Estrogel and Norethisterone - advice please!

[Gevvy]

Hello, I'm 51 and have mostly regular periods, with about 4 missed in the past 18 months - I only ever skip one, if at all. I've taken black cohosh which kept the hot flushes at bay, but in the past few months, they've come back, and I've also had joint pain, horrible fatigue and total lack of motivation. I went to the GP who prescribed a conti patch, but the leaflet said I needed to be period free for 18 months, so I went back again.

This time, she prescribed Estrogel and Norethisterone, and the pack says I should take them within five days of my next cycle. Trouble is, I was due 10 days ago, and have skipped this month (horrendous hot flushes and what feels like an actual battle going on in my body). I don't want to wait until my next period to start the gel.

Should I just use the gel and leave the Norethisterone until my next period? Or use them both together now? Any advice would be greatly appreciated - I'm new to this HRT lark!

I'm really confused by this @Gevvy.

I was given Norethisterone and used it for some years before swapping to something else.

It's quite unusual - not to say unheard of- for a GP to prescribe this as HRT (mine was through a consultant) as usually Norethisterone is in a patch or a combined pill.

It's not correct to take them 5 days into a bleed.
The way they are used is for several days a month- 10-12 days- from either the middle of a cycle (like day 15) or you can take them on the 1st day (or any day as long as it's the same one each month) to try to 'set your cycle if you have irregular periods.

How many days are you supposed to take them if you start on day 5?

Is this the information in the pack for women wanting to delay a period? (very different to using it as part of HRT.)

As it's the 1st today, you could start your gel and by the 15th use Norethisterone for 10 days. Then start again with Noreth on 15 April etc.

HOWEVER what dose are the tablets? They come in different strengths, of 1mg and 5mgs.

I think you need to see another GP- yours doesn't know what she's doing and although I am trying to help, I don't want to 'prescribe' for you!

Thank you @JinglingHellsBells - so grateful for your thoughts. The dose is 350mcg and it says I should take one a day for 12 days every cycle.

I was also confused by the information suggesting it was for delaying periods. I can't find anything online to suggest it's used in HRT. My GP has prescribed it as progesterone to balance the Estrogel.

I'll ask to see another GP I think - still using the gel, but haven't taken the norethisterone.

@Gevvy
There is nothing wrong with what you've been given.

It's just that most GPs don't know this is an option!

The dose is a bit odd; it's usually 1mg a day for 12 days (as it would be if it came in a 4-week blister pack.) There is no harm in using 3.5mgs but nevertheless I'd go back and ask on that basis alone.

If you look at this table about HRT types (these are packs of pills) you can see the Norethisterone is 1mg in each.)

www.menopausematters.co.uk/perimeno.php

@Gavvy BTW that dose is too low; it's only 350mcgs. For HRT you need 1mg (which would be approx 3 tablets.) See your GP.

Thanks @JinglingHellsBells - I'm going to call them in the morning. Really, really appreciate you taking the time to respond and share your insight. Thank you!