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[Essexcountrygirl]

Hi, I am a bit unsure what to do. I have been on everol conti since January, and had still been getting light periods every month.
But the last 2 months I've had no period, which is good. But I have also been feeling really nauseous and have a hard, bloated stomach, along with a few hot flashes again.
Could it be that I need to increase my HRT? or do you think things will settle down again?

My GP was keen to put me back on sequential HRT seen as I was still having bleeds, but I would prefer not to have a period every month if i can avoid it.

[CLKD]

Sorry can't advise.  I understand that sometimes it can take 3 months-ish B4 the body adjusts to a regime depending on what hormones might be doing.

MayB put the product name into the search box?  Make notes ;-)

[bombsh3ll]

The best way to approach hormone therapy is to first find the dose of estrogen that meets your needs ie gets rid of menopause symptoms and protects you against the onset of future diseases related to hypoestrogenism.

Then you address endometrial control and bleeding preferences by choosing a suitable progestogen.

As you are on a low dose of estradiol (the combi patch contains 50mcg) and having hot flushes, this suggests you are undertreated.

A combination product can be convenient but this is at the expense of flexibility.

If you like the combi patch, your GP may agree to double your prescription so you could wear two, however they may be reluctant due to cost/lack of knowledge.

Another good option would be a higher strength patch with a mirena IUS if you prefer not to bleed.

[Essexcountrygirl]

Thanks both, that's really helpful. I think i'll give it a week and see if I feel any better if not i will ask my GP about changing my HRT.

[Dr. Heather Currie]

Just to pick up on this, Evorel conti provides a medium dose of estrogen and proportionate progestogen, it is not a low dose. See the decision tree at www.menopausematters.co.uk/tree.php with the various preparations listed according to type

[Mary G]

On the subject of Evorel conti, my sister has been using these patches for well over a year and they have done absolutely nothing.  She had them prescribed for osteopenia and a recent Dexa scan revealed zero improvement in bone mass.

I would question the strength and effectiveness of these patches and from what many women say, I wonder if they don't stick properly and provide a low and unstable dose.  They contain norethisterone which is a heavy duty synthetic progesterone which can cause a lot of unwanted side effects - in my case it was endless migraine auras.

I would try a different form of HRT like Oestrogel and a different progesterone although I realise how difficult that is when it comes to getting an appointment with an NHS doctor.  My sister finds it extremely difficult to get any meaningful help and the doctors at her surgery know virtually nothing about HRT, just the basics.

[Essexcountrygirl]

Thank you, I must admit I was considering asking about changing to another type. I used to find the gel and tablets good when I was on sequential, so maybe that's something to consider.

Just to pick up on this, Evorel conti provides a medium dose of estrogen and proportionate progestogen, it is not a low dose. See the decision tree at www.menopausematters.co.uk/tree.php with the various preparations listed according to type

I will take a look at that, thanks very much.