Neurology asked me to come off HRT

[101trees]

I have had chronic migraine without aura since I was a teenager. Predominantly menstrual migraines.

I'm on 100mg evorel + 200mg daily utrogestan. I'm only 40, but have strong family history of early menopause + osteoporosis.

Initially HRT + Rimegepant really stabilised my migraines, so Neurology passed my care back to GP 9 months ago.

6 months ago I migraines worsened again, I started to get way more hot flushes and night sweats, so I increased the patches to 75mg, then 100mg. I've been on 100mg patch almost 10 weeks.

Since going up to 100mg patch, I've had significantly more flushes and night sweats, and a few more migraines. They seem to keep getting worse.

My migraines are out of control, almost daily, GP hasn't been able to help so asked me to go back to Neurology to email and ask. They advised to come off HRT. Experience tells me if I don't do this, they will not help until I've tried it.

I'm concerned I'll be much worse if I come off HRT.

Is it possible increasing estrogen can cause more hot flushes and symptoms? They are getting significantly worse, but I'm not sure if it is just natural progression of peri, or the HRT causing it.

I get flushes a lot, but much more in the week before my period (which seems to be getting later and heavier).

I'm reluctant to come off HRT also because of osteo risk.

Any advice much appreciated!

Thanks very much for the info.

If flushes are fluctuations, then perhaps using a higher patch caused more fluctuations which made them worse?

Aside from migraine I have no other risk factors for stroke.

I will skip the blood tests but try and get a DEXA scan.

Go back to Neurology, and talk to my menopause specialist about trying Zoley or maybe estrogen gel.

Thank you all so much for your thoughts and experiences, it's really helped me clear my thoughts and come up with a plan. I'm very grateful 🙏

I'm on tibolone instead of normal hrt. There are so many types out there, it's worth trying something else to see if it helps, because hrt has other protective benefits, I would not come off mine willingly