and if you don't care for your health nobody will do it for you! Hope it helps! 🌹

[Mandylou]

Thankyou so much for your help, I really appreciate it.
It's nice to know that I am not on my own and it seems you are lucky if you get a GP that knows about Menopause and it's treatment.

I have been reading up and trying to get my head around it all, which is hard as I have Fibromyalgia and ME which I have had for 20 years or so. These illnesses make it hard to retain information and they have progressed rapidly for the last few years.

My menstrual cycle was very regular before it was stopped by the prescribed Elleste duet continuous HRT so I don't know what will happen on the 3 month cycle Tridestra? I suppose time will tell.

I  feel very let down and dissmised by the Doctors I have seen. I really can't believe how woman who are going through this are still treated this way!
Woman are losing their jobs, marriages, quality of life through this effects of the Menopause. some are losing their life through being miss treated on drugs given out to "help".

All this shouting about woman's rights and the year of the Woman and I don't hear one thing about how woman's health should be taken more seriously. How all GPS should go on a course to learn about the Menopause and the treatments out there!

Once again Thankyou to those that helped me out on this. X

[Dorothy]

I feel your pain!  I've had 3 GPs since starting symptoms at 35 (now 42) - 1st one said you couldn't be menopausal before 50 (I had to ask her to check out the 'early menopause' section on the NHS website, which didn't improve our relationship!), 2nd one was brilliant, admitted she didn't know much but was willing to work with me to a solution; third one was 'no idea what you're talking about, just tell me what you need and I'll write a prescription'.  About to move again shortly and dreading what GP number 4 will be like!

I don't expect them to be experts, but they should at least be able to read the guidelines on the meds before they prescribe them to make sure they are appropriate!  All I can say is 1) you're not alone and 2) keep fighting.  Make yourself well-informed and be prepared to fight for what you need.

[CLKD]

Sadly GPs over-all don't have much clue 

I feel as you do, that GPs should take courses on a regular basis to keep up to date as to how The Change impacts on women: symptoms, feelings, work/Life balance, relationships ....... I don't need a soap box 

What do you propose to do in order to get advice, make notes from here and take to your Practice Nurse maybe?

[Mandylou]

Hi,
I have come back to update my original comment.
It's a bit graffic and gross so I apologise in advance.
I have been taking the Tridestra now for 3 months and it's been fantastic, my energy levels were up, the hot day and night sweats stopped almost imeadiatly, which is fantastic.
The trouble was when I started the placebo for the 3 monthly bleed last Saturday! 😰 omg the first day was ok but because I use a menstrual cup I noticed that it was very light and watery, not what I expected with the cramps I was getting.
On Saturday night I developed the most horrendous pain that woke me up, I mean Labour type pain, it was excruciating. I almost telephoned an ambulance because I was in that much pain, I knew something was not right! I was hardly losing any blood.
I felt sick, I couldn't walk, talk, sleep, it was honestly like late stage labour.
At 4. 32am on Sunday morning I passed the biggest clot ever, I am sorry if this is gross but it happened and I would like to know anybody else on Tridestra that this has happened to.
I had put a pad on by now as the pain was that bad and I felt the clot leave me and automatically the pain stopped completely.
The clot was the size of my night time pad I was wearing and I lost more after this.
I think the clot was stuck in my cervix and I was litraly contracting like labour to pass it.
I don't know whether it was because of not having a period for over a year being on the continuous HRT, which was wrongly prescribed or it's just from the 3 months of not having a bleed on Tridestra? In which case I will have to come off it.
Also I want to know if I can take oestrogen on the placebo week of Tridestra? Because as soon as I started on the placebo, my hot sweats came back!
I don't know why there is a placebo week, it's 10 weeks of oestrogen then 2 weeks progesterone and than a placebo week for your bleed but this means all my symptoms come back 😣 x

[Dorothy]

Poor you, that must have been so frightening.

I'm guessing someone will be along shortly who can advise more about the HRT.

I don't know if this will reassure you a bit, but I used to get periods that started off with hardly any bleeding but lots of pain that would build until I passed a large clot.  I've never given birth so can't compare to labour, but the last bit I would be bent double gasping with pain and unable to talk or move until the clot passed and the pain would then ease.  I'd then get really heavy flow for a couple of days.  I ended up being put on the combined pill to stop it.  It was incredibly scary, but I had it for years and there was no underlying problem apart from a hormone imbalance, so although it was very painful there wasn't anything seriously wrong.

[Dancinggirl]

Hi Mandylou
Firstly, I thought with Tridestra, as with all HRTs, you do continue with oestrogen when you start the progesterone phase.  Oestrogen should be used every day with any HRT. TRidestra is a 3 monthly cycle, so 10 weeks of oestrogen then 2 weeks of oestrogen with progesterone adn then back to oestrogen only - the bleed should arrive after finishing the progesterone phase. Does it say to have a week without any hormones in the leaflet or did your doctor tell you to do this?

I suspect the long months with only oestrogen would have built up your uterine(womb) lining and this resulted in the clot, pain and heavy bleeding. You will be better off with a normal sequential HRT e.g Femoston 1/10 OR perhaps have a Mirena fitted so the lining doesn't build up and you can then as much oestrogen as you need to control your flushes without any problematic bleeding.
DG x

[Southselly1]

I too am prempack c bereft ! I'm not doing well finding a replacement

I'm virtually same as you as I. Early memo, age and 2 previous not clued GP s but the one I have now is not clued up but listens to my requests and asked me to research my options and come back to talk this through

Reasonable approach if not clued up I think

I'm not sure I would try your brand as I'm awful without progesterone hormone

Hope you find suitable replacement ASAP x

[Hurdity]

Hi there

Yes just to confirm that the Tridestra is a 13 week treatment - 10 weeks oestrogen, 2 weeks oestrogen + progestogen and 1 week placebo during which the bleed occurs. I hadn't realised this either - I thought it was a 12 week treatment. This one tends to have fallen out of favour a bit due to problems with heavy or breakthrough bleeding and icnreased rsik of over-thickeing of womb lining on 3 months cycles. Those of us who are on longer cycles, they are not usually as long as 3 months and result from our own experimenting (under medical supervision) of gradually lengthening the cycle from the usual 4 weeks to a calendar month then to 5 weeks an so on. How far this works depends partly on your stage of menopause ie whether you are still ovulating, and also the dose of oestrogen together with other issues you muight have going on eg small fibroids or polyps in the womb etc.

Hurdity x