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[Banana11]

I spoke to my doc re medicine review.  The conversation ended by being referred on a 2 week pathway due to bleeding every 2 weeks since being on continuous progesterone.  I take Everol conti 50 and another Everol estrogen patch of 25.  He wants me to stop the extra patch.  I am getting lots of headaches atm and a constant stomach like headache.  Any advice? Thanks x

[CLKD]

Morning.  Do U have a history of migraines?  Who suggested the 'extra' patch?

Did your GP give any indication as to how long U will actually wait until the appt.?

[sheila99]

The prog in the conti patch is enough for the oestrogen in the same patch so it's unusual for them to give you more oestrogen without more progestogen. Long term you need more prog for the oestrogen but what you do in the next 2 weeks isn't going to make much difference. Were you meno (1 year without a bleed) before you started hrt? Just wondering if a sequi regime would be more appropriate.

[bombsh3ll]

You would be better on a 75mcg patch with separate progesterone, rather than adding extra estrogen to the combi patch.

As sheila suggested, a cyclical regime might be a better fit if you are still having regular bleeds.

I can understand continuous combined being prescribed where someone has hormonal migraines, as these patients are usually better with stable hormone levels than seesawing up and down with progesterone, however there is potentially a trade off with bleed pattern.

Another good option if suitable is a mirena IUS - you could possibly ask for this to be inserted at your hysteroscopy.

[Banana11]

CLKD - I have suffered from headaches since I was a child. 
Sheila99 - on Everol Sequi I was having monthly bleeds before changing to conti and getting bleeds every 2 weeks.
Thanks Bomdsh3ll.  It’s so difficult, especially as one doctor said have 100mg estrogen and separate progesterone while another at the practice said have Everol Conti 50.  It seems a big difference! X

[bombsh3ll]

That's simple then, stick with the doctor who is offering you the customisable body identical regime rather than fixed low dose synthetic combination.

I'm not saying there is never a role for the combined patch - the more choice there is the better - however it very frequently leads to undertreatment as it is just 50mcg of estradiol, and few non-specialists will prescribe it in multiples due to both cost and lack of knowledge.

[sheila99]

If you were having 2 bleeds a month then perhaps one was your own cycle and the other the hrt one? Did you try adjusting the hrt cycle to align with your own? Easier to tweak with utro rather than patches though. If you still have a strong cycle of your own it's very likely you'll bleed on a conti regime unless you use something stronger like a mirena.