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[Deb71]

Hello, I ve been on utrogestan 100mg for almost three months with Evorel 50 patches. This was a switch from sequential HRT (Novofem) as I m now post menopausal.
After one month I had breast tenderness which went after a week or so. At the end of the second month I ve had bleeding (been referred and had scan and biopsy) pelvic pain and now nausea and a weird weak, slightly disoriented feeling- maybe jittery/ anxious. It’s hard to describe but horrible.
Has anyone else experienced these side effects? Grateful for any response, I m struggling with all of this.

[bombsh3ll]

If you felt better with a norethisterone based treatment and the problems seemed to start with switching to utrogestan, you could always switch to either an oral continuous combined preparation with norethisterone, or try the combined patch evorel conti. This contains norethisterone.

[sheila99]

Evorel conti patches might be the answer but as you've changed both it might be worth doing a couple of cycles of sequi first (2x100mg utro x 12 days, days 15-26) in case it's the patch causing the problem. Sore boobs and anxiety, particularly jittery, can be signs of too much oestrogen though of course anxiety can be from too little as well.

[Deb71]

Thank you both. It’s really hard to know what is causing it. Could the symptoms I m having be caused by either the patch or the oral utrogestan? I ve been assuming it’s the utrogestan but maybe not.

[Dotty]

Hi was the Novofem a 1mg tablet ? If so what you are experiencing could be because you have increased the oestrogen by moving to a 50 patch.

[Deb71]

Yes I believe it was 1mg. There were red and white tablets. Red for first part of cycle and white for the rest, no break between.

[Dotty]

Hi a 1mg tablet is roughly equivalent to a 25 patch. Perhaps the 50 patch is too high a dose of oestrogen.

[sheila99]

Perhaps try cutting the patch in half and see how you get on before you do anything else?

[Deb71]

Please tell me if I m getting muddled but isn’t 1mg =1 milligram so 1 milligram in novofem. Evorel 50 is 50 micrograms so that half the amount  that is in a novofem tablet. Very confusing

[Dotty]

https://www.womens-health-concern.org/wp-content/uploads/2022/11/27-WHC-FACTSHEET-HRT-Doses-NOV2022-A.pdf

See page 3…. It gives you the equivalent doses of different hrt preparations.

[Deb71]

Thank you so much. That’s very helpful. I really don’t know what to do but can’t talk to nurse yet anyway. Could these side effects pass?

[Dotty]

Hi can I ask how old you are ? How long were you on Novofem? x

[Deb71]

I m 51 and was on novofem for about 3 years I think. I was on patches before that but didn’t seem to help.
I haven’t had a period ( until the recent bleeding) since May 2023. The thing is my husband was diagnosed with cancer in July 22 which was incredibly stressful and my daughter was unwell too so I was under a lot of stress. I have wondered if my periods stopped because of that and I m not actually post menopausal. Both my husband and daughter are doing well now. Maybe I should just stop the HRT?

[Dotty]

Hi if you’re on hrt then you can’t tell if you’re post menopausal . Post menopause is 12 months without a period without being on any form of hormonal contraception or HRT. So you might not be post menopausal. You can try continuous HRT at any stage but it takes about 6 months to settle.

If the HRT was helping you then I wouldn’t stop it. But you have doubled the oestrogen which has probably led to your bleeding and side effects. You could use a 25 patch which would be equivalent to the tablet you were on. Or you could carry on with Novofem if that suited you.

Hope that makes sense x

[Deb71]

Thank you Dotty, that does make sense. I ve started bleeding more again this morning. Just so hard to find someone medical to advise and get a prescription from. And I think the stress is adding to it. Pharmacist sent me back to gp this morning saying I shouldn’t just stop HRT. I am waiting for a call from dr - very lucky to get one so we ll see.
It sounds like you think it’s more do do with the everel 50 than the utorogestan?