Up my dosage or change method of HRT?

[thenewaveragebear1983]

I have been on evorel sequi 50 for 2.5 years now, and I have an appointment on Monday to discuss with my gp my ongoing list of symptoms.

palpitations - I’d say they are the worst they have been in months
tiredness
hair falling out a lot
weight gain/ plateau for months
aches and pains, heavy legs, restless legs and general heavy joints
irregular cycle- the last 3 have been 17 day, 12 days, 34 days
anxiety
driving anxiety

I’ve had all the bloods and it’s not:
thyroid
cortisol
my ferritin is low 40 but not nhs low - taking iron
my b12 is low but not nhs low - taking supplements

I have given up gluten and feel a considerable amount better in that I no longer have constant anxious intrusive thoughts and I no longer fall asleep at my desk after lunch. But all other symptoms remain.

I have a very generous 9 minutes with my gp to discuss this, I think my first request is that I need to adjust my HRT. I tried to come off it 6 months ago and developed a huge recurring cyst in my breast and extreme anxiety so I went back on it. I have previously thought that patches were enough but I am starting to think I’ve pretty much got all the symptoms I had when I went on them in the first place!

Any advice or suggestions? What should I ask for?

Very similar to myself. I was on the same prescription and I am a similar age. Recently my symptoms have returned coupled with severe anxiety.
I saw gp this week who has recommebddd increasing oestrogen patches to 75 and then taking a separate progestogen (?) tablet for the last two weeks of my cycle

@digitalisationthank you, that’s really interesting. How are you finding it on the progesterone tablets? Do they make you more tired? I really notice the 2 weeks I am on the combi patch whereas I suppose with tablets you take them at bedtime?

Yes, ask to try a higher dose.
This is my experience in case it helps you.
I found I needed to increase my hrt dosage as time went on. Like you I quickly went to evorel 50 at the start (25 didn’t touch the sides!) but then over time I went to 75 and am now on 100. This transition was probably over 4 years - I’m now 51.
The other thing to mention is that I was initially on progesterone tablets for 2 of every 4 weeks. However they gave me symptoms similar to mild PMT. After discussion with a gynaecologist I had a mirena coil inserted and came off the progesterone and I feel much better. Gynaecologist said the coil is ‘gentler’ because the hormones are released locally into the uterus rather than across the whole body as when taking tablets.
Good luck.

I’m on evoral 75 plus progesterone tablets and estriol. Definitely go to your gp with symptoms.
I confess I used ChatGPT to help me work out what might help me, saved it to my phone and came in armed. Disappointedly I was much better informed than the gp.

@hitched I went onto 50 but have only ever been on 50, they’ve never really given me any kind of review of it. They offered me a mirena about a year ago due to my heavy periods and low iron, but I cancelled the fitting because I read the side effects and they were exactly what I was trying to avoid- weight gain, tiredness, etc etc. however I am worse now than I was so I may as well ask again.

I have asked the gp for antidepressants- basically I said I am so miserable feeling tired all the time, I may as well have something to help me feel slightly less miserable. However I would prefer to resolve the issue. I am at least feeling a bit better armed for my appointment, thank you everyone who has offered their experiences