Combined HRT question

[Demeter1978]

I have been using the Evorel Sequi patches for the past 4 months, 2 weeks of the Evorel 50 patches and then 2 weeks of the Evorel Conti patches. I had a review this week and they need to up my dose and I’ve been prescribed a higher dose, the oestrogen still in patch form but the progesterone will need to be taken by tablet form.
I have been advised to use the patch and take the tablet on days 1-14 of my cycle and then just the patch for the following fortnight. I’m just finishing this months box of the Evorel Sequi so am currently on the conti patches and its just occurred to me that when I start the new dosage I’ll be having another 2 weeks of oestrogen and progesterone. Does anyone know if this will be OK or if I spoke to my pharmacist would they be able to advise?

No I would just wait 2 weeks then start your tablets and do 2 weeks on and 2 weeks off the same as you did with your patches.

Thank you, that makes sense, give it a break for 2 weeks and start afresh.

It's a bit confusing what you have been told @Demeter1978

Why would you have to use tablets (exactly which?) as well?

This only makes sense if the higher patch is estogen-only. So are you saying that the new patch is just estrogen?

If so, you just follow the same pattern as before. New patch ever few days and tablets (are they utrogestan?) for 14 days per month.

The dose of Utrogestan is actually 12 or 14 days and you can do whichever you want.

@JinglingSpringbells

The patch I have been prescribed is Estradot 75mg (oestrogen only) and there is no combined patch of the same dosage so the progesterone has been prescribed in pill form (Utrogestan)

I’m just finishing my current cycle which oestrogen only patch for days 1-14 and then the combined patch for the remaining 2 weeks.

From what you're saying should I just keep on the oestrogen for days 1-14 and then combined patch and pill for the remaing 14 days even though the directions say to use the Estradot and Utrogestan together for days 1 to 14 and then just the Estradot for the remaining part of the cycle, so the opposite to what I'm currently doing?

I hope that makes sense.

I’m not sure about taking utrogestan with a combined patch. My understanding is that you take it every two weeks along with a daily oestrogen only patch or gel. Can you check with your GP?

You take utrogestan the same way you do now with combined patches. It is the SECOND 2 weeks of your cycle like you do with combined patches. The only difference is you are taking them separately. So finish your cycle with is combined patches. Then start new cycle with new oestrogen only patches for 2 weeks then your utrogestan for the following 2 weeks. You usually have a bleed a couple of days after you have finished your utrogestan.

@Christine0708 Thank you x

You can do either- it's not important.

I was advised that when doing a monthly cycle, the day you start progesterone is your choice. Just stick to the same day each month. So like the 1st Nov, then 1st Dec etc.

@Christine0708 is sort-of right, but it doesn't matter as HRT resets your cycle. You can do the progesterone days starting at any time.

What you might want to do is start it on a day when the withdrawal bleed ( 3-4 days after the last capsule) comes at a time when it suits you (eg if you don't want bleeds at a weekend or whatever.)

The other thing is that on a higher dose patch, the BMS suggested recently that some women more need more Utrogestan - like 300mgs a day for the days it's used.

if you have heavy withdrawal bleeds on more estrogen, it's worth talking to your GP about this.

@JinglingSpringbells Thank you, that is very useful information x