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[JPEdinburgh]

Hi Everyone,  I am hoping for a little advice from those with experience of using Evorel Sequi (50 & Conti), prescribed for poor sleep and brain fog, FYI still having a regular period. I am finishing month 1, EV 50 gave me strong headaches, so cut patch in half and experienced a much needed improvement in my perimenopause symptoms. Since moving onto the Conti and getting to the end of my normal cycle (still on half a patch), I have headaches, confusion, nausea, very low mood and my sleep has become disrupted again.

Is this normal and does it get better? Knowing that the 50 and Conti Parches provide different hormones, I'm wondering if I actually need the additional hormone added in the Conti patch. Any thoughts on this, gratefully received.

[Hurdity]

Hi JP Edinburgh

 

The hormones in the combi (conti) patch provide oestrogen and progestogen - and you need both in order to protect your womb as you are adding in extra oestrogen. If you are still having regular periods, as in, no difference in cycle length, then you will be ovulating and producing your own progesterone, which may be sufficient for the time being, but if you become properly peri-menopausal then your cycle is less frequent and oestrogen only patch will be insufficient and could cause your womb lining to overthicken some months.

Your side effects may be partly due to the protestogen in the conti patch ( norethisterone) which gives some women adverse effects that you describe. Alternatively it could be due to this in addition to your own progesterone giving you too much, or due to the fall in your own progesterone during the second part of the cycle, though not sure this would cause nausea. Low mood could be due to too much progestogen or not enough oestrogen - ie that the small  amount of patch that you are using is not sufficient to cushion your own hormonal fluctuations  - because your cycle is going on in the background.

How old are you?

There are alternatives - depending on your age -  for example the combined contraceptive pilL QLAIRA or ZOELY which contain bio-identical estradiol, the same as in Evorel patch which suppress the cycle and so evens out the dramatic fluctuations of peri-menopause.

Some women in your position - early or not quite peri but getting symptoms due to the hormones beginning to go awry even while ovulation is still happening regularly - get on well with Femoston, an HRT tablet. This also contains estradiol as the oestrogen component, but contains dydrogesterone for the progestogen part which is very close in structure to our own progesterone and seems to be well tolerated judging by reports on here.

Hope this helps

Hurdity x

[JPEdinburgh]

Thanks for all the information Huridity. I am 50, It’s sleep and brain fog  and mood fluctuations which are my main issues for taking HRT. It would appear the estrogen is making a positive difference but as you suggest it would make sense that I am still producing my own progestogen as my periods are still regular, just a little shorter and heavier. I will have a chat with my doctor on the options you suggest, thanks very much.