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[Katejo]

I have just been reading up on the advice on this site re. types of HRT before my appointment tomorrow. The reasons why I want to try it are as follows: No particular order

1. To supplement the benefits of vagifem which is working quite well
2. To see if it helps relieve aching joints/tight muscles (particularly hips, calves and feet)
3. I have read the recent book about the longer term  benefits of HRT (as long as you start before 60)  and want to try it  as a prevention against osteoporosis and heart problems (and the other benefits listed in the book) . My recent bone density scan showed very mild osteopenia.

I haven't had  significant problems with sweating/hot flushes, depression, severe anxiety etc. and those are the reasons why I hadn't pushed to try HRT before now (together with GP reluctance).

It looks as though Femoston Conti or Evorel Conti might work for me? Think I'd prefer to try patches first. I am 5 years post periods.  Any tips welcome?

[Hurdity]

Katejo I've just typed a long reply and it's gone!!!

I can;t face doing it all again - it took ages!

Basically in note form - some of us prefer cyclical HRT even if post-meno to see if oestrogen alone agrees with us - to try first - and see how different we feel on the prog part.

Evorel conti comes in only one dose so you could go for patch gel or tablet with separate prog ( Provera, Utrogestan or Mirena coil) enabling you to increase oestrogen separately. However if you're not doing it for symptom relief then 50 mcg may be OK and is licensed for osteo protection

Patches less associated with stroke risk if you're near 60 and want to take it medium/long term but you are low risk anyway if low BMI, not overweight, good diet, low BP. lots of exercise, don;t smoke, limit alcohol.

Tabs may lower libido if this is an issue.

Don;t be fobbed off by reluctant doc if on NHS. Also if they try to say you can;t have a particualr type - you can have anything provided you justify it and they put it in your notes, even on NHS and even if not on their prescribing guidelines/formulary for your area. All my HRT inc testosterone is on NHS and none is on the local formulary and the T is off-licence but doc has noted it all.

Sorry this is very brief - due to loss of post - pressed the wrong button and it went - but hope it helps!

Hurdity x

[Katejo]

Katejo I've just typed a long reply and it's gone!!!

I can;t face doing it all again - it took ages!

Basically in note form - some of us prefer cyclical HRT even if post-meno to see if oestrogen alone agrees with us - to try first - and see how different we feel on the prog part.

Evorel conti comes in only one dose so you could go for patch gel or tablet with separate prog ( Provera, Utrogestan or Mirena coil) enabling you to increase oestrogen separately. However if you're not doing it for symptom relief then 50 mcg may be OK and is licensed for osteo protection

Patches less associated with stroke risk if you're near 60 and want to take it medium/long term but you are low risk anyway if low BMI, not overweight, good diet, low BP. lots of exercise, don;t smoke, limit alcohol.

Tabs may lower libido if this is an issue.

Don;t be fobbed off by reluctant doc if on NHS. Also if they try to say you can;t have a particualr type - you can have anything provided you justify it and they put it in your notes, even on NHS and even if not on their prescribing guidelines/formulary for your area. All my HRT inc testosterone is on NHS and none is on the local formulary and the T is off-licence but doc has noted it all.

Sorry this is very brief - due to loss of post - pressed the wrong button and it went - but hope it helps!

Hurdity x

Thanks for the advice Hurdity. I did ask the consultant about cyclical v combination but he wanted me to try combination. I didn't argue as I hadn't previously tried either.  He has given me Evorel Conti with instructions to use half patches not whole.
I am only just 56 now and don't have a problem with weight or blood pressure. He seemed to think that I had looked into it quite well. He said this in a letter dictated for my GP. He mentioned that it was fine to use Vagifem and the HRT together (which I knew but it was good to hear).

When I went to the pharmacy to collect the Evorel Conti , a pharmacist tried to tell me that Vagifem was only needed for a short period to treat the symptoms. I challenged her statement. She appeared to be referring to the leaflet in the pack which is actually about systemic HRT. She didn't want to accept my view. We didn't get to say any more because the phone rang.

[Hurdity]

Great Katejo - well I hope it works for you. Heavens we can do without pharmacists not being on the ball either and just reading the pack leaflets! Good job you know your stuff! Let us know how you get on anyway...

Hurdity x