Question re HRT prescription

[CurtisSilky]

I'm 53, last period was 9 months ago.Have been on Vagfem for just over a year for VA.
Have been prescribed HRT though doctor seemed to know v little about it, she had to do lots of googling at my appt. She's prescribed Evorel Sequi which comes in little box as follows: 1x Evorel 50 patch to be applied twice weekly for 2 weeks, followed by 1 x Evorel Conti patch twice weekly for two weeks.
Reading some of the comments here, it seems that Conti should only be for 54+ women or for 1 year post-period, so I don't qualify.
I had mentioned to GP that some doctors don't recommend norethisterone, to which she replied there are no alternatives unless I want a Mirena coil, which I don't.
As an aside, some of my female relatives have thinning hair, which I understand can be made worse with norethisterone.
I haven't started the course yet as still have some Vagfem left. But should I be going back to the doctor to ask for something else, like Estrogel and Utrogestan?

Is it Evorel Sequi or Evorel Conti that you have - your post mentions both? (or does Sequi contain a Conti patch for the last two weeks?)

You're not technically post-menopausal, so you should be on Sequi, which will give you a monthly bleed.

Useful charts here: www.menopausematters.co.uk/perimeno.php

There are lots of passionate advocates of Estrogel and Utrogestan on here, but it's not for every one. The Utrogestan made me very, very ill.

Why not give the Sequi a go?

Op I elwill be amazed if you can even get that prescription filled. There is a major shortage of HRT in the UK at the moment with patches being hit the worst

MotherofOne yes, the Sequi contains a Conti for the last two weeks. I'm just nervous about the hair thinning part, I suppose.
IndieTara, yes, I'm amazed that I got it filled - the pharma had 3 months' worth but warned me that it would be difficult to get hold of again, which is another reason for my nervousness of starting something that maybe I can't continue anyway.
I bet there's no bloody shortage of Viagra, funny it's women's meds that are affected.

@CurtisSilky yes!! Even the last doctor I saw commented that if men needed HRT there'd be plenty in stock.

I would urge you not to take it because if you do and then can't get anymore - which none of can you'll be back where you started! As a side note my hair was thinning and I found it helped it come back if anything!!

@CurtisSilky There is no point worrying about something that may never happen to you. :) Usually women with thinning hair have it because of menopause- not using HRT! ALL HRT can cause hair thinning but equally ALL HRT can help hair grown and be luxurious. You simply have to try .

Norethisterone is an older progestogen and it is considered less safe re cancer risks if used longer term. You'd be better off with Femoston or an estrogen patch/ gel and Utrogestan (there is no shortage of those at the moment) or the Mirena coil and estrogen patches/ gel.

THE HRT shortage ought to be sorted because a few weeks ago the government instructed wholesalers to stop exporting it (this was to do with the value of the £££ and they were making money from exports) and to fulfil the UK requirements.

I was back at GP today re HRT and he didn't think it would be sorted by mid next year despite most manufacturers saying it would be

I'd suggest that perhaps you go and speak to the pharmacist who dispensed the prescription.

I didn't know Sequi had Evoral Conti in the second half, but I had lots of hair loss with it within 4 weeks of using them, but I have read somewhere that Norethisterone is to be discontinued, I will try to find a link, but both sequi and conti have norethisterone in them
I think it is just disgusting the shortages of HRT and other meds, and hopefully will be sorted before too long

There are types of hrt available which should suit most women.

There are a couple of brands with manufacturing issues which are out of supply for another 6-8 months.

This ought not to stop anyone using hrt.

There are options- Estrogel and Utrogestan are not in short supply and neither are several types of estrogen patches, the Mirena and also the mini pill can be used as the progestogen in the right dose.

The BMS has a n updated list of what is available.

but I have read somewhere that Norethisterone is to be discontinued

Highly unlikely. It's in 90% of HRT such as patches and tablets, and the only other options are Utrogestan, Provera, or the Mirena (or the mini pill but that needs a consultant's expertise to combine it with HRT.)

There is a growing trend to move away from it as it does have higher risks, but no one has talked of discontinuing.

Can i ask a side bar question of you all, has anyone extracted a prescription on the NHS for testosterone? Can’t have HRT, don’t have terrible sweats but want my libido back.

Where I read about either discontinuing or it not being prescribed was in one of the reports about HRT just after the shortage started, it wasn't by anyone on a forum, but it was connected with bad side effects
I will try to find it ,and search through everything I can remember reading about it

princessTiasmum I think what you read was a comment by a dr in the Mail saying it was one of the old types and there were newer, safer sorts.

There is nothing about it being discontinued as that would mean around 90% of HRT- everything except Femoston (pills) and estrogen gel/patch with utrogestan. Mirena - would go out of production.

No it definitely didn't say that, I will try to find it tomorrow when I have more time, I have an idea where I read it, but will need to search through some articles
It wasn't out of a newspaper it was something by either a Dr or someone connected with HRTand the shortages

www.menopausematters.co.uk/postmeno.php

I wonder what it was?
Norethisterone is in most HRT apart from those containing MPA and Provera. Both Norethisterone and MPA are known to have higher risk factors but the on;y real alternatives are Utrogestan, or the coil or dydrogesterone, which is only in Femoston.

Jinglinghellsbells this is the article i was talking about,it doesn't actually say it is being discontinued, but is to be discouraged ,hope you can read it,had to photograph it, no good at copy and pasting

@princessTiasmum It was in lots of papers- maybe you could link to the Guardian where it's taken from? There was a breast surgeon quoted in the Mail saying the same thing.

It's not discontinued as it's in around 80-90% of HRT women use. Some drs are now preferring to use micronised progesterone but it's not common knowledge.

Jinglighellsbells i will try but not good with linking etc,
It might have been the one you are meaning,it was from the guardian think

Yes it wa" Supply s in the Guardian 5th September , the best i can say is to look on Menopause matters under the heading " Supply issues update" sorry can't link
It is the norethisterone and believe it is maunly the oral which are mentioned
It seems rge manufacturers of Femseven and Evoral are merging
More info on that on MM too,or one is buying the other out

Sorry message got a bit mixed up there ,at the beginning