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[Poppi]

Hi
I've been swithering about posting as I don't want to sound like a moaning-minnie, but here goes.

Age 51 I had irregular peroids, awful mood swings, hot flushes all the time day and night and very understanding GP put me on Prempak C. All symptons disappeared and I was happy again. 4 years later a very close relative died and my boss at work changed. My emotions were all over the place and I was very unhappy, stressed and couldn't function properly so was signed off.

To cut a long story short I saw a herbalist whilst off sick and wish I hadn't. He told me HRT was poison - did I want that in my body? I came off all meds (HRT, ADs and pain killers for a degenerative back condition, result of a car accident where I was trapped in the car and driver was killed). Fast forward to 2+1/2 years later and we have relocated to a new area 300 miles away and I have new, fabulous GP. I started back on HRT last year (Estelle Solo, Prempak is no longer made) but it was only helping daytime hot flushes, so I moved onto Estelle Duet 3 months ago but it has made things worse. No daytime flushes but night sweats are nearly unbearable, I'm crying very easily,feel very dry and itchy "down below" , have no sex drive whatsoever and I'm constantly in a bad mood.

I am now 58 and post-menopausal. I have an appointment with a new lady GP tomorrow and plan to ask her if I can change HRT to something more similar to Prempak. I did read about one HRT which is very good for increasing female sex-drive - has anyone heard of that? I can't remember where I read it as the amount of information on HRT is so vast.

Lorraine Kelly put it very well and said "I feel no joy in my life although I have it all, daughter doing very well at university, a fulfilling job and comfortable home but I always feel down". After her GP altered her HRT (patch) she said she immediately felt the joy come back into her life and she could appreciate good things again, and stop crying!

[Dancinggirl]

You are not moaning - we are here to help.
I would suggest that transdermal HRT would be a good idea at your age. The progesterone you liked before was Medroxyprogesterone (Provera) I think, so I would suggest you ask for oestrogen as either patch ( Estrodot is best) or try Oestrogel (which you apply daily) and  You would then have Provera in pill form for either 12 days each month, if doing a sequential regime, OR take everyday as a continuous HRT non bleed regime.
The other option is to have the Mirena fitted and use the oestrogen as patch or gel.
Look under TREATMENTS on this site to see your options.
Some women love Utrogestan but this can bring sedative effects if taken continuously.
DG x

[Poppi]

Thanks Dancinggirl for your advice!

I've had the most strange breakthrough type of bleeding too. I'm not worried about it being anything other than Estelle as 1 months ago, I had a hormone surge 14 months after my "last" period and was checked out very thoroughly (and painfully), and all was fine. This happens after 9 days of starting new pack of Estelle then 9 days into different coloured pill, so worse than a proper period. 

The mood I'm in just now makes me feel like nothing is going to get better, I'm not really looking that forward to our 1st grandbaby due in 20 weeks, which makes me feel so ashamed of myself, here come the tears, roll on 9.30 tomorrow when I see GP. There must be light at the end of this horrible tunnel.

[Dancinggirl]

If you are on the sequential Elleste, then you should only get one bleed each month!!!!  Elleste has the toughest progesterone to tolerate and if your mood is low then you need a different progesterone e.g. Utrogestan or Provera or perhaps consider the Mirena.

it's best to start with a sequential version of any HRT before moving to the conti version, so you can tell if the progesterone suits you or not. Elleste is obviously not suiting you. If you want a non bleed HRT regime then the Mirena might be your best option.  DG x

[Poppi]

Hi
Went to see GP and bless her, she was about 12! Seriously, new lady GP so hoped/thought she'd be more understanding, was kind of but was quite contradictory of a few things I know to be right, but of course I kept quiet. Upshot is she was puzzled as to why Elleste didn't agree if Prempak had, gave me a month's supply of different HRT (previously told 3 months to test it is best?) and made me feel very small when I asked if I would bleed on new one “of course not, it's a continuous preparation!” Anyway, I have
Estradiol Valerate 1mg/Medoxyprogesterone 2mg I'm to finish ellestse packet then wait 2 days before starting new pills, go back to see her and if no better go to Menopause clinic 20 miles away as she's concerned that this is the 3rd HRT I've tried.
Can someone help me straighten out in my head what this well-meaning young lassie GP has told me?
Anyone else have one good day/one bad day? Bad today and just want to curl up with a hot water bottle to keep warm to see if that stops the tearful feelings.
       Poppi x

[Dancinggirl]

It is a shame that this GP didn't offer you the combined patches or the Oestrogel with Utrogestan - did you take a print out from the TREATMENTS on this site to show her what you wanted? I'm afraid very few GPs are up to speed on HRTs and meno treatment ( it's up to us to educate them) so they need to be led - in other words we have to tell them what we want but in a subtle way so we don't puncture their confidence or put their backs up!!!!

You've probably been given Indivina?  this is probably the closest to the Prempac C you had before, so it may well work for you quite well. This is a continuous HRT but you may get some bleeding or spotting in the first few weeks or even months but ultimately you should get no bleeding at all.  Try this and see how you get on.  Going to the meno clinic may be the best idea if this doesn't work as you GPs are clearly not up to speed.

