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[Desperado]

Im 54, was still bleeding monthly when I started HRT so went onto evorel sequi which has on the whole been fantastic. My worst symptoms before were severe PMT, suicidal level, 2 weeks or more a month and that completely settled down. Until recently that is. I have missed 4 periods now, unusual for me, and each month the PMT is getting worse and lasting longer. So do I need to increase my dose? Change to conti? Any other possibilities Im unaware of even? Any advice would be so gratefully received.

[Mrs C]

Hi!  This is uncanny, as just logged into the forum to ask the exact same thing!  Sorry I can't advise you, but hoping someone can, so we can both get some answers!

My GP had suggested trying FemSeven patch, great I said, then find out they will not be available until Jan 2022 due to shortages .

Fingers crossed the ladies on here can help.

 

[Hurdity]

Hi Desperado - it depends how long you've been on HRT. Obviously if you were still having regular periods when you started then you weren't properly peri-menopausal but taking the HRT has helped you through part of this stage and giving you an artificial cycle. Some women eventually settle into a no-bleed regime even on cyclical HRT and it just means that the womb lining is not building up sufficiently to need to shed and that these months you most likely did not ovulate. If you are taking the hRT as prescribed and licensed, and haven't had any ABNORMAL bleeding or spotting then there is not usually any cause for concern. Any increased dose would be indicated by a return of symptoms - so if these are well controlled then no need to change dose. I can't comment on the pms but does this occur at a particular point in the HRT cycle? it could be due to progesterone withdrawal - when you change back to the Evorel 50 patch after stopping the conti) or if during the conti part - maybe  if your own cycle has lessened you are feeling the (negative) effects of the progestogen a bit more?

I would continue to monitor and keep a diary of symptoms and which patch and if no improvement after a few cycles maybe time to change regime - possibly a higher dose oestrogen and then with separate progesterone?

Hurdity x