Have been prescribed Elleste Duet 1 mg, but is that right for me?

[Quandry]

I'll be 49 in a couple of months. 18 months since last period.
Was having loads of awful peri- menopause symptoms over 5-6 years, but didn't realise that's what it probably was as I had such a lot going on with sick elderly parents, job issues, busy with childcare/household etc.

Hot flushes, night-time wakings (poor sleep) and constant need to wee (bladder irritation) were what finally tipped me over the edge and I went to see my GP about 2 months ago.

She asked a few questions and did an quick internal and then prescribed me Elleste Duet 1 mg which is Estradiol 1mg tablets for 16 days followed by Norethisterone 1mg for 12 days.

I've been sitting looking at it for the last couple of months (haven't started taking it) deciding whether it's right for me! Seems such a big decision, and I don't feel like I really had a long enough discussion with the GP about it, or any other options!

When I looked it up on www.menopausematters.co.uk/perimeno.php it doesn't look like the right prescription for me? Says it's for perimenopausal women, but surely after no periods for 18 months I am postmenopausal?

In the last month or so my hot flushes have subsided, but the bladder irritation is really still an issue.
I've read lots of people talking about transdermal gels and creams, and wondered why these weren't discussed as an option for me?
The slight issue I have with tablets is that it is a fixed dosage. How do I know that 0.5mg of estrogen might not be enough for me?

My mum had breast cancer in later life (her 60s) so that is a risk factor for me which I need to consider. I don't want to take more HRT than I have to, but I do desperately want to feel 'normal' again - I feel as if my life has been on 'hold' for the last few year

I don't know whether I should try to talk to a different doctor, or book into the (v. expensive!) private menopause clinic in a nearby town?

[pinkfrocks]

The tablets are 1mg not 0.5 mgs - yes?

There's a couple of things to consider. Some drs won't prescribe continuous ( no withdrawal bleed ) HRT to anyone under 54 although the thinking has changed a bit and some think it's ok if you have been period-free for at least a year.

The other point is that it is often the progestogen ( Norethisterone in your case) that causes bloating, PMT and all the 'nasty' symptoms we can get in a pre-meno cycle, so you might not want to take it daily which is what a continuous regime would involve.
It might be a case of trying to see that suits and whether you prefer a light period instead of taking 2 hormones daily.

I wouldn't like to post things here that are not proven but there is increasing evidence that it's continuous therapy with oestrogen and synthetic progestogens ( both hormones used often) that are linked to breast cancer. Oestrogen alone results in lower numbers of breast cancer.

There is also evidence- plenty of it- that strokes and blood clots are less with transdermal oestrogen ( patches or gel) so really, drs ought to offer these first unless you don't like the idea- some women just want to 'pop a pill'!

Many GPs are not very familiar with all the different ways of offering HRT and if they gave you gel then you'd also need a separate progestogen. Many women who do that sue Utrogestan which is bioidentical progesterone and is thought to be safer re. breasts than synthetic sorts.

Lots to think about! You might need to chat to your dr again and ask for what you'd like to try and take along some evidence off the web, or see someone else. What do you think?