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[Donna Suzanne]

Hi, has anyone had any adverse symptoms switching from bleed to no bleed HRT? Started Prempac aged 44, no side effects, was taken off market so changed to trisequens 9 months ago but now getting melasma and hair falling out. Doctor said it's the progesterone. Doctor advised moving to Femoston Conti 0.5 - 2.5 no bleed type even though not sure if still at peri stages. I'm so worried at the level drop in estrogen and effects that will have. She also gave Vagifem even though I have no issues with vaginal atrophy, doctor said to help with estrogen fall. Has anyone any thoughts on this?
Also read 54 yrs is a better age to change, due to bone density etc. I'm just 49. I'm so worried, more for my teenage kids and husband than myself! Could I have changed to a different cyclical HRT? I'm in terror

[Hurdity]

Hi Donna Suzanne

 

The good news is you can continue to use cyclical HRT for as long as you want provided you haven't any medical reason why not ( eg endometriosis), or maybe large fibroids.

Although Femoston has a better tolerated progestogen than Trisequens (which contains norethisterone that causes problems for some women and as it is derived from testosterone can cause androgenic effects such as hair loss), reducing your oestrogen dose to 0.5 mg from almost 2 mg on average throughout the cycle is a drastic reduction, let alone the change from cyclical to conti - which can lead to continuous progestogenic side effects.

When changing HRT types it is best to change only one thing at a time - in your case the progestogen - and take it cyclically to see how you tolerate it. Therefore I would recommend Femoston 2/10. This will give slightly higher oestrogen as there are no days with a 1 mg dose as with Trisequens. You are still below the average age of natural menopause and nowhere near 60, so no problems with continuing with 2 mg.

Vagifem will help with symptoms of vaginal atrophy due to reduced oestroen but not all the other menopausal symptoms. I would go back and say you agree with the type of HRT, but not the dose/conti part of it. Say you want to continue with a cycle and would like to continue with more or less the same dose of oestrogen that you have been having and therefore ask for Femoston 2/10. If you are still peri-menopausal then cyclical HRT is definitely advised. Unfortunately Femoston conti does not come in a 2 mg dose.

Good luck and keep us posted - no need to be terrified - just assertive with your doc, and read as much as you can about menopause and HRT types!

Hurdity x

[Donna Suzanne]

Hurdity I can't thank you enough for taking the time to read and reply to my 'call for help'.

Not only have you given clarity but also the words to what my instict was telling me. I've been reading today on this site about all the HRT types and already gained lots of info, but was so confused about what my needs were untill your reply. Infact it was my doctor who recommended this site to me as here in Ireland shared information is so limited.

Armed now with new insight I feel stronger already, will call GP tomorrow.
You're a life saver!
thank you so much

Donna  X