Still having periods (proper periods, not withdrawal bleeds) on Evorel

[AnnoyingPopUp]

Hi all

I’m nearly 52 and have been using Evorel patches (2 weeks Evorel 50, oestrogen only, followed by 2 weeks Evorel Conti, combined oestrogen and progesterone) for nearly 2 years. I am still having periods!! Not withdrawal bleeds - proper periods, including horrible PMT, premenstrual headaches, period pain, etc etc. All the stuff I was experiencing before I started HRT (which I’m taking to help with sleeplessness and migraines, and it does seem to be helping with those).

But why I am I still having proper periods rather than just a withdrawal bleed? The periods aren’t regular either, and they don’t always correspond with when I’m taking the progesterone. I have a vaguely 28-day-ish cycle but some months it’s 5 weeks between periods and other months it’s 3. I’ve seen 3 different GPs, all female, and they all just say that my periods will stop eventually. BUT WHEN?? And is there any point in my being on HRT at all if, as seems likely, my body isnt absorbing it? I had blood tests about a year ago which showed a lower-than-expected level of oestrogen, but 1 GP said that this showed that I wasn’t absorbing the HRT and the other 2 were noncommittal and said that, if they were me, they’d keep taking it anyway….

What to do? I want my periods and my pre-menstrual symptoms to stop. They’re awful. I’d be fine with a painless withdrawal bleed. I can’t take HRT tablets due to migraines. I started my periods at 11 and I feel that, after over 40 years of this shit, I deserve a break!

These are withdrawal bleeds you are on sequential HRT and will always have bleeds whilst taking it. You may need to change type of sequential HRT there are spray, gel or oestrogen only patches and separate progesterone. There are different regimes out there. Oestrogen may need increasing too x

I'm having exactly the same thing! When I first started taking it I started bleeding just after changing from the progesterone patches (as it says you should) but now it's all over the place. I feel a bit short changed by an 18 day cycle tbh!!

I'm taking exactly the same HRT but I'm a few years younger than you. I had only one period in a 12 month period before using these patches.

I'm back to my old 28 day cycles. I thought they must be withdrawal bleeds connected to the patches, but my GP reminded about contraception in case of pregnancy. Perhaps that's just an extra precaution due to my age though...

They are withdrawal bleeds but they don’t stop ovulation.

@NotFastButFurious you might need to change your HRT regime .

If you can’t tolerate progesterone tablets then you might fare better with a coil and oestrogen gel as it sounds like the patches aren’t working for you

What do you mean by change it? I think I’ll have to do a medication review before I order the next batch anyway as it’ll be a year since I first got it. I raised an econsult a couple of months ago when the bleeding started going haywire as I was concerned I wasn’t getting the right dose because the patches often come off and I have to replace them with new ones, but then still put another new one on at the correct time. But they got the pharmacist to ring me rather than a GP and she did was tell me how best to make them stick, as I’d already read in the leaflet! I’ve also had Covid recently which sent my periods crazy last time, as did the first jab.

Maybe ask to try separate progesterone like utrogestan and just oestrogen patches or Gel or spay if you don’t find the patches stick well. It’s easier to titrate if they are separate. If you want to go higher the 50 eastogen patch you will need them separate as everol seqi don’t go any higher then 50. X

Stupid question but does the gel just go on your skin?

There is no way of knowing if a bleed is a period or a withdrawal bleed. The other period type symptoms can occur during withdrawal bleeds. They can even occur when you are no longer bleeding around the time of the month you would be because there are still hormonal actions going on.
At 52 you may want to try changing to conti from the sequi you are taking. You may stop bleeding then.
A scan may show the state of your ovaries. That is another way to get an indication of whether you still will be getting periods or not

@NotFastButFurious yep you rub it in on your arm or leg. I haven’t tried it as use patches but loads of ladies on here have.

I am definitely having proper periods:

1. they do not always occur when I’m taking the progesterone
2. they aren’t regular
3. i get the same horrific PMT symptoms that I had before I was on HRT
4. i still ovulate. I know all the signs!

I can’t have a coil. I will ask my GP about a scan of my ovaries though, thank you.

Ooh I will ask about switching to Conti as well, although as I am still having periods (yes I am!!) I don’t think this is possible/advised??

I am already taking extra oestrogen - I wear an additional Sequi patch as well as the Sequi/Conti patch. I had a blood test a year or so ago which showed that I have lower-than-expected levels of oestrogen, despite the double patches, which is why I think I’m not absorbing the HRT. The GP at the time said that this would mean that I wouldnt absorb it via gel either. However, 2 other GPs since then (I’ve moved house, and had to move to a different surgery) have differing opions.

Why isnt there a definitive answer?!

