Switching up from Evorel 50 to 75

[pudsma]

Hello. I'm 54, still having periods, and have been on Evorel 50 oestrogen patches and oral progesterone (Utrogestan) for just over a year. I was happy on it and things were fairly steady but there were one or two things I could have done with tuning up.

It was suggested to me in December that I might benefit from going up to a higher dose of eostrogen so I was given Evorel 75 and from day one my sleep went to pot. I stuck it out for a week but it was really hard, so I tried literally cutting them down to be a smaller dose but after a couple of weeks I threw in the towel and went back to the Evorel 50.

My question is whether anyone else has suffered side-effects from increasing oestrogen? It wasn't worth it for me as I was fine on the 50 but I was surprised to have the negative effects. A doctor told me oestrogen is a stimulant and for me it was like I'd had an espresso at bedtime on the 75. I'd love to hear if anyone else has experienced similar.

Thanks :)

I've just gone up to 75 due to ongoing joint pain (can't say there's been any improvement yet). The only negative side effect for me was a weird bout of intense nausea the morning after the first new patch, otherwise - can't really tell the difference!

I found the progesterone great for sleep - maybe that needs to increase for you, to balance out the extra oestrogen? I'm not personally having periods - I have a mirena coil in its 5th year so it's progesterone has pretty much run out now, it's being left in for a couple more years for contraception. Hence they gave me the progesterone too.

Sleep is OK - I'm mostly woken up by nocturnal regurgitation which is gross. 🙁

Oh dear, that does sound a bit rough - I hope it passes soon.

I used to take Utrogestan two a night, two weeks on two weeks off, but when the Evorel dose was changed the doc suggested taking one Utrogestan every night.

I might go back and talk to the GP but it doesn't feel like a priority just now. I was invited to a group zoom event about HRT, run by a GP group in Herefordshire, and then to an in-person event. The GP could prescribe but she didn't have any follow-up. It's a pilot project. It was good in that the GP was a menopause specialist, but it's shame there's no follow up because if I now go back to my own GP to ask about eg increasing the progesterone they just aren't as knowledgeable so I can see myself not getting very far with it.

One reason for changing the progesterone to one every day was to see what my periods were actually doing. Apparently the two weeks on two weeks off is more likely to lead to a period or something that looks like it than if you're on a daily dose. So far my periods have been arriving pretty much when I expect them. I would really love them to stop now!

The British Menopause Society recommends if you are on a higher oestrogen dose, you should be on a higher progesterone dose too. So 200mg every night continuously or 300mg for the fortnight if you're on 2 weeks on, 2 weeks off.

It sounds like you didn't need an increase in oestrogen, why was it prescribed? Indications of needing an increase are feeling a return of symptoms before a patch change and times of the monthly cycle when oestrogen dips e.g. before your period.