Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: peacemakerukuk on October 16, 2015, 01:23:28 PM
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Hi all,
I hate making my first post a questions, questions, questions post but I'm desperate so I'm diving in.
I'm 49 and my GP put me on Evorel Conti 50 patches a month ago, I literally put the last patch of the box on last night. So far the only thing the patches have helped with is the hot flushes/night sweats. My mood is still very low / feeling angry / want to cry all the time, feeling tired with no energy and no period for three months. I had until today thought my worst problem now was the mood swings but today I am SOOOO bloated I look 9 months pregnant. I'm not slim at the best of times but this is ridiculous. Today I've spent the bulk of the day crying and feeling so down. I can't get an appointment with my GP until 4th November and I'm going on holiday next week to Corfu so I'm not sure what to do. Question is, should I carry on with the next patch on Sunday and hope the bloating will get better or should I cut now and not start a new box on Sunday? Am I being too previous in wanting to stop the patches, can things get better or is this it? Also I gather I'll get a withdrawal bleed when I put a fresh Conti patch on on Sunday – how bad will this be and how long does it last roughly?
Thank you all for any help you can give me.
Sue
:'(
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Hi and :welcomemm:
I'm not sure you should be on a conti regime if you've only been 3months since a bleed ,hopefully someone with more knowledge will be along soon to help just wanted to say your not on your own now you found us all here.
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Could it be because I had a DVT during my last pregnancy 8 years ago - she didn't want to put me on tablets
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Hi peacemakerukuk
:welcomemm:
Don't apologise - that's not long - you should see some new member's first posts :o
Dazned is right - if you have only just been put onto HRT and you were still having periods you should have been put onto cyclical HRT which causes a withdrawal bleed. You are only supposed to be given conti HRT when you have been 12 months without a period. Nothing to do with tablets - you can still use transdermal HRT (patches or gel). What were your periods doing in the year or so leading up to starting HRT?
The problem for some women with that particular one is that the progestogen (norethisterone) which you need to prevent the womb lining thickening ( from the oestrogen - which helps with the symptoms) is notorious for causing side effects in some women - and you are taking it all the time - which could partly explain your symptoms.
The side effects may settle - it is usually recommended to try an HRT type for 3 months before settling or changing it, but in your cases you may have been given the wrong type anyway - although if you were not post-menopausal and still having a cycle of sorts you would expect more breakthrough bleeding. Perhaps you are near menopause?
If you have been given Evorel conti you will not get a withdrawal bleed. There is often some bleeding or spotting within the first few months and this is more likely as I said above, if you are given this type before you have reached menopause. Most post-menopausal women do not bleed on this HRT after the first 6 months.
The other thing is it could be that the oestrogen dose is not high enough for you to improve your mood, although as it has dealt with hight sweats and flushes this implies it is working.
"Previous"???? Not sure what this means in this context?! Typo??? If you stop now you may well feel worse while you are away as the hormones leave your system so personally I would leave it on - but up to you - only you know how bad you look/feel now and whether you are happy to go on holiday like that!
Hurdity x
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sorry everyone, brain fog - I am on Evorel Sequi. I put the last patch on yesterday from the first box. Its since week 3 I've felt even worse than before with the mood swings, tears, bloating. I think I'm due a bleed on Sunday when I put on a new patch from a new box??? Sorry for the confusion
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me again, when I said previous I meant is it too soon
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Hi again - oh I haven't come across that expression!!!
Ah - Evorel sequi - that explains it! The comments I made about norethisterone still stand - during the third and 4th weeks you are taking the combi patches so could expect pmt symptoms that you describe.
Unfortunately you should still expect "normal" pms when you stop the conti patches ( ie the combi ones that you are using now) as this is part of what happens in a normal menstrual cycle - so you may feel irritable. headachey, tense etc on Mon/Tues and yes you will expect a bleed at some point (usually a day or two after changing back to the oestrogen only patches) and you won't know how heavy it's going to be.
The other alternative is to take the conti patches from the second box for another week (or two) which will delay your bleed. (although you could possibily get some spotting sometime during the week). You might like to speak to your doc about this - but this wouldn't do any harm. Problem is you would have the wrong number of patches as you would then have too many oestrogen only ones and probably wouldn't want to go 4 weeks on these. Your doc might say this is OK though?
You will either have to put up with a bleed or the side effects of the Evorel conti! A few women don't get a bleed though....
Hurdity x
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I don't normally get PMT, I'm pretty even tempered all the time to be honest
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HORMONES >:( ::).
