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[Louise 08]

Hi

I'm 56 and have been on continuous HRT tablets, Femoston Conti 1mg/5mg, for around 18 months. I'm pretty stable on this regime but have been reading this forum for a few months plus the Louise Newson, Menopause Doctor, website and Instagram feed. I'm feeling that I need to take into account clot risk as I do occasionally suffer from migraine with aura. I'm planning to see my GP to ask if I could try oestrogen patch (Evorel, Estradot or Elleste) plus utrogestan. I do have a hiatus hernia and suffer indigestion with sore pain under breastbone so thought perhaps oestrogen transdermally might be better for my digestion.

I wondered what dosage might be appropriate for the patches (25,50,75,100mcg) to roughly match what I'm on now, low dose femoston conti.

What are the pros and cons of each brand of patch?
I have terrible thinning and fine hair, and don't want a change in medication to make things worse.  Anything that could improve my sleep would be welcome.

I welcome any thoughts or advice you may have.  Thanks.

[Hurdity]

Hi Panda

 

The HRT you are on is low dose so best to swap to another low dose one - although how much you get from each delivery method is very individual. Also tablets are not advised for digestive problems, nor migraine with aura!

In your position I would suggest maybe Estradot 37.5 mcg which is low to medium - as they are very small and stick well - with a view to increasing to 50 mcg if your flushes return. This would need a separate progestogen - either Provera tablets, or micronised progesterone capsules (Utrogestan) although. These might affect digestion (Utrogestan can be used vaginally off-lcience although you might not want to have it every day like this....). There is a combi patch Evorel conti which has 50 mcg oestrogen - but the progestogen in this one may be less well tolerated than in the Femoston. Also the tesosterone derived progestogens may cause more hair loss:

Progestogens which can be used cyclically are of 3 main types:

    Testosterone derived - Norgestrel, Norethisterone acetate and Levonorgestrel.
    Less testosterone related - Medroxyprogesterone acetate(MPA).
    Least testosterone related - Dydrogesterone and Micronised progesterone (Utrogestan).

Side effects are often experienced during the progestogen phase of treatment and can be reduced by using a product containing a different type or route of progestogen.

https://www.menopausematters.co.uk/perimeno.php

All the different types of hRT are listed under treatments/ HRT preparations on the menu above.

Hope this helps

Hurdity x

[Louise 08]

Hi Hurdity

Thank you for your response, this is really helpful. I have found the list of HRT treatments on this site now.  I'll consider and go prepared when I see the GP shortly. I want to find a combination that works best for me so I can stay on it long term, particularly for the cardiovascular protection.

Panda