Informed about HRT but still confused!

[menopausemuddle]

Hi,

I'm in menopause ( last period August 2016)
I was always wary of HRT but I know there are some health benefits . I was referred to a HRT clinic a year ago where the consultant was enthusiastic about the benefits. Still, I hesitated .
About 3 months ago I went to my gp and she said just try it , you'll be a new woman . She gave me everol conti patches . Within days I was sleeping through the night . The flushes went .
However as the weeks went by I noticed a nagging headache the day after I put a patch on and some pmt like crying jags and pelvic aches. Also aching calves which come and go . I also have a borderline under active thyroid which I would like treated .
As an experiment I started cutting the patches in half . The headaches went . I don't have quite the same energy as when using full patches but I like the idea of an even lower dose .
I will be ringing my gp on Monday but has anyone else gone rogue and cut patches in half ? Any other thoughts about everol conti ?
Thank you in advance

You are possibly being affected by the progestogen in a conti patch. This can be a real issue of loads of women. GPs are very keen to dish out conti HRT (going by the rule book of no periods for 2 years) but it's often best to start with sequi. That means you take estrogen only for half the month ( at least) then estrogen +progestogen for the rest and have a withdrawal bleed at the end of the 4 weeks.

Starting with conti means you can never tell which hormone is too much or too little.

Not much point cutting patches in half as you will lose the benefits of estrogen . It's not the estrogen that is the issue.

FWIW I have been on HRT for 11 years, am 60+ and can't get on with conti at all (headaches etc.)

Maybe swap to a sequi type?

Thanks queen for your reply.

I realised it was probably the progesterone . I might ask the gp to send me back to the hrt clinic .

I cut them in half to lower the dose overall because Im a bit overweight and I know that's more of a risk factor for cancer than hrt . So I was trying to reduce that combining effect I suppose . I don't even know why dose everol conti is !

I'm not too keen on having periods again or the effects of progesterone . I'm still confused despite doing little else but read about hrt !

The cancer risk is almost negligible for the first 5 years anyway. Better to get the right dose and feel so much better to help tackle the weight loss. Also- and this is fact- there is less of a cancer risk with sequi than conti; the cancer risk comes from the progestogens.

There are plenty of options so don't give in yet if it's helping. You could think about the Mirena coil plus estrogen? Or another type of progestogen- Utrogestan- which is not synthetic so may have fewer side effects.

Yes , I'm thinking of a transdermal oestrogen and a separate progesterone . I'm hoping if I have to go back to having 'periods' they won't be like the perimenopause ones.

I have been watching a series of videos by a retired dr , she's a bit eccentric , (nothing wrong with that) but my goodness she is thorough in her explanations .
Google 'menopause barbie' ( her name is Barbara ). You'll need a week!

Only had a tiny peek at her but don't forget she is in the US; their research is behind the UK in some respects (on HRT), their WHI research was flawed, and they tend to use the older types of HRT too.

Queen I think that they tend to use higher doses of estrogen especially for young ages and hrt is a kind of anti-aging method in USA if my understanding is correct.

Menopausemuddle, dr Barbie is one of my favorites experts, I find her unique and very very informative. She actually makes my day! :)

Re menopause Barbie, I started by watching whichever video took my fancy. But she insists that they should be watched in order and for once I did as I was told. The early videos might be a bit basic but that's good teaching , she has to establish a baseline.
A lot of detail is added bit by bit . I feel much clearer about the biology but she is neutral, giving only the facts. She also looks in detail at herbs and complementary medicine if anyone is interested in that . She treats all approaches with respect.

I still want someone to tell me ' do this'.
Everything has risks though, as she points out. Taking HRT and not taking it -both have risks.

Queen , I didn't know that the UK was ahead in HRT research, I assumed we would be similar. Though I did notice that Dr Barbie says HRT protects your bones and I've read that the latest research is more nuanced about that.

Have a look at the website of Dr Louise Newson- My Menopause Doctor. Great site and she is a specialist GP.

Queen , I didn't know that the UK was ahead in HRT research, I assumed we would be similar. Though I did notice that Dr Barbie says HRT protects your bones and I've read that the latest research is more nuanced about that.

It's not so much we are ahead with research per se but the UK was the place where they reviewed the US WHI study and found it flawed. (HRT was given to old, overweight, unfit women and hence the data reflects adverse effects which were then extrapolated to younger, fit and healthy women.) The US also relies heavily on estrogen made from horse urine rather than natural types made from plants.

HRT undoubtedly protects bones and is given to women for that in some cases.

Thank you

I'll have a look at that site

Re your OP - not withstanding that you may not get sufficient oestrogen to alleviate your menopausal symptoms, it is perfectly OK to cut Evorel conti patches in half ( off licence) - leading gynae Dr Heather Currie sanctions this. I can understand why your headaches went because of the reduced progestogen. I agree with what QueenoftheNights suggests - try a different type, preferably sequential. I use Estradot patches with separate progesterone - patches much smaller and stick very well.

Bit overweight? If only a bit, then not such a problem compared to being very overweight or obese - and also makes it very easy to lose whatever you need to! Not such a big hurdle! No time like the present....

Hi Bellacio

Thank you for your post .
How does HRT help with losing weight ? I found I put it on . Water retention maybe . I had the same with BC pills when younger.
I hope you are right though!

I didn't say anything about HRT and losing weight! Just pointing out that if you are only a bit overweight then not so much to lose than if you were very overweight so should be easier....

There is information about menopause, HRT and weight gain here and here

Also some of the synthetic progestogens can cause bloating and water retention....or even progesterone itself if you take it all the time.