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[Vicky81]

That's interesting xxx
When I've spoken to Dr morton tonight il post sn update on this thread xx

[Vicky81]

Just to note....back in 2016 i started cerelle pill...I just googled the box to make sure it was the pink one! I had absolutely no trouble on this back then... obviously it was purely to prevent conception. But if I did choose this again would I need oestrogen too? Say in firm of patch or gel? Or purely just the cerelle?

[joziel]

Cerelle is the brand name for desogestrel - Cerazette, the pill I'm on, is another brand name for the same pill - desogestrel. There seem to be about 4 different brands, all desogestrel 75mcg, no idea why we need 4 of these.... 

Desogestrel isn't licensed to be used as the progesterone for HRT purposes. There is some limited research where it was used at double the dose and was fine, but it was a limited sample size so not considered acceptable to prescribe on that basis. I think in future years there will be more research and it will be accepted but not yet.

Which means that if you want to take desogestrel, you also need to take a progesterone which can function for HRT purposes to protect the uterus. Like utrogestan for eg. That's what I do. I only take desogestrel to suppress my endo, but some women are on it for contraception alongside HRT.

You will always need estrogen if you take HRT, that's the heart of HRT. Progesterone alone you could get from taking a POP if you wanted, but estrogen is what declines and has most impact and causes all the symptoms.

[Vicky81]

Aahh ok ...so if I decide (which I'm really thinking of calling gp for monday), to go on normal combined pill that would be ok?
My friends mum has been on rigverdon in peri 4 years (gp gave) and hadnt looked back. X

[joziel]

Well, not really....

Firstly, you have to come off the combined pill at 50 due to clot/stroke risk. So even if you love it, you're only going to be able to use it for a few years till you're 50 and then will have another transition to make onto HRT. So may as well find a HRT that works for you now.

Second, almost all pills use a different estrogen to what our body makes. It's a synthetic estrogen. Which isn't as effective in terms of bone protection and other health benefits as a body identical estrogen. And the clot risk is higher because of that.

Third, most combined pills don't give you enough estrogen because they are designed for younger women whose ovaries are also producing estrogen. And you can't add in more estrogen without more progesterone as it wouldn't be safe/enough protection.

Fourth, the progesterone in all pills is synthetic too. And really the lowest risk (if you can use it okay) is micronised progesterone/utrogestan - which is body identical progesterone. Synthetic progesterones can be estrogenic or androgenic or have slightly increased risk of breast cancer.

Whilst some women do use the combined pill in peri with no problems, it's probably best to go onto HRT - unless you are already on a combined pill, in which case just continuing it until 50 might be best unless you have symptoms. Or unless you also need contraception. (Although you can take the mini pill along with HRT if you need contraception.) Or maybe also if you have endo and need to shut your ovaries down somewhat(!).

Is there a reason you specifically want an oral tablet rather than transdermal? Some women don't get on with transdermal but it's probably the safest/best thing to try in the first instance. That would be either a gel or patch along with utrogestan. If you're still having periods and are peri, you would take the utrogestan 2 weeks of the month and still have a bleed.

[Vicky81]

Thanks so much for that lengthy explanation hin I really appreciate it.
Ok, I'm sticking with zoely....see how I get on.
Much love xxxx