HRT pills to patches, confused & frustrated

[BillytheMountain]

Hope someone can help here, I'm getting a bit desperate and frustrated.

I started HRT pills a few months back (Elleste duo) as night sweats, sleeplessness and the rest was all getting too much. They seemed to calm things down and I could sleep and be semi-normal again. When it was time to renew the prescription they were no longer in stock and unlikely to be any time soon according to our pharmacy.

Doc prescribed Femoston, which was initially okay but I feel real queasy in the mornings and now very tender sore breasts (mainly one). When I take my bra off, they feel so heavy. It was never like this before even with onset of my period.

I spoke to the doc (phone consultation, it's all they ever want to do) yesterday and she suggested I tried patches. I've been given Everol Conti and as I forgot to ask how to transition to them and have been pouring over the instructions and net-searching. It would appear they are usually for woman in menopause, my last natural period was December, before that October.

How long does it take on average to get some medication sorted that is (a) available and (b) works!

I'm really scared to go back to how things were, I was exhausted with lack of sleep and no concentration at work. I feel I'm taking really strong medication without that much thought or interest even from doctors (all female doctors) too.

Any advice, help, positive and happy endings appreciated!

You ought not to be using a continuous combined HRT after only 6 months of no periods. Conti HRT is for women who are 12 months post menopause or over aged 54.

The other HRT you had was sequential.

If you want a patch you need one that is sequential.

You could try what is now considered the best and safest type of sequential- estrogen gel ( or an Estrodot patch) and Utrogestan 12 days per monthly cycle.

Femoston though is supposed to be well tolerated so maybe you just need to give it a bit longer. How long have you used it? You are supposed to trial any HRT for 3 months at least.

I feel I'm taking really strong medication
HRT is not strong and it's not medication. It's replacement hormones and is less that you ever had as a fertile woman!

Thanks for replying and advice JinglingHellsBells.

I was quite concerned after reading leaflet and searching around, kinda thought the doc herself should've been aware of this before prescribing. I feel like you have to keep on top of it all, and in the state I'm in that's not the easiest!

I've been taking the Femoston for a month or so, so as you say I should give it the three months to settle down. Eager something should work, and annoyed that the first HRT was working well but not readily available any longer.

The gel sounds interesting, that's never been discussed with me so I will try and get a face to face appointment to go over all the options again.

I guess it's not regarded medication, but I don't take any other pills so it feels like that to me. It's something my body can't make any more.

Doctor told me that she could only prescribe HRT for a year and when questioned what would happen after that, she said she didn't know. Scouting around this doesn't seem to be common, and when I asked other doctor they were puzzled. There seems to be conflicting info from the professionals here, and it's confusing. I appreciate every woman's body is different but it would be amazing to find some solid researched info to navigate this minefield!

Hi! When I started hrt 2 years ago I was convinced that it is dangerous and not appropriate, a kind of addictive drug. My first gyn said that it is addictive like heroin!!!! Give some time and things will be better with time!:)

Thanks Emerld13, I'll try and relax a bit!

How much time did it take for things to settle down for you?
I realise I'm at early stages, still finding HRT that works for me, and that only taking it for a year like the doc said initially isn't the norm.

Like ballet dancing through a minefield at the moment

Ah, meant to ask, were you given a time limit to take it? Emerald13 or will they review things every so often?

Did your dr really mean she would only prescribe for a year OR did she mean you need an annual review?

You need a review at least once a year even if it's on 'repeat'.

There is no time limit to using HRT. I am now into year 11 on it. I will carry on as long as nothing happens meaning I need stop.

Have a read of the website of the dr Louise Newson. It's easy to read and loads of info there.

Hi Billy, I started to feel relieved almost immediately and normal again after 4-5 months.
As for how long I can stay on hrt, I don’t know for sure. My gyn and my endocrinologist say that I can stay at least until 51 and afterwards it is up to me. It is my biggest fear, what will happen if I stop taking it. I guess that I will age almost immediately! 😱😂

Yep, Jingling she did tell me at initial consultation that she could only give me HRT for a year! I have no other health issues other than getting older!

