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[Zara69]

I’m 52 had successful ablation 7 years ago I’m on evorel sequi for 6 years plus testosterone but need more oestrogen I don’t do well on utrogestan. I add a bit of gel which I know I can’t continue to do so sought advice… I’ve had 3 consultations with 3 different menopause specialists…one said as I get on best with norethisterone continue using evorel sequi plus 1/2 or one extra evorel 50 patch all month plus testosterone but ensuring to keep in female range…the next dr told me at my age I must be on continuous prog so to use 1 1/2 or 2 evorel conti patches together plus testosterone monitored to keep within range..the 3rd said to use no less than 100 patch or 4 pumps of gel..probably no need for prog as I’ve never bleed since ablation or while on hrt ..my testosterone is upper end at 5% they were unconcerned if I feel well on high testosterone use a bit more telling me female ranges are more guess work than science…also have annual scans to check womb lining. I don’t know why I’m posting this other than to show how many differing opinions there are ..meanwhile my GP still doesn’t really like prescribing systemic hrt with vagifem…🤷🏼‍♀️

[CLKD]

Did U make a decision ?  Why did U feel it necessary to seek 3 opinions?

I would be sending an e-mail to Dr Currie - details above, there is a charge. 

[Zara69]

I spoke to different people because the first two options didn’t suit me either..the third is the best for me but I caught covid twice and it’s thrown all my hormones up in the air …I couldn’t tolerate anything so starting again slowly and I’ll go from there when I feel stable again..I was just surprised by the difference of opinion..

[Kathleen]

Hello Zara69.

I find that this sort of thing  very confusing and the varying opinions mean I lose confidence in every 'expert' I meet.

I have a similar dilemma in that my meno clinic always favours increasing my Oestrogen but an NHS consultant said that in his experience, 'Less is more' and I should reduce my dose.  I have my next clinic appointment in June and  as I have breast tenderness and bleeding on higher amounts of Oestrogen I have decided to experiment with lowering my dose as advised by the Consultant. Goodness knows if this is right or not and my poor body must be wondering what's happening to it. My GPs surgery are very helpful but not particularly knowledgeable.

Surely there should be more consensus than this! I wish you good luck and please keep us updated.

Take care.

K.

[Zara69]

Hi Kathleen
It is confusing..I know we are all different in the way we absorb and then react to hormones so I suppose there is no “exact science”but I believe in starting low and building up slowly until we feel well..so that is what I’m going to do..I have enough patches/gel to do this slowly myself and when I find what suits me whether that be patches plus a squirt of gel or adding a bit of a patch I will then contact the specialist that I think most closely matches what I feel I need to support me in it!Seems a back to front way of doing it ! And takes months Xx

[Kathleen]

Hello again Zara69.

I completely understand your approach to the problem!

My issues are the emotional ones of anxiety, low mood and tearfulness though fortunately my physical symptoms are well controlled by my HRT. The meno clinic wanted me to go on increasing my gel but this led to tender breasts and heavy bleeding. I then decided to follow the contradictory advice of the NHS consultant and actually lower the dose.  I will have to figure out a way of explaining myself to the clinic and the consultant when the time comes but with any luck I will be feeling better by then and I won't care what they think lol.

I hope you find a regime that works for you. 

Take care and let us in how you get on.

K.

[sheila99]

I don't like the advice of any of your specialists! Dr 2 is talking through his backside. Conti is for post meno women and at 52 there's no guarantee you are. Some women aren't meno til their early 60s (I'm one of them). You might well be meno and OK on conti but not just because you're 52. Dr 1 has a point that you tolerate the patches well but the prog and oestrogen are balanced so if you increase by half a patch when you're on the conti patches it should be an extra half conti patch. Dr 3 - what makes him think you need double your current dose? Best to increase to 75 and see how you are on that. Assuming you need no prog is too risky for me and if you go down this route IMO you definitely need the scans. And your gp should know some women need topical oestrogen as well as systemic. I'm another one who was fine with norethisterone but get fatigue with gel but I developed an allergic reaction to the patches so I've had to change. Good luck with whatever you decide.

[Dotty]

Hi I agree with sheila99 that actually none of the advice is correct .

If you have a womb then you need a progesterone regardless of the fact that you’ve had an ablation.

There is no need to change to a Conti regime if you’re happy on a Sequi regime.

The first lot of advice is probably the best. xxx

[Zara69]

Thanks ladies..I agree none are great advice..I think because I don’t get on with utro or provera I’m a bit difficult. I’m not doing any of the 3 but just using evorel sequi for now thinking a bit of oestrogen is better than nothing..hoping a lot of the way I’m absorbing/feeling is down to covid. My oestrogen was only 127 hence 100 patch