Experiences of different HRT options when current treatment is working(ish)

[QueenieElle]

Can I have your thoughts on different types of HRT please. I’m currently on Evorel Sequi (been on it 18 months) and doing well but feel some days like I might need something a bit more. Nurse suggested getting a coil and then using a patch or gel for estrogen as it can be upped if needed but I'm a little nervous of making changes when on the whole I am able to manage at the moment. The one thing that’s wonderful are my moods - absolutely no issues with anger, tears, being irrational etc - and I’m scared in case this changes if I swap my HRT.

Unsure if managing is the best I can expect and should be grateful that I’m good, or whether I can find a HRT which brings me 100% back to my old self and I get my spark back. Am I hoping for too much?!

What HRT do you use and how do you feel about it? Thanks!

The only reason you may want to change is if you want to swap from a patch which has the older, synthetic type of progesterone (it's usually Norethisterone) to a body-identical one - micronised progesterone. More relevant if you intend to stay on HRT longer term (ie more than 5-10 years.)

The research appears to show it has a better safety profile for breast cancer.

The coil contains a synthetic type of progesterone. Not a lot is absorbed into the system, but a small amount is.
Some women love the Mirena coil as it means no withdrawal bleeds or natural periods.

The problem with patches is they are in standard doses. You can't change the dose a little bit - whereas with estrogen gel you can change the dose yourself, from the equivalent of a 25mcg patch up to 100mcg patch but using more or less.(Obviously the dose is not changed daily, but every few months if you feel you need more.)

HRT helps but it's also important to really focus on diet, doing exercise and kicking any 'bad habits'.

Thank you, really appreciate your response. My diet is really good and I exercise. I’ve never been over weight but I did put about 5kg on as I turned 50. That’s come off now since I got on the HRT. I sleep really well although lately I’ve started waking early again. So as I say, I’m actually doing ok but recently just don’t quite feel like myself. I’ve had a bit of anxiety which I’ve never had before and didn’t know whether a change would get my old spark back.
What’s the best way to get a body identical progesterone?

What’s the best way to get a body identical progesterone?
From your GP.
It's mainstream and many women use it.

You'd need an estrogen only patch or swap to estrogen gel or spray.
And maybe you need a slightly higher dose than you're using if you feel your symptoms are back.

Thank you, you’ve been very helpful

Thanks for starting this thread OP. I've got my 3-month review of Evorel Sequi soon and was thinking of asking about options as I'm still struggling with bad PMT symptoms (but might be because I've just been diagnosed with ADHD).

Some of my symptoms cleared in what felt like a matter of days but I’d say it was more than 3 months until I really started to notice the difference. I think my doctor said to give it 6 months? I’ve really liked the Evorel Sequi patches and was told it’s one of the better ones so now I’m wary about changing. It’s just such a minefield isn’t it. Hoping to hear from others who have tried the coil plus separate estrogen to help me decide

i would try a higher dose before changing types, unless you’re already on the max?

I don’t think the exact type I’m on goes any higher. The higher are estrogen only I think hence the need for a coil. I’ll have a research thanks

@QueenieElle These are the patches available .
If you're post menopausal the most in a patch is 50mcgs.
That's why patches are so limiting if you want one with the progesterone in it as well.

You can use estrogen only and add a separate type of progesterone (not just the coil.)

You do not need a coil with more estrogen- if that's what you were told it's wrong.

COMBINED HRT (AS PATCHES OR TABLETS)
https://www.menopausematters.co.uk/postmeno.php

ESTROGEN ONLY TABLETS, PATCHES, GEL ( USE WITH MICRONISED PROGESTERONE, THE MIRENA COIL OR 5MGS NORETHISTERONE TABLET. )

https://www.menopausematters.co.uk/treatafter.php

I’m on Evorel Sequi 50 which is 2 weeks of estrogen followed by 2 weeks of both. I’m not post menopausal hence why I need progesterone as well. The exact type of patch I’m on doesn’t go any higher from what I can tell so my nurse suggested the coil for progesterone and then we would be able to try options to obtain my estrogen…. One of them being the Evorel patch which is just estrogen as these are available in 75 and 100. Seemed like a fairly reasonable solution but I’m just doubting whether I want to start playing around when I’m currently ‘ok’.

Ideally hoping someone doing similar would have a little feedback although I know it’s a very individual experience.

It's your choice what you choose as the progesterone.
Some women don't get on with the coil, some love it.
If you change to more estrogen either as a patch or gel, you can use micronised progesterone. You can also have the same progesterone that is in your current patch (Norethisterone) but taken as a tablet for 12 days a month.

Hello, I am on the same patches and just had a similar conversation like you have started here with my GP. She suggested before changing anything to have a blood test to make sure the hormone is properly absorbed. Somtimes position needs changing etc. Have you had a BT yet? If not it sure won't hurt to request one. This might make things clearer

TBH specialists (mine) don't advise blood tests as they are not reliable even when using a patch. They prefer to go by symptoms.

Mine won’t either. She did a testosterone test and mine was low so gave me a gel a while ago which made such a difference but she won’t test for progesterone or estrogen.
I think I must be absorbing ok as been on it 18 months and was great. I feel like I’m lacking something but don’t know - maybe I’m just getting old and my spark is fading 🤣😢

Ive just changed from the sequi patches for the same reason. I'm now doing gel and progesterone only tablets (11 days of cycle) I'm finding it's working well and I already feel better.