I would have a talk with either your Practice Nurse, GP (who can give you a ring-back) or visit a Pharmacist, most of private rooms. Bloating is awful :( ………. I had it prior to each bleed. It made me asthmatic.
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I managed to get an emergency appointment in the end after crying down the phone. The GP (male) told me to stop taking the HRT patches and has put me on Sertraline 25mg. Don't know how much good they will do but I've got to try something. I've now got the bleeding to worry about which I'm guessing will happen tomorrow
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Sorry to hear this peacemaker - your doc is doing the standard thing of trying to fob you off with ADs after only trying one HRT type! I despair! I have no experience of these but from what others have said there may well be initial side effects anyway which you certainly don't want just before going on holiday on Sunday. If it was me I would change the patch to the oestrogen only one tomorrow (saturday), take all the sanitary protection with you on hol, and fingers crossed you don't get pms or cramping.
Remember whether you stop the HRT completely before you go away, or change to the oestrogen only ones, you may get side effects from the withdrawal of progesterone and a bleed - hopefully the bloating will subside though once you've stopped the combi patches?
You just have my sympathies for having to think about this just when you are going on holiday! Hopefully the sunshine will make it all OK and you will be able to relax!!!
I think a different HRT type is in order for you and at your age you could try Femoston (tablets starting with 1/10 which are well tolerated by many women)
Whatever you decide to do - make sure you enjoy your holiday even if you are not feeling 100 % - try not to dwell on this and sort it out when you get back!
Hurdity x
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I agree! Your GP is treating your symptoms. The most obvious one being 'depressed' because you were crying, not crying because you are frustrated and feeling below par due to HORMONES ::).
I would continue with the HRT without a break - another 1/2 weeks are unlikely to do any harm. Leave taking the AD until I returned [or you won't know if you are flying a bike or riding a kite]!
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I also agree I'm afraid - keep up with the hrt for now and I think your low mood will pass. Every ad I tried made me feel absolutely terrible with out of control anxiety - I definitely wouldn't risk it just before a holiday! Plus you will likely have a return of flushes and sweats if you stop the hrt now xxx
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Thank you all for your replies. When I got back the doctors yesterday I took the patch off I'd put on Thursday. After a lot of thoughts going round and round and around in my head overnight I've come to the same conclusion as you all and have put a patch back on today. I go back on the single hormone one on Sunday (I change mine Sunday's and Thursday) and hopefully things will settle back down again. I did take 25mg Sertraline when I got back from the doctors yesterday but I don't plan on taking anymore. I'll try to struggle on until i see my female GP on 4th. Tampax and ibuprofen are packed. I normally have heavy periods anyway - would it be ok to take the Tranexamic Acid as normal? Why does everything go awry before a holiday??? We fly this evening - me and two children, I can't be feeling unwell / sad for them.
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If required take the Tranexamic Acid? Pack plenty of sanitary protection in case. Let us know how you get on when you are back! Rest, rest, rest ;-)
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Hi all,
I'm back and desparate yet again :-( I'm on week two of pack two now and started bleeding yesterday and not the 2-4 days after the end of the last pack which is weird. Problem is the bleeding is now really heavy and I don't know when to panic. I'm getting through a super tampon every hour and the bleeding is still getting through to the sanitary towel I'm also wearing. I've changed the towel x3 today. It feels absolutely dreadful. Everytime I move I can feel the blood pouring out of me (TMI I know I'm sorry). Thankfully I'm not in pain but this amount of blood is worrying me. Could anyone give me an idea on what I can do. I didn't take the tranexamic acid yesterday because it seemed to be quite mild the bleeding yesterday but overnight its turned into a torrent and if I remember correctly unless you take it as soon as you start bleeding I don't think it does anything????.
Also I've had a return of the night sweats and hot flushes in the mornings which I find bizarre.
Thank you all again for any help/comforting thoughts :-).
Sue
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Try the Tranexamic acid as though it was your first day of the bleed? Visit a Pharmacist once the bleed is under control for advice, they have private rooms now for discussion.
How as Corfu?
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Hi , I was on the evorel sequi patch and like you my mood dropped when I was using the conti patches, my period also got very heavy.
I went to see my GP and he has given me a different patch, he says these patches have different progesterone in them so might suit me better, we shall see, this is my first month on them, he has given me femseven.
I hope you get sorted soon. Hope you had a good holiday.
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Thanks CKLD, thats what I did as soon as I got home. I was stuck at work and ran out of tampons and towels and had to resort to wads of toilet paper :( I'm now really really cold and shaky as if I have flu but I don't :-(
Corfu was lovely thanks and I'm so grateful this didn't start while I was out there or I'd have really panicked.
