Menopause Matters Forum
Menopause Discussion => Personal Experiences => Topic started by: Katejo on August 04, 2020, 03:19:16 PM
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Hello All
I started Evorel Conti half patches in April 2019. Benefits were initially limited so I moved to full patches in June which worked better. However the bleeding started in September and has continued since then. It gradually reduced over time but is showing no sign of stopping and I get period style pains with it. A hysteroscopy found nothing wrong but I have had enough of the bleeding.
I want to try reducing down to half patches again to see if that stops the bleeding but I am not sure how it will work. I did apply a half instead of a full patch a couple of days ago but the bleeding reappeared by the following day so I added the other half patch.
Has anyone managed to reduce bleeding by using half patches? Did you get bleeding to start with which then stopped?
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will be watching this thread with interest, as i also have had bleeding with evorel conti, but heavy bleeding, dr changed me to evorel sequi but bleeding is so heavy with dreadful period pains, which i didnt think i would have at 56 years of age, as i was period free before starting this!!!! be interested to see your replies.
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https://www.menopausematters.co.uk/stopping.php
Just found this on this site
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https://www.menopausematters.co.uk/stopping.php
Just found this on this site
Yes I have read this in the past. I don't want to stop the patches completely but just want to see if reducing to half patches will stop the bleeding.
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Also interested in hearing about this. Hopefully there's some women out there who have had success with this.
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Hi katejo - sorry to hear about your ongoing bleeding on Evorel conti. What were the results of your hysteroscopy ie what was the womb lining measurement? Unfortunately some women never settle on continuous combined HRT and choose to change to cyclical so that the bleed is predictable. Is this something you can consider? Another possibility is a Mirena coil but that might be overkill - and it depends on the amount of bleeding and what your womb lining was like?
Hurdity x
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Hi katejo - sorry to hear about your ongoing bleeding on Evorel conti. What were the results of your hysteroscopy ie what was the womb lining measurement? Unfortunately some women never settle on continuous combined HRT and choose to change to cyclical so that the bleed is predictable. Is this something you can consider? Another possibility is a Mirena coil but that might be overkill - and it depends on the amount of bleeding and what your womb lining was like?
Hurdity x
My womb lining was only 5.5mm . No fibroids or polyps. No biopsy taken in the end because the lining found was 'scanty' as the consultant described it. I was offered a Mirena but I really don't like the idea of that at all so I said no. My bleeding is already pretty regular once a month without a change to cyclical. I just want to know whether the bleeding might stop if I drop back to half patches. Not sure how to go about trying it.
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Hi Katejo, just wondered how you got on, did you go to half patches??????
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Hi
I've been on Evorel Conti for four years and been okay with it, apart from having a polyp and bleeding for three months last year.
All seems fine now.
Hope you are ok Katejo.
Xx. Vicky
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Hi Vickypk are you still taking evorel conti and did they think the bleeding and polyp was related to it at all?
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Hi Katejo, just wondered how you got on, did you go to half patches??????
I haven't got any further. I applied 1 half patch and immediately got a tiny bleed the following day so added the 2nd half of the patch and haven't tried again yet. Think I will wait another month or 2 before testing it again.
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Also interested in hearing about this. Hopefully there's some women out there who have had success with this.
I have just heard that I have an unexpected phone call appointment with the meno clinic next week. They have moved a hospital appt (which I didn't even know about!) from later in the year to now. I am going to make a point of asking (if I can) about the continued bleeding with Evorel Conti/reducing to half patches. I will report back afterwards.
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Also interested in hearing about this. Hopefully there's some women out there who have had success with this.
I have just heard that I have an unexpected phone call appointment with the meno clinic next week. They have moved a hospital appt (which I didn't even know about!) from later in the year to now. I am going to make a point of asking (if I can) about the continued bleeding with Evorel Conti/reducing to half patches. I will report back afterwards.
Look forward to hearing what they say
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Hi shrosphirelass
No they didn't think the polyp was connected to the Evorel Conti. They just said it was okay to continue using it
Hope all is fine with you xx
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Also interested in hearing about this. Hopefully there's some women out there who have had success with this.
I have just heard that I have an unexpected phone call appointment with the meno clinic next week. They have moved a hospital appt (which I didn't even know about!) from later in the year to now. I am going to make a point of asking (if I can) about the continued bleeding with Evorel Conti/reducing to half patches. I will report back afterwards.
Look forward to hearing what they say
I had the call this morning. I told her that I had cautiously tried with one half patch but got a tiny bleed the next day so had stopped. Her view was as follows:
She thinks that this would be a good idea to try but persevere a bit longer with half patches, perhaps 3-4 months to see if it stops. If I do get more bleeding, I should continue for a while unless it becomes continuous for a week or more or I find that the VA symptoms become worse despite using Vagifem as often as i need it. She thinks that the tiny bleed could have been a coincidence.
