HRT dosage - when did you go up (patches)

[Marasme]

i ve been on patches for 10months approximately, evorel sequi 50. I saw some sort of improvement, it was quite gradual, to the extent that i "forgot" how bad it was before starting, and almost dismissing it bringing me that much relief.

since last month, anxiety is bad again, i wake up again at 4am, joints are painful again, and i feel hot (could be anxiety or it could be flushes?) - i now remember how crap i felt before starting.

Is it too soon to already up the dose? how often do you review yours? i am a bit weary as GP had told me that evorel sequi does not come in same formulation at higher dose, and that i would have to take oral progesterone, which does not appeal...

I’m on Evorel too, have been for about 5 years, It doesn’t sound too soon to up your dose-I went up to 75mg when I started having night flushes again after a few months of none-that’s always been my main symptom.

i wouldn’t be accepting oral progesterone at this point. The 75mg patches have been fine for me-and I think the patches go up to 100mg

thanks @Samewrinklesnewname

do you use a patch and one cut in a half?
GP told me that the sequi formulation comes only in a single dose - 50. that's what I don t understand

Sequi only comes in a single dose of 50. Some women cut their patches diagonally in half and use 1.5 patches to give them extra oestrogen and they then also have the extra progesterone.

This usage is unlicensed but many women find it beneficial.

You could consider a Mirena coil for your progesterone protection, and then use oestrogen only patches, gel or spray which gives you more ability to tweak the dosing. Or don’t discount oral progesterone as it’s bio identical and many women find it incredibly helpful.

Different women have different HRT experiences so try not to be too influenced by others especially where regimes are concerned. Think about what would work for you and what fits with your lifestyle.

thanks Sidge
i m not the best at remembering to take pills, that s why patches work so well for me - but i could trial it out.

i would rather avoid mirena too as it feels too permanent and untweakable...

I'm on evorel 50. I started off on the gel and had gone from one pump to two within 4 months. Then last December the symptoms came back with a vengeance. I went to the GP and she didn't think I was absorbing the gel, so put me on evorel 50, so the same dosage. It worked and I feel great at the moment (although I am now currently experiencing a bleed). But I keep wondering how long the good times will last!

I understand your concerns about the Mirena but it’s definitely not permanent, removal is much easier than insertion, and if it suits you can forget about it for 5 years! Generally very well tolerated too.

With the coil you only need oestrogen so can stick with your patch, and have oestrogen only which come in many different strengths so you have more potential to adjust dosing.

The oral progesterone you take at bedtime, potentially every night but yes if you are rubbish at remembering things that may not be the best option!

Have a look at the website Menopause Matters for some good, sensible advice.