When pressed on this, and mentioning I had never read of this before she said it's too dangerous to take for more than a year and closed the conversation.
I feel reluctant to trust the doc's tbh, with this and the prescription of 'wrong' patches too. You have to be on the ball, and what with brain and concentration all over the place, it's hard to keep on top!

Thanks for the website tip, I'll check it out this evening

That's interesting Emerald, I'd give anything to feel normal, seem to lurch from one thing to another!

You sound young, I'm already 53, thought I had to wait until periods were gone before seeking help but it all got too much, was a real mess when I got there.
During the consultation I felt she understood but when asked the same question: what happens when I stop? Doc shrugged and said I don't know...

How did you find your gynaecologist? I feel like the GP, or the ones I have access to, are not that clued up.

I am 43 and my early menopause was a huge shock for me.
I am not in UK and I went privately. I spent a lot of energy and time to find a gyn who knows and cares.
For me hrt is a lifesaver and my only concern is about breast cancer risk and the duration of use.

Yep, Jingling she did tell me at initial consultation that she could only give me HRT for a year! I have no other health issues other than getting older! When pressed on this, and mentioning I had never read of this before she said it's too dangerous to take for more than a year and closed the conversation.

I would report her as being unable to prescribe correctly.
How she can be so misinformed? It's truly a disgrace. She is incompetent.

BMS
Summary consensus statement

Hormone replacement therapy

Summary points

All women should have access to advice so that they can make informed decisions about diet and lifestyle and treatment options to optimise their menopause transition and postmenopausal health.

HRT dosage, regimen and duration should be individualised, with annual evaluation of advantages and disadvantages.

Transdermal estradiol is unlikely to increase the risk of venous thrombosis or stroke above that of non-users and is associated with lower risk compared with oral estradiol.

Limited evidence suggests that micronised progesterone and dydrogesterone may be associated with lower risk of breast cancer and venous thrombosis compared to other progestogens.

Arbitrary limits should not be placed on the duration of use of HRT; if symptoms persist, the benefits usually outweigh the risks.

HRT prescribed before the age of 60 or within 10 years of the menopause has a favourable benefit /risk profile and is likely to be associated with a reduction in
coronary heart disease and cardiovascular mortality.

If HRT is used in women over 60 years of age, low doses should be started, preferably with a transdermal estradiol preparation.

Women with POI should be encouraged to use hormonal therapy at least until the average age of the menopause. HRT or the combined contraceptive pill would be suitable.

However, HRT may confer a more favourable improvement in bone density and cardiovascular markers compared with the combined contraceptive pill.

This is really helpful Jingling, thanks for taking time to post this, got some more research to be getting on with.

I will ask for face to face meeting with original doctor too to speak about the year only HRT

I feel less panicked about things, thanks both!

I'm angry on your behalf - why do we get such poor treatment from some GPs?!

Have a look here at (some of) the alternatives for perimenopause:
www.menopausematters.co.uk/perimeno.php

Were you on Elleste Duet 1mg or 2 mg?
If 1 mg, you could swap to Novofem which has identical ingredients as Elleste Duet 1mg.
Femoston has Dydrogesterone in the progestogen phase which may be causing your side effects?

If you were on 2mg then there are other tablet options with the same ingredients.

If you want to switch to patches, the EVOREL SEQUI is the medium dose option.

Lots of people on Mumsnet seem to recommend what Jingling said:
estrogen gel ( or an Estrodot patch) and Utrogestan 12 days per monthly cycle.

But it isn't for everyone. I tried to switch away from Elleste Duet to a transdermal/gel route and the Utrogestan capsules made me feel terrible - migraines, confusion, sleepiness - so I had to stop.

Good luck!

Wow Llama, that's so helpful, thanks!
It was Elleste Duet 1mg

It does feel like an uphill battle with the GP's tbh, but armed with this information I more ready.
Was shocked, saddened that I could no longer obtain Elleste, when things were going well so will definitely pursue Novofem option too.

I feel like they make me fit the stereotypical hormonal raging old woman, but, hey, no wonder!

I look forward to delving into this properly, am truly grateful for your input

Elleste is back in stock according to someone on Menopause matters, whether all Ellestes ar e i dont know

That's amazing news, I'll speak to our pharmacy today! Thanks princessTiasmum