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[KaraShannon]

Hi everyone

sorry for another post, but it's a specific question (and thanks for the responses to my other posts which I promise I will come to, it's been a week of family crises, but I will come back to them very soon).


I was planning to re-try using my progesterone patches from Evorel Sequi again but timing is a bit out, I should have done it on 5th June.  I've been on 100 estradiol for around ten weeks.  My dizziness and postural hypotension have got a bit better but I don't necessarily think lack of oestrogen was the problem, so was thinking of going back onto my cyclical regime.

I noticed the Vagirux caused predictable dizziness and now I've changed to another pessary I'm a little better. 


I really wanted to go back onto the progesterone this time around, partly because I used to feel good on it, and it seemed to get rid of water retention etc and give me energy.  Does anyone know if I start it now will I upset things?  Being one week late?  My period came last week by itself, this is the second one while I did the continuous regime, so I think it's still happening, therefore I am probably in 'progesterone phase' and might be worth assisting that by changing to the progesterone patch?

Anyone any ideas on this? 

[KaraShannon]

Part of the reason for asking is that I'm feeling a bit out of sorts, a feeling that usually reminds me that I need to put a new patch on (I get a feeling of not being sure what to do with myself which goes shortly after replacing a patch). 

[McPeri]

Hi KaraShannon,
Not sure if I can help, but it sounds like you are still trying to find the best solution for you. It is a rough road!

You have said you are using Evorel Sequi, so you will have in each box 4 Evorel patches that are estradiol only and 4 that are estradiol + norethisterone (progestin). The 100mcg estradiol you have been on for 10 weeks, was this an Evorel patch?

The progestin in Evorel Sequi is norethisterone, so not progesterone (whereas utrogestan is progesterone). But many women do really well with norethisterone. You can technically start a progestin any time you like and then, when you stop, you will usually get a withdrawal bleed. Of course, if you are fighting your own cycle you may get some breakthrough bleeding along the way.

Do you have any idea where your own cycle is at? If you had a period last week, of its own accord, I would count the first day of that period as 'Day 1' and start the progestin on Day 14. That way you are more likely to sync it with your own cycle.

If you use an Evorel Sequi patch for progestin, you are going to also get some more estradiol with it because it is not a progestin-only patch, it is estradiol + norethisterone.

Usually, if someone is using estradiol-only patches then they take a separate progestin or progesterone, such as norethisterone tablets or Provera or utrogestan. These can be taken cyclically or continuously.

Sorry if I have misunderstood your situation. It sounds like it has been tricky!

[KaraShannon]

Do you have any idea where your own cycle is at? If you had a period last week, of its own accord, I would count the first day of that period as 'Day 1' and start the progestin on Day 14. That way you are more likely to sync it with your own cycle.

If you use an Evorel Sequi patch for progestin, you are going to also get some more estradiol with it because it is not a progestin-only patch, it is estradiol + norethisterone.

Usually, if someone is using estradiol-only patches then they take a separate progestin or progesterone, such as norethisterone tablets or Provera or utrogestan. These can be taken cyclically or continuously.

Sorry if I have misunderstood your situation. It sounds like it has been tricky!

Thanks McPeri

actually you've understood exactly what I was getting at.  Yes I know it's not progesterone in the sequi patches, it was lazy talking, just referring to oestrogen and progesterone as that's what the patches are replacing, but I should be exact.

I think I did ok with norehisterone, I wanted to try utrogestan so was given estradiol only patches and utrogestan tablets, but I used one utrogestan vaginally and within half an hour I felt bloated up and asthmatic.  I've noticed a bit of asthma lately though which I never normally get so I'm still open to the fact it might have been a massive coincidence.

Hence thinking I'd go back to my old evorel sequi regime at the moment as I've had ten weeks of dizziness and generally not feeling right (some of which was vagirux pessaries which have been stopped but I'm not 100% back to how I was so thought I'd stop trying the 'continuous' method with 100 estradiol)

Interesting you say the 'progesterone' starts on day 14, according to my old regime I was meant to start the progesterone /norehisterone last sunday 5th june, but didn't and that is when my period started.

So maybe that's why I've been feeling off, the regime had somehow got out of sync with my own cycle perhaps.  So I could try the norehisterone on 18th. 

Thanks for going through it with me, I'm a bit pedantic but appreciate it.   

[KaraShannon]

Update, still feeling odd.  Thinking is all over the place, remembering stuff that I have to do but then lose it again.  Then remember it again.

This isn't me.  I am usually focused.

Feel the way I usually feel momentarily before my patch change, but it was changed last night......still on estradiol.  I seem to have had a 'low level' period since 5th, it was noticeable at first, now it's just extremely light.  Urethral irritation too (it won't be infection it never is, almost always hormonal with me)

Still wondering whether to switch to my norehisterone patch.  In the past everything clicked when I did and I would 'sail' effortlessly back to the estradiol patches.  I think oestrogen may be my problem, but only because it may be too high and my body doesn't want continuous.

[KaraShannon]

Would it be a disaster if I switched at this point?  The timing should have been on 5th.

[KaraShannon]

Anyone any thoughts on this?

I feel pretty bloated atm, I think progesterone is a diuretic and so would like to begin the patch.  I have left a message with the doctor to see what they think, no idea if they'll
get back to me today though and don't want to miss the window before it's 'time' to be back on estradiol again.  Thanks for any ideas. 

[KaraShannon]

If I switch tomorrow, it will be 14 days after a period.  Though I think that period wasn't on the proper timing, and I should have changed to norehisterone on 5th..

still waiting for doctor. 

I might go ask the pharmacist.  I seem to be retaining water since been on continuous estradiol.

[KaraShannon]

don't know whether to switch... 

[Ecl]

Hi KaraShannon
I’m afraid I’m rubbish at names so apologies if I get any wrong. To answer your questions using my own thinking process, your period started on the 5th which was a Sunday so you should have started the progesterone part on the 19th and take it until the 30th (if tablet utrogestan) otfor 2 weeks if patch.
I know what you mean about feeling more settled in the progesterone phase. It often brings better sleep which helps and some of us find it helps with anxiety too. I also feel I can be quite sensitive to oestrogen, with bloating and abdominal symptoms and can take a few weeks to settle when there’s a change, however the utrogestan doesn’t give me those issues.
Just one thing I am not sure of and want to make sure you’re aware, the Evorel sequii comes in one size only, it’s Evorel 50 and you are on 100 at the moment I believe. To go straight from 100 to 50 would be a big drop and may give you issues. If you stay on 100, the norethisterone in the sequii may not be strong enough as it is meant to go with the 50 oestrogen dose (I don’t know what the dose would be orally). With utrogestan it doesn’t matter your oestrogen dose, the utrogestan stays the same. One thing for you to know is that initially I though the utrogestan was giving me side effects but they settled with time it may be worth you trying the utrogestan again.