Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: pebbles on August 09, 2018, 07:58:21 PM
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I am 55 and my last period was a few weeks ago. Last one before that was Dec 17.
My GP prescribed Evorel conti patches however i have just looked at the information leaflet and it says that to use it you should not have had a period for 18 months ?
Does anyone know is this ok to use ?
Many thanks
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Hi pebbles
I noticed this on your other post. I think - and hopefully someone will correct me if I'm wrong - that you should be on Evorel sequi as you are still having natural periods. Albeit not regular. You need to be a full year past your last period to take a conti HRT.
Phone your GP.
J xx
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Hi pebbles - you are right to question this - you need a sequential hrt.
Also the patches are medium dose and I always think it is better to start on a low dose - so don't give the body too big a hit of hormones straight off. Why not ask for Femoston 1/10 sequi ?
If you really want a transdermal hrt then you could ask for separate oestrogen(as gel or patch )and progesterone pills (Utrogestan or Provera) that you take for 12 days each month but this regime can be a bit of a hassle. Femoston 1/10 May be a good first option as it's easier to pop one pill a day. DG x
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It's also good to start with a cyclical HRT anyway so that you can see how you get on with the progestogen phase of the cycle - and then switch to continuous combined in your case after about a year - if you prefer to try the no-bleed type.
I started on medium dose patch - Evorel sequi when I first started HRT in late peri-menopause (previous period 5 months earlier but one before that several months earlier) at age almost 54 - and was fine with that - and have mostly only ever been on (approx) this dose of oestrogen (50 mcg patch) for the past 11 + years on HRT.
As the others say you should be on the sequi version, and perhaps as Dancinggirl suggests you could start on a lower dose - so half a patch for the first few weeks and see how you get on - although you may well be fine with it as you may be late peri by now - depending what your periods were doing before December?
Hurdity x
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thanks for your replies. this is just what I don't need as it is so difficult to actually see a doctor. It is not possible to get an appointment for a day that suits, you have to phone at 08.30 tell receptionist what is wrong and then doctor phones you back. this plays havoc if i am at work as you don't know when they are going to phone. they will then offer you an appointment but i might be at work by then which is 40 minutes away. I am just so disappointed that she has got it wrong.
In 2017 i had four periods and this year so far I have had one.
should I just use half a patch ? do you just cut it in half? Dr has prescribed two patches per week.
what are the risks of continuing with it as it is?
agh !
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pebbles - I really wouldn't use the patches you have been given - you may end up with erratic bleeding and, as Hurdity has pointed out, starting with a conti HRt is not the best idea anyway. So sorry to hear your have a surgery that has such a complicated appointment system. Could you simply write a letter and hand it in? DG x
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ok I will take it off. Thanks for your advice, i so dont want eratic bleeding.
I am so disappointed as it took me so long to decide to go for it.
thanks again
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I think I would phone and ask to speak to the practice manager. Explain that the GP has given you incorrect medication, and that you need it corrected immediately. Hopefully that should get them moving. :)
I had to speak to the PM at my surgery after a GP had told me I didn't need progesterone with oestrogel as it was "only transdermal" I knew better than that.
Not easy to do this sort of thing when you feel crap, but take a deep breath, be strong and do it! Don't give up, because once you have the right hrt I'm sure things will improve. Good luck.
Jane x
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Thank you for replies , I wonder if anyone could have a look at this site.
It is the nhs nice guidelines for hrt.
www.gah.nhs.uk
Am I right in understanding that as long as you are 54 you can have Evorel Conti ?
This contradicts instruction leaflet grr ???
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Hi the guidelines do state that you can have continuous hrt after 54 or 12 months after your last period. I think the age guidance is for ladies who have been taking hrt and so don't know if they are post menopause or not. They work on the idea that most ladies are post meno at 54 but that is not always the case.
You can try the Evorel Conti patches. They won't hurt you but you may find that you get breakthrough bleeding if your body is not ready for a continuous hrt. You may find that this bleeding will settle down . Breakthrough bleeding can happen in first 6 mo this of any new hrt.
Give them a try and see how you feel.
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Thank you so much for your post .
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Pebbles, the same thing happened to me. I rang the surgery and said I had been prescribed the wrong thing. The GP rang me back very apologetic and issued a new prescription for sequi I picked up from the surgery the same day. You shouldn't have to wait for an appointment. I tend to believe the info issued by the drug company as they should know. I was 57 & in peri.
