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[Pauline67]

Morning Ladies

Was on Evorel Conti for 9 months but was bleeding after the 6 months continuously, went to doctors and she referred me for a scan.  Came back ok 3mm.  She suggested that i have the coil fitted and a week later she tryed to insert the coil but couldnt.  So she put me on Utrogestan 100 x 2 caplets a night (oral) and evorel 75.  Bleed stopped for about 1 month then bleeding again, its now been 3 months and im still bleeding, some days are heavy with clots, others are light.  I also had the jitters and i reduced my patch by cutting off a small corner probably reducing it to about 60/65, the jitters went but still the bleeding.  Im also waking up feeling like someone has slept on my chest all night, sore boobs, heartburn bad, aches and pains everywhere.  Im having to take paracetamol every day to ease this. I spoke to my doctor a few weeks ago and she said to carry on with it and see how it goes. Ive been post meno for about 5 years.

When you change to do different HRT do you have to give it another 6 months for it to kick in? Like it resets itself.

Should i reduce my Utrogestan to 1 caplet a night orally?  I dont want to insert them.

I dont want to go through the pain of trying again to insert a coil and im terrified of having a Hysterectomy.

I dont know what else to do and advice will be appreciated, as my OH is now getting impatient with me. as this has been going on for 1 year now and i still cant get the right combination

[Nas]

Hi Pauline67
Sorry to hear you are having a roughtime of things right now.
Finding a suitable HRT dose type can be a real battle I know 

Maybe the E75 is too much oestrogen for you?
What about lowering to 50, as I think this is the dose the conti patch comes in?

It is probably a case of trying each regime for a few months and then re assessing.

Why couldn't the GP insert the coil? Could she refer you to a gynae instead? They often have more experience of fitting coils and may be able to do it for you, with less pain and stress?

Alternatively, you could request to try a different progesterone. There are others which may control the bleeding better, particularly as the 200 utrogestan is not being effective.

Best of luck.
You have my total empathy.
x

[Dazedandconfused]

So sorry to hear you're suffering Pauline67.  I can't offer much other than empathy but do feel for you.  It feels like a constant battle to get the balance right. Sometimes just when you think you've cracked it, something comes happens to show you you haven't 

[sheila99]

I think your oestrogen is too high too. If your symptoms were under control on the conti patch (which is 50) you would be better staying on the same dose. A mirena is the best to stop bleeding but if you don't want to try that again you could either switch to a different type of progestin or you could see how you are on a sequi regime, at least then the bleed should be predictable. I use long cycle sequi so 12 days x 200mg utro per 6 week cycle. Using it vaginally might also be worth trying as more is supposed to get to where it's needed. I assume they didn't find any fibroids or polyps that could be causing it?

[Pauline67]

Hi Nas
She seemed to be having problems up there and I was in agony so she stopped, yes she can refer me she did mention that but wanted to try ultrogeston first.

Hi Sheila99
They didn't mention any fibroids when I had the ultrasound, well it wasn't actually a ultrasound as I didn't drink enough water so had to have it inserted into me instead.

I will try and get a telephone appointment  again with doctor but could take weeks to get one.

[CLKD]

Why will it take weeks to get a phone call .  .......... is there a Nurse Practitioner with whom you can speak? 

[Pauline67]

Why will it take weeks to get a phone call .  .......... is there a Nurse Practitioner with whom you can speak?

As soon as I mention hrt there's 3 doctors that deal with it at my surgery and all 3 have a massive waiting list.  Last time it took me 5 weeks to get a telephone call.

[CLKD]

Do they know what they are doing though ?  And of course if they R all part-time = long waiting lists. 

[Pauline67]

Do they know what they are doing though ?  And of course if they R all part-time = long waiting lists.

Yes I was told 2 of them had been trained by dr Louise newson

[Pauline67]

woke up this morning feeling rubbish, headache, chest hurts, boobs hurt and aching all over again,  Think im going to reduce my Utrogestan to 1 caplet a night and see if that improves, while i wait for my doctors telephone appointment. 


My question is can i do that or do i need the doctor to tell me its ok to reduce? 

[Ermin2trude]

Hello,

If you are on a continuous regime, then the recommended dose which is usually prescribed, is utrogestan 100mg a night (1 tablet). By reducing to 1 x utrogestan a night might well sort out your problems, although you might find an Evorel 75 patch might be too much.

With regards to Evorel patches, the oestradiol in them isn’t the same as in Evorel conti (oestradiol hemihydrate). I found I didn’t absorb from Evorel patches at all and had very heavy bleeding and the symptoms you describe.  I switched over to Estradot which is also oestradiol hemihydrate (same as evorel conti) and found they worked brilliantly. That might be something for you to try next.

[Pauline67]

Hello,

If you are on a continuous regime, then the recommended dose which is usually prescribed, is utrogestan 100mg a night (1 tablet). By reducing to 1 x utrogestan a night might well sort out your problems, although you might find an Evorel 75 patch might be too much.

With regards to Evorel patches, the oestradiol in them isn’t the same as in Evorel conti (oestradiol hemihydrate). I found I didn’t absorb from Evorel patches at all and had very heavy bleeding and the symptoms you describe.  I switched over to Estradot which is also oestradiol hemihydrate (same as evorel conti) and found they worked brilliantly. That might be something for you to try next.

Thanks Ermin2trude

The dr put me on 2 tablets to try and stop the bleeding but it isnt working so i guess i have nothing to lose by reducing to 1 tablet.  I already cut a triangle off the patch to reduce the 75 dose so i will cut a bit more off.

Im ringing the doctors today so when i get my telephone callback i will ask them to change to Estradot and see if that works 

Thanks again

**Update** doctors appointment 28th sept  but asked to change to estradot via email. fingers crossed.

[Nas]

Make sure you can get Estradot locally Pauline, they are in short supply in some areas.

If bleeding is your issue, then reducing to one utrogestan tablet against the 75 patch, may not suffice. It’s a balancing act. Bleeding often requires more progesterone unfortunately, which is why the “ Marmite mirena” is often suggested ( you either love it or hate it !)

Maybe Estradot will work better for you and you can crack on with life again.