Is Evorel Sequi 50 right for a 42‑year‑old with fatigue, brain fog and migraines?

[PM2026]

I’ve been advised to start HRT for perimenopause symptoms. My GP has been suggesting I’m in peri for the past 2-3 years, but I kept pushing back until now 😬

I’ve just been put on 50 mcg patches (Evorel Sequi).

My key symptoms over the past 2–3 years:

• Fatigue
• Brain fog
• UTIs
• Joint pain
• Accelerated skin ageing

More recently:

• Increase in migraines (I used to get hormonal migraines 4–5 days around my period, now they’re almost daily)
• Feeling hot at night (but not remotely close to full night sweats)
• Decrease in libido

Sleep has always been bad. Anxiety comes and goes but isn’t too bad at the moment. I still have fairly regular periods. Mum has osteoporosis.

The 50 patch is giving me nausea. I’ll give it more time (it’s only been 3 days), but I’m starting to feel like my treatment plan might not have been well thought out. Since starting HRT, I’ve been reading more about it and I’ve noticed that many young-ish women like myself seem to start on lower doses (25 mcg patches or 1 pump of gel).

Also, my GP didn’t tell me there were two types of patches in the box. I’m only finding out now as I’m typing this and checking for nausea in the leaflet! 😳 I was just told to put a new one on every 3.5 days. Insane!

Now I’m wondering whether the treatment I’ve been prescribed makes sense. Has anyone else started on 50 mcg? How did it go for you? 😊

Im annoyed because she didnt even go through symptoms with me to look at what sort of type migh be better for this and that

So now I have the patches. I'll see how I go for a couple of months but I didnt kno wyou can do patches and then an oral tablet for the progesterone.

She didnt explain anything.

Yes they're good to keep for 3/4 days. I put mine back inside the wrapper then put it in a zip lock bag. Cut them with the backing sticker still on.

The only irritating thing I found is they peel off more when it's half a patch.

My migraines are almost completely hormonal, so it's always my indicator that there's something off when they get suddenly worse.

She sounds crap! This is important stuff.

Yes tell me about it.