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[shrosphirelass]

As some of you know I went on HRT at 56 and still peri because of really bad headaches which I had always had premenstrually, but had a got a lot worse. Also stomach issues, nausea and dizziness that accompanied them and don't get me started on dryness. Felt like I was turning into a prune!
Well I started on evorel sequi half a patch and headaches gradually improved. Stomach was still bad. I increased to a full patch and got much much better, skin and hair less dry and generally less dryness though didn't feel as good on progresterone part.
Anyway, over the last month my headaches have returned with a vengence, worse than before, though I'm not sure if they could be aggravted by hayfever as I have had itchy eyes and sinus like headaches. Ive also had the occasional hot flashes which are pretty new to me and the dryness has returned. I was wondering whether I might now be fully menopusal and that I need to increase from my current dosage, but I understand that evorel sequi only comes in 50 dosage. I don't want to increase dosage unless necessary and also am concerned about what to try. Anyone got any ideas?

[Hurdity]

Hi shropshirelass

As you say it could be that you need a higher dose now if your symptoms are returning ( ie hot flushes). Do these occur at any particular point in the HRT cycle have you noticed? Also the headaches? Some women react to the progestogen part as you have noticed and symptoms also sometimes return on this phase of the treatment. Therefore if these persist then you could try a separate 50 mcg Evorel patch  (or try a different one - Estradot for example) with either Provera or Utrogestan or even a Mirena coil to see if it is the progestogen in Evorel sequi causing your symptoms. If the symptoms continue ie flushes - but unrelated to the progestogen phase) then you can stay with whichever regime you have chosen but try an increase in patch dose to 75 mcg and see if this helps.

You might also like to explore the option of local ( vaginal) oestrogen eg Vagifem or estriol cream to help with the dryness - many women need to have both systemic HRT and local oestrogen to keep things comfortable.

Hope this helps

Hurdity x

[shrosphirelass]

Thanks Hurdity. I am much worse on the progesterone part which is why I am experimenting with 5 week cycles (my previous cycle was always over 5 - 6 weeks). However, I have had headaches on both parts this month, so I'm in a bit of a quandry.

If I were to increase the evorel to 75 I guess I couldn't have evorel conti as it wouldn't be the right dose, so would I need to swap to a different progesterone?

Also, re different progesterones are tablets likely to make the headaches / stomach worse? I had transdermal because of possible side effects of headaches and stomach issues, or is it just the oestrogen that needs to be taken that way?

I don't fancy the coil as if it doesn't suit me it would be a rigmarole taking it out, though the doctor is quite keen on this.

Probably sounds daft but Im reluctant to try completely different things in case they make me even worse. I know some people have problems with anxiety and depression and I have been really fortunate that despite always suffering from anxiety I have not got worse and if anything am better, than I was before. I know I'm asking the impossible!

I really appreciate you taking the time to help x

[CLKD]

Do you need to take pain relief for the headaches?  Headaches can be caused by being dehydrated.  I was always really thirsty prior to each period I would dip celery into water, drink the taps dry, cold tea - things I wouldn't usually touch during the rest of the month.  So obviously my body was needing liquids.  It was simply cyclic so I never questioned why.

Not daft at all, nowt is here!  I too worry if I'm offered anything that might upset my apple cart.  I have taken many years to reach symptoms that on a daily basis I can cope with and that don't over-whelm me. 

Transdermal will bypass the gut.  I would feel queasy prior to a bleed, some crave chocolate prior to a bleed ...... what's the worst upset for you?

Do U need anything to ease your anxiety [sorry you may have said already  ]. 

[shrosphirelass]

I do take pain killers, alternate ibprofen and paracetamol when its bad, though I try to avoid ibprofen when my stoimach's bad incase it aggravates it, but nothing really works. Just have to get through it. I drink lots of water and am very conscious of my diet, so much so that Ive lost a stone without wanting to and can't put any on. Only 7stone 13 now and don't want to lose anymore!

I have good days and bad days and I guess maybe Ive just got to put up with it.

[CLKD]

We shouldn't have to 'put up with' should we  .  You seem to be doing 'right' ......... 

[shrosphirelass]

We shouldn't have to 'put up with' should we  .  You seem to be doing 'right' ......... 

Thanks