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[FionaR]

Hello. I have been on Elleste Duet 1mg for three years. It is sequential combined. Due to shortages of this HRT brand I hav ebeen swapped to Femoston 1/10mg. I have been on this for a couple of weeks and feel crap. Tired, irritated etc.
Anyway, I chatted with the GP about how angry and irritated I felt for two weeks of each month while on Elleste Duet. It is when I take the green tables (oestrogen/progesterone mix phase). I feel like I have PMT on steroids. The GP has suggested a change to Femoston Conti 2.5mg. This is a continuous dose of oestrogen and progesterone (synthetics obviously). 28 tablets, each containing 0.5 mg 17β-estradiol (as hemihydrate) and 2.5 mg dydrogesterone...
The theory explained by my GP (she is thoughtful and helpful) is that this might help to ease my symptoms of anger and irritation etc. I am not sure why or how... These tablets are extra progesterone every day and less oestrogen than i have been taking.
Can someone please advise.
The HRT worked a treat for the first two years. Now I am experiencing many more menopause symptoms such as sweats at night, lack of sleep, major anxiety, low emotions, feeling depressed, migraines (they have come back again), irritation, anger etc. I guess his could all mean that I am older (51) and the natural hormones have reduced still further and therefore the HRT is not doing he same job. But why, then, has my GP suggested less oestrogen and more progesterone in HRT form?

[dizziej]

SAME!!!  Was on 1mg Elleste duet
I have been told July for Elleste by the manufacturer. Late June maybe for Conti. 

I went to gp yday for the same and put on Kliofem Conti as same type of progesterone as Elleste but now scared as he's given me 2mg.  And read about cramps and bleeding.   

[Dotty]

Hi Fiona it spends like you need more oestrogen, not less. The Femoston Conti might be too low for you.

The thinking behind giving you continuous progesterone is that you take it all the time and do fo not suffer from the withdrawal of the progesterone . You cannot compared the 2 progestetones as they are different types do although one seems more, its not.

As you have been on hrt for 3 years you may be ready for a continuous hrt but you may not be. It depends where you are in menopause x

[Dotty]

Hi dizziej

First of all your GP has changed you from a Sequi hrt to s continuous one. If you are still in peri menopause this is not the right one.

Secondly , your GP has increased the dose. The equivalent dosage would be Kliovance, but that is still a continuous hrt.

The equivalent to Elleste 1mg is Clinorette or Trisequens. X

[FionaR]

I think the thinking is that i am in mid menopause not peri menopause anymore. Although, how will i know if i am on hrt because of "artificial periods".
Due to being on HRT for three years already the GP suggested a drop in oestrogen due to potential dangers of being on HRT for too long.
The increase of progesterone was to counter balance the low and angry moods i get from a generally drop in this hormone.
But maybe another GP would advise I stay at 1mg oestrogen (?) and also have continuous amount of progesterone.
One of the problems is getting hold of some brands of HRT so maybe that has been the influencer in the choice of Femoston.
Thoughts? Thanks.

[Dotty]

Hi it looks like the progesterone is increased but it's two different types . The progesterone in Elleste is Norethistetone and the one in Femoston is dydogesterone, which is a kinder progesterone. You can not compare the dosage of the 2 and say one is stronger.

Your GP is wrong to say there is a risk to being on hrt long term. The guidance now is that you can stay in hrt for as long as you need it. The guidance about only being on it for 5 years has been proved incorrect.

You may be fine on a continuous hrt. Can I ask how old you are ?

You say your symptoms were coming back which implies that your own levels of oestrogen are probably dropping and you therefore need more oestrogen not less. Xx

[Dotty]

Hi Fiona I've just read that you are 51, so you might be ready for a continuous hrt.

Have you thought about Oestrogel and Utrogestan? X

[FionaR]

not sure what these are? estrogel and Utrogestan. Tell me more please and why they might be good.
I am sporty and therefore patches etc are maybe not the best for me. I get sweaty and rained on a lot!

[Dotty]

Oestrogel is a gel containing oestrogen which you apply every day 1-4 pumps.

Utrogestan is the progesterone which you take at night to protect the womb. You take it every night if you are on a continuous regime.

It is regarded as many as the best and safest way of using hrt, but it doesn't suit everyone xx

[FionaR]

Why might it not suit everyone?
I can't help wondering why my GP hasn't suggested this.

I think it should be on more oestrogen plus the continuous progesterone. Can you suggest an hrt that is similar to elleste that might have these extra doses? Then I can go back to the GP and suggest this.
Thank you

[Dotty]

Hi not every hrt suits everyone . Some ladies love tablets; some love patches and others love gel.

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

Have a look at this link and you'll see all the continuous hrts.

If you need 2mg then all the tablet forms contain norethisterone , which is what is in Elleste 1mg.x

[dizziej]

Hi Dotty. thank you for replying to me as well. I have been in menopause for about five years or through it I don't really know what you say. I am nearly 49. The 1mg Elleste diet seemed to suit me fine. I would try the Kliofem I have if I don't think it's going to give me head explosion like this Femeston seems to be doing.   Is a Conti generally better once you are at this stage? 

[jaycee]

Dizzy, bumping for you

[Dotty]

Hi dizziej

You can use a continuous hrt at any point, but if you are still in peri you are likely to get breakthrough bleeding. x