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[Friend of lhasaapso]

Hi ,been feeling so bad today ,don't think I can go on like this   
     I'm 55 post meno for nearly 3 years and tried lots of different hrt to try and  feel better .
     I have bad side effects with progesterone and was taking evorel 25 and utro 200 mg on sequi cycle .
      Dr suggested I take continuous evorel and utro 100 mg as I'm post meno and to stop utro withdrawal symptoms;however, I'm not coping and feel so bad after a week 😢 so exhausted, nausea and jelly legs I can hardly function .
      I upped the patch to 50 to see if it would help but it hasn't.
       Feeling tearful tonight, as getting desperate now .
       Question for Hurdity if you're there ?I know you're on a long cycle and was wondering if this was arranged privately?and you have regular scans ? I think this would benefit me ,but don't think nhs gp would agree and I would be concerned about thickening of womb .
       Any suggestions? Thanks .

[sheila99]

I use a 6 week cycle, I'm fairly sure this is what hurdity uses too. No agreement from my gp who is clueless. I have a natural 6 week cycle and trying to fit it into a 4 week hrt cycle in peri just didn't work so I have continued on a 6 week cycle. Lining was thin after 40 years of my own 6 week cycle so I haven't been concerned about it.

[Dotty]

Hi I think your Oestrogen is too low. I get symptoms just as you describe when my Oestrogen is low x

[Hurdity]

Hi friendsoflhasaapso

Sorry to hear about your symptoms.

Yes you and sheila99 are right - I take it on a 6 week cycle. It used to be 8 weeks but then the bleeds are too heavy and I was bit worried about overthickening of endometrium at my age ( late 60's). No not decided privately. I have a great NHS gynae specialist GP at local practice who says there is no need to bleed monthly.

I don't tend to monitor with scans - I have had scans on  NHS from time to time for various reasons and a couple of private ones through ultrasound direct which are very cheap - but as I've mostly had no untoward bleeding at the wrong time, and the lining has always been OK I am cautiously optimistic.

To decide on whether it is OK to go to long cycle you should be guided by how your bleeds are on your current regime. eg when I was on 28 days cycle in my late 50's I got no withdrawal bleed using the licensed dose of progesterone, so I knew that I could extend the cycle without problems.

There is an increased risk of endometrial hyperplasia and cancer with cyclical HRT which is also why I decided on a conservative compromise of 6 weeks!

It's best not to change two things at once. Your oestrogen dose is definitely very low. What were your bleeds like on that sequi cycle with 25 mcg patches? Did you bleed much?

The standard oestrogen dose for post-meno is a medium one ie 50 mcg though women may need more or less depending on absoprtion, age etc. You are still very young and I woiuld want to at least be on the medium dose if possible - as better protection against osteoporosis.

So depending on your bleeds on the sequi cycle on the low dose patch, I would want to work towards 50 mcg patch with 200 mg vaginally for 12 days per calendar month and then gradually extending this to 6 weeks depending on your bleed. You could pay £30 for an e-mail consultation with Dr Currie specifically asking about the 6 week long cycle , if this would help with your doc?

You could play around with it yourself as your doc would not know (you would be using less prog) though really you need to know if there is any medical reason why you should not extend your cycle? You will know this surely eg if you have endometriosis, fibroids etc?

Hurdity x

[Friend of lhasaapso]

Thanks ladies for your replies,
I've had a horrible 8 days unable to do much at all .
I decide after 8 days I'd had enough and stopped utro. 
I'm going to try upping patch to 50 and  go back to utro 200 for 12 days & speak to doc .
 I'm already feeling better 2 days after stopping .
  I had thrush from swab,a problem I had a lot on the combined pill in my 20s.
Not sure if I need gel for down below as I'm itchy on outside skin ,if that makes sense?
    Feeling less down than I was so thank-you all for responding xx
 

[CLKD]

It makes perfect sense.  I had 'thrush' after stopping The Pill and again years later when I had emergency surgery.  Upset the gut flora. 

Get some VA treatment to ease any discomfort around the vaginal area. 

[Friend of lhasaapso]

Hi clkd, just wondering if you take anything for gut flora? R:e drinks with friendly bacteria ,&if they help ?x