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[jaymay]

Hi,

I have been on patch hrt since i was about 42 years old and still having periods because I started having severe peri symptoms of flushes and night sweats. I started on femseven sequi and then moved to evorel sequi due to manufacturing problems at that time. I’ve been fine on the sequi patches and had regular withdrawal bleeds at the right time with no unscheduled bleeding.

I tried to move over to conti patches in the past on a couple of occasions, but ended up with backache that went away when I briefly stopped the hrt and then changed back to sequi patches. I have had three scans in the past years and the womb thickness was always fine. I have a small fibroid that has not changed size at all on approx three scans.

I’m now 55 (56 this year)  and I have booked an appt to ask the gp if i can try to change to evorel conti again. I recently had blood tests that showed I am definitely post meno now.

I just read something on the internet that mentioned the need to move over to conti from sequi after 5 years at the latest. I’m happy to give it a try again now, but now I’ve gone i to anxiety overdrive because I have been on the sequi for  nearly 14 years (apart from a couple of attempts to move to the conti that only lasted a few months. I’m worried that there will be issues caused by being on sequi for so long!!

Can anyone advise please. Can it cause any problems being so long on sequi? Thanks.

[DottyD68]

Hi jaymay,

I'm not a medic but from what I understand there shouldn't be a problem moving over to conti. Infact, in my experience the GPs are keen to move you over after 55 (based on the "theory" that you should be post menopausal by 55 - even if you aren't). I understand that there could be a very small risk of endometrial cancer if you stay on sequi  longterm post menopause (but I'm sure I will be corrected if that is not fact). I imagine this could be monitored by regular scans.

Sounds like you are post menopausal so moving to conti now would be the standard medic approach in the HRT world, but I believe you could move back to sequi if it doesn't agree with you.

Radical thought. Have you considered coming off HRT for a while to see how you get on without it? Yoiu could always go back on it if your symptoms return.

I hope you get on well whatever you do. X

[bombsh3ll]

Changing to continuous after 5 years or age 55 is a guideline not a mandate, and treatment should always be individualised.

As you started them at a relatively young age, this is essentially just the same as having healthy ovarian function until 50-51 then going onto them, so really you haven't exceeded anything.

It is reasonable to change now however there is no cause for concern.

[jaymay]

Thank you so much for your replies DottyD68 and bombsh3ll.

Iusually do a trial without hrt once a year and the symptoms have come back after a couple of weeks off hrt. I  havent done a trial without over past year though because i was diagnosed with hashimotos and hypothyroidism so didn’t want to rock the hormone boat too much. Maybe i should try again now before any change.

[bombsh3ll]

Do you have a clear medical reason for trying to stop it every year or just a vague belief that it is somehow dangerous or that you aren't deserving of hormone treatment?

Many people have subconsciously internalised negative and scientifically inaccurate messaging that there is something harmful, immoral, weak, vain or frivolous about replacing our ovarian hormones, or that "toughing it out" is strong and admirable, and this causes them to put pressure on themselves to come off a beneficial treatment when there is no medical reason to do so, often at considerable detriment to their wellbeing.

Any treatment is a choice and won't be for everyone, but any decision you make should have a sound rationale behind it.

[jaymay]

Thank you for your reply. I appreciate your thoughts on this.