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[kittywells]

Hi everyone, I've been on transdermal HRT for a few years now, pretty happily on Femseven Sequi and then Evorel Sequi when the Femseven was taken off market. Just called to reorder and found out there is no Sequi available at all, any brand.

So what are my options? Chemist suggested Evorel Conti would work but I think I still need a cycle at 46. I tried Sandrena/Urtogestan a couple of years ago and it didn't suit me as I felt really tired and low on it, so would prefer to avoid that but may have to deal with it temporarily. Will see doc on Wed but want to go forearmed with knowledge as they are unreliable with HRT at my practice. Is there any other option besides Sandrena/Urtogestan? Thanks

[ladylollipop]

Hello kittywells, I had the same problem also took Fem7sequi. Tried a spray called lenzetto which didn't suit me. Then I found out that the Fem7 estrogen only patches are still available. So I take the patches two weeks without progesterone and for two weeks I add utrogestan 200mg because I still have my womb. Maybe that would be an option for you too

Lady lollipop

[kittywells]

Thanks -it's good to know the estrogen only patches are still available. I really would prefer to stay transdermal as much as possible so I might ask to do that, not sure if you can get progesterone transdermally though. I guess if I have to take urtogestan orally for only two weeks that's half the time, at least!

[ladylollipop]

Hi, yes I can understand because I also prefer transdermal but there wasn't an option. I know that some women take the progesterone vaginal. Just a thought
Hope you will find a way which suits you.

Lady Lollipop

[kittywells]

Thanks for the help. In the end, I had to go with an oral medication (Femoston 1/10) as the prescribing nurse was not into the idea of me supplementing estrogen only patch with progesterone in another form. I feel so bad on the pills that I will probably go back, they have started my insomnia and flashes again. But giving it a full month just to make sure.

[Hurdity]

Hi kittywells

The BMS has produced a document with all the alternative preparations and doses here:
https://thebms.org.uk/wp-content/uploads/2019/11/HRT-alternatives-04.11.2019.pdf

Also  an update on the shortages here:
https://thebms.org.uk/2020/01/british-menopause-society-further-update-on-hrt-supply-shortages-27th-january-2020/

However the latter update refers to manufacturing issues only so there may still be local shortages when demand outstrips supply which is still happening.

On this website also you will find all the different preparations under "HRT preparations" - look for oestrogen. progesterone, and peri-menopause products.

I am using Elleste solo patches 80 mcg cut down to 62.5 and there are various other ones available depending on your pharmacist's supplier. With this I take utrogestan on a long cycle but there is also Provera (tablets).

You prescribing nurse is out of order there or should I say out of date. If s/he is not familiar with different types of hRT then she should not be in the position of prescribing. Do look into all the options and then go back and insist on the  combination you want. You are entitled to have transdermal HRT - patches if this is what you prefer and s/he should learn about the different options especially in this time of shortages. I have never taken HRT orally.

Good luck and keep us updated.

Hurdity x

[kittywells]

Thanks so much Hurdity, as ever your advice is really helpful. How did I miss this alternatives sheet? It's exactly what I needed. Will print out and bring in. I think I will have to be more assertive with my practice in trying alternatives - I was willing to give Femoston a try, but I think my instincts about avoiding oral meds were right. My system just doesn't seem to like it, and it may be down to differences in how easily the hormones are absorbed. The prescribing nurse told me I was actually getting more estrogen with Femoston, but it actually feels like less and my awful pre-HRT symptoms are returning.Just heard a report about HRT on the radio on the drive home, as if I wasn't obsessing about it enough!

[Mogster71]

Hi Kittywells,

I am doing the same as Hurdity but on a standard sequi basis. There is nothing I can take combined which is available either. So I have Estraderm patches 25mg and just had my 2nd of 14 days of utrogestan (2 x 100). I'm finding the progesterone does make me drowsy and I was slightly spaced out at work yesterday, but as everyone says, it's so individual. I might need to pluck up a bit of courage to try it the other way 

I was on 1/10 of femiston, my doctor first of all tried me on 50 patch but that felt too strong for me, was getting palpitations and dizziness, so I've cut a patch in half till I pick my 25's up on Monday. The way the pharmacist described it to me is that the 1mg of oral has got to go through the digestive system and be processed by the liver so you won't actually be getting all that, whereas transdermal is a more direct route, even though it sounds less at 0.25mg. I actually had a lot of side effects at the time of pill swap week, going from 2 hormones back down to one again. Never had PMS before this but headaches and generally feeling poo. Will be interesting to see what happens on this regime!!

Hope you find something that works, as Hurdity says the nurse is so far behind with current treatments. You just want to feel well. It makes perfect sense to prescribe separates to most of us, as we can see how much easier it is to tweak for us as individuals x