Evorel Sequi Transdermal patches

[GrumpyOldBag]

GP has just prescribed these for me.

I am 52, peri-menopausal, still having regular periods.

I asked for patches rather than tablets after reading advice on here. He says start taking them on Day 1 of period.

What should I expect?

Where do people put the patches?

Also annoyed as pharmacy charged me a double prescription charge as there are 2 different types of patch wth different drugs although they all come in one box. Is that right?

Thanks.

[PollyPerky]

You should expect to feel like a new woman ! :)

Is there not a leaflet in the box about how to use? If not, google and there will be info.

Yes, 2 different drugs are 2 payments.

[GrumpyOldBag]

Thanks Polly. yes there is a leaflet in the box which explains it all. Quite complicated, but i think I'll get the hang of it.

Was just interested in other's experiences, especially if they've been prescribed the same actual meds.

[Cocolepew]

I put mine on my bum. Change cheeks with each one

[KilburnOriginal]

I didn't get charged double! I pay one prescription fee for the entire prescription regardless of the fact the box contains 2 different types of patches, it's still only one prescribed item, I'd challenge them about that personally.
I've noticed a huge change in hot flushes and night sweats. I sleep better and slowly feel like my constant pmt is easing. You should start to feel much more like your old self soon.

[asilverraindrop]

I've been on them for about a year and find them wonderful. I actually only use half the prescribed dose (I cut them in half) and find that sufficient. They have made a huge difference to me in all sorts of ways, and the adhesive is really good IME. The doctor warned me that there would be two prescription charges because there are 2 hormones, and I have always been charged two. KilburnOriginal is the lucky one here!

[GrumpyOldBag]

Interesting silverrain. Did you start with a full dose and then cut to half?

[PollyPerky]

There was a feature online a while ago about people reducing medication- tablets and patches- by cutting in half. The advice from pharmacists was not to do this for various reasons. Tablets for example can be in a slow release coating so cutting them destroys this, but with patches some of the content can be lost or the slow -release rate of the drug can be affected- it depends on whether the patch is a matrix or reservoir patch. TBH if you need a lower dose, then it's better to have a lower dose patch!

[asilverraindrop]

I'm a health care professional (though not a doctor) and so feel pretty comfortable with deciding which medications you can adjust the dose of without problems. I started on a half dose because I never got on with the Pill very well when I was younger, and I thought I would rather titrate the dose upwards than wallop myself all at once. It was a way of getting the sort of flexibility one might get with using a gel format while using the medication that the GP was willing to prescribe. Given that absorption from the patch must fluctuate for other reasons, such as the blood supply to the area, how well the patch has adhered on that occasion, the ambient temperature, etc, I'm not too worried. And it reduces the cost!

[PollyPerky]

sounds as if you know what you're doing silver. Why won't your GP prescribe gel? It's mainstream and plenty of women get it on the NHS.

[asilverraindrop]

She didn't refuse, she just recommended the patches, and while I wanted transdermal I wasn't sufficiently set on gel versus patches to argue. Also, I wondered about absorption from the gel, because if you are applying it twice daily then surely the hormone levels in the bloodstream must fluctuate more than from a patch which is there all the time, and it seemed to me like constant absorption would be more physiological. My only concern with the patches is that they contain progestagen rather than progesterone. I deal with that by using the oestrogen one for 4 weeks and then the dual one for two weeks, so I am using it on a slightly longer cycle as well and thus reducing the time I take the progestagen for (which is another thing that comes from the half dose, because it gives me the spare patches to do this). Obviously all this is my own tweaking, not as it was prescribed, don't try this at home, etc. If the GP gets round to a medication review at some stage then I might ask about going for bioidentical gel for the progesterone.

[PollyPerky]

As far as I know, the gel absorbs well and lasts over the day keeping serum levels where they ought to be. I apply it as a split dose, morning then at bedtime, which is what some drs suggest. I don't think oestrogen levels rise and fall that critically over a 12 hour period. Women who stop using it say it takes 3 months for their levels to fall to a level where their symptoms resume (if they are going to.)

There isn't a gel for progesterone unfortunately, the only route for progesterone is capsules - Utrogestan.

[asilverraindrop]

Oh, really? I thought there was. Maybe that's in the US?

[PollyPerky]

As far as I know, it's not available at all. The US is usually 'behind' the UK in terms of HRT because they still keep pushing synthetic oestrogen (as was used in the WHI study.)
My consultant says that you can't use transdermal progesterone except as a progestogen patch because the amount needed to rub on the skin to have the desired effect would be unacceptable- it's not available, anyway. I'm sure if it was, he'd have offered it to me- been using gel for over 7 years now.

[asilverraindrop]

I don't doubt you. Thanks for the information.