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Thanks Robotwars. I've got the appointment next Wednesday to see a female GP. I work for a consultant at our local hospital and she's trying to pull in favours for me so that I can see a gynaecologist but unfortunately she only sees NHS patients on a Monday so I've missed this week. I'll see how it is tomorrow and if its still this bad I'll make an emergency appointment at the GP surgery hopefully with a female doctor this time.
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Hormones can cause the chills ………. bleeding heavily can be quite a shock to the system. When I had Taxmoxifen I had cold chills :-\
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So sorry you are having such a rough time. Try not to panic too much about the bleeding or feeling cold and shaky - I've had both and I'm still here! It's an upsetting time and mad hormones bouncing round all over the place don't help. :(
Hope you are able to get an emergency appointment with someone who doesn't think that any distressed female automatically needs ADs!!! Don't let them fob you off with ADs, I can't believe the number of menopausal women who get this treatment - GRRRRR!
Things will get better. You just need to keep trying till you get the solution that works for you. Hugs x
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Feeling very chilled is a common hormonal symptom. I used to be unable to get warm, despite wearing warm clothes and having a throw around my shoulders. I just felt very shaky and chilled to the bone.
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I'm glad to hear its not just me with the coldness. After the cold yesterday evening I spent the whole night absolutely burning hot and woke with a night sweat again. The patches now appear to be doing absolutely nothing apart from making me bleed. The consultant I work with did speak to a gyanecologist for me. She's written me out a prescription for Norethisterone 5mg three times a day. Now I know this hormone is also in the patches I have so I'm too scared to take these tablets too because I don't know if she's aware I'm on Everol Sequi and I'm worried about having too much of this hormone. I am still bleeding though not as much as yesterday. She's told her secretary that if I get a referral letter from my GP she'll see me but to be honest I don't know if its worth seeing a gynaecologist so soon, I'm hoping when I see my GP next week she'll just give me a different patch to try - opinions anyone or should I see a gynaecololgist ?????
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I'm quite confused now.
The Consultant for whom you work has written out a prescription for you :-\. After speaking with a gynaecologist, neither of which have examined you? How much medical history has the Consultant asked for?
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not my consultant, a consultant friend of hers just gave me a prescription to stop the bleeding, not as anything ongoing.
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Without talking to you :-\ directly ………… I'm more confused than ever ::)
See your GP?
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yes without talking to me. I told the doctor I work for, she passed it on to a gynae consultant friend who wrote me the prescription to stop the bleeding. I don't have a GP's appointment until next Wednesday
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So the problem is ………… :-\ I'm not keeping up on this am I ::)
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IShe's written me out a prescription for Norethisterone 5mg three times a day. Now I know this hormone is also in the patches I have so I'm too scared to take these tablets too because I don't know if she's aware I'm on Everol Sequi and I'm worried about having too much of this hormone. I am still bleeding though not as much as yesterday.
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Aaahhhh …….. I'm about as useful as a chocolate fire guard aren't I ::)
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An update - I went to work today, still bleeding, felt okay until someone on the phone called me 'just the secretary', no idea but that started me off crying and I couldn't stop. I came home sick and rang the GP surgery and asked if they had any emergency appointments. She said no but she'd get the duty doctor to ring me. She's called me and I've told her that I'm not coping well and that the patches don't seem to be working anymore, I've literally in the past week gone back to having night sweats and hot flushes during the day plus the low mood. She's basically said `I should have taken the anti depressants I was given last week. She said that as the patches are giving me all these symptoms then HRT obviously isn't for me. She said anti-depressants are a second line treatment in perimenopause and shouldn't be disregarded. She's told me to come in at 4 to see another doctor. Can anymore give me some help on how I should handle it? The original doctor said that if these patches didn't agree with me then not to worry there were lots of other alternatives but all the other doctors I've spoken to/seen don't seem to think the same way as her and I haven't been able to see her again. I'm not hopeful of anything helpful coming out of this I can see :-(
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Bless you, what a horrible time for you.
I don't find my HRT covers my anxiety enough, I need to take Citalopram too and that helps, though I have down days. I also have had days of feeling the chills or burning up, wobbly weak legs as if a bug coming on but wasn't. Often an upset tummy, loss of appetite or nausea too.
Also I didn't find patches helpful, couldn't keep them on so wondered about absorption.