She mentioned the possibility of a Mirena coil again but I am really not keen. I don't want another general anaesthetic which I would need to have it inserted. I also don't like the idea of something in me which I can't remove myself (lack of control for me) and I have read of women having bleeding with that too.
A third point she made was that if the bleeding were to continue much longer, I would have to have the hysteroscopy repeated even though my layer was only 5.5 mm and they failed to get a biopsy at the 1st attempt. I said that I regretted having the first one. I have had recurrent cystitis episodes since that was done and I suspect that there is a connection. I have a follow up urogynaecology appt. in November and intend to ask about the cystitis. It usually responds to bicarb of soda and water but comes back a few weeks later.
I applied just a half patch this morning so will see how that goes and report back. Please let me know if you decide to try it.
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Katejo sounds similar response to the one I got, except to try provera rather than the coil if the half patches didn't work. I hope they do work for you and also don't increase other symptoms. Ive been bleed free for 10 days , but I'm not holding my breath. Lert us know how you get on and good luck.
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Katejo sounds similar response to the one I got, except to try provera rather than the coil if the half patches didn't work. I hope they do work for you and also don't increase other symptoms. Ive been bleed free for 10 days , but I'm not holding my breath. Lert us know how you get on and good luck.
What exactly is Provera ? Have heard the name but don't know anything about it. Applied 1st half patch yesterday. No bleed yet.
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Its a progesterone in tablet form. SO would have to take it along side a oestrogen patch or gel. Apparently its supposed to be good at contolling bleeding but some people get unwanted side effects!
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Its a progesterone in tablet form. SO would have to take it along side a oestrogen patch or gel. Apparently its supposed to be good at contolling bleeding but some people get unwanted side effects!
OK thanks. The consultant avoided tablets with me because of other medication I take and possible interaction in the liver. I also wanted to avoid tablets.
Let's hope that the reduction to half patches works. Still no bleed so far.
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Katejo sounds similar response to the one I got, except to try provera rather than the coil if the half patches didn't work. I hope they do work for you and also don't increase other symptoms. Ive been bleed free for 10 days , but I'm not holding my breath. Lert us know how you get on and good luck.
Hi Shropshirelass Are you still bleed free now? I have been so far (almost 3 weeks so I need to wait a little longer to be sure).
Katejo
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Hi Katejo, I've been digging into patches and gels before I decide which one I might end up with (have serious allergy and anaphylaxis issues) and Theramex has been very helpful replying to all my enquiries. They've sent me a letter advising NOT to cut Evorel patches, particularly the combo ones (with norethisterone), because the two hormones might not be equally distributed over the patch surface. Maybe this could explain why you've been bleeding for so long?
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Hi FrannyB, I'm copying/pasting their reply, but I'm not sure I can do this on a public forum.
Evorel® Conti (estradiol hemihydrate & norethisterone acetate) - Cutting the
Patch
The Summary of Product Characteristics (SPC) is a more detailed document than
the Patient Information Leaflet (PIL), and is primarily written for healthcare
professionals.
The Summary of Product Characteristics (SmPC) for the Evorel range does not
make any recommendations about cutting the patch.
Evorel transdermal patches use a matrix system, which is translucent or transparent.
There is no guarantee that the hormones in the Evorel range transdermal patches
are distributed evenly throughout the patch.
Transdermal systems may be altered in both absorption and efficacy if patches are
cut, potentially putting a patient at risk.
In the absence of available efficacy and safety data, cutting of Evorel range patches
is outside the terms of the product licence, and any such use would be the
responsibility of the prescriber.
However, Doctors sometimes prescribe off-licence doses to those recommended on
the Patient Information Leaflet or Summary of Product Characteristics, as doctors
are able to make an informed decision based on your medical history. We would
therefore suggest that you discuss this matter further with your doctor.
REFERENCES
1. Evorel Conti SPC (October 2019)
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Hi Katejo, I've been digging into patches and gels before I decide which one I might end up with (have serious allergy and anaphylaxis issues) and Theramex has been very helpful replying to all my enquiries. They've sent me a letter advising NOT to cut Evorel patches, particularly the combo ones (with norethisterone), because the two hormones might not be equally distributed over the patch surface. Maybe this could explain why you've been bleeding for so long?
I doubt it. I was only on half patches for a couple of months at the start. No bleeding until I was on full patches. I was specifically prescribed half patches by an NHS meno clinic not a GP.