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I personally think it is better to start on a sequential hrt if you are Peri meno at any age. Erratic or problematic bleeding can be such a nuisance and this is more likely to happen if you are still producing some oestegn yourself. DG x
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Hi everyone , thanks for your messages . I know it is early days but I am feeling a bit better. There is a small shift in my mood. So far I have not had any side effects - no bleeding although do feel a bit bloated and like I have put Weight on . However I just want to continue with Everol conti , will it do me any harm do you know ? Thanks again everyone
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Hi Pebbles ..... Evorel Conti won't harm you. Am I right that you were 11 months without a period when you started it? You might get some breakthrough bleeding in the first 6 months and then hopefully it will settle. If your body isn't ready for a continuous hrt then the bleeding may continue past 6 months and then you may have to decide to try a different one or try Sequi hrt.
There are lots of women happily using Evorel Conti x
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In your original post you say your last period was a few weeks ago so you wll be in peri and are not yet in menopause. The conti patient information states it is for women who have not had a bleed for at least a year (menopause not peri). Personally I wouldn't go against the manufacturer's instructions as it will have been tested and licenced only for the stated group. Why are you so against everol sequi which is designed for women in peri? I don't know the consequences of using the wrong one but I would guess at a build up of the womb lining. If you do carry on with conti perhaps it would be wise to have the thickness of the lining checked periodically. Using sequi has the advantage that you will know if the progesterone in it doesn't agree with you as you will only be on it for 2 weeks.
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thank you everyone. I am not against using sequi it is just that it is so do difficult to get to see a gp ! In addition it was difficult to get hrt in the first place as she said that it was not effective with low mood/anxiety etc which are my main symptoms. I lack confidence in questioning their decision but I told her that the flushes were disturbing my sleep which is not true so that she would prescribe it ....
I have started to have problems with the conti in that I have been bleeding heavily for three days and I feel quite jittery (almost like I have had too much caffeine when i havnt !).
I am under so much stress just now that the thought of contacting my gp just fills me with dread. I have also been awake all night with anxiety, worrying about work again and just feeling I cant cope.
starting to think that it is not worth being on anything! initially I did seem to feel better but so cant tell what is going on. I am so tired of being so unbalanced. I look forward to the weekend but just sitting here like a zombie with no motivation to do anything. should I take the conti patch off? I am just so confused i dont know what to do.
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pebbles - what a shame you weren't given a sequential HRT. I suspect the conti HRT is causing the heavy bleeding( it often happens even if one is very post menopause) but if you are peri meno then bleeding is more likely. Using progesterone all the time is also not easy to cope with for many women.
If anxiety and low mood are your only meno symptom and these have only happened since the menopause started (so you didn't used to suffer with anxiety and low mood before), then at this stage I would stop the HRT and let things settle - you can do without the erratic bleeding for a start, as this just adds to your problems.
It seems to me as though you need help to cope with all the stress going on - I know how overwhelming things can get and frankly one has to just draw a line, ask for help and if the help isn't forthcoming then just say NO to anything you find too much and isn't essential. So many women are used to looking after everyone else, taking the strain and if you have to work as well, then 'something has to give'.
It's not easy but paring down your life and only doing what is absolutely necessary can be a very good thing - don't jump to help others - put yourself first.
Do you have a friend you can talk to? Could she go to see the doctor with you? Does your husband support you well and LISTEN? If you do see the doctor again, write everything down and take print outs from this site so you get what you want.
Have you tried Mindfulness or relaxation techniques?
HRT doesn't fix everything and whilst it can help with anxiety and low mood, HRT is just part of a range of strategies that will take you forward.
Do try reading the book my GP recommended as I found it very helpful:
Mindfulness: A practical guide to finding peace in a frantic world
by Mark Williams and Dr Danny Penman
DG x
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Your GP is in the wrong here, she has prescribed the wrong HRT as you are in peri not meno. My GP did the same but was VERY quick to rectify it when it was pointed out, I'm sure they know how much trouble they could be in if you chose to report it. You don't need to see your GP again for her to correct her mistake. If reception won't help then ask to speak to the practice manager and explain the situation to her. Tell them you want a prescription suitable for someone in peri which would be a sequi HRT. My symptoms were similar to yours and HRT has made such a difference to me. I know it's hard to make a fuss when your mood is low and you can't be bothered with anything but it really is worth persevering. And if you feel brave enough tell her she is the doctor and ought to know more about than you do, and perhaps she could do with some training!
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thank you Sheila