Maybe you just need a differnt type of HRT? Have you thought of Utrogestan tablet and Oestrogel gel, its a combination that suits a lot of women. Theres a thread on here somewhere. I wouldn't give up on the HRT just yet there are many options and don't dismiss an anti anxiety med either even if it's only till you get settled on an HRT that suits. xxx
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Thanks Jedigirl. I think I have slightly less choice in the HRT choice because I had a DVT in pregnancy 8 years ago and I think the GP said I couldn't take a tablet form because of this. I'm happy to try another form of HRT, its the GP's who seem to be against it other than the original GP
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Ask if you can be referred to a menopause clinic, they will be more knowledgeable about what is best for you. Otherwise ask when the original GP is available. Or maybe e mail Dr Curry on this site. There will be more options for you. xx
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I'm pretty sure our hospital doesn't have a menopause clinic. Also with our surgery you can't book in advance with specific doctors you have to ring each day for an appointment. I'll have to see how it goes later I guess.
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There are several types of HRT and sometimes ADs ease some of the symptoms that ladies suffer with.
Patients are now Registered with a Surgery rather than a specific Doctor, would it be possible if you booked on-line? I can get to see the GP I need that way.
Let us know how you get on!
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Hi , just found this on http://www.irishhealth.com/askdoc.html?q=2472
"HRT suitable - history of DVT?
Can you tell me if it is safe for someone who has had a DVT to take hormone replacement treatment by non oral methods such as the patch?
Several studies have shown that HRT (hormone replacement treatment) may marginally increase the risk of DVT (deep venous thrombosis or clot in the leg). It has also been shown that the risk remains the same irrespective of the type or strength of HRT, which answers your particular question about patch treatments. However, a single episode of DVT as a result of pregnancy, surgery or prolonged immobility is not a contraindication to using HRT. If that scenario does not apply and the woman has experienced a DVT for no apparent reason then she should be screened for possible clotting defects before commencing HRT. In that case the risk of DVT needs to be weighed in the balance against the benefits to the patient. If on the other hand if there is a history of repeated DVT or a permanent increased risk of DVT then HRT should be avoided. Therefore the crucial issue in deciding on a woman's suitability for HRT is establishing the circumstances under which the clot occurred. Was it because of a particular situation that created an increased risk of DVT such as surgery or prolonged immobility or did it happen for no apparent reason? A history of DVT is not necessarily a contraindication to having HRT in either the form of a tablet or a patch."I'm not sure I've used the proper way of quoting something but thought it interesting
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ps you can google your nearest menopause clinic and ask to be referred, I did!
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That was really useful thanks Jedigirl
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No probs, let us know how you get on. Good luck xxx
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I'm back. She's put me on Elleste Duet 1mg tablets. I was a bit naughty I didn't mention the DVT. She queried why the original GP put me on patches and I said I didn't know :-\ I took the article with me just in case but I didn't need it. She was a young and inexperienced doctor and she took my list of symptoms with her to speak to another doctor which I'd typed up ready in case I was crying too much to get it out and she came back suggesting these. She also recommended that I took the Sertraline that I was given the other week as well which I'm happy to do. I asked her to do me a referral to the gynaecologist at the hospital I work at and she's said she'll do that too. All in all a positive experience.
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:-X
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Brilliant news! Hope it all works for you.
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Well done you! You can at least take some proactive steps to feeling better now. xxx
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Hi all,
Just thought I'd bring you all up-to-date. I finally got to see my preferred GP today. She has put me on Elleste Duet 2mg from the 1mg and told me to stop taking the Sertraline. I told her I wasn't happy taking them in the first place and that I'd gone on to the Menopause Matters forum and all the other helpful ladies told me to not take it and she agreed. She said she tells her patients to come on here because of the wealth of information :) :) :).
Also I have an appointment on Monday with a gynaecologist who my GP reckons may want me to have the mirena coil to help with my heavy periods but I'm quite weary of it after hearing the horror stories of how painful it is to have inserted. I'm hoping the higher dose of Elleste will sort those out and make them more manageable. I'll got back and see my GP in six weeks.
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Thanks for the update peacemakerukuk
Hope it all works out well for you :)
Hurdity x
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Could you postpone the Gynae appt. or go along and explain where you are in treatment and maybe wait if he/she suggests the Mirena? Don't feel rushed into anything, you could ask for a follow-up appt. with the Gynae in the New Year ;)
Let us know won't you!
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Yet another update - the gynae appointment was a waste of time. She's basically said I should give the Elleste Duet 2mg three months and if I'm still having problems then to make a follow up appointment. Today its been 6 days since stopping the anti-depressant and I've had no problems with that so tonight I'll start taking the 2mg instead of the 1mg Elleste Duet. Hopefully I'll see some change in the next few weeks because the 11 days of 1mg have done nothing. Onwards and upwards :-\