Print

Please login or register.
1 Hour 1 Day 1 Week 1 Month Forever
Login with username, password and session length

[MrsJ25]

Hi
I am new here. I hope I've posted in the right place.
3 weeks ago I started HRT mirena and evorel patches 100.
Over the last week or so I have been feeling very sick.
It feels like pregnancy sickness but I am not pregnant.
My consultant has said I can cut the patches in half.
Do you think it is likely the patches causing me to feel sick?
Has anyone any experience of how long this usually lasts?
Is it better to ride it out, rather than cutting the patches in half, because what if I then need to increase again? I'd have to go through feeling sick again.
I am worried if I made the right decision having HRT.
 
Thank you

[CLKD]

Hi!  nausea may be caused by the HRT ....... it's difficult to decide which is the culprit, hopefully some1 will be along with advice.

   U may not require the amount of patches right now, so cutting in half might work.  If no one responds do put the product name into the 'search' box on the Forum, make notes ;-)

I had nausea when I began The Pill.  A change of medication stopped that side effect. 

Which symptom would you like to ease first?

[Joaniepat]

The usual starting dose for transdermal oestrogen (patches or gel) is 50 mcg. You would normally stick to that for two or three months and then review. If your symptoms are not controlled with 50 you would increase to 75, and eventually to 100 if necessary. 100 is the highest licensed dose. It seems strange to be started off on the highest dose, so yes, cut them in half and see how you get on.
JP x

[bombsh3ll]

It shouldn't make you feel sick, but that doesn't mean it can't, especially if you are particularly sensitive or your body hasn't seen estrogen in a long time.

I would start with half a patch in this instance and see if the nausea improves.

After a few weeks if all ok you can increase, using 3/4 patch if you want, and build up to your intended dose gradually.

Osteoporosis and premature CVD develop over years not a few weeks, so you are not harming yourself by going low and slow initially.

[MrsJ25]

Hi
Thank you for the replies. Sorry for the delay in getting back.
Right now the nausea is unbearable.
However, my peri/pmdd symptoms specifically rage/irritibility/mood swings/suicidal/crying all the time ... plus lots of other things, are ruining my life!
I have read about increasing the dose slowly and you mention it in your replies ... do you think given my symptoms this is why my consultant went straight to 100? I'm going to ask at my next appt.
I was in such a state and have no previous experience of hrt so I didn't give it a thought at the time.
Is there such a thing as too much oestrogen?
My consultant said that blood tests are not reliable unless you are looking to confirm menopause. Would you agree with this?
I asked my GP to do bloods (before hrt) to see if I was in peri but they said my bloods were fine.
But I was also told via another test elsewhere that my hormone levels were very low.
I'd love to know exactly what my levels are and what my body needs or doesn't need.
Or are extra hormones only a good thing?
I've read about the benefits etc
And with the mirena do I have to have oestrogen?
I know that the mirena protects my womb etc.
It's a mindfield isn't it when you're just starting out.
I don't like the patches really they are a bit unsightly but I have no idea about gels etc
I cut my patch in half last night because I had a panic attack. I felt really strange.
How long do the increases/decreases take to take effect?
Sorry for so many questions! It helps to write everything down. X

[CLKD]

 

[chopsuey]

I agree that starting you on the maximum licensed dose seems odd. 50 mcg is standard and you gradually increase from there if you need to, based on your symptoms, after, as Joaniepat says, 2 -3 months at each dose. This gives time for your body to adjust to each level and time for you to see if it is sufficient to control your symptoms. When I started on HRT, I tried to increase my Oestrogel from 2 pumps to 4 pumps in one go, in a vain effort to control the adverse effects from the Utrogestan. It didn't help and I felt very nauseous and I was told by the consultant that the sudden increase was the reason why. I gradually increased to 4 pumps over several months, and had no more nausea that way.

If you are perimenopausal still, then the hormone levels in your blood are still going to vary a lot, hence the variabiity in the tests.

You don't have to have oestrogen with the Mirena but I wouldn't personally want to have synthetic hormones in my body for an extended period of time if it is serving no purpose, unless you are using it for contraception. I would keep it in whilst you are deciding whether you are going to continue with HRT though.

As for patches versus gel, it's about personal preference really and how well you absorb from each product. Patches irritated my skin, so I switched to gel. The drawbacks are having to take the time each day to apply it, wait for it to dry and decide whether you are going to apply it in the morning or night time or split the dose. You tend to get more peaks in blood levels with gel whereas patches give a more steady release but I can't say that I notice it.

[MrsJ25]

Thank you. I will definitely question the dose at my follow up.
Regarding the mirena the consultant said it's a first line treatment for peri/pmdd and adeno/fibroid changes.
Am I right in thinking that the mirena has to be there to protect my womb from the oestrogen?
I am concerned about synthetic hormones. I did ask about synthetic vs body identical at the time.
I felt sure at the time that hrt was the answer. I also felt desperate. I'm only 3 weeks in and I'm
doubting everything. I feel like I don't know what my body needs anymore. I step forward 2 and back 3. I also have unresolved gastro problems and I can't see the wood for the trees 

[CLKD]

Gut problems may become more noticeable as we age.  I've had to alter my diet in the last 4/5 years which has made a great difference.

Do U keep a mood/food/symptom diary?

[chopsuey]

I don't know much about using the Mirena for adenomyosis or fibroids to be honest, but yes, you need some form of progestogen/progesterone to protect the lining of the womb from any oestrogen you are taking. 

There are pros and cons for synthetic or body identical hormones. I would have preferred body identical progesterone but couldn't tolerate Utrogestan either orally or vaginally, so have ended up with a Mirena myself. I've not had any problems with it and most of the hormone is said to be acting within the womb. There is still some in the general circulation but not as much as you would get from the contraceptive pill. Synthetics are better at controlling unwanted bleeding though.

I'm think HRT is often not straighforward for many women, particularly during peri when your own hormones are also all over the place. It can take a while to find the right solution and you need the support of someone knowledgeable about menopause and HRT to guide you through that, particulary if you have other health issues.  I had a horrible time during menopause and it took time and help from a private specialist to work out what was right for me but it gave me my life back.

Is the consultant you are seeing a specialist in menopause?  Do you think your gastro issues are connected to hormonal changes?