I think the you were given a Sequi Elleste HRT before and you‘ve got to finish the pack??? If so, I'd be inclined to wait a week after stopping the Elleste (so have a week break) before starting the knew one, as this will allow your womb lining to shed properly - in other words, you start fresh. 

If your ‘lady bits' are itchy and sore, then you could probably do with some Vagifem local oestrogen but in the mean time, do buy some vaginal moisturisers e.g. SYLK or the YES products (buy these online)  as using moisturisers daily can really help alongside the HRT.  When you go back in 3 months time, I'd ask for some Vagifem to use with the HRT. Look under TREATMENTS for info on this.

You originally asked about the HRT that can boost libido?  It's Tibolone and info on this should be under TREATMENTS  - some women find it good, so could be worth considering if the Indivina doesn't suit you.

It's been a horrid winter - I think we are all feeling a bit ‘blue'.  Once things warm up, get out for some walks, eat small really healthy foods often and perhaps take a few supplements with B vits, Vitamin D and Omega oils to give your body and mind a boost.
Keep us posted.  DG x

[Katia]

Prempak is conjugated estrogens.  Have you thought of trying premarin, which is the same and then adding a progesterone?  I think the one in prempak comes individually, so you could probably 'make' prempak.  See how the estradiol valerate goes first and then premarin is an option if not.  1mg estadiol is about equal to 0.76mg estraiol valerate.  I hope you feel better.  It can be a bit of trial and error and horrible when you get there and it's discontinued.   

[Rosie63]

Hi Poppi. I'm not as knowledgeable as some ladies here but just wanted to share my journey with you which will hopefully offer some support. I too did well for a number of years on Prempak C.  My journey of change started last October when I could no longer obtain Prempak C and I was put on Elleste Conti Duet. It did help with some symptoms but the side effects were too much for me and since then, I have tried several different preparations to try to find the right one for me. With my fingers crossed, I can say that I think I have finally found ‘the one', although it's only the last week that I have started feel like my old self, hence the crossed fingers ! I've found it a slow and difficult process because it is very much trial and error and to be fair it has been more thanks to the lovely ladies on this forum who gave me the confidence to try different HRT preparations and dosages to help get to where I am today. 

What I'm trying to say is that please don't give up hope that you will find something else that suits you because with patience and the support of this forum, I'm confident you will.

Sorry if I've rambled on but hope it helps a little and do I wish you well.

Rosie63 x

[Hurdity]

Prempak is conjugated estrogens.  Have you thought of trying premarin, which is the same and then adding a progesterone?  I think the one in prempak comes individually, so you could probably 'make' prempak.  See how the estradiol valerate goes first and then premarin is an option if not.  1mg estadiol is about equal to 0.76mg estraiol valerate.  I hope you feel better.  It can be a bit of trial and error and horrible when you get there and it's discontinued.

Conjugated EQUINE oestrogens to be precise. Some women will want to know the origin!

Re the estradiol - I think you mean the other way round? ie 1 mg estradiol valerate is about equal to 0.75 mg estradiol. I also read this once a while back but I have also read elsewhere that there is virtually no difference!

[Katia]

HUrdity,

Yes, conjugated Equine estrogens. Thank you for adding the equine.

No I don't mean the other way around at all. 1mg of estriol Is actually equal to 0.76mg of estradiol valerate to be precise. It's in a science direct article. I'm sure that may be where you read it. Easy to mix them up 😊

[Katia]

There's quite a lot more research into the conversions since qlaira came on the market.  I understand why you may think estradiol valerate the stronger one as Qlaira is a pill, it would be logical, but it's weaker and it's to the amount of progesterone that the pill isn't recommended in HRT not estrogen. I had problems with estradiol. 

[Hurdity]

Hi Katia

I haven't mixed them up! As I said I have read that 1 mg estradiol valerate would be equivalent to taking a 0.75 g estradiol tablet because some is lost in the body after metabolism of estradiol valerate (although I have also read elsewhere that the doses equate to each other - so inconsistency there). In other words this information said that you get 3/4 of the estradiol into the body from estradiol valerate, compared to taking the same dose of a pure estradiol tablet. ie if you take 1 mg estradiol valerate and 1 mg estradiol tablet, you will end up with 75% estradiol from the E valerate, compared to the pure E.

I presume also you meant estradiol in your post not estriol?

Hurdity x

PS Just googled and looked at the science direct article and this confirms what I said "Estradiol valerate 1 mg is equal to estradiol 0.76 mg. " https://www.sciencedirect.com/topics/pharmacology-toxicology-and-pharmaceutical-science/estradiol-valerate - I didn't read the rest of the article! This is all a bit off topic though!

[Katia]

Hi Hurdity,

Here's the link the the article.   I think we're looking at the same article.  That's what I said that estradiol valerate is 75% of estradiol. So 1mg estradiol is equal to 0.76 estradiol valerate.

https://www.sciencedirect.com/topics/nursing-and-health-professions/estradiol-valerate