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Menopause

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Evorel Sequi - period issues arising after 3rd month.

3 replies

chasinghormones · 14/11/2018 15:26

I was prescribed Evorel Sequi approx. 4 months ago and for the most part, it has been a god send. The prescription is 50 micrograms of estradiol per 24 hours for the single hormone patch and the same again on the dual patch, with 170 micrograms of norethisterone per 24 hours.

My symptoms were quite bad – high level of anxiety, depression, crying over the slightest thing, crying over nothing and not being able to stop, not being in control of responses to people, sleep issues, upper thigh pain which then began to include elbows and shoulders, dropping almost everything I picked up, tripping over my own feet, brain fog, forgetfulness and lack of concentration/focus. I am 47 in 4 months and my periods are regular but much, much lighter and shorter.

Since being on these patches, overall my symptoms have improved massively. I have found I am 100% back to my ‘normal’ self on the dual hormone with still some small adjustments going on with the single hormone patch – bad eating mainly, with some lethargy which is improving each month.

Initially I had my first 2 periods on the last patch of the dual hormone and sailed through, no problems.

However……. for the last 2 periods, both times I have come on after starting a new round of patches. That is, my period comes on the 2nd day of a new 4 patch cycle of the single hormone.

It has been horrendous – the cramps come in waves, like a contraction, and build up until I am physically sick. I sweat profusely and have a flat fizzing sensation start at my feet and work up my body, where the cycle then starts again, gradually decreasing in severity until I fall asleep out of exhaustion. I literally cannot move a muscle whilst this is going on or its projectile vomiting.

It only lasts between 4 – 6 hours and has then passed but I haven’t had symptoms like this for over 10 years.

(When I did have these symptoms before, they were due to fibroids, cysts, endo and polyps, because my body reacted to a remedy for PMT I have been prescribed from a naturopath. As soon as I stopped the remedy, my symptoms disappeared within weeks. My gynaecologist was perplexed, as scans had shown the fibroids, etc, but when they went in for camera work, everything had gone and my uterus was showing as healthy. The only explanation he had was for my body to have reacted to the remedy when I was taking it.)

My GP, who thankfully is a gynaecological GP and hugely supportive, thinks it’s highly unlikely I have reacted and thinks it more to do with a surge in hormones and my body trying to balance it out the quickest way it can. She has suggested I don’t put on the single hormone patch at the end of the dual hormone until I have my period start, like what you do when you start HRT (if you still have periods)

Has anyone else experienced this at all? If I delay putting the new, single patch on at the end of an 8 patch cycle, am I risking more unbalance in my body from not having a patch on for a few days? I really don’t want to stop HRT as it has helped and emotionally, made me much more balanced and saner.

OP posts:
QueenoftheNights · 14/11/2018 16:26

I will try to answer...

However……. for the last 2 periods, both times I have come on after starting a new round of patches. That is, my period comes on the 2nd day of a new 4 patch cycle of the single hormone.

Yes that is what you would expect.

(I've never used patches so have no idea how many patches there are in each part of the cycle, but it's not relevant anyway.)

You should have a bleed roughly 3 days after the last patch containing Norethisterone. This is the same for any type of 'bleed' HRT- roughly 3 days after the progestogen is withdrawn.

This is not set in stone. sometimes my bleed starts even when I have 2 days to go on the progestogen (each cycle.) Sometimes it comes 2 days after stopping or even 3 days after stopping.

Unfortunately, it sounds as if you are having bad period pains. This can happen. I have had a few over the years and 2 cycles ago I had the most awful experience similar to the one you have described- leg cramps, sweating, feeling sick, had to lie down.

Delaying using your next patch with the estrogen won't make a blind bit of difference. I'm a bit surprised your GP isn't recognising this as a painful withdrawal bleed- which is what it is.

Norethisterone is a powerful progestogen. You could use other types of HRT that don't have this. eg Femoston (which is a tablet), the Mirena coil plus estrogen, or micronised progesterone (Utrogestan) with estrogen.

Sadly, a few women do have bad period pain with HRT and it might settle down. You could ask your GP for something like Tranexamic acid to take before the bleed is due- I think you are supposed to take it for 3 days prior- and it might help the cramps.

chasinghormones · 14/11/2018 16:46

Thanks Queen, that's all really helpful. The patches are 4 each within a one month cycle - 4 estrogen, 4 dual then repeat, and i change every 72 hours, not the days that they recommend as i was struggling with going over 72 hours between changes.

I love the dual patch - i am 100% no symptoms at all, and have had no PMT for the entire 4 months i have been using it. Considering i was experiencing PMT from as early as day 10 before the HRT this is nothing short of miraculous for me!! But, if my withdrawal period next month is the same, i will go see my lovely GP for a chat about changing.

OP posts:
Lucyk333 · 07/06/2023 06:54

Hi, I know this is an old thread but just wondering what you did after in relation to your patches. Your story is identical to mine, in terms of symptoms and how much of a difference you felt when on the patches so I was just wondering if you did take the break on the patches to have a withdrawal bleed or whether your GP changed your prescription? I too am not able to last the 72 hours with my patches.

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