Time to give up on HRT?

[HensTeeth2]

Hi folks, I have been taking HRT for 3 years (with a gap of year because of bleeding). Though in some ways I feel better I'm not convinced its doing much any more and I have also had really challenging dryness over last few months. My dr says himself he doesn't know much about menopause so I've given in and have a nurses appt at Newson health to try and talk things through with someone who wants to listen. I originally had femoston but started bleeding 2x a month so had to pause while they did all sorts of tests, all were fine and was just unexplained, went onto patches 6 months later Evorel 50 - and noticed an uplift in mood and energy quickly. But within six months of that I've started with bleeding several times a month again. Plus the dryness has become much worse, so can't wear knickers at all... (in winter thats going to be fun). Am posting on here for any advice really - I don't want to be on HRT for years - how do you know when you are past worst of meno and can stop? I'm just 50 so should I wait longer? Should I maybe go onto the gina pill for dryness and stop the Evorel? Any advice gratefully received. I'm starting a new job soon and need to feel ok and like I can still achieve things so worried about stopping HRT and entering brain fog and palpitations and anger again ..... thank you x

went onto patches 6 months later Evorel 50 - and noticed an uplift in mood and energy quickly

Maybe if you can explain your meno 'journey' and the exact types of HRT it will be helpful.

Is this Evorel Conti ( 2 hormones daily) or Evorel Sequi ( a sequential type)?

If you have been using conti, it's normal to have erratic bleeding for up to 6 months. (This ought to have been explained to you.)

If you are not post-menopause (12 months at least with no periods) then you are better off on Evorel Sequi because erratic bleeding is a side effect of using Conti too soon. (The progestogen won't control the womb lining enough in peri.)

Did you start on a continuous regime 3 years ago at 47? Had your periods stopped for at least a year then?

You can use vaginal estrogen as well as systemic HRT. It doesn't have to be Gina, the ones in use that are prescribed are Ovestin ( a cream to insert) or Vagifem (a small pessary.)

You definitely need to see your dr about this and get it sorted as it will only get worse.

Many of us need this as well as full HRT, or you can use it on its own.

@JinglingHellsBells thanks so much for replying! I'm on Evorel Sequi, so thats 2 weeks of evorel 50 and 2 weeks of Conti. I hadn't heard that about the bleeding with Conti. My periods hadn't; stopped and haven't as far as I'm aware - guess I wouldn't know now unless I stopped HRT for a while? Could it be imbalance in progesterone causing the bleeding? And the HRT making the dryness worse? All questions I will ask Newson health of course - from what I've heard/read, they seem to have a standard set of HRT they recommend as first choice, so am half expecting to be switched from Sequi.
Even though I feel I've read up as much as possible on menopause (my default strategy always to find a book on something) still feel like I don't know very much.

Why can't you wear knickers?

Have you tried the spray op?

Hmmm...it's real PITA for you I can see!

Maybe you are someone who doesn't absorb from patches very well. Too much estrogen and too little progestogen does cause odd bleeding.

There are plenty of other options such as the Mirena coil + estrogen, or estrogen + micronised progesterone, or other types of patches and tablets.

Dont give up yet.

I doubt the HRT is making the dryness worse, but it's more likely it's getting worse anyway (which is tends to) and applying estrogen to your body doesn't always reach the parts needed! Get yourself onto vaginal estrogen of some sort- Ovestin cream might work well if you are sore externally. How are you managing with no knickers? Are you just wearing skirts or dresses?

I’m off completely now but I came off slowly and gp supported me I’m six months in no periods hot flushes dreadful utter hell but getting better less and less cooler weather has helped. No sex life (non for years sexless marriage) and won’t again ever.

@Always4Brenner Were you not temped to go back onto HRT given your flushes are still utter hell?

Just one point for anyone reading: vaginal atrophy or GUS (genito urinary syndrome as they call is now!) is not about "just"sex. It's about vaginal and bladder health. Very old women or women who are celibate who are not having sex still use it to help prevent soreness and bladder issues.

Too sore!

Sorry the too sore response was meant to explain why I couldn't wear knickers at mo.. ok in summer with long skirts but not so good in winter (though know of someone who cut holes in all her tights at the crotch to deal with it). Thanks for info re vaginal oestrogen. Is it perfectly ok to take that on top of systemic HRT?

1:4 women use both (or have to!)

Vaginal estrogen is a teeny amount. if you use it 2x a week for a year, the total amount used is the same as 1mg of estrogen ( a low daily dose.)

same as 1mg of estrogen ( a low daily dose.)

The same low daily dose as systemic HRT.

Vaginal estrogen is not classed as HRT anyway. it's called 'topical vaginal estrogen'.

Might be vaginal atrophy. You can get little tablet pessaries which you use for 2 weeks straight then twice a week. Vaginal moisturiser is good for the outside to stop it being so sore but the pessaries make a difference to that too. You don't have to suffer this.

There's a fab menopause group on Facebook which is great for info and experience. Sone doctors will tell you that the patches or gel should help with the internal dryness but that's not the case and you are within your rights to ask for the pessaries.