Slynd for HRT?

[Rufus27]

I’ve been prescribed 2 pumps of estrogen gel plus Slynd to be used for a combination of HRT and contraception now I’m too old for Qlaira (mid 50s).

My GP has told me to take a double dose of Slynd (2 x 4 mg) daily, but this seems a really high dose of progesterone? From the little info I can find online, 4mg (so just the one pill) seems to be prescribed (off licence) as standard. I can’t find any reference to taking 8mg, but my GP insists it’s right.

Can I check what other people are taking?

Why does your GP think you need contraception at 55?

This is from the NHS site
Stopping contraception
You can stop using contraception at the age of 55, as getting pregnant naturally after this is very rare.
You’ll be advised not to take the combined pill from the age of 50. You can change to a progestogen-only pill or other method of contraception instead.

It's been the case for many years to offer body identical micronised progesterone (Utrogestan) rather than synthetic progesterone for HRT. It's safer re breast cancer.

Im 54 so they’re making me have it for another year. It’s also because when I tried gel/Utrogestan years ago, I loved the time I was taking the progesterone but hated when it stopped (headaches, anxiety) so I’m better on a continuous regime - but still have periods, so GP says it would have to be sequential 😞

The odds of becoming pregnant even at 54 and are almost nil.
You could consider the Mirena if you fancied that? it would tick both boxes.

And, you can use continuous HRT over the age of 54 even if you have periods.

The BMS suggests Noriday (mini pill) 3 a day as part of HRT and contraception if that helps?

Maybe see another GP who is more flexible?

Thank you, that’s super helpful. Really appreciate your advice. Will speak to a different GP!

I take 2 x Slynd as part of my HRT, but it’s very much off license and definitely an unusual regime for your GP to start with.

2 per day is a high dose, the usual dose for Slynd as part of HRT is 1 per day taken continuously (missing out the 4 green tablets). So you can take Slynd as your progesterone element of HRT if it suits you, but it’s very unlikely you need to take 2 per day.

I’m also on a high oestrogen dose (200mcg) which is why I need a higher progesterone dose. Slynd suits me where other types of prog have not (I’ve tried Utrogestan, Mirena coil, Noriday, Cyclogest - tbf I was running out of options!)

My regime was agreed by a meno specialist Doctor, not by my GP. They also told me there is a risk of having raised potassium with Slynd so if you are taking a high dose, your bloods should be monitored for this.