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[Trackie50]

I am back on everol sequi as hot flushes returned on 50 patch just finished thebcinti started the everol 50 yesterday. I spoke to my gp who said to try two patches upto 100 without any blood test is this ok to do? I read horror stories of to much eostrogen and what it can do? Please someone advise me afrer putting the second set of everol 50 patches on im having an end to my period yesterday but sore boobs again aching joints headache and nausea should i increase or not

[sheila99]

50 to 100 is a big jump, it would be better to halve the second patch to give you 75.

[bombsh3ll]

Absolutely you can use a patch and a half.

However if you are using one and a half patches especially with sequi this could start to become a pain if it leads to you running out of estrogen alone patches too soon or mixing and matching an estradiol only with half a combined patch etc and getting thrown out of step if you don't have an adequate supply.

There is no clinical indication for a blood test in this situation - if 50mcg is too low, you increase it, but only by the amount you are comfortable with.

You may be better off with 75mcg estradiol patch and a separate progestogen. This would give you more choice and flexibility.

[Trackie50]

Thankyou for the advice so you think cut a patch in half and use 75 at first? Also do i do the same with the everol conti when ita time to switch to those? 75? I thought 100 was a big leap but he suggested it said patches shouldnt be cut?

[bombsh3ll]

The old reservoir patches couldn't be cut but they have been matrix patches for many years now which are well suited to cutting as it allows a customisable dose.

It is just trickier when using sequential patches as not every patch is the same, so you will need to find 7 extra estradiol patches and 7 extra combined patches and do one and a half estradiol for 14 days then one and a half combined for the next 14 days.

There are actually far better options than this unless norethisterone is the only progestin you tolerate.

Also is there a reason you feel you need to spend every 4th week bleeding, because if you are close to or past menopause, you could either use the continuous combined patches which at least are all identical if cutting them, or if not then there are other oral progestins that could have you bleed free regardless of menopause stage, alongside a 75mcg patch that you wouldn't have to mess about with.

[Trackie50]

Thanks i am 50 and still having periods or is this because of the sequi? I suffer pretty bad when i tried utrogestan and a little with conti on th sequi but not as bad so i stick to this. Am i only still bleeding because im using sequential hrt sorry im not clued up on menopause and my go isnt the greatest either

[bombsh3ll]

You have no way of knowing unless you were to stop the HRT and see if you continued to menstruate.

However this is far less important than most people think and certainly not worth interrupting beneficial treatment to find out.

Having just the regular artificial withdrawal bleeds without any other bleeding is a clue that you are probably at or close to menopause, as sequential HRT in earlier perimenopause tends to end up with more chaotic bleeding as they have the withdrawal bleeds plus their own menstrual period as well, as the two don't always line up given the artificial bleeds are fixed and the menstrual period increasingly variable.

[Trackie50]

Thankyou most helpful nore than my gp sadly