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[Jaylow]

Hi again, thought I'd update with my hrt journey so far. I'm 45 and started FemSeven Sequi 3 weeks ago. The first 3 days or so I had a migraine. The first patch stayed on for the whole week but only just (plasters holding it on). The edges were curled up and the patch became dry and crispy. I feel that my body is absorbing the hormones within the first few days and it's not working so well for the remaining days until patch change.

The second patch lasted 2 days then I noticed one morning it wasn't on my thigh any more. I never did find that patch! So I replaced with another. Problem is my gp prescribed just 4 weeks worth of patches so only 2 of each phase. Luckily I'd pestered previously for more so I eventually got 8 weeks worth and had a spare. I mean 4 weeks worth what use is that!

So far I see a slight improvement in hot flashes. Also slightly less bone aches. Slight improvement in vaginal dryness but only on the inside, outside area is very sore and feels like thin skin. Sleep slightly improved. Dry mouth a tiny bit better. Slightly is the key word here.

Around the end of phase 1 second patch I developed thrush (I was also using vagifem twice a week which I've now stopped). I haven't had thrush for years so either the vagifem or hrt must have caused it. This made my vagina even more dry and sore.

So onto phase 2. I was apprehensive about this stage as I'd read about problems with the progesterone but I'd also read that the type in FemSeven Sequi was one of the more tolerable types. And not too bad tbh. Side effects I've noticed are strange dreams, period type stomach cramps for the first few days, but they wore off. I had slight spotting for the first couple of days.  Last night I applied the second phase 2 patch. Period cramps returned and now I'm getting spotting again, heavier than the last lot. But I'm definitely noticing that the patches are running out too early. I wonder if I'll get a full bleed or if the hormone level will drop before a period kicks in.  Over all I feel ‘slightly' better, but I have a lot of questions..

Should I give these patches a bit longer to work? But I'll still have the problem of them running out early and not sticking well.

Should I try a different patch that sticks better and is replaced every 3 days? But do all those come with a less tolerated type of progesterone? I imagine I'd be one of those who doesn't tolerate it well as I had awful pms and hormonal migraines.

In my mind I feel like the gel would be best for me, but which type of progesterone can I use with this? Am I right in thinking my options are tablet form or vaginal suppository? Are these the bio identical progesterone? And I thought the tablets had a slightly higher risk, is this just the oestrogen part or is it the progesterone part that carries the higher risk?

I don't want to take tablets for both hormones.

And the trouble I had to get any kind of hrt from my gp was ridiculous, it's going to be a full scale battle to get the gel. Even the gynaecologist I saw (who prescribed hrt when gp wouldn't give me any) said that you can't use the gel if you still have a womb. I know that you can with separate progesterone.

Is it worth finding a menopause expert and paying for advice/tests and treatment? Why is it this so difficult to sort out. Any help or advice welcome. I also could do with help regarding possible testosterone / dhea but that's for the private lives section.

[Wilks]

Hi- regarding the patch, it sounds a bit rubbish if it's not staying put. I took Evorel Sequi for a year or so and the patches stayed put and I didn't have any trouble with the progesterone. I'm now taking Estradot patches which I prefer as they're about half the size and don't irritate my skin. I take Utrogestan capsules 12 days in each month and so far no problems.

[Dancinggirl]

These patches are clearly too much hassle adn not working properly.  Teh spotting will happen if there ins't sufficient absorption.

If you want to try the OEstrogel with progesterone regime, your best bet is to print off the info in the TREATMENTS section, write down all your symptoms and questions and show this to the GP/Gynae and ask specifically for Oestrogel with Utrogeston (under micronised progesterone in their drug book). Oestrogel is widely used for any HRT regimes and has been for over 30 years, so that gynaecologist is really ‘out of touch'!!!!!
I'm not sure why you felt you need to try a medium dose HRT from the outset? Femsevern patches are medium dose!   Personally, in your position, I would have asked to try Femoston 1/10 to start with as this would have been pills and a lower dose so easier to manage and tolerate.

When you had the discomfort around the vaginal area, did you actually have the cottage cheese discharge or were you simply dry and sore? Vagifem, when first used daily for 2 weeks, can make things burn a bit and this is quite normal and should settle. To prevent thrush and BV problems, you need to use vaginal moisturiser daily (SYLK or the YES products) and also get some Multi Gyn ACtigel to treat any infection that does corp up.  DG x

[Jaylow]

I didn't ask for a particular dosage but I did say I didn't want oral hrt so maybe femseven is the lowest patch? With my symptoms being mostly still here wouldn't that mean I'd need an even higher dose?

It was definitely thrush that I had. When I started the vagifem a couple of months ago I felt like thrush was about to start during the 14 day loading phase. It eased off a bit during the 2 times a week but then developed into full on thrush eventually. Shame as it did seem to help a little.

I shall try the sylk moisturiser and ask about the oestrogel. I'm unsure of my progesterone options with the gel but I'll look into that. Period arrived today and symptoms of meno still quite bad. All trial and error I guess 

Feel like all the moisture has disappeared from everywhere , eyes, mouth, skin, vag uhh I hate this.

[Dancinggirl]

Jaylou - I do think you have absorption issues with these patches and this is not uncommon. If you are not absorbing properly then this will explain why you are not getting the symptom relief you need. 
Here are your choices of HRT for the peri meno stage :https://www.menopausematters.co.uk/perimeno.php

Near the bottom of this page are the 2 types of progesterone that could be used with oestrogen as patch or gel. There is also the option of the Mirena which can often prove a very good no hassle HRT option with oestrogel of oestrogen patch.
You will also see that there is an alternative combined patch which you might like to try.
The vagifem shouldn't have given you thrush, in fact over time it should help to prevent thrush. Thrush often develops when bacteria from the gut gets transferred from the bowel - cleaning really well is vital and maintaining the vaginal flora will prevent infections like thrush from taking hold.  I'd get some Multi Gyn Actigel to help rebalance the flora next time you try Vagifem.
DG x