Would you recommend your HRT?

[bigTillyMint]

I am curgently on Kliovance which my GP said was fine despite me still having periods. It is continuous and supposed to make periods stop (Notheristerone) but I have had daily spotting since starting on it over 2 months ago and constantly feel like I'm about to start a period Plus my libido has plummeted.

Prior to this I was on Fermosten for a few months but wanted to swap as I was feeling really grumpy and my periods /PMT were getting worse.

And I had swapped to that from Prempack C which I had been on successfully for about 5 years as I wanted to try a lower dose and GP agreed.

I am thinking of asking to go back to Prempack, but maybe there is another one I could try?

I think finding the best type depends on your priorities. For me, it's safety and reducing the risks. I've used it for 8 years and been told I can carry on (unless reasons not to occur.)

I use Oestrogel which is great because you can alter the dose to suit needs. I use micronised progesterone (Utrogestan) for 10-12 days every few weeks (have avoided a 4-week monthly cycle because I didn't want bleeds every month in my 60s) but this is under the guidance of a consultant.

My own preferences are:
I want bio identical hormones ( so that rules out Prempack as it's conjugated oestrogen)
I don't want pills because they are linked to a higher risk of blood clots.
Don't want patches as they are unsightly (imo)
Don't want synthetic progestogens taken daily are linked to the highest risk of breast cancer. (All the research is leading this way - dydrogesterone seems safest of the synthetics, medroxyprogesterone the least safe) )
Don't want the Mirena for same reason.

I tried continuous Utrogestan but I got headaches and spotting daily for 3 weeks and decided it wasn't for me.

They do say give all conti types 6 months for the bleeding to settle so you could carry on a bit longer?

Thanks for replying!

My GP says they only prescribe pills - not gels/patches.
I would rather have bio-identical hormones, but as I don't know which pills contain them and the GP isn't an expert either...

I was trying to give these new pills a chance - got to go back soon as GP wanted me to just try 3months, but it feels like my body is telling me it is not ready to stop periods completely

I'm not sure about this but I suspect your GP is not allowed to 'ration' the types of HRT they prescribe. I don't know where they are coming from with the 'can't prescribe patches or gel' but I suspect it's unethical.

If it's on the basis of cost, this is not right. I'd query it and if necessary ask the practice manager or someone else.

I'll try and do a link :)

www.menopausematters.co.uk/perimeno.php
This shows the cost and the type of oestrogen. CEE (conjugated equine estrogens are made from horses- they are not bioidentical- all others are.)

Conti HRT is for women who have not had a period for 12 months. If this is not you then you should be on sequential.

If necessary, ask if there is an NHS menopause clinic in your area, or pay to see a gynae for a one-off consultation and they will write to your GP saying what you have to be prescribed.

Thanks, Polly. I think I will ask if there's a menopause clinic - I'm in inner London, so it's possible and then at least I could talk to someone who knows.

I also thought that about the continent, but she said that as I had been taking HRT for over a year, I could go on it. I did wonder. I ghink she's muddled that with not having s period for a year.

*conti obvs!

I am on the same regime as Pollyperky and can't recommend highly enough libido back and around healthier and happier.

The very best NHS clinic is with Nick Panay and team at the C&W.

here are the details

www.chelwest.nhs.uk/services/womens-health-services/gynaecology-services/menopause-and-pms-clinics/referrals

Thanks! I will enquire!

I sm nearly 52 - would the gel you are usin be suitable for me too?

Just Google for my authority and there is a clinic in a teaching hosp and it says referrals by GP for bleeding when on HRT - that is me, so I will asK to be referred - thanks!

I think the line to take with your GP is that she doesn't know much about HRT( has she said this to you? If not be tactful!) so you'd like a referral having tried 3 types and not really got on with them.

Gel is suitable at any age. I started with it around the same age as you. Transdermal (gel/ patches) is recommended for all women as they get older because it's safer re. blood clots (this is in the NICE info on menopause) so if you wanted to stay on HRT long term, your GP would have to consider this anyway. That's why it doesn't make sense for her to say they 'don't offer it' because one day there will be a woman who needs it due to age or medical risks.

There is usually a list of products different health areas will allow you to prescribe but these should include patches and I think gels too. Where I am we can email for advice when we get "stuck" with menopause problems. I'm on evorel Conti and it's changed my life. Only been on 5 weeks.

I am on Evorel Sequi. Been on it for 3 months. 52. Getting on fine.

Wear the patches on my thighs & not an issue with 'unsightliness' as only DH sees them! And he appreciates the benefits they bring ...

If I had to go to a beach/pool would move to my bum for the duration of the holiday.

I'm 50 and perimenopausal, I've had a Mirena IUS for just over two years and this provides my progesterone (originally just as a contraceptive). I've been using Oestrogel for 8 months now and I'm very happy with it.

I started on the minimum dose but have upped that for the last few months (GP aware) as I was starting to really struggle with mood/anxiety issues and the increase in oestrogen has helped.