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[meno lesley]

I have reduced my patch of Everol
 50 from twice a week to once. I’ve continued with the Utrogestan 100 but have stomach issues and wondering how I cut down on the Utrogestan? Has anyone any info at all about this? Many thanks

[bombsh3ll]

I would advise against changing your patch weekly (if anyone can even keep a patch on that long) as it will be delivering nothing by the last couple of days, resulting in unstable estradiol levels.

If you have a reason for wanting to reduce your estradiol dose, and progesterone intolerance especially having only ever tried one option is not a good one, then you would be better using half a patch and changing it at the appropriate frequency.

Regarding the utrogestan, this depends what you want to achieve going forward.

If it is causing GI problems I would first think about using it vaginally.

The recommended dose within the NHS is still 100mg daily even if you are only on 25mcg of estradiol.

If you are intending to wean down and come off the hormone therapy completely, again foregoing the long term health benefits should only be considered for a good reason, but if this is your informed choice then you can just ditch the progesterone and taper the estradiol over several weeks.

Endometrial hyperplasia develops over years of unopposed, therapeutically dosed estrogen, not a few weeks.

If you cannot tolerate micronised progesterone either oral or vaginal, then there are multiple other progestogens available as well as tibolone. Nobody needs to lose their estrogen for this reason.

[sheila99]

If your aim is to stop hrt altogether you can just go cold turkey. If your symptoms are going to come back they'll do it whichever way you go. Newson used to advocate utro every other day so presumably you could wean down this way. Your stomach issues should go if you use utro vaginally. I too think you should use half a patch, there's no point having oestrogen for 4 days then nothing for the other 3.

[meno lesley]

Many thanks for your reply, my gp
wanted me to reduce hrt due to my age (67) and told me to use one patch a week! I’m floundering around not knowing what I’m doing. It frightens me to stop HRT altogether as was in such a mess with anxiety and all sorts before I became settled on Everol 50 and utrogestan.

[sheila99]

In that case I would use half a patch and go back up to a full patch as soon as your symptoms return. There is now no age on hrt (see the NICE guidelines) so you can stay on it as long as you need to.

[bombsh3ll]

I would change your doctor not your treatment.

[chopsuey]

Agree with bombsh3ll. Evorel 50 is not a high dose product. If you reduce this, it may drop your oestradiol levels below the level needed for bone protection. If you are settled on this regime, there is no reason at all to reduce this, purely on an age basis. The fact that the GP thinks keeping a patch on for a week, when it has been designed to be changed twice a week, in order to give a steady delivery of hormones, just shows their ignorance about these matters. If they wanted you to halve the dose, they should have prescribed Evorel 25.

[meno lesley]

Many thanks for all your replies. I’m feeling a bit annoyed about such poor advice from my gp. The doctor I had for my annual review was next to useless and didn’t know anything about HRT. I’m going to try to get an appointment with a menopause specialist as there is now one in our area.