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[Tulip256]

I have been on hrt 3 ish years. I was on utrogestan and evorel 50mg but the utrogestan gave me reflux (both orally and vaginally) so I switched to evorel sequi.

The reflux on the progesterone part of the regime has been a bit better than for utrogestan but is still bad so I am wondering whether 12 days of the combined patch will be sufficient protection instead of the standard 14 days (I was only doing 12 days of utrogestan each month). Any idea?

[bombsh3ll]

Yes, particularly with a synthetic progestin anything over 10 days is considered adequate, and you are only on a low dose of estradiol anyway with the combi patch.

[Tulip256]

Really, that is great news. Please may I ask how how you know this though? Do you have experience of it being prescribed or using it this way or some other source?

I tried to find some official guidance on this but could not find anything, only that it had been only trialled as 14 days so they could not recommend reducing it. It makes sense though if utrogestan is safe at 12 days a stronger synthetic progesterone should be safe also.

[bombsh3ll]

The 10 days is clinical guidance for progestins generally and doesn't specifically refer to the patch.

Professor Studd's website, the BMS and the international menopause society all cite 10 days as the minimum for progestin cover.

50mcg of estrogen is a low dose and norethisterone a strong progestin so physiologically this should be fine unless a person has significant risk factors such as severe obesity, Lynch syndrome etc.

However the patch manufacturers will not state this as it deviates from their product license.