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[kristina12]

Hi
I actually became a member about a year ago when I first realised that the symptoms I was experiencing were due to being perimenopausal, but this is my first post.
I am now 50 years of age and after experiencing frequent palpitations, night sweats, aching limbs and anxiety I eventually asked my GP to start me on HRT. I tried Elleste Duet last year and when I was on the oestrogen only tablets I felt great but when I took the progestogen tablets I felt bloated, irritable and miserable. After almost 3 months I stopped taking it and decided to try to manage without anything. A year ago I was still having fairly regular periods but with quite long gaps between periods at times.
I have continued to suffered since then though and this year have only had one period since January and my symptoms have got a lot worse. After looking into different types of HRT I went back to my GP a couple of weeks ago and asked if I could try a patch with a different type of progestogen since most HRT seems to contain norethisterone which clearly doesn't agree with me. She agreed to try me on Femseven patches as it is a different progestogen but she decided to give me a conti patch as she thought it might have less progestogen side effects if I have a continuous supply rather than the up and downs that cause symptoms of PMT. She prescribed 4 patches and wants to see me again in a couple of weeks after her holiday.
I found out from Boots that there was a manufacturing problem with Femseven patches and they didn't have any but I managed to get some from one pharmacy after phoning around a lot of pharmacies. So I started using it but also emailed the manufacturer who said it will not be in stock again until 2019, so that means I will need to change to another form anyway when my GP returns from her holiday!
I had spotting for a few days when I first started this patch which has now stopped completely and I do feel slightly bloated but also feel slightly better generally than I did before starting it.
I am just worried now about what I can ask my GP to change me to now that I won't be able to have femseven patches (none are available at all) and I can't take norethisterone. I think the other combined patch contains norethisterone but I would rather use patches if possible. I am also concerned because I keep seeing posts about other forms of HRT being difficult to obtain through pharmacies as I had wondered about asking for an oestrogen patch and possibly a separate progestogen. I wondered whether anyone might have had a similar experience and be able to advise me about alternatives that have worked well for them and have been readily available in the UK on prescription? So far my GP has been willing to prescribe what I've asked for as long as it comes up on her formulary when she has searched on the clinical system for it.
Thank you for any advice that you might be able to offer.
Kristina

[CLKD]

It should be on the up-2-date info that GPs get, regarding medications.  She should be OK if you explain that it is out of stock until next year.  In the mean time, browse round and see what else might suit you.

Put your HRT into the search box on here and see what pops up?

 

[Hurdity]

Hi kristina12

 

It's a right pain that different brands of HRT often seem to be in short supply - I bet this doesn't happen with Viagra  . You'd think the pharma companies would want to sell it but maybe the demand is unpredictable?

Re what to choose. Yes the best solution is to try separate oestrogen and a progestogen although the options for the latter are linited - you will find them here: https://www.menopausematters.co.uk/to_progestogens.php

Basically there are three - Utrogestan (micronised progesterone - same as we produce), Provera a synthetic one, or the Mirena coil which also acts as contraception if you need it. Personally I would still go for a cyclical  HRT or take the separate s on a cycle - so that you can find out which progestogen suits you best, before deciding whether to go for continuous progestogen ( which some women cannot cope with due to continuous side effects).

In terms of oestrogen - you can then continue with your patch - eg 50 mcg Estradot (or Evorel - although these are much bigger), and then if you find you need a higher dose - it is very easy to go to a higher patch, which isn't possible with the  combi patches like Femseven or Evorel sequi or conti.

I've been using patches for most of the last 11 + years I have been on HRT and love them - now in mid 60's.

Good luck and let us know how you get on

Hurdity x

[kristina12]

Thank you, it definitely is a pain when some types of HRT are in short supply. The Femseven manufacturer said that they are not available due to increased demand. I'm guessing that if nobody in the UK can get them until next year that demand will drastically reduce for them though!

I think I will ask my GP if she will prescribe me utrogestan and and an oestogen patch. I quite like the patches that I am using currently but I don't think the continuous progestogen agrees with me. I feel pre-menstrual constantly, although I can also feel the benefits from the oestrogen so although I'm tempted to remove the patch I think I will persevere with it until my GP is back from her holiday in 10 days. She is very good and worked for a while in gynae so is very sympathetic to any gynae problems that I've had.

I had a mirena coil about 8 years ago for heavy bleeding and that made me feel awful too so the gynaecologist removed it and I had an endometrial ablation which worked wonders. So I've only had very scant periods for the last 8 years anyway and don't really build up much endometrial lining. I'm not sure whether that means I need less of the progestogen part of HRT though. I don't need contraception as my husband had a vasectomy after we had our children.

This site provides amazing support and information, I'm so pleased that I found it. Thank you so much 

[Hurdity]

Hi again kristina12

Normally you would only be given continuous combined HRT if you were post-menopausal (ie without natural periods for 12 months) but I presume with the ablation things are a bit different ie if you don't have proper periods all the time then breakthrough bleeding may not be such an issue - hence I presume your doc suggesting it for you? However if you are peri-menopausal then your own cycle may well still be strong so you will likely get some of the fluctuations from your own hormones breaking through the conti HRT anyway.

Yes the continuous pms is typical of progestogenic side effects some women get when taking prog all the time. I know theoretically you get less fluctuation if you take it all the time - particularly as you don't have to go through the progesterone withdrawal phase which is like extreme pms for some women - but this is only temporary and if you are feeling rough all the time then that defeats the object of HRT!

Sorry I don't know if you need less prog if you've had an ablation - your specialist should be able to advise here?

All the best anyway with your next GP visit - great to have a sympathetic one - and let us know the outcome.

Hurdity x

[Jo24]

The manufacturers of Fem7 Conti (Teva) tell me that they are switching the adhesive on these patches, and that they now do not expect to resume supplying this item until 'the last quarter of 2019'  😏
Fabulous news huh ... ?!
I am in the same boat, scrabbling around pharmacies to try and get a few boxes in hand, but they are like Hen's Teeth ...
I do not want the noreth prog in Evorel Conti, and think I may have to go for oest patch + oral prog, however, I am seeing my Meno Consultant in Nov, so will seek her expert advice - hoping ...