@squigglygiggly What you’ve said - about not knowing if it is a period or a withdrawal bleed - is interesting. And terrifying. My GP told me that my periods would stop at some point and I would stop bleeding. Do you mean that, if I take HRT for ever, I will bleed monthly for ever? I can’t cope with this!! Surely women in their 60s 70s and 80s aren’t expected to deal with bleeding, heavy flow, leaking, sanitary protection & disposal, cramps, PMT headaches etc?? Plus the cost of sanitary protection. This can’t be right?? Are there 80 year olds still bleeding monthly??!! What about when you have arthritic hands and a dodgy back and can’t physically deal with it all????

(I hope my post comes across in a non-aggressive way …. I’ve recently been diagnosed with autism and I’ve been told that my tone sometimes isn’t as expected).

No you are unlikely to bleed forever. I was quite fixed on your exact question when I started on sequential HRT around 50 when I was still having regular periods.

No one seems to give a particularly satisfactory answer to the question.

Most women have a withdrawal bleed that is not necessarily every month or regular. Most women transition onto a continuous HRT like Evorel sequi to conti after they have reached around 52/53 ish. Once on conti you don't have a withdrawal bleed anymore although I still have the very occasional spotting.

Any unusual spotting or bleeding on conti should be checked out. I have been and it's all fine down there. The radiographer doing it shared that she still gets very occasional spotting on conti and she was in her 60s. It's very very occasional and in my case very very little so not overly annoying. Hopefully it will stop. Tbh I think I get spotting when for some reason I missed a progesterone capsule for a day.

@AnnoyingPopUp just incase you don't know this, I'll explain.
Evorel sequi (sequential) is for women with periods. It consists of 2 weeks of Evorel 50 and 2 weeks of Evorel conti. Evorel conti contains progesterone

Evorel conti (continuous) is for women whose periods have stopped. After being on Evorel sequi a few years and reaching around 52/53/54 women are generally advised to change from Evorel sequi to Evorel conti as it is assumed periods have stopped. (Can't tell due withdrawal bleeds )

Once on Evorel conti you are getting the progesterone daily so you don't bleed.

I am on a slightly peculiar combo of Sandrena gel, Utrogestan capsule and a 25 Evorel as I need a bit more estrogen than the Evorel conti patches provide and I got sick of having multiple patches on me!!

@squigglygiggly That is so helpful, thank you 🙏

I did know the difference between Sequi and Conti, but it definitely was not explained to me that I should switch to Conti at age 52/53/54 whether or not I knew if my periods had stopped.

Is it dangerous to go on to Conti if I think I’m still having periods rather than withdrawal bleeds? Like, too much progesterone if you’re still naturally ovulating?? (I tried 3 different progesterone-only mini pills when I was younger and they all sent me absolutely loopy, although I seem to fine with the norethisterone for 2 weeks out of every 4 in the Evorel patches). I’ve been on Sequi for 2 years and am about to turn 52, and I have been having periods for 41 years so if I can stop them now I will be absolutely delighted!😀 When I was younger I had a 19-day cycle so I really do feel that I have bled far more often than any woman should have to, and I am DONE with it!!

(I will ask my GP but she was pretty clueless last time I spoke to her!).

@AnnoyingPopUp they say if you move to continuous too early you will get breakthrough bleeding. Instead of conti patches there is also the option of separate progesterone so it can be tweaked. Utrogestan is body identical progesterone and is thought to be better for us.

I agree with you, i feel like I definitely get normal periods on the conti patches as I can tell when I’m ovulating and get backache etc

If you want to make sure that you are past periods? The only way is to go off all HRT and leave it a few months and see (not something I would ever have done as there was a huge reason i went on HRT, get a scan of your ovaries (not 100% accurate but if they are extremely small and shrivelled right no visible eggs it very likely and you could stay on sequi until your mid 50s where you are most likely past periods. It's true some people have periods into their 60s but most people don't and are fine by their mid 50s. It's a bit of a trial and error thing. You can go back to sequi any time

I was a bit nervous of changing to conti as when i was on sequi, the progesterone portion was the unhappy part of the month so o feared I would be miserable all month. Once I changed I found I didn't have the good part and the not so good part of the month. It all just became good

Another option for you would be separate oestrogen and progesterone but on a longer cycle. So you could take oestrogen for 10 weeks then both for 2 weeks. Then you would have the withdrawal bleed to clear out your uterus. So you’d have fewer withdrawal bleeds.

Of course this wouldn’t override your natural cycle. You really need something that would suppress ovulation by taking some kind of progesterone daily.

I'm 44. I haven't had periods for a few years because I'm on the POP and my periods stopped. I asked to go onto a combined patch, as I didn't find the gel/tablet combo helpful. My GP wrote to gynae fire advice because I'm still quite young and they said the Conti was fine. I'm on my third patch, so I'll see what happens.

OP i changed to the coil from progesterone and I still ovulate, I still get hideous PMT, I still get horrible cramps and period diarrhea and my mood is on the floor. But I don't really bleed any more.

I can't bloody wait for my ovaries to shrivel up and piss off. Hope you get some answers soon!

Not progesterone, I meant utrogestan