On Evorel 100 but getting worse

[rivercobbler]

I've been on HRT for about a year. I've always been on Evorel. I tried the sequi patches but didn't get on with that type of progetserone. In Sept I went up to Evorel 100 with 300mg Utrogestan, and that was good for a while, but lately I don't think it's enough.

I change my patch every 3 days because I start getting hot flashes after 2.5 days. Sometimes I get hot flashes randomly too. My mood and energy have dropped noticeably. They're bad. My face appears to be sliding right off :)

I also have GSM. As in, my clitoris is practically gone and I have difficulty reaching orgasm. My libido is gone. I've tried Blissel, but that stopped helping so I went up to pessaries (Vagirux). There was some improvement when I was using the pessaries daily (for the first two weeks) but it declined again when I went to twice a week. I've bought sex toys for the first time in my life to try to keep things going down there but... meh.

I went to the GP about 3 week ago. I had a hormone test and my estrogen was below reference range for that point in my cycle. But the Dr said they don't go any higher than Evorel 100. She gave me Testogel for libido and sexual function which I've been using as instructed. I've noticed very little difference so far. They said to give it 3 months and I will.

I want to know what else I can and should be asking for. I think if I'm not getting symptom control on my current HRT (Evorel 100, Utrogestan 300mg, Vagirux 2 x week, Testogel)and my estrogen is still low even on patches, then surely I should be referred? Or maybe I should ask for a gel or tablet instead of patches? Or maybe there's another stronger pessary for GSM?

All help gratefully received!

I've no advice re the HRT unfortunately. I've been on the Sequi patches a year now, but recently switched to the coil & patch combo.

In terms of orgasm though, I'd recommend getting a Doxy Wand. Very powerful. Can be used over clothes without any lube. I don't even think of it as a sex toy - more like a health device. Allows you to have organs regardless of libido but I'm hoping it'll help with that too. It is expensive though. Love Honey do their own version, which would be a bit cheaper I'd assume.

On the HRT front, have you considered swapping the Evorel to the gel or spray?

I recently went from Evorel 75mg patch to gel (3 pumps daily). The menopause specialist told me that we can all absorb Oestrogen differently, so whilst the patch can work perfectly well for one woman, it might be different for another woman.

I’m coming up to my 4 week on the gel and I have to say I feel more ‘steady’ in myself. Less reactive and calmer than I was. It could of course be all in my head! The test will be the last few days of the month, I was getting very ragey and intolerant to just about everything, hence the reason for requesting the gel instead of the patch.

Thanks both.

Yes, I could ask to change to the gel or spray for the estrogen as a first line.

I've also realised that my Utrogestan is probably an issue, maybe because it isn't being balanced out by estrogen anymore. I've wondered why I'm so dopey and sleepy the last few days and then connected the dots. So I could ask for a pessary for the Utrogestan as well.

just bumping for the evening crowd:)

I’m surprised you’re on 300 Utrogestan.
I went from 100 Evorel patches to 4 pumps of Oestrogel daily and I take 100 Utrogestan every day.
The gel has been much better for me, I was still very depressed and flat on the patches.
Once the Testogel kicks in you’ll notice an improvement in libido, it’s a game changer for many women.
The Vagirux did virtually nothing for me, the gel has been good though.

Hi OP. You need estriol cream for the labia etc. Rub it everywhere not just internally.

Also you can use the utrogestan you already have vaginally. Made no difference to me, I still felt drugged. I switched to a mirena coil.

The GP said that high dose estrogen (and Evorel 100 is classed as high) needs more progesterone to protect the womb, and I thought my dose was in line with BMS guidelines. But if you have anything that says otherwise I'd love to see it as I hate being on this much.

Good to hear the gel made that much difference! That gives me hope.

I use Vagirux twice a week and rub Blissel on the external parts most days.

I did very badly on the Mirena a few years ago, and on the Evorel Sequi patches. Made me suicidal. The Dr said that Utrogestan is a different form of progesterone and so far it hasn't had such a bad effect. I wouldn't go back to the Mirena or Sequi but I don't know much about the different options available.

I wonder if starting the testosterone has made me extra tired as my body acclimates. My instinct is I need more estrogen but obviously I don't know.

Do you still get periods? Do you take Utrogestan every day?

Yes I still get periods, and no, I take Utrogestan for 12 days a month.

My friend changed from this to a smaller dose every day, perhaps you can try this. Also you can use it vaginally. Ask your Dr but this is not working for you. Hormones have to be tailored to the individual and the guidelines aren’t a one size fits all. The gel is good place to start.

Thanks so so much. 🙏 I will go back to the Dr with all of these options.

Update: the doctor had sent a question to gynaecology about the use of pessaries, and they just got back to me. I can use Vagirux up to 5 x week, so I will start with that and persevere with testosterone. Next time I'm due to use progesterone I will use it vaginally and see what happens.

I'll have a review in less than 2 months and ask for advice about progesterone and ask for the estrogen gel then.