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[LCB]

I am currently using two patches twice a week of Evorel conti but find the oestrogen is too low to control symptoms adequately.
Can I safely add one pump of oestrogel (750 mcg og oestrogen)once daily to this?

[Nas]

If E conti isn’t controlling your symptoms effectively, you may be better using a higher dose oestrogen patch plus separate progesterone. Evorel doses range from 25-100.

Obviously discuss this with your GP/ MS, but you may find that adding in an extra gel pump, then requires you to increase your progesterone?

[LCB]

Thanks for your reply. If I used Evorel 100 patches I would need an additional progesterone, as Evorel 100 patch only contains estradiol. What would I use for the progesterone?I would prefer both components to be in patch form, not least because I have some surgeries lined up and my consultant requires me to be on patches to lower the risk of blood clot.

[Nas]

I’m pretty sure E conti is the only combined HRT patch, but obviously comes in a 50 dose only.

You could ask your GP whether it’s a wise move, adding in an additional pump of gel?

Alternatively, you could get a mirena coil fitted for the progesterone element and then
you can safely increase your oestrogen. Or there are utrogestan progesterone tablets.

[sheila99]

When you say you're on 2 patches twice a week do you mean you use 2 evorel conti patches at the same time? The conti patches only contain enough progestogen for the amount of oestrogen in the patch. Some gps will let you use more than one conti patch, others require you to use a different progestin. You could use utrogeston orally or vaginally alongside an oestrogen only patch.

[LCB]

Yes two patches together.As I'm currently using two evorel conti patches equating to 100 mcg estrogen it seems that even the 100 dose of estrogen isn't high enough and so the evorel 100 patch likely would make no difference. I don't really want a coil fitted and so am still  a bit stuck with this dilemma. At the moment I can't take progesterone orally as my surgeon seems to want me only on patches and no other form.

[Nas]

Ah, two patches together? Sounds like you aren’t absorbing the oestrogen then?

If you are still symptomatic, then 100 patch probably won’t help. Patches, gels and sprays are all transdermal products and are pretty safe blood clot wise.

Maybe you need to wait until after you’ve had your surgery, so you can try something else?

[LCB]

Yes I will wait until then as that's the safer option.

[sheila99]

That's probably the best option. When you consider this again it might be worth getting your oestrogen levels tested so you'll know if it's an absorption problem ( I'm assuming you're meno so won't have big fluctuations of your own). I found I absorbed more from estradot than evorel. Poor absorption from evorel doesn't necessarily mean you can't find a transdermal product that suits you better. It seems a bit of a failing to me that conti patches only come as 50mcg.