# Choice of HRT



## Elpida (Feb 11, 2008)

Hi


I wonder if you have any advice about hrt options. My pituitary is not working as it should so I will have to be on hrt long term, regardless of fertility treatments/outcomes. I am really struggling to find a preparation that I can cope with and am feeling quite desperate. I am unable to tolerate progesterone. When I've been on the pill, or had to take norethisterone in the past it has left me a sobbing, bed ridden, foul - verging on violent - mess. I have a history of depression and although I am aware that these feelings are triggered by the hormones it's very difficult to manage.


I was prescribed Trisequens hrt initially and after the first disastrous month would take it back to back for a couple of months then take about 4-5 days of the progesterone phase in order to trigger a bleed (and even these few days left me struggling to leave the house and get into work).


After the last ivf I started Evorel Sequi - the thought being that the patches might make things easier. I'm still on the first month and know that it might settle down yet, but the oestrogen phase left me nauseous with a terrible upset stomach, cramps and exhausted (and I'm supposed to be adding more, in gel form at some point). I'm only on day three of the progesterone patches today but have already been in tears and can feel the cloud descending. I know I can take the patches back to back for three months or so, as with the tablets (the doctors are happy with me doing this), before having a bleed, but I don't know how many days worth of the progesterone patches would be enough to trigger a bleed with this different method of delivery.


I've only recently had an appointment with the specialist and don't have a follow up for some months and my GP won't change the prescription.


If you have any suggestions on what I could try next I'd be really grateful and if you can advise on how to manage the progesterone phase of the Evorel Sequi I'd be really grateful. 


Many thanks
Esperanza 


ps Long term (ie once I'm no longer ttc) the plan is to have a mirena coil (which I've had in the past and tolerated) and add in oestrogen using gel, this will also help prevent the return of endometriosis, which I'm at risk of whilst I have a cycle)


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## mazv (Jul 31, 2006)

Hi esperanza,

Sorry to hear about your ongoing problems   I'm afraid this isn't an area that I'm all that clued up on   I do know that there are a myriad of HRT preps available and that often women will need to 'try' a few to find one that suits them. There is no hard and fast rule as to when a bleed will occur either   Most of the comapnies will quote a percentage of women who will settle into a routine pattern with bleeds when starting a prep and a higher percentage doing well after 6 months but unfortunatley there are a small group that don't always react the way expected. The side effects you are describing are fairly common with these types of meds too and agian ti can often be a case of changing to a different hormone to see if that helps.

Sorry not really able to help   You can always call up and leave a message for specialist explaining how thigns are and asking for them to get back in touch.
Hope things improve for you   
Love
Maz x


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## Elpida (Feb 11, 2008)

Hi Mazv


Thanks for your response - I know it's so hit and miss and there are no real answers, but I live in hope   . I went back to the triseqens as at least I know what I'm dealing with there.


Thanks again
E


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