HRT - No idea how to take it

[OldMcDonaldHadABigMac]

I'm 44 and have been experiencing erratic periods and hot flushes for some time. I went to the GP and was prescribed Femoston 1/10mg tablets and Provera 10mg tablets. The GP told me during the consultation to take the femoston every day and the provera for 14 days a month. However he didn't tell me which 14 days to take it! Nor does it state this info on the box and there's no patient information leaflet. Is it supposed to be from the first day of my period for 14 days or any 14 days of the month? I'm working for the next few days and work in a secure environment so we can't have phones so I'm not going to get a chance to get a callback from the GP till Thursday at the earliest and I would prefer to get started on taking my HRT, I've suffered with symptoms long enough!

Bump?

I'm very confused by your prescription.

FEMOSTON is a tablet with both hormones in.
You should not be using Provera as well. That is a progesterone to be used with estrogen-only patches, gel or tablets.

Is your GP not knowledgeable on HRT?
See the product list here and see Femoston.

https://www.menopausematters.co.uk/perimeno.php

FEMOSTON 1/10*
Estradiol 1mg
Dydrogesterone 10mg for 14 days/28 THIS IS THE PROGESTERONE.

YOU DON'T NEED PROVERA AS WELL.

Go back to your GP and ask to see another dr.
This is appalling.

I don't know, I assumed he was knowledgeable on HRT seeing as he is a GP. I don't think he's done extra training on it as he did advise me to see a "lady doctor" for my 3 month review as "they've had extra training in menopause", but I assumed he'd have a basic level of knowledge?

Could the provera be to give me additional progesterone? Would the prescription have got through the pharmacist if it was wrong?

This is what I've been given, provera says to be taken 14 days of each cycle...

It's actually quite shocking that a GP makes this error.
They can read the product ingredients online.

There is no need for more progesterone.

Femoston has both and you don't need extra.

The pharmacist can't override a GP because as far as they know, the GP may have had a reason to do what they did and also pharmacists are not experts on HRT.

Ok thank you, I'll call the surgery at the end of the week (first time I'll get a chance) to discuss.

You can see on the label that is has 1 mg estrogen (that's the 1) and 10mg of dydrogesterone.

That type of progesterone is similar to micronised progesterone (Utrogestan) and is more body-identical than other types.

Provera is a totally different type and no one uses both.

Your pack of tablets (femoston) will contain only estrogen for 14 days then estrogen + dydrogesterone for 14 days (is that on the back of the pill strip?)

Apologies for the bigly writing. It must have been something in the paste that did that.

Edited to say I managed to remove the bigly writing.

Oh OK, I didn't know that dydrogesterone was progesterone. The back of the box says the below and the strip is just grey and white tablets...

It doesn't matter what Chat GPT says. It's not right in this case.

Chat GPT is incorrect to call Femoston a continuous HRT because it's not - in your pack- it's sequential, where there is only estrogen for 14 days.
Continuous means both hormones every day.

Hopefully some posters who use Femoston will come along and say the same thing.

Yes, so there are two types of tablets= those with only estrogen and those with both.

14 of each.

Ok thanks for the advice, I'm going to go back and clarify my prescription before starting. One more question...when I do start the tablets, do they need to be commenced on a specific day of my cycle? Just in case I get more poor advice from the GP.

I agree with the others that you don’t need extra estrogen if it’s in your main tablet.

If when it’s sorted you are on the extra estrogen it can be any 14 days, just needs to be consistent. So easiest thing to do is take it from 1st to 14th of the month.

It is shocking how little some drs know. Though I saw a suppposedly specialist hrt proscriber when I first started and the changes she made, and told me if I didn’t I would get cancer, led me to being suicidal. It was horrific.

thankfully I have a wonderful younger female dr now who knows her stuff.

if there’s a local community group on Facebook, post anonymously to ask if anyone can recommend which dr to see at your surgery.

You can start the estrogen only tablets any time.
If you can (but it's not important) start on the first day of your period or thereabouts. This is so the progesterone phase will coincide with your own mid-cycle progesterone.

However, it's not that important because HRT will reset your own cycle in the end, especially if you're missing cycles.

I think @welshpolarbear means extra progesterone here - If when it’s sorted you are on the extra estrogen it can be any 14 days,

Good luck!

(No one uses Provera and dydrogesterone. They are totally different progesterone for a start. )

Apologies, I did mean progesterone, I’m sorry.