Moving from sequential to continuous HRT, can't tolerate progestogen

[user12696648]

My GP has suggested moving me from sequential HRT to continuous (51, on HRT for about 18 months).

I'm concerned because the progestogen part of my sequential HRT (norethisterone) causes my anxiety and depression. I've put up with it because it is temporary but would this be a permanent fixture of continuous HRT? I couldn't live like this permanently.

Any advice welcome, I have a Dr appointment in 1 week to discuss. Thanks!

Try a different progesterone?
Assume you’re considering switching from Evorel sequi to conti patches? If you want to go on to a continuous regime (which I think is recommended after 1 year on HRT) you could change to oestrogen only patches and have an alternative progesterone?

I get on best with norethisterone but it’s known for not being particularly well tolerated. I use 2 conti patches and a 50mcg Estradot patch - I’m like a patchwork quilt! Plus 2 x Noriday tablets. All of which is an off licence regime that’s taken time & trial and error to figure out, but it works for me. That’s 150mcg oestrogen & 1mg of norethisterone daily. I’m 49 and on a continuous regime (at my request) because I do not tolerate fluctuating hormones (not even my own ones).

The general consensus is that the best tolerated & lowest risk progesterone is the body identical type (eg. utrogestan) so you could start there.

Utro made me feel groggy & murderous. My Dr told me there was a higher risk of DVT from norethisterone so I told her “and there is a higher risk I will murder my husband if I stay on utrogestan” 🤨
She switched it. We are all different.
Try other options.

FWIW I also tried Mirena for the progesterone (hated it, but others love it)

You can do whatever you choose.

It's a choice to swap to continuous.

I've not swapped after 15 years as I don't like using progesterone daily. Fully supported by an excellent menopause consultant with this.

It also has a higher risk of breast cancer compared to sequential.

Hi jinglingspringbells,

I seem to recall you really kniw your beans re. HRT…
How do I go about finding an excellent meno consultant, or any clinician who might be able to tailor my hormone dosages. My GP is lovely but too busy to care and just references Nice guidelines.

TIA for any advice.

https://thebms.org.uk/find-a-menopause-specialist/

Hi @mummyhat Try this link first but not all specialists are on the list.
Also, check out your local private hospitals and look under 'Gynaecologists'- they usually have a biography of what they treat and not all are experts in HRT.
You can have consultations by video with many consultants now but your choice if you prefer in person. I don't know where you live but if you can access London there are a lot there in both private clinics and also working in private hospitals. Most don't need a GP referral- you just book the appt yourself.