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I was also advised to sct in half by the menopause clinic. Katejo I have had very slight spotting, hardly anything so an improvement. Long may it last for us both!
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can i just ask is this the conti patches your cutting in half...... just wondering if that would work for me, as given up on sequi and now trying conti again!!!!
I have managed to get a telephone call with GP at the end of the week so just need to decide what to ask for!!!!!! whether to stick with conti or try gel and ultro again but ultro last time upset my stomach taking orally........ dont want to take pills if i can help it prefer transdermal..... its a pity there is no stock of an alternative conti patch.....
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can i just ask is this the conti patches your cutting in half...... just wondering if that would work for me, as given up on sequi and now trying conti again!!!!
I have managed to get a telephone call with GP at the end of the week so just need to decide what to ask for!!!!!! whether to stick with conti or try gel and ultro again but ultro last time upset my stomach taking orally........ dont want to take pills if i can help it prefer transdermal..... its a pity there is no stock of an alternative conti patch.....
Yes it is.
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I see you've been cutting Evorel patches under your doctor's supervision, but I don't think doctors know better than manufacturers and scientists. There are many different types of matrix patches, as you can see on the world's leader transdermal therapeutic systems manufacturer, LTS Lohmann, which by the way was the original manufacturer of Evorel patches.
https://ltslohmann.de/en/technology/transdermal-therapeutic-systems/
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I was also advised to sct in half by the menopause clinic. Katejo I have had very slight spotting, hardly anything so an improvement. Long may it last for us both!
Hi Shropshire Lass
Just a quick update here: After doing half patches for about 2 months (up to approx early October), I cautiously moved back to full patches as a test. I haven't had any bleeding so far. How are you getting on?
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Hi Katejo, I was wondering how you were getting on. I have been bleeding for the last two weeks and its getting quite heavy and I'm generally feeling pretty rubbish (headachey, stomach problems and nausea so I don't know if my natural hormones are kicking in). I had a scan a few weeks ago and the lining was 4mm but they thought there may be a polyps but weren't sure without a hysteroscopy. I negotiated a wait and see appraoch given Covid and have a scan booked for 6 months. If things haven't improved I guess Ill have to have the hysteroscopy and biopsy under GA. I am a bit worried about the bleeding and am concerned I'll get anemic again. How were you symptom wise when you had the half patches?
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well i stopped the patches for a month but VA was awful, so stuck them back on thought i was doing great as went from 6th Aug to end Oct no bleeding but now been on for two weeks!!!!!
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well i stopped the patches for a month but VA was awful, so stuck them back on thought i was doing great as went from 6th Aug to end Oct no bleeding but now been on for two weeks!!!!!
Have you tried half patches at all? My bleeding stopped for those 2 months. If I get more bleeding with full, I will go back to halves again.
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i havent tried half yet
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Hi Katejo, I was wondering how you were getting on. I have been bleeding for the last two weeks and its getting quite heavy and I'm generally feeling pretty rubbish (headachey, stomach problems and nausea so I don't know if my natural hormones are kicking in). I had a scan a few weeks ago and the lining was 4mm but they thought there may be a polyps but weren't sure without a hysteroscopy. I negotiated a wait and see appraoch given Covid and have a scan booked for 6 months. If things haven't improved I guess Ill have to have the hysteroscopy and biopsy under GA. I am a bit worried about the bleeding and am concerned I'll get anemic again. How were you symptom wise when you had the half patches?
Hi Shropshirelass Sorry for not replying more quickly. I did see your reply but was only on my phone (not ideal for a longer reply). Really sorry to hear about the heavy bleeding. Am i right in thinking that your periods hadn't yet stopped or had stopped very recently when you started the patches? I am a bit surprised that they have allowed you to postpone any further hysteroscopy for 6 months. At the hospital which saw me, they insist that ALL bleeding must be investigated. Even though I had had a hysteroscopy in May and nothing had been found (scanty lining so no biopsy), the doctor started talking about the need for another hysteroscopy when I still had a tiny bit of bleeding during June to August. That is what made me try half patches again.
When I first started Evorel Conti, I was already 4-5 years post period so I knew it couldn't be natural menstruation.
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Hi Katejo, I was wondering how you were getting on. I have been bleeding for the last two weeks and its getting quite heavy and I'm generally feeling pretty rubbish (headachey, stomach problems and nausea so I don't know if my natural hormones are kicking in). I had a scan a few weeks ago and the lining was 4mm but they thought there may be a polyps but weren't sure without a hysteroscopy. I negotiated a wait and see appraoch given Covid and have a scan booked for 6 months. If things haven't improved I guess Ill have to have the hysteroscopy and biopsy under GA. I am a bit worried about the bleeding and am concerned I'll get anemic again. How were you symptom wise when you had the half patches?
