Menopause Matters Forum

Menopause Discussion => Personal Experiences => Topic started by: menomope on November 30, 2020, 11:05:28 AM

Title: New member - worried re bleeding and Evorel Conti
Post by: menomope on November 30, 2020, 11:05:28 AM
Hi Everyone. I have read all the posts I can find on this subject but could do with more advice from anyone who has experienced similar. Brief history- I am 57 stated menopause 10 years ago. Didnt take anything for years but suffered with anxiety ( didnt know it was a menopause thing) and VA very badly. Had a scary DEXA so asked Dr if I could go on HRT at least till 60. Put on Evorel Conti in July 2019. All seemed fine and VA cleaerd up. Due to supply issues I switched to Gel and tablets in september 2019. Carried on fine with these but I found the gel inconvenient and messy- waiting for it to dry before I did anything and found it an effort to remember the tablets each night. So I switched back to Evorel Conti in August 2020. first 6 weeks were fine then I started spotting for a few days. Then every two weeks since I get a light bleed for a few days then it stops abruptly. Seemed to be linked to my change over days but not always. My breasts fluctuate in soreness too. Can get very bad and then suddenly stop. I am due an ultrasound scan this wednesday and tbh I am very scared. Advice about bleeding and patches welcome and also your experiences of scans and womb linings welcome. I dont have any females to talk to in my life about this so I feel very alone.Just hubby who is a bit lost.  I just cant understand why this happens on a continuous HRT and so keep thinking it must be something sinister? Please help if you can X  :-\
Title: Re: New member - worried re bleeding and Evorel Conti
Post by: CLKD on November 30, 2020, 11:10:58 AM
Morning.  MayB put the product name/s into the search box on the forum and see what pops up?  Make notes ;-)

Do read the 'bleeding issues' and 'vaginal atrophy' threads too.  Localised HRT is often necessary and really does help with vaginal dryness etc..

 :welcomemm:
Title: Re: New member - worried re bleeding and Evorel Conti
Post by: menomope on November 30, 2020, 11:23:22 AM
Thank CLKD. unfortunately I never get any search results when I use the search bar. For example when I just put in evorel Conti and bleeding just now it just came up with my post- no other posts. I cant be the only one who has ever put Evorel Conti or bleeding in a subject heading. So all I can do is trawl through all the threads looking for similar posts to mine. It would take me many hours, So that is why I decided to post in the hope that someone can reply with their experience.  :(
Title: Re: New member - worried re bleeding and Evorel Conti
Post by: CLKD on November 30, 2020, 01:13:28 PM
I'll give it a go ;-)

Title: Re: New member - worried re bleeding and Evorel Conti
Post by: CLKD on November 30, 2020, 01:16:12 PM
Hi - there are over 20 threads in the 'all things menopause' room. 
Title: Re: New member - worried re bleeding and Evorel Conti
Post by: menomope on November 30, 2020, 01:58:18 PM
Oh thank you - I will go over and take a look. As a newbie I am still finding my way around
Title: Re: New member - worried re bleeding and Evorel Conti
Post by: CLKD on November 30, 2020, 03:34:06 PM
Of course.  Ask away! 
Title: Re: New member - worried re bleeding and Evorel Conti
Post by: Katejo on December 02, 2020, 04:19:58 PM
Hi Everyone. I have read all the posts I can find on this subject but could do with more advice from anyone who has experienced similar. Brief history- I am 57 stated menopause 10 years ago. Didnt take anything for years but suffered with anxiety ( didnt know it was a menopause thing) and VA very badly. Had a scary DEXA so asked Dr if I could go on HRT at least till 60. Put on Evorel Conti in July 2019. All seemed fine and VA cleaerd up. Due to supply issues I switched to Gel and tablets in september 2019. Carried on fine with these but I found the gel inconvenient and messy- waiting for it to dry before I did anything and found it an effort to remember the tablets each night. So I switched back to Evorel Conti in August 2020. first 6 weeks were fine then I started spotting for a few days. Then every two weeks since I get a light bleed for a few days then it stops abruptly. Seemed to be linked to my change over days but not always. My breasts fluctuate in soreness too. Can get very bad and then suddenly stop. I am due an ultrasound scan this wednesday and tbh I am very scared. Advice about bleeding and patches welcome and also your experiences of scans and womb linings welcome. I dont have any females to talk to in my life about this so I feel very alone.Just hubby who is a bit lost.  I just cant understand why this happens on a continuous HRT and so keep thinking it must be something sinister? Please help if you can X  :-\
Hi Menomope  I read your queries during last night but only had my phone on so thought it would be better to reply today. My situation is similar. I am also 57 and first started HRT 18 months ago (about 5 years post meno)  to add to Vagifem for VA and prevent osteoporosis (Dexa scan in 2018 had shown mild osteopenia). I started on half patches (as instructed at the meno clinic) but the benefit was insufficient if any at all so I moved to full patches. 2-3  months later the bleeding started. It behaved just like a monthly period. I was told that this was perfectly normal during the 1st 6 months and not to worry if it happened.
After 6 months, the NHS has a red alert and you have to have scans and maybe a hysteroscopy to check for things like fibroids and cysts if your endometrial lining is 5 mm or more. They may take a biopsy. In practice my layer was so thin (scanty the doctor said) that they couldn't even get a biopsy.
After that my bleeding still continued (but very light) so I tried going back to half patches and it stopped. In early October I tried full patches again and no bleeding until during  last night when I got a tiny bit. 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 but didn't add the new one until the evening.

