Evorel Sequi & family cancer history

[medianewbie]

Hi. I'm 54. After 3 yrs of asking my GP finally agreed to start me on Eveorel Sequii Conti (50) due to many peri symptoms (tho still menstruating). Ive been using it for 8m. It helped to start with, but the effects started tailing off. I was just about to increase dose when supply issues so I've stopped completely for last month.

Qu is: my Mother just died of Ovarian cancer. She was 82 tbf but she told me that her Aunt died of this too. A different aunt & my own aunt (her sister) both died of breast cancer.
I told GP & she said: 'all fine'. I asked for ref to Menopause clinic. GP agreed but said: 'it will be a year or more'.

I wondered if it's worth asking if I can get checked for the BRAC (spelling?) gene. I had lots of IVF 18 years ago & its always worried me what that may have done to my ovaries.

Am I worrying unnecessarily do you think?

I'm sorry to hear about your mum.

If you can afford it, I'd recommend you see a menopause consultant privately, and that will cost you about £300 for up to an hour.

That way, you will get expert advice and not need to wait for a year.
They can liaise with your GP and may suggest an BRACa gene test on the NHS.

The thing is, you've got a few different issues going on. HRT rarely increases ovarian cancer risks (statistically it's tiny increase that doesn't really make a lot of difference.) Most deaths are, sadly , due to late diagnosis.

You can also be screened (either by paying or on the NHS if they agree) and have your ovaries scanned with an ultrasound annually.
Likewise, mammograms, annually for women 'at risk'.

I'm confused about the type of HRT as Evorel is either sequi OR conti (not both!)

You might want to think about swapping to body -identical types like an estrogen patch or gel, and micronised progesterone (Utrogestan) which appear to have lower risks.

Evorel is a body identical patch isn’t it?

The estrogen is but not the progesterone. www.medicines.org.uk/emc/product/10930/pil

It's Norethisterone.

The only body identical progestin is Utrogestan (capsules.)

You should be able to be referred for genetic counselling with that family history of you read the NICE guidelines.

Ah I see. I tried the separate patch and pill combo but prefer the simplicity of the combi patches. My DM had breast cancer after taking HRT so I was always hesitant (didn’t even take contraception throughout my fertile years) but after watching the Davina prog I was convinced to give it a go. It’s been a life saver for me, so tbh I’m happy to take a risk.

@RoyKentsChestHair Specialists now do not believe that HRT causes breast cancer. They think that BC starts 10 years before it can be diagnosed, and that HRT may in some women accelerate a growth that is already there. (There is a longer description of this by Dr Currie on Menopause Matters.)

Research has shown micronised progesterone to be safe re. BC for at least 5 years with no additional cases in that time.

Again, you can find this info online such as a report in the BMJ and the BMS.

If you are worried about risk, it's considered the safest as is sequential, with combined continuous carrying the highest risk.

Thanks Jingling. I think it was described as an oestrogen fed tumour, so yes, accelerated by HRT rather than caused by it makes sense

@RandomMess @JinglingHellsbells
Its Evorel Sequi 50 patches for 2 weeks, the Evorel Conti patches for 2 weeks that I'm on @ 50mcg strength.

I've been offered 'an extra 25 mcg patch
OR oestrogen only patch at q00mcg & utrogesran vaginally at 100mcg on cc or 200 mg /4 if sequential'
GP said: 'I don't know much about HRT as I smiled through so I googled it'

Its reassuring to hear rhat HRT doesn't hugely increase cancer rates but with the family history & the IVF& the fact I'm sole Carer for two teens with Autism I'd like to feel I'm improving my overall health & longevity chances.