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[Kit14]

Hello, this is my first post, although I have been following the forum discussions for a while and am very grateful for all I have learnt so far. 
I'm 46 and have been perimenopausal for about 6 years.  I started Evorel sequi HRT in November and until now have usually had a withdrawal bleed just after going back onto oestrogen-only patch after two weeks of the progesterone patches. 
Except this week when I have had quite heavy breakthrough bleeding for the last three days.  I am hoping to speak to an out of hours doctor later today (of course I can't get in to see my own GP).
Has anyone had this experience or know how worried I should be? I am freaking out rather and don't know whether to remove my patch. I fear the consequences either way!
The Evorel sequi information leaflet says a) breakthrough bleeding is normal in the first few months but also b) if this happens then remove the patch straight away and speak to a doctor immediately.  Both of those things can't be right!
All and any advice gratefully received, I am really quite worried just now.
Thanks.

[Mollys65]

Hi

I am 56 and 9 years post menopausal.  I have been on Evorel Sequi twice now and also Evorel Conti, but both gave me really heavy bleeding, lasting on average 10 days.  I persevered, but I have now really had enough as it is getting me down....I have spoken to my GP today who has referred me to the Menopause Clinic (but said I won't get an appointment for months!!).  Her solution at the moment is to now prescribe Tibolone tablets (Livial), but I believe these are only suitable for women at least 1 year post menopause, so won't be any good for you..... I hope you find a solution, don't give up, I know it's a nightmare at present trying to even talk to your GP on the phone!

[Kit14]

Hi @Mollys65 thanks for your response.  It's a struggle alright.  I am trying to get referred to my menopause clinic at the moment but so far my GP has refused to refer me - despite not being very knowledgeable about HRT!  I do hope things improve for you with the Tibolone!

[sheila99]

Oh yes, lots of experience of this and no, you shouldn't worry. I have a natural cycle longer than 28 days and found my cycle was always stronger than the hrt one. So I'd bleed when my own hormones dictated, sometimes I'd bleed because of the hrt cycle too. Your own cycle can vary in length during peri so it's likely that at some point they will get out of step. I solved it by changing to gel and utro, I'm lucky I can tell when I ovulate so can start utro after that and it keeps the cycles in sync.
As this is the first time I would carry on with the patches and see what happens next month. If it's regularly out of step then try and adjust the patches to bring it back. If heavy bleeding is a problem you could consider a mirena with an oestrogen patch.

[Floradora]

Please don’t worry unduly. Breakthrough bleeding is unfortunately part of the deal for many ladies on HRT. Particularly when you are so young and your own cycle will be doing its own thing in the background.  I agree with Sheila99 just keep your patch on and see what happens next month. May be a one off and if not you can then reassess what’s needed. Don’t get yourself in a panic though x

[Ches15]

Hi,
I’m on evorel sequi and also 46  . I saw the nurse this week to get more patches and mentioned that i’d had a period in the middle of my cycle while I had covid this month.
She said not to worry at all and keep going as I have been as it won’t be a problem and that it is not unusual for it to go out of synch!

[Kit14]

Thanks so much to all of you for your responses (can't work out how to do individual replies from my phone). It's a real relief to know that others are in the same boat. I saw a GP today and she advised that my own doctor should request a transvaginal ultrasound just to be sure but that most likely the progesterone dose isn't high enough(?). I'll read up on that. She also suggested oestrogen gel and progesterone pessaries instead, which tallies with what Sheila99 said too. I'm very grateful to you ladies - us all supporting each other is such a precious thing!