Have you had your scans today? How did it go?
Title: Re: New member - worried re bleeding and Evorel Conti
Post by: shrosphirelass on December 05, 2020, 07:54:53 PM
Like Katejo I have had bleeding on and off the whole time I have been on evorel conti (10 months) I didn't have any bleeding issues with evorel sequi. I also had a very slightly thickened lining but that has improved, though I have a fibroid and a possible polyps but they don't seem concerend about them. They are concerned about the bleeding and recommend a biopsy, which Im deferring until things imporove with covid. It seems like the bleeding continues for some women on evorel conti with no underlying structural reason for it. I have generally felt much better since being on evorel conti so I'm reluctant to change, but it is really inconvenient and also I always my symptoms always seem worse when I'm bleeding. I'm 58 and am probably menopausal but when I went on HRT 2 years ago I was still having regular periods so its hard to say. I hope your scan went well.
Title: Re: New member - worried re bleeding and Evorel Conti
Post by: menomope on December 07, 2020, 12:21:37 PM
Hi Shropshire Lass and Katejo
thanks for the replies from both of you. I have followed your previous posts where you talk about your experiences of bleeding on Conti. I have not yet had the results of my scan yet so still no idea about lining. Hoping its below the 5mm threshold in which case I will probably discuss switching HRT to what I was on before. If its above 5mm I assume I will be sent off for other investigations and start that journey. I have been reading about absorption over the last few days. It seems where you stick the patch has an effect on absorption. I tend to move mine around ( bottom - thigh- abdomen-hip) and so I wondered if I am getting an irregular absorption from these different sites. So a sudden slight reduction or mixed absorbtion with progesterone is causing a bleed for me.The oestrogen is absorbed well through the skin but not the progesterone - in some women. Maybe me. But of course there is no way of finding out and I may be clutching at straws. But I may take care where I stick the patch and make a note to see if it helps. I have also started to make sure I put a new patch on every 3.5 days so I avoid going to 4 days. Going to see if that makes a difference too.... your thoughts welcome  :)
Title: Re: New member - worried re bleeding and Evorel Conti
Post by: Katejo on December 07, 2020, 03:52:53 PM
Hi Shropshire Lass and Katejo
thanks for the replies from both of you. I have followed your previous posts where you talk about your experiences of bleeding on Conti. I have not yet had the results of my scan yet so still no idea about lining. Hoping its below the 5mm threshold in which case I will probably discuss switching HRT to what I was on before. If its above 5mm I assume I will be sent off for other investigations and start that journey. I have been reading about absorption over the last few days. It seems where you stick the patch has an effect on absorption. I tend to move mine around ( bottom - thigh- abdomen-hip) and so I wondered if I am getting an irregular absorption from these different sites. So a sudden slight reduction or mixed absorbtion with progesterone is causing a bleed for me.The oestrogen is absorbed well through the skin but not the progesterone - in some women. Maybe me. But of course there is no way of finding out and I may be clutching at straws. But I may take care where I stick the patch and make a note to see if it helps. I have also started to make sure I put a new patch on every 3.5 days so I avoid going to 4 days. Going to see if that makes a difference too.... your thoughts welcome  :)
My original scan showed 5.5mm so I was pushed into having a hysteroscopy but, when they did it, it was too scanty (as I said above). I wasn't convinced that it was needed really.
Title: Re: New member - worried re bleeding and Evorel Conti
Post by: shrosphirelass on December 07, 2020, 08:37:24 PM
Re absorption. I put my patches on alternate buttocks, but last year experimented with the top of my thigh. I don't know if it was a coincidence but I felt alot worse, with a return of symptoms so I switched back.
Title: Re: New member - worried re bleeding and Evorel Conti
Post by: menomope on December 08, 2020, 12:14:29 PM
That is very interesting Shropshire Lass. Thanks for the reply. I have been reading about different sites and absorption. Apparently the buttocks or thigh can absorb 20% more hormones from the patch than when placed on areas with less fat. So side of hip ( where I place mine) might absorb less so if I switch from say thigh to side of hip I potentially might lose 20% of hormones which could perhaps cause a bleed due to drop in prog? I am speculating of course but I am going to experiment. Apparently it is advised that we switch sites each patch  but not between areas. So either swop from buttock to buttock or thigh to thigh but not recommended to change areas. I did not know this. Obviously everyone is an individual and our sensitivity to hormones is different too. I dont know but I will stick to top of inside thigh from now on to see if it helps me. I am prepared to try anything to stop these bleeds.
Anyone else have experience on this?
 :)
Title: Re: New member - worried re bleeding and Evorel Conti
Post by: Katejo on December 16, 2020, 09:32:28 PM
That is very interesting Shropshire Lass. Thanks for the reply. I have been reading about different sites and absorption. Apparently the buttocks or thigh can absorb 20% more hormones from the patch than when placed on areas with less fat. So side of hip ( where I place mine) might absorb less so if I switch from say thigh to side of hip I potentially might lose 20% of hormones which could perhaps cause a bleed due to drop in prog? I am speculating of course but I am going to experiment. Apparently it is advised that we switch sites each patch  but not between areas. So either swop from buttock to buttock or thigh to thigh but not recommended to change areas. I did not know this. Obviously everyone is an individual and our sensitivity to hormones is different too. I dont know but I will stick to top of inside thigh from now on to see if it helps me. I am prepared to try anything to stop these bleeds.
Anyone else have experience on this?
 :)
I have been putting mine just above the hip. I did once try the buttock but it didn't stay on. Think I may have had a similar problem on the thigh but might not be remembering that correctly.
Surely a 20% drop would be a drop in progesterone and oestrogen? Not just progesterone.
Title: Re: New member - worried re bleeding and Evorel Conti
Post by: menomope on December 17, 2020, 09:51:54 PM
Hi Katejo
Yes you are right it would be a reduction in both hormones but if some of us dont absorb prog very well in patches maybe it just messes up the balance? I think some of us are more sensitive to others to any fluctuations. When I forgot to change my patch once  I started spotting within a few hours whereas with another woman this may not happen at all or maybe not so quickly.
But I am just trying out different things to find a way through if I can.
Title: Re: New member - worried re bleeding and Evorel Conti
Post by: menomope on January 13, 2021, 05:17:01 PM
Update- thanks for all replies so far- really appreciate other members thoughts
I finally got round to getting my 6 week old TV scan results today. I had not heard from the Doc so had assumed it was all ok- and then it was xmas etc

