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Author Topic: Change from Femoston 1/10 to Evorel Sequi patch when is best? Advice needed  (Read 2242 times)

pricey

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Hi ladies,

Following my mistimed bleeds and almost a year of trying Femoston in one form or another, my GP has prescribed Evorel Sequi patches. I will be 54 in January - previously did well on Elleste Duet in terms of regular bleeds but was very headachey. The kinder progesterone means less headaches but my bleeds are erratic. I also still get a severe headache before each bleed.
Last month I started a bleed 4 days into the progesterone.  I then didn't bleed at the start of the new pack and on the withdrawal of oestrogen, but had all the symptoms and have had some mild flushes breaking through as well as sore breasts.  As I predicted I have now started bleeding 4 days into the progesterone.  Clearly my own cycle is overriding the Femoston. When the nurse confirmed my prescription for Evorel has been agreed I asked her should I switch when I started bleeding ( i expected this would happen) or at the end of the pack? She advised at the end of the pack "to follow the hormones". I know I have had few progesterone days but my this is clearly my current cycle. I am concerned if I wait to the end of the pack I will bleed at the wrong phase of the patches next month. Also apprehensive about the change of progesterone . Is the patch less likely to cause headaches than the tablet?

Thanks in advance x
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Hurdity

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Many women get classic pms symptoms including a headache before the bleed due to the withdrawal of the progestogen - and this often happens regardless of the type of progestogen chosen and is much like we would experience during normal periods. It can be difficult trying to sync your cycle with HRT during peri-menopause since ovulation does not happen each month. However if it seems to be regularly out of sync then you can just start counting again as the nurse says. You would do this by counting Day 1 as the first day of your bleed  and this would be the oestrogen only part of the pack. Hopefully you would then bleed again either just before the end of the combi patches or a couple of days afterwards.

In terms of your tolerance to the progestogen in the patches - you can only try and see - different women react differently to the different types and also may vary if it is taken transdermally compared with orally, so have a go and see how you feel. The mian thing is whether you get headaches or other side effects during most of the progestogen phase ( combi patches) every time you use them - this would indicate an intolerance to that type perhaps?

Fingers crossed they work for you - even though Elleste Duet (same progestogen as Evorel) did not!

Hurdity x

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pricey

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Hi Hurdity,
Thanks so much for replying. I have 9 days of progestogen to go in my Femoston but have started my bleed.  I think the nurse intended for me to finish the pack regardless but as I feel my own cycle has been overriding the HRT this is my natural bleed.  So am I correct in thinking you are saying start the Evorel now as this is day one? It would just mean I have only taken 4 progestogen tablets this cycle.  Or should I do what the nurse says and finish the pack even though I will then likely get a withdrawal bleed?

Hope this makes sense! x
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Hurdity

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Ah yes it's probably best to take the whole course of progestogen if you've only taken four - but if the bleed is due to your own ovulation and therefore your own progesterone, you may well have shed all the lining. I would follow the nurse's advice then and hopefully as you say you will get another bleed at the "right" time?

Hurdity x
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