Coming off patches

[GeorgeOrwellsTurningGrave]

In my mid 50s and I'm trying to come off Evoril 50 patches. Has anybody else done this?

I cut my patches in half for 6 weeks and feel better than I did and the weight is slowly coming down again. However GP says I shouldn't do that as they're not formulated for cutting in half so he's going to put me on Evoril 25. That's fine for now.

However, I'm on 5mg daily Provera tablets too and not sure what to do about those. GP doesn't seem to know either! I had my ovaries removed surgically two years earlier to make things interesting. Anyone here know a bit more about phasing out HRT? Thanks

Hi I'd be interested to follow this for the answers, I'm about to have both ovaries removed

@GeorgeOrwellsTurningGrave My understanding is patches come either as matrix or reservoir. One type- perhaps the reservoir- can't be cut as you won't get an accurate 50%.

Regarding the progestin you're taking. You still need to take it -or another sort- because you still have a womb. Not having ovaries isn't relevant. Estrogen stimulates the womb lining, so anyone who's not ovulating (for whatever reason) still uses progestin if they have a womb.

Women who are post menopause may still have their ovaries but post-menopause they are redundant and not doing anything much.

My understanding with stopping combined continuous HRT is that can just stop (unlike cyclical where you need to complete a whole cycle with a withdrawal bleed.)

So, I'd assume that when you don't use a patch any more, you also stop using Provera.

You don't have to come off it gradually unless you want to. So you could just stop without going onto to a lower dose patch.

It would be sensible for your GP to arrange a scan shortly after you've stopped to make sure the womb lining is normal (thin.)

Is there a strong reason why you want to stop HRT as you're still quite young?

Thanks @JinglingSpringbells, I really appreciate the response.

I want to come off them (or at least reduce the dose) because I believe HRT is behind, among other things, my weight gain and ridiculously large Hattie Jacques chest. 6 weeks of cutting them in half and I've noticed I feel more like myself again and the weight is slowly coming off. My symptoms so far remain mild so I think its a good idea to take less anyway and see how I go.

Thanks for explaining the need for Provera alongside patches. I'm on a very low dose- 5mg - my doc didn't know if an even lower dose would still be effective and suggested I contact our madly busy hospital myself to find out. Hence my question to the internet... :)

Nothing like passing the buck- asking YOU to find out! That's his job.
I can't believe that info is not available online for him to find. There are lots of dosage charts available produced by the British Menopause Society.

https://thebms.org.uk/wp-content/uploads/2024/02/15-BMS-TfC-HRT-preparations-and-equivalent-alternatives-JAN2024-B.pdf

Page 3- it shows the doses of Provera needed with estrogen only patches.

Sounds like he needs to go on one of their online courses!

If you find it's a problem you could swap to Utrogestan which many women choose rather than Provera as it's body identical and is considered a lower risk regarding breast cancer. The dose for continuous use is 1 capsule of 100mgs a day.

Thanks so much @JinglingSpringbells - I got the impression the doctor would rather be talking about anything else!

My GP told me to cut my patches in half to increase to 75 instead of 50 so one of them is wrong, which is actually quite scary. I'm also taking progesterone each evening before bed as prescribed by my GP and I have to say It has worked a bit better than the combined patch I had.

I've only been on HRT since I had a full hysterectomy last year but I have to say I'm not sure if the pros outweigh the cons. It has helped with my flushes, night sweats, mood but I've piles the weight on, I'm so tired a lot of the time and my joints are aching so badly, I'm only 48 so surely I shouldnt feel this bad :(

When I couldn't get 50s in the shortages a few years ago they gave me 100s and told me to cut in half!

@summersolstice43 @NashvilleQueen As I mentioned in my previous post here, there are different types of patches. I don't know which is which (yours will be on the leaflet) but there are matrix and reservoir.
One sort - matrix- has the hormone 'embedded' in the patch and the other has it in a kind of 'well' with the patch as a border.

I don't think it's advised to cut the reservoir one as it would leak/ not be accurate.

Don't quote me on this- it's just my understanding and having read other women discussing cutting or not cutting.

@JinglingSpringbells ah I didnt realise that, thank you for clarifying. Mine are impregnated rather then having a well :)

I didnt find hrt amazing felt weight gained too. I got magnesium gel this week sleep a bit better. Im 51. Hrt can be good just wasnt for me.

Hopping on here as I am trying to wean myself off HRT too.

I have a Mirena coil and Oestrogel. I don’t feel like it’s been a huge benefit for me, and like others have really bloated up. I could never take the combined pill (fine on the PoP) and found it made me very mentally unstable and bloated so I suspect I don’t do great with synthetic oestrogen. I know people are going to jump in and say HRT doesn’t cause weight gain but I swear to god, I went through that whole pandemic and gained 3lb with me and DP both working at home for two years and the 3pm cake break every day - in two weeks on HRT I gained an entire stone! I chucked the scales after that and haven’t weighed myself since but do use a tape measure regularly to keep track of myself. I’m a 12/10 rather than my previous 10/12, and now have a tummy which I didn’t ever have before. My waist is still there and 29” so I know I am not huge, I just feel huge!

Anyway, I reduced the gel from three pumps to two last week, and today have just done one. I’ve been bleeding a wee bit but have had irregular “periods” since getting the coil - just odd bits of spotting - so that feels quite normal.

I’m 51.

I tried coming off patches due to a huge weight gain after starting HRT and my HRT a lady said to actually double the dose as I'm on low anyway.

Her thinking was due to lack of motivation, low mood and tiredness by adding in more it would help me moving more and be motivated.

I did roll my eyes and feel dismissed about the weight gain, when I'm under 1200calories a a day, but though well I'm paying her for advice, so I've just upped my dose for the last 2 weeks and hate to say I feel much better, more never and have increased my movement.

I'm still 10kg over weight but I just thought I'd share a different experience, I'm only 2 weeks in and going to give it 3 months.

I also bought and started taking probiotics as I was feeling bloated and those seem to be reducing the puffy middle stomach area I've gained.

She did also suggest adding in testosterone in 3 months to boost my mood and energy levels.

@blackandwhitestripes its such a guessing game I think - I’ve never even seen a doctor face to face other than having the coil put in which was done at a sexual health clinic rather than my surgery (although I had to be referred by the doctor).

I’m pretty active, average about 15k steps a day so that logic doesn’t add up for me but I am interested to know how you get on. my tummy feels flatter and my face less puffy just reducing the dose but maybe that’s wishful thinking!