novofem gave me migraine, will Elleste Duet be the same?

[queenrollo]

The first HRT I had was Novofem. I was wary as I had awful trouble over the years finding a contraceptive pill that didn't cripple me with migraine.
I persevered through two hellish months on Novofem but had to stop. I was put on Evorel Sequi patches. They have now stopped working and my GP has given me Elleste Duet instead.
I have been talking to a few people and reading online and am just really worried that I am going to be the same on this as I was with Novofem.
I have been reluctant to swap my copper coil for a Mirena but now am thinking that actually that might be a better option.

I really cannot face the debilitating headaches, I have another chronic pain condition which they cause to flare up putting me in a viscious cycle of pain.

I'm just trying to get as many experiences as possible before I make a decision as to whether to start the Duet or just not risk it.

I was on Elleste Duet for years and had a regular monthly migraine. I have always had monthly hormonal migraines almost all my life though.

Elphame I spent most of my 20s losing days to migraines and eventually found it was the various contraceptive pills I was on. When I came off them the migraines stopped.

I'm just so reluctant to start this prescription next month. I will be on the latter part right when we're on a camping break and I do not want to spend 4 days losing my holiday because I am crippled with a migraine!

In that case I would delay. Mine would hit 48 hours before the bleed, so for me about 3 days after starting the progesterone phase.

Have you been offered the gel/utrogestan combo? It didn't suit me at all but I didn't get any migraines from it.

The only other option they will offer is gel and Mirena. I have been reluctant to have the Mirena for various reasons, but am thinking now that maybe I should try it.

Could you ask?

I was also offered the Mirena but I was worried that if it didn't suit me I'd have trouble getting it out. They seem much keener to fit them than remove them from what I've heard.

That's my issue. I have several local friends who did not get on with it at all and had real problems getting it removed. My GP surgery don't fit them so I'm reliant on the Family Planning clinic which is less accessible.

@queenrollo A lot depends on WHEN you get the headaches. As a migraine sufferer myself, my migraines (pre menopause) always came at the end of a cycle, just before a period (when progesterone was falling.) Some women find the same with HRT.

So- is that the pattern you have?

Also, the type you have been given comes as both sequi and continuous. Which do you have? Sequi gives a fluctuation in the progestin over the month but continuous won't (as it's every day.)

This is really something your GP ought to have talked over with you.

The progestin each of those is the same- Norethisterone.
So if it's that type which doesn't suit you, maybe you need to swap.

All patches contain it, so your options are:

1 Oestrogen-only patch or gel plus Utrogestan
2 Femoston (tablet) that has a different progestin to those you have tried before.
3 Oestrogen plus Mirena

Yes that is the pattern for my migraines. I tried lots of different types of contraceptive pill before finding one that didn't cause them. I had no issue with migraine when I was contraceptive free for conceiving. Absolutely fine with my copper coil. The Novofem brought them back, and I have been fine on the Evorel Sequi patches.

I have been given a Sequi version of Elleste.

I did tell my GP that I was concerned about migraine with progestin in tablets but honestly I don't feel they really grasp how debillitating it is.
I'm not sure my surgery really understand all the various options either as I was told it's this or an Oestrogen/Mirena combo.

Thank you for your post, it has been really helpful. I will arrange another call with my surgery and ask to try something else.

Evorel sequi and Elleste are the same- it's same hormones in the patch and the tablets.

HRT for perimenopause

Why do you think the Evorel stopped working? It's a 50mcg patch. Maybe you need a higher dose of estrogen?

Over the last month some of my symptoms are back (hot flashes, nights sweats, insomnia, anxiety are the worst)
I had a phone appointment after filling out an e-consult, requesting a review of my patches. GP says I need to increase the level of hormone I am getting but that I can't do that with just patches. They said I need to match the level of progestin to the level of oestrogen.

I explained I don't tolerate progestin well orally which is why I ended up on patches. They said they will speak to pharmacy and see what we they can give me. I didn't hear back and when we colllected the family bundle of prescriptions mine was in there - and it was this. So there was never a full discussion with me about what to prescribe anyway.

Not sure that is entirely true (increasing the progestin.)

Because lots of women are using patches of 75mcgs or even 100mcgs and still using the same amount of progesterone (it would be Utrogestan which is used along estrogen products.)

www.menopausematters.co.uk/treatafter.php

You say your GP doesn't offer Utrogestan? it's known as micronised progesterone. Unless you live in Scotland where it's different, it ought not to be a problem. Maybe they just don't know about it?

There is no higher combined patch. What some women do it add estrogen by using 1 pump of gel or even a 2nd low dose 25mcg patch as well.

However, if you get migraines with progestin withdrawal, some women like you use the HRT without a break (same as using the Pill back to back.) So that would mean the sort that are for women post-menopause.

It's the withdrawal of progestin that's your problem not so much the type.

I think you need to try to have this kind of chat with a dr who knows about HRT!

My DH is so fed up of seeing me struggle that he would rather raid the savings to pay for me to see someone privately as clearly my GP surgery do not understand how HRT works!
I'm 46, and my mother was post-meno at 48. I'm not assuming that it will be the same for me but I have been struggling with peri since I was 41 and only got HRT a year ago. I was told initially that I was too young to be in peri, then that you can only take it for 5 years so they wouldn't give it to me so early.