Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: Trixiecat22 on February 04, 2025, 10:27:20 AM
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Hi I'm new to the forum. I have been taking Evorel Conti for just over 6 months. The main issues were period like cramps and bleeding, but then it all seemed to settle down and for 8 weeks I had no bleeding, just the odd cramp every now and again. However in the past week and each time on the day I change my patch I have seen a litte but of blood and then nothing until the day I change my patch again. Does anyone have any advice? Is this common? I am just on the verge of reporting this to gp but would appreciate your thoughts. The hrt has improved my vaginal atrophy symptoms so I am loath to come of the patches.
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Hi welcome to the forum.
Were you post menopausal ( 12 months without a period ) before you started on Evorel Conti ?
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Hello, yes I am in my 60s and last had a period over 10 years ago. My reason for trying hrt patches was diagnosed vaginal atrophy/dryness and i also have lichen sclerosus, which adds to the issue.
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Do you also use vagifem or estriol cream as these are usually prescribed for vaginal atrophy.
I use both of the above plus a patch (for other menopausal symptoms).
I used evorel conti for a few years but had frequent bouts of unexplained bleeding. No problems were found so I finally swapped to a Mirena last March and have been bleed free since. Many women on here have continued to experience bleeding with evorel conti with no underlying cause found. Many are fine with it too.
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I tried Evorel Conti as the first HRT to be offered to me, despite 15 months bleed free before starting it made me bleed a lot.
It sounds like you are getting either less or more on the days you change the patch and that is making you bleed a little on that day.
A patch still delivers it's medicine after it is removed, it stays in the subcutaneous tissue a while, but similarly when a new patch is applied it takes a while to sink into the skin and start it's work.
Usually those two delays cancel each other out so you get a reasonably steady stream of the medicine.
I'd guess one of your delays is bigger than the other, leading to less or more on patch change days and some bleeding as a result.
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Cheers everyone for your replies, Flo69 - that sounds a real solution.
Yes I do use Estriol alongside the patches and it has given relief, but with urinary symptoms mostly. I am wondering whether to try Vagifem vaginal tablets instead of the Estriol and then use these to replace the patches. Has anyone had success with these for VA, mine is quite severe so the question is would the Vagifem dose be sufficient treatment without the Evorel Conti patches?
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I would consider changing the progestogen rather than forgoing the benefits of systemic estrogen.
Micronised progesterone is the obvious choice alongside an estrogen only patch.
Also how well are your patches sticking? If it is hanging on by a thread by day 3 it won't be delivering anywhere near the intended dose, and unstable levels are likely to increase the chance of bleeding.
You can use whatever vaginal estrogen you need to in addition to a patch if required and should not be made to feel that it's either or.
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The first line treatment for VA/GSM is vaginal oestrogen.
Here's a direct quote from Dr Currie from another thread
For vaginal and bladder symptoms, vaginal estrogen should be the focus as stated. There are a range of different types and it is usually possible to find one that suits, and it can take several months, as Ayesha explains, to have the full effect. Increasing patches at this stage is unlikely to help and is more likely to cause side effects.
Great advice is to ask for a longer appointment either with a GP or Nurse Practitioner.
Hope this helps.
How often are you using the Estriol? Are you using it internally as well as externally? It may be that if you are only using it twice a week as per the patient information leaflet it's not enough for you to control your symptoms.
There are definitely ladies on here who just use vaginal oestrogen to control their va/GSM successfully. Me included. It takes a combination of pessaries and cream for many to feel comfortable again.
Having said that, if you feel that the Everol patches are having a positive effect on other things, it may be worth investigating alternatives.
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Hi, I have been on Evorel Conti since July 2024. I put the patches on my buttocks but have been finding that I have bleeding for about 3 days after applying to the left buttock every time I apply it here, but weirdly not when I put it on the right buttock!
I've checked in putting the patches in roughly the same place on both and can't see an obvious difference in size or fat levels on either buttock.
Any ideas would be welcome. I have a GP appointment booked for 3 weeks from now so will ask them then too.
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That's interesting Juliak, I wonder if the blood supply is better on one side? Or if it's as simple as being closer to a working ovary instead of a non working one? I used to put Evorel Conti patches on my abdomen, until I read on here buttocks work better, they do.
After that I stuck them where they worked best, but like you, I'm a curious person who likes to know why.
I've found nothing more than speculation.
It could be a cool way to control when you bleed or if you bleed at all.