Will a change from patches help?

[OutlandInland]

I'm currently on Evorel sequi patches. I had virtually stopped having periods before starting on these. I'd actually gone 13 months without one and then bled for 3 weeks (all was checked out). Because it then hadn't been 12 months without a period I had to go on Sequi patches and have a period every month. The patches have helped with the brain fog and general anxiety but the periods are problematic. They are fairly heavy and last a full week. I'm also getting awful mood swings - I've been vicious to my husband for two days. I guess I'm wondering if there are alternatives that would make any difference or whether my only option would be to try without HRT for a bit?

It sounds like the progesterone in the patches are causing the mood swings, I’m the same, in fact I’m very intolerant.

There is a HRT called Tridestra, it’s tablet form. It’s 3 months of estrogen only followed by progesterone along with the estrogen, then a withdrawal bleed. This was wonderful for me, I could tolerate the short blast of progesterone but the tablets have lactose in them and I’m bloody lactose intolerant 🤦‍♀️🤬

I now have estrogen patches for 3 months then the progesterone, advised by a specialist not a G.P. Progesterone for me is hideous, I turn into someone my husband doesn’t recognise, I never got on with the pill for this reason.

It’s taken me 3 years to get it right, I’ve tried most of the regimes, believe me I am better on it and would never give it up. My sister in law is 58 and decided to go au natural, she now has osteoporosis pretty bad and is already breaking bones easily.

The progesterone I have is medroxyprogesterone, this is what’s also in the Tridestra regime. Ask the G.P to let you try it, not a lot of people know about it, I was prescribed it by my menopause specialist. Don’t give up, life for me is so much better on it. I also have testosterone for energy and libido.

Thank you. I think I'll book an appointment then and have a chat. I'll certainly make a note of that progesterone. I would much rather only have a period every three months - they're so annoying after only having about 4 periods in 3 years beforehand!

Have you considered a Mirena coil. It is licensed for use with Oestrogen during HRT. It provides the progesterone localised to the uterus. There are less side effects and the bonus is very light to non existent periods.
I had one for 15 yrs and added in patches when I started with menopause symptoms. It worked well. There is evidence that the Mirena lessens the perimenopause symptoms without the need for oestrogen. It was certainly the experience both my DSis and I had.

@OutlandInland @Snippit

I agree with Snippit that you may well do better on a longer cycle. I've done this for years (15) with a consultant.

However, you may like to know that the synthetic progestogens like MPA and Norethisterone (and even the Mirena) are considered a higher risk for breast cancer. There's a definite scale of risk with MPA being the highest, then Norethisterone, then the Mirena.

Obviously the overall risk of any is low, but if you think you might use hrt long term, it's worth thinking about using micronised progesterone (Utrogestan) as it appears to be safer. The BMS has research showing no added risk for 5 years' use.

I'm early 53 and my understanding is that at 55 I should be ok to go on oestrogen only patches - I may have misunderstood though! I've booked an appt in a few weeks time so will take a note of these options and speak to the menopause nurse about what is best to try. One thing for sure is that I can't cope with this rage every month!!

?

Unless you have had a hysterectomy you use a type of progestogen for as long as you're on HRT.

Nothing to do with age.

I trialed the patches and the progesterone in the patches made me feel awful. I switched to oestrogel and then separate progesterone tablets 14 days out of each month

Sorry I can't remember how you quote someone's name to reply! I guess I assumed that the progesterone caused the period so if you went on to patches that don't give you a period they didn't have progesterone but obviously I'm wrong!