Need help talking to the doctor about hrt

[Inspirationpending]

Ive been on evorel sequi for the last 3 years (now 51)
my own period has always broken through but for symptoms it’s been amazing.
Last couple of months though my muscle aches and insomnia are back with a vengeance so feel sequi is not quite cutting it anymore.
Please help! What do I need? Testosterone? More estrogen?
My doctors are useless with menopause and I had to tell them originally what I wanted to try

Id be will to pay privately at a push but hoping some wise mumsnetters might have some suggestions first

In the same boat as you I hope you get good advice! X

Use the free balance app to log all symptoms. It's a really useful tool and lots of info on their website. Show it to the doctor.
The app and its founder are well regarded in medicine.

Should also add they have a private service available as well.

The obvious thing would be to probably increase your dose a little - depending on what you're on now, dosage wise. So I'd try that before anything else.

You can probably do this off your own bat but obvs wise to run it past your doctor first. I understand what you're saying though, it's a bit disheartening when you're the one telling your doctor what you think you may need / want to try.

You could look at private? The Louise Newson clinic or the BUPA menopause thingy which I believe is about £200. That may at least get you listened to properly

CricketWhites1 which part would be the best to increase?

thanks foodtooorder I will have a look at that now

What are you taking now? Dosage wise?

Sequi is an evorel 50 patch first half cycle and then conti for second . Is it the estrogen part that makes most difference to symptoms?

my own period has always broken through but for symptoms it’s been amazing.

@Inspirationpending Can you explain a little bit more about this?

Evorel sequi is a form of hrt that gives a monthly withdrawal bleed (and will forever, regardless of age or natural periods.)

When you say 'my own period' do you mean you're getting more than a withdrawal bleed each month?

If you feel it's not working so well now, it's the estrogen side that needs increasing.

You might need a different patch giving 75mcgs estrogen.

I get an extra 25mg estrogen patch prescribed on top. Leaves me feeling rather like a Panini football Sticker Book, but it does the job.

I just told them that I'm having breakthrough symptoms - flushes, mostly - and thought that perhaps the 50mg isn't quite enough anymore.

Hi JinglingSpringbells
ive never had my bleed in line with the patches.
i only get one bleed a month but all over the place cycle wise
so I’ve always assumed patches not having any impact on my cycle?

that’s really helpful patch wise thankyou 😊

NeverDropYourMooncup
thankyou, so presumably I’d do 75 for 2 weeks and normal patch conti for next 2? Or do you use the extra 25 all 4 weeks?

I think you should speak to a dr who knows about hrt.

After that length of time on HRT you should be getting a regular withdrawal bleed. And, to be honest, you should ask your GP for an ultrasound scan.
The patch is medium strength and it's unusual to have bleeding outside the cycle. Most women get a bleed 3-4 days after the last progestogen dose each month.

You need this looking into because either the dose is too low, or your womb lining isn't shedding regularly for some other reason.

Your prescription would be based on a pack of patches. You don't need to worry about how they come- the pharmacist does that for you.

If there isn't a 75 mcg patch in Evorel you would be swapped to another sort.
It would be 75mcgs every day.

JinglingSpringbells oh really thankyou I will mention this
I did have a gynae scan about 18 months ago for fibroids and womb lining was considered too thick
Had a hysteroscopy and it was back to normal

There is a menopause clinic at my local hospital but waiting lists are crazy

If on everol sequi and need to up the oestrogen I think best practice is to change to a separate 75 patch and separate progesterone. Adding another oestrogen patch to combined patches isn’t the best as there may not be enough progesterone in the combined patch to cover the extra oestrogen. Plus who wants to wear 2 patches 1 is enough 😂😂

Thankyou for all the advice
I will update once I’ve spoken to doctors 😊

Update. GP’s advice was to come off hrt and see if my periods stopped naturally! Panic set in at thought of no hrt at all
Booked a private meno consultation who thankfully dismissed this as a terrible idea

Currently on Utrogestan and oestrogel which a week in seeing a big difference already in symptoms. Ideally she advised a mirena but unless I pay privately my GP is insisting on me having my smear first

She had no concerns about my bleeding cycle she felt this was probably due to hrt dosage being too low

So far money well spent 🤞

@Inspirationpending great news x