Evorel Sequi - 4m in & not great - return to GP?

[52andblue]

Hi, I am now on my 4th month of Evorel Sequi.
GP prescribed after asking for 2 years of peri symptoms getting worse. I was still menstruating each month. I am 54.
I have had a slight relief but am still getting insomnia, hot flushes & brain fog, plus itchy skin etc. I am also having v heavy periods on this.
GP is disinterested. I'm rural so no other option. It is possible I might be able to ask for a referral to a Menopause clinic. Do you think it is worth it, or do I just 'settle for this'?

I would ask for a referral. It will take a while by which point you can categorically say it isn't working!!

You could ask to try Esteogel (gel) and utrogestan (tablets).

Research all the options and go back in as informed as possible. Good luck!

Is the dose high enough?

@Summerhillsquare
ah, I didn't know it came in different strengths?
I am on the 50 unit dose (age 54, BMI 26ish)
Although I was still menstruating when I started it, (aged 53 3/4) my periods were beginning to shorten and the gap between lengthen.
The only other poss relevant info is that my hormones do seem to be a bit sensitive in general. I had 3 rounds of IVF many years ago (when the hormone doses were pretty brutal and they were harvesting 40+ eggs each round). I ended up with OHSS and long term problems with my ligaments after I had early hormone induced 'relaxation' each time (SPD) so I've always thought it would be worth seeing a specialist in female reproduction / hormones type of thing. But I am NHS, rural Scotland and my GP is very 'unsympathetic' so I've never got anywhere with it (and am still on crutches which I am sure the GP thinks is psychosomatic!)

Yes, I started on the low dose, and went up to the medium (as per the link below) as after a week or two of relief, my symptoms came back.

www.menopausematters.co.uk/treatafter.php

This website seems quite reputable, my GP recommended it.

I went back to my GP.

she says that Evorel Sequui Conti is only available in 1 strength.

I cannot absorb tablets properly (gut issues) so tablets not ideal.
She said I'd have to have a coil then' but I'm not sure about this.

Can anyone advise please?

(I appreciate I should do my own research but have been offered a short notice cancellation for tomorrow and have a sick child (not covid) tonight so chance would be a fine thing...

Sorry I can't help!

Bump.
Anyone ?

i would as to use the gel and the utrogestan tablets, but instead of taking the tablets by mouth, insert them vaginally. I think Dr Louise Newson is where i read about doing that, and has fewer side effects than taken orally, but would also have the benefit for you that it bypasses the gut

@Branleuse - thank you! I didn't know you could do this?
I just googled Utrogestan vaginal but it came up with a capsule that is used in IVF. I take it I should ask about the Tablet but use it vaginally? (GP already knows I have gut absorption issues)

I'm really surprised that there isn't a higher strength patch too?

I did read somewhere that if you take Utrogestan orally as 2 capsules you take only 1 if taken vaginally.

But please research that, dont take my word for it!

[quote 52andblue]@Branleuse - thank you! I didn't know you could do this?
I just googled Utrogestan vaginal but it came up with a capsule that is used in IVF. I take it I should ask about the Tablet but use it vaginally? (GP already knows I have gut absorption issues)

I'm really surprised that there isn't a higher strength patch too?[/quote]
if you follow dr Louise Newson, she has suggested it and she is very well respected and expert in menopause issues.
She mentions it in this
www.newsonhealth.co.uk/uploads/2021/07/Progesterone-Intolerance-v21-02.pdf

@SprayItOnMe

I did read somewhere that if you take Utrogestan orally as 2 capsules you take only 1 if taken vaginally.

But please research that, dont take my word for it!

It’s been widely discussed on here that you should still take two even if vaginally. I haven’t tried it but I have had to go up to the 100 strength patches and utrogesten tablets as the sequi weren’t strong enough.

@roykentah! So there ARE stronger patches then? (GP says no)

Yes there are stronger Estradiol (estrogen) patches, in Evorel and other brands. They come in 25, 50, 75 and 100. Just how GPs are so clueless on HRT remains an enduring mystery to me - they could just read the NICE guidelines and NHS advice like the rest of us.

I'm sick to death of my GP and her utter drivel and I've got to the point where I need to request a change of GP and a referral to a menopause specialist. Bloody awkward though, when one feels physically and mentally buggered to start with.

I use evorel sequi 50s and I also have estrogel to top up when I need to.