Hi shropshire Lass Here is a mini update. Just as I thought I was doing well (no bleeding since early October on full patches) I woke during last night with a period like pain and , by the morning, had a tiny bit of bleeding. It had stopped by later in the morning. i am hoping that it was just caused by me forgetting to apply the new patch on Sunday. I had taken the old one off in the morning but didn't apply the new one until the evening. Otherwise it would have continued for longer. I have had a flare up of cystitis burning at the same time. I have just managed to persuade the nurse at my practice to give me a form for a urine test. If the symptoms don't clear in the next day or so, I will get a test done as a precaution but it is probably just the VA flaring up.
I have a follow up meno clinic appt. this month but, unfortunately phone call only.
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HI Katejo, I think it probably is likely it was the delay in patch change. Ive found any gaps can be a trigger for me too. I think some people must be more sensitive to hormonal fluctuations than others, which produces bleeding. Just a theory. Ive had a week with no bleeding and feeling good but woke this morning with a pounding headache and stomach cramps and had spotting again. Feeling rubbish and bleeding seem to go together for me so I'm guessing its hormonal rather than a physical problem. Let me know how you get on with your appt, good luck with that and I hope the cystitis settles, its trully horrible.
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HI Katejo, I think it probably is likely it was the delay in patch change. Ive found any gaps can be a trigger for me too. I think some people must be more sensitive to hormonal fluctuations than others, which produces bleeding. Just a theory. Ive had a week with no bleeding and feeling good but woke this morning with a pounding headache and stomach cramps and had spotting again. Feeling rubbish and bleeding seem to go together for me so I'm guessing its hormonal rather than a physical problem. Let me know how you get on with your appt, good luck with that and I hope the cystitis settles, its trully horrible.
Hi Shropshirelass Sorry to hear about the pounding headache and stomach cramps. My bleeding was minimal but I also got a period style pain which still hadn't quite cleared yesterday. I also still had slight cystitis symptoms. I managed to get a urine test done but won't hear until next week. Eventually decided to take my back up/rescue supply of Trimethroprim. It expires this month anyway so I can't keep it any longer. Things are slightly better today so perhaps it is helping.
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Hi Katejo
I have replied to your post on my thread via Shropshire lass. But just about your spotting and forgetting a patch.
My first slight spotting with conti ( before it became more of a problem) was when I forgot to change my patch. As soon as I remembered and stuck a new one on it went away.
Other bleeding issues have not been caused by forgetting patches. But I think you are right and some of us may be very sensitive even to very slight changes in hormones. This is leading me to speculate about absorption issues causing my bleeds and even where the patch is stuck on. Apparently hormones are absorbed better in some places more than others so if I have been switching sites too readily... who knows.
I hope your bleeding has stopped- it is very disconcerting isnt it?
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Hi Katejo
I have replied to your post on my thread via Shropshire lass. But just about your spotting and forgetting a patch.
My first slight spotting with conti ( before it became more of a problem) was when I forgot to change my patch. As soon as I remembered and stuck a new one on it went away.
Other bleeding issues have not been caused by forgetting patches. But I think you are right and some of us may be very sensitive even to very slight changes in hormones. This is leading me to speculate about absorption issues causing my bleeds and even where the patch is stuck on. Apparently hormones are absorbed better in some places more than others so if I have been switching sites too readily... who knows.
I hope your bleeding has stopped- it is very disconcerting isnt it?
Yes I have attributed that bleed to a delayed application of the new patch. It was a tiny dribble and lasted only a few hours. Nothing since then. I haven't noticed any problems with absorption/position of patch.
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Hi Katejo
I have replied to your post on my thread via Shropshire lass. But just about your spotting and forgetting a patch.
My first slight spotting with conti ( before it became more of a problem) was when I forgot to change my patch. As soon as I remembered and stuck a new one on it went away.
Other bleeding issues have not been caused by forgetting patches. But I think you are right and some of us may be very sensitive even to very slight changes in hormones. This is leading me to speculate about absorption issues causing my bleeds and even where the patch is stuck on. Apparently hormones are absorbed better in some places more than others so if I have been switching sites too readily... who knows.
I hope your bleeding has stopped- it is very disconcerting isnt it?
Yes I have attributed that bleed to a delayed application of the new patch. It was a tiny dribble and lasted only a few hours. Nothing since then. I haven't noticed any problems with absorption/position of patch.
Hi, I know this is old, but how did you get on with half patch in the end? I’ve been bleeding on a full patch with mirena and extra progesterone.. wonder if I should cut mine in half?