I actually stopped bleeding after having had 4 x fortnightly three day bleeds. I stopped on the day of my scan and not had any problems with bleeding for 6 weeks. Until today when I have started spotting again which has completely thrown me. I was convinced I had sussed my issue by sticking the patch only on my thighs. So that has blown my theory out of the water!
Anyway Doc said that my lining is 3.6mm so he is not worried at all. Says to see how it goes and if bleeding still troublesome then we could change meds. Apparently menopause society suggest giving a little more prog to women like me who bleed on continuous HRT. Anyone else heard this or have tried this?

One thing I read recently was that heat and patches do not mix and patches should not be exposed to direct heat.
 The reason being that direct exposure to heat causes the patch to release more estrogen, more quickly. This effect is known as “Patch Dumping” and can result in the patch quite literally dumping its estrogen content into your body at an accelerated rate. This can throw  hormones off significantly with accompanying symptoms.
Anyone else heard this?
I have been using hot water bottles in the last 6 weeks   as its winter and I am a sucker for them. Could having one of these inadvertantly next to the patch  cause this 'patch dumping'? Or am I clutching at straws here?

 Perhaps my spotting/bleeding today is just the way it is for me on evorel conti and I need to get used to it or move on instead of trying to find explanations.
Feel fed up especially with all the other c@&p going on around us all. :(
Thanks in advance for any members thoughts x