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[dwb]

Hi all

I was diagnosed with POI at 37. Now 42 years.

I’m just about to change over from taking combined contraceptive pill (yasmin) to estradiol patches and progesterone pills. I have everything I need except the very practical advice on how - i would have to wait two weeks for a tel call with my GP for this!

Do I have a break so I bleed and know when to take the progesterone (1st day of cycle)? Or can I switch straight away? If so then when do I take progesterone given I won’t know my cycle yet? Any time in the month?

Any advice from those who have walked this path would be very welcome.

[CLKD]

   what R your periods up to?

Why have is been suggested to change a regime?

Who is overseeing your medication ?  Sometimes GPs aren't aware of the advice which should be given re HRT.

[dwb]

Thanks for the reply.

I have requested it. Having read scientific evidence it seems it would be a better option for POI.

Just need to how to info…

[duffed]

Hi, I have POI and am on HRT. Its pretty much the same for any menopausal woman -  the difference between whether you take continuous or sequential (so having a break for bleeds) depends on whether or not you are still having periods naturally - If they've stopped then you just take it continuously.

My periods stopped and I had over 12 months without them, so I take HRT continuously. I chose this mostly because my partner had a vasectomy so I could be free of contraception and I didn't want to go back to it, but really it makes little difference.

I wouldn't be so sure that HRT is better compared to the contraceptive pill - you are essentially using the same hormones just in different strengths. Things like Mirena are licensed for HRT or contraception so there's a lot of cross over.

Switching can also be more of a headache than its worth and bring up new symptoms that takes a while to settle, so if you aren't currently having any problematic symptoms you might want to think carefully about changing.

As you have POI, its probably worth asking to be referred to a menopause clinic or gynaecologist so they can advise you and check your levels are appropriate.

[duffed]

Oh also-  each time I see my consultant he reminds me its still possible for me to get pregnant, so just be wary of swapping to HRT if this is something you need to consider.

[bombsh3ll]

Just take your last pill one day and apply your first patch the following day. No need to overthink.

Also no need to put up with medically unnecessary withdrawal bleeding unless you want to, either with the pill or with MHT.

I would however second the caution above about MHT not necessarily being superior to the COCP.

All being equal, transdermal 17 beta estradiol is in theory metabolically superior, however in clinical practice many women both with POI and typical age menopause are severely undertreated with hormone therapy.

This can result in both a lower quality of life and increased risk of conditions like osteoporosis.

Additionally women can suffer from more bleeding with MHT particularly if it is prescribed sequentially and if micronised progesterone is used.

Taking the combined pill continuously gets rid of any bleeding that is still occurring naturally and also avoids withdrawal bleeding.

I plan to change from the pill to MHT in my early to mid 50s and will never know what age my natural cycle ceased, unless it hasn't stopped by the time I come off the pill.