Hrt and combined pill?

[icecreamisforwintertoo]

I’ve just got an hrt prescription from a private doctor (through work) following a menopause consultation. She was reluctant to prescribe af first but I really wanted to try it as struggling with mood, anxiety, irritability etc lately. I’m on the combined pill and we talked at length about it and that what she has prescribed me is compatible with the combined pill.
im just about to take my first dose of eostrogel and googled a bit about how to apply it and everything I’m reading online says you can’t take the combined pill and hrt together. I’m confused!

has she got it wrong? Or is this ok? What will happen to me if it’s wrong and I take both?
I’ve been prescribed 2 pumps of oestrogel and 2 tablets of utogesten. I will also email her to check but she was adamant this was ok.

I think @Jinglinghellsbells might be able to help, but from my experiences I suspect your private doctor has got this wrong.

Hmm. I’ve only ever heard of taking the mini pill - I may be wrong. (That’s what I’ve had before - mini pill, utrogestan and oestrogel).

Maybe you could do one pump of oestrogen gel and one dose of utrogestan?

I have a friend who's on oestrogen gel and the coil for progesterone.

I'm currently on sequential HRT - Femoston tablets. I'm going to be moved to combined HRT shorty, in order to get more progesterone. When the consultant phoned me, at first she was talking about the coil for me...

I queried this. I'm 64 and have an atrophied cervix. Plus I've never had children... (She had to use a local to get the straw through for a biopsy.)

There was a pause and then she said "Ah. Yes. You're 64. It'll be the combined HRT then."

Thanks for the responses. I’m thinking she has got it wrong, which is a bit concerning as a menopause specialist. I will hold off starting this month until I’ve double checked or got a second opinion at least. Will be on holiday for this cycle so don’t want to spoil that by dealing with out of control hormones!
I could come off the combined pill but it keeps my heavy periods under control and don’t want to come off that suddenly without a back up plan

Thanks for the suggestion - yes i wondered whether to try a lower dose. Assume the issue over doing both is having too much oestrogen?

You cannot take HRT with the combined pill. If you want to take contraceptive pill it needs to be a progesterone only one. Best option for you would be Mirena coil as that will control your heavy periods as well.
Unless your doc explicitly said you can take HRT and combined pill , it could be possible that she forgot you were on combined pill rather than getting it wrong. Not saying this is right but being human and all ...

I don't understand what your doctor has done.

You can have HRT + progesterone only pill (I know this as I'm on it!) but my understanding was that if you are on the combined pill, it's doing the job of HRT so no point.

Thanks for clarifying. She definitely didn’t forget as we had several conversions about it and I gave her the name of the pill when we were talking about how to take it. She definitely understood it was the combined pill and said she’d prescribed me this specific regimen of hrt as it was compatible.

The amount of oestrogen and progesterone in HRT is a fraction of the oestrogen and progesterone in the combined pill. Anyway, no you can't take both together.

No you can’t have combined hormonal contraception and HRT.

How old are you? Younger women eg age less than 50 and especially under 45 with menopausal symptoms also requiring contraception can often benefit from a combined pill where clinically appropriate instead of HRT.

On your regimen you’d need progesterone only contraception, non hormonal or consider a IUS such as a Mirena coil as it would give you contraception, control bleeding and act as endometrial protection too. Then you’d just need your oestrogel.

As others have said, it's overload and also mixing natural body-identical HRT with synthetic hormones in the CCP.

If you need contraception, you can use 3 POP to get the right HRT dose, but this is off licence and on a private prescription initially. This would cover the progestogen needed for HRT and also be contraception.

I'd find someone else!

You also shouldn't need to 'push ' for HRT. Why was she 'reluctant'?
That's not a good start anyway.

Yes that’s what I thought too! Slightly odd a menopause specialist would be reluctant to prescribe hrt. She was very much pushing natural solutions which I have been trying too - and also prescribed cbt originally which helped a bit with anxiety.
Anyway I really appreciate the quick and clear responses! I have put the hrt back in the cupboard - luckily it doesn’t expire for a couple of years!! Will continue on combined pill for now h til I’ve worked out what to do about contraception and get a second opinion!

I’m 48 so yes maybe I’ll just carry on with the pill for a bit while I work out whether to move to coil or mini pill

Also what is POP @JinglingSpringbells ? Wasn’t sure what if stood for.

Progesterone Only Pill @icecreamisforwintertoo

I don't think the dr you saw knows anything about menopause.
The NHS website on menopause/HRT says very clearly that you can take both the combined pill and HRT.

Even if she wasn't sure she could have taken 30 seconds to google it.

Appalling, really.

Two types of pills are sometimes suggested for younger women instead of HRT- Zoely or Qlaira.

What qualifications did your menopause doctor have?

She should be on the British Menopause Society list or working from a clinic on the list.

You honestly would have better advice from someone menopause trained at your GP surgery.

Thanks, I agree I don’t think she should be claiming to be a menopause specialist. She’s a private gp who runs menopause clinic appointments that are offered as part of our workplace medical centre. I don’t specifically know what her qualifications are. But I think I will raise a compliant. I will check first whether I was all some massive misunderstanding but won’t be going back to her for menopause advice that’s for sure.
I agree, I think I’d be better off going through my normal nhs gp practice.