Returning menopause symptoms despite HRT?

[heartchakra]

I've been on the everol conti HRT patch 50 for about 14 months. The last few weeks I've noticed some of the old symptoms creeping back especially losing names/words (v embarrassing at work) .. fatigue sleep problems and worst of the worst .. weight gain with seemingly ferocious appetite... this is so depressing. I did try to increase my patch from 50 to 75 and had to add in progesterone tablets and didn't get on with those so dropped back down. Feeling like the patch that helped me so much before is now much less effective. Not sure why I'm posting this but am wondering whether menopause makes you hungrier?! Wondering why I can't just put two 50 patches on instead of one ? Any suggestions?

I am totally with you and on same patches.

No weight gain but I am very underweight so unlikely ever going to be an issue But the brain fog and poor memory…. I am so worried I have early onset memory problems!

got a doc app today to discuss

I don't know about everol - is that a combo patch of oestrogen and progesterone ? I'd say Gp back to Gp and adjust regime. You may need a different type of patch and progesterone

I found going 50 to 75 really hard going for some reason. You can ask for extra 25s that you cut in half to add to the 50 for a while (2 months for example)

I've done that for 75 to 100, have only needed to do so for 6 weeks

I did try to increase my patch from 50 to 75 and had to add in progesterone tablets and didn't get on with those so dropped back down.

?????

You don't need to add progesterone to the patch as it already contains Norethisterone at the correct dose for 75mcgs estrogen.

www.menopausematters.co.uk/postmeno.php See the type you are using here. No mention of having to add additional progesterone.

Whichever dr did this is wrong. That is rather worrying! Not surprising you felt unwell on it!

If you need a higher dose, there is no other combined patch but you could add in a small dose of estrogel or (more common) change to an estrogen only patch and use a separate progestogen which is usually Utrogestan.

I'd see another dr.

Sorry - I misread what you had said. I thought you meant you used a 75mcg patch- but there isn't one! So you cut the 50 patch in half? And your GP said you needed more progestogen ? That's still a bit debatable, because for women on estrogen-only patches, or gel, the dose of progesterone is the same whether they use 1 pump of gel a day or 4.

You'd be better off going to a higher dose of estrogen and using Utrogestan.
That way you can use as much estrogen as you like and the Utorgestan stays the same. 1 x 100mg a day.

And yes, you could use 2 x 50 patches.

The hunger thing could be because you are using combined HRT- both hormones daily. There is no need to do combi - it ought to be a choice- and you can carry on with a sequential cycle, even post meno. That would mean a monthly withdrawal bleed that you may not want, but it may help with the weight gain.

@JinglingHellsBells sorry I'll clarify: I was on (and am now back on) evorel conti patches 50mcg. I then said to the menopause nurse things were getting bad again so she said you can't get a higher dose combined so she tried me on evorel 75mcg oestrogen only patches with utrogestan 100mg x 1 at night. These made me feel bloated and painful boobs and generally rubbish so I just went back to the 50mcg combined. Hope this helps.

I felt rubbish and bloated on 75 (it eventually settled) and oral utrogestan makes me feel rubbish and hung over.

I'm moving to 100 so asked for some 25s to add to the 75 in halves so that I've gone to 87.5 for a while (I was ok after 6 weeks) before going to the 100 (just this last week.)

I find I have to use utrogestan vaginally.

@heartchakra If you need a higher dose of estrogen, your only options (on a continuous regime) are estrogen as a patch or gel, plus Utrogestan. Or doubling up on the patches you have but 100mcg patch is a very high dose.

You might have got used to Utrogestan in time - sometimes it settles down in 3 months.

@JinglingHellsBells thanks it all seems to complicated and 😖 I guess it's a process of titration. I'll have a think ...