Femoston Conti

[Cori21]

I’ve been taking Femoston Conti tablets for 8 years and am now considering trying the continuous combined patch, only because the patch is meant to have a lower risk of blood clots. After researching, I’ve found that the progesterone in the patches are close to testosterone and can cause oily skin, acne, headaches, mood swings etc. So now I’m having a dilemma, as I don’t really have any side effects from the Femoston Conti tablets.

Has anyone tried both these tablets and the patch and can compare them? Did you have more side effects from the patch?

If clot risk is the main reason for switching, the difference comes from the oestrogen going in through the skin instead of being swallowed. NICE's menopause guideline (NG23) says transdermal oestrogen (patch, gel or spray) doesn't raise clot risk above your baseline, while oral HRT raises it slightly.

You're right about the combined patches. The UK ones use norethisterone (Evorel Conti) or levonorgestrel (FemSeven Conti), and both are derived from testosterone, so some women do get oily skin or spots on them. The dydrogesterone in Femoston Conti is closer to the body's own progesterone, which may be part of why you've had no side effects.

There's a third option you could ask your GP about: an oestrogen-only patch or gel with a separate progestogen, such as micronised progesterone capsules (Utrogestan) or a Mirena coil. That keeps the oestrogen on the skin route without the testosterone-type progestogen. The NHS page on types of HRT covers these combinations, and after 8 years on tablets it's worth talking it through with your GP or a menopause clinic before you change.

Thank you for your advice. I am now wondering if the progesterone in the combined patch could actually have the benefits of testosterone in an addition to the side effects? For example, could it elevate my mood, motivation, energy and libido? Perhaps it may be worth trying and if the side effects are too much, I could then go back to the tablets.

@Cori21 Your problem may be solved!

The progesterone in Femoston (dydrogesterone) is now available as Nalvee, a tablet. You can use this with an estrogen patch (or gel.)
The blood clot risk applies to estrogen, not progesterone.

Or as PP says you could also try micronised progesterone (Utrogestan- brand name) and see if that suits you.

As a by the way, some menopause consultants say the blood clot issue is overstated for women in good health (ie non smokers, not overweight etc) and if women are happy on tablets they can carry on till 60, so depending on your age, something to think about.