Weaning off evorel conti patches..

[patti21]

Hi, I am new here and I hope I am posting in the right place.. I have been on everol conti patches for 13 years and my Dr has advised I stop by weaning myself off. I have actually been cutting the patches in half for the last 5 years and it seems to have been ok. He has prescribed some Oestrogel for me to wean myself off but I am not sure how to implement this.. also thinking about it now, I could cut my patch down over a period of time and wean that way? if I cut the patch down further does anyone have any advice on how slowly to do this please.

[pinkfrocks]

I use Oestrogel and suggest that if you want to wean yourself off HRT then weaning off gel would be easier than cutting up a patch time and again!
With gel, you can reduce the amount to 1 pump daily (as an example) which we would 0.75mgs a day. You could then reduce it to half a pump and use it only every other day, then reduce further.

However why has your Dr suggested you stop? How old are you?
If- guessing- you have used HRT for a premature meno and are now around 50-ish, there is no need to stop at all if you feel you gain some benefits. It is also safe to use HRT after 60 as long as it's (usually) transdermal and you have no other medical conditions that make it high risk.

The latest guidelines from NICE which came out June 2015 say that drs should review HRT annually, explain risks and allow a woman to decide for herself what she wants to do, unless she is at high risk for some reason.

NICE has categorically stated that there are no time limits to the use of HRT and every decision must be made on an individual basis for the patient, taking their wishes into account.

[pinkfrocks]

Sorry- forgot something. Oestrogel does not contain any progestogen so if you have used conti HRT before you will need to use another progestogen either once a month as a sequi regime, as long as you use the gel, or daily if you want to continue the conti regime with no monthly bleed.
To be honest, your GP ought to go through all of this with you if you agree to stop in the first place.

[patti21]

Hi and thank you for your reply. I am turning 65 next month and my Doctor is not happy about me using HRT because of the instance of breast cancer etc., I will taper off and see how I feel. The reason I started it was because I had bad night sweats. If they come back then I will have to rethink my situation. I am quite happy to cut my patch down by slithers.. but would like to know how much and how many weeks etc.,

[pinkfrocks]

You ought to ask your dr then. How can they ask you to do this and not tell you how?

Your dr I am afraid is misinformed and ought of date. It is not his decision to stop your HRT because of very small risks of breast cancer.There are consultants who are far better informed than your GP who are happy for women to carry on forever because they know the facts and stats better. This was the whole point of the NICE guidelines- to try to stop this kind of practise by GPs who are out of date. Basically,the choice is yours- if you have researched the stats and decided the risk is not one you are happy about, then stop. If you don't know the risks and your own absolute risk, then find out and make an informed choice. In other words don't be 'told' what to do- it's your body!

[patti21]

Thank you Pinkfrocks, well this is certainly thought provoking. I was told if he prescribes further then (his words) "the men in black will come for me" So If I tell him I want to stay on HRT he should in all fairness agree to keep prescribing it? He told me the instances of breast cancer, heart attack and stroke go up as I get older. I understand this and I feel healthy at my age, not much to grumble about.. I have booked a call with him so as to discuss this further. Thanks so much for your advice, much appreciated!

[patti21]

Sorry forgot to ask, do you have a link to NICE info please?

[pinkfrocks]

I'll find the link for you. There is the full version and the shorter version but both are quite long. It's available under 'NICE guidelines for menopause June 2015, draft paper'.

I have also sent you a PM.

[pinkfrocks]

This is the consultation / draft paper which is going to be finalised later this year.

NICE GUIDELINES

It's fairly long still but is easy-ish reading. you ought to be able to find the parts about no stipulated length of time to stay on HRT if you scan through it.

[pinkfrocks]

This might be easier to follow- see the bullet points about no arbitrary length of time and the decision being the woman's.

www.thebms.org.uk/statementpreview.php?id=1

he British Menopause Society Council aims to aid health professionals to inform and advise women about the menopause. This guidance refers to estrogen- based hormone replacement therapy (HRT) and tibolone, which is classified in the British National Formulary as HRT. Treatment choice should be based on up to date information and targeted to individual women's needs. HRT still offers the potential for benefit to outweigh harm, providing the appropriate regimen has been instigated in terms of dose, route and combination for a valid clinical indication.

23 May 2013

Summary practice points

The decision whether to use HRT should be made by each woman having been given sufficient information by her health professional to make a fully informed choice.

The HRT dosage, regimen and duration should be individualised, with annual evaluation of pros and cons.

Arbitrary limits should not be placed on the duration of usage of HRT; if symptoms persist, the benefits of hormone therapy usually outweigh the risks.

HRT prescribed before the age of 60 has a favourable benefit / risk profile.

It is imperative that women with premature ovarian insufficiency are encouraged to use HRT at least until the average age of the menopause.

If HRT is to be used in women over 60 years of age, lower doses should be started, preferably with a transdermal route of administration.

It is imperative that in our ageing population research and development of increasingly sophisticated hormonal preparations should continue to maximise benefits and minimise side effects and risks.

This will optimise quality of life and facilitate the primary prevention of long term conditions which create a personal, social and economic burden

[patti21]

Many thanks!.. I feel I have used a 'lower dose' as I cut the patches in half.. I must say this has made me feel unsure about my Doctor's advice..

[pinkfrocks]

And don't forget that the comment above about lower doses after 60 possibly means (it's a bit ambiguous) that they are talking about women starting HRT over 60, not who are already on it.

[patti21]

Hi Pinkfrocks, I have spoken to my Dr. this morning and we have a plan for my way forward which I am happy with. You have been so helpful and kind. thank you. Very much appreciated! Warm regards. Patti

[Jannygirl3]

Hi there, it has really helped me to read this discussion thank you.
I have had the same problem with my (male) doctor telling me that I am too old now (at 65) for him to continue to prescribe the hormone patches -Everol Conti.
I told him that when I try to stop the sweating comes back but he says that he's not happy (!)
This is the same doctor who keeps on insisting that I should take statins to reduce my high cholesterol (even tho they make my hair fall out.)
I found this site because I was looking for a way to wean myself off the patches & I too was going to cut them down slowly (with scissors!)
After all, they're a matrix patch which means that the hormones are evenly distributed through the glue...
I've just seen that this thread hasn't been posted on for a year but good for you mumsnet, you are the only site with this info on.
I am disgusted that my GP still hasn't caught-up with the NICE recommendations after they've been available to him for a year, disgusted but not surprised.
I actually want to cut down on the hormone therapy for a different reason chlamydia -my immune system is messed up because of poor diet & heavy drugs (I have ME & fibromyalgia) so I was considering trying a chlamydia diet, to see if an overgrowth of yeast is causing the problems for me.
Thanks for your help & bless you.💐