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[southerngirl]

Hello everyone!
I've been on elleste duet 2mg since I was 44 (10 years) for menopause reasons and other!!
I've always felt brilliant on them. However, the last few months I've not been feeling myself. Some of the symptoms point to oestrogen excess.
I have really random periods on them. I sometimes go 6 weeks and then 3 and then back to the 28 days as per the pack ??
Not really sure what's going on.
I really, really want to stay on HRT as I have Crohn's disease and since starting HRT have not had a flare up.
I'm off to the doctors on Friday and though I need to go armed with a bit of information.
Thanks in advance for your help.

[Rowan]

You could try lowering estrogen naturally so that its metabolized better even when on HRT.

"Oestrogen is metabolized by the liver,so a liver detox is a good first step. You can do this by eating plenty of leafy greens as well as superfoods like spirulina, wheat or barley grass and chlorella help to keep the liver clear and functioning properly. Milk thistle is also an excellent cleansers to supplement in this process. Avoid processed foods and focus your diet on fruit, vegetables (especially cruciferous) and omega-3 rich foods and include a high quality probiotic along with flax and plenty of fibre as it sweeps excess oestrogen from the intestinal tract.

If you are following a high carbohydrate and low protein diet that has been shown to decrease activity of  cytochrome P450 that detoxifies estrogen so is counterproductive in this instance. The amino acids lysine and threonine, found in meat, fish, beans, eggs, can help get rid of estrogen from the body.  If  you are carrying a few extra pounds then try to lose them as the more fat tissue one has, the more oestrogen is present due to higher levels of aromatase, an enzyme that transforms testosterone to oestrogen"

[southerngirl]

Thank you for advise. This maybe the problem recently!
My gastroenterologist referred me to a dietiecian, who has put me on the FODMAP diet. This is is a diet to help anything 'gastro' related. E.g reflux, Crohns, and IBS. It is very low in fruit and veg as they are now known to exacerbate these conditions. Also to cut out wheat. So, although I used to eat loads of fruit and veg, my intake has seriously reduced. I'm 5'8" and 10st 10lb. So not massively over weight but very, very apple shaped! Lots of belly fat!
Once again thanks for the reply
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[English Rose]

Hi southerngirl
I was wondering what makes you think you have "oestrogen excess"...if you are on a daily regular dose of oestrogen at age 54 (?) then your oestrogen levels should be quite stable.
Have you considered asking your GP for a no-bleed HRT?
All the best,  ER x

[southerngirl]

Hi English Rose
I am wondering if it is that because I've always been absolutely fine on the HRT. But just lately have had lots of symptoms on the oestrogen part of the pack. They include

PMS
Fatigue
Fluid retention and abdominal bloating
Weight gain
Insomnia – esp. before a period I only sleep about 4 hours a night for about 4 days before my period.
Frequent thrush
Sugar and Carbohydrate craving
Decreased sex drive (totally non existent  )
Gallstones

I'm off to the GP on Friday so am going to ask (now I'm 54) if I can go on a no bleed HRT.
Thank you for taking the time to reply. I'll let you know how I get on 
Thanks
X

[English Rose]

Sorry to hear about your grotty symptoms Southerngirl.

There are some 1mg oestrogen continuous HRTs too - maybe you'd get on better with one of those.  Re: your vaginal symptoms (i.e. recurrent thrush) - may be worth considering something like Vagifem alongside a lower dose HRT?   

Good luck, ER x

[Hurdity]

Hi southerngirl

To me the irregular bleeding while on Elleste Duet implies that you still have some oestrogen of your own cuasing your own cycle to break through. Alternatively maybe something else is causing the irregular bleeding that perhaps the doc could investigate eg a small fibroid?

It is very unlikely that 2 mg estrogen in tablet form would give you too much oestrogen - especially at age 54!!

Also - have you thought of going onto patches rather than pills? By taking pills all the oestrogen has to be metabolised by the liver, much of which is converted to estrone and is excreted. With patches, the estradiol ( which is the type of oestrogen we need to replace during and after menopause) is absorbed straight into the body and the levels are more consistent than with pills.

There are no bleed patches - Evorel conti (which contains the same constituents as Elleste) and Femseven. Some women (like myself ) even though over 54 ( I am 60) still remain on cyclical HRT though, because we prefer not to have continuous progesterone due to undesirable side effects.

Alternatively you could use an estrogen patch along with the bio-identical Utrogestan as your progesterone - which has fewer pms side effects for many women that use it.

Looking at your symptoms - oestrogen does not cause fatigue - it is usually the progesterone which does this, if anything. PMS is also not caused by oestrogen - it can be due to either the progesterone itself, or the drop in oestrogen or the drop in progesterone - so feeling pms for the few days after stopping the progesterone part of the pills is not because the oestrogen doesn't agree with you This also happened to me and lots of other women too. It is just what happens in the normal menstrual cycle!

Re gallstones - this is exacerbated by the mode of delivery. Using patches is better if you suffer from these.

This is what it says on this site under health conditions

http://www.menopausematters.co.uk/atoz.php#GlossG

Gall Bladder disease   
    HRT has been shown to increase the risk of gall bladder disease, particularly gall stones, thought to be due to an effect on bile composition. Transdermal (patch or gel)HRT is usually recommended with a history of gall bladder disease.

Hope this helps

Hurdity x

[southerngirl]

Thank you so much Hurdity for the information. I think you are correct about it being the progesterone  I don't know what made me think it was the oestrogen?
I'm currently on the progesterone tabs of my Elleste duet and am feeling really bloated, jittery etc.
When I go to the doctors on Friday I think I'm going to ask for Femoston as I believe this is a much nicer progesterone. I was also looking at Angeliq as apparently it is much closer to the birth pill (and I was on this from 15-35 without any problems whatsoever) I think I'd like to try a no bleed HRT - but how long is best to try it for if I do get bleeds? How long before things *should* have settled?
Any suggestions would be gratefully appreciated.

[Hurdity]

Hi again southerngirl

The only problem with a no-bleed HRT is that you won't be able to tell whether you are sensitive to the progestogen or not - or perhaps you will if you feel bad straight away, or feel OK all the time!

If you are still having random periods then personally I would go for the cyclical HRT to start with and see how you go - but you could always try the Femoston conti and see if the progestogen agress with you and whether you bleed.

I think normally the advice is to give a conti HRT six months to settle down and if you continue to have spotting/bleeding then going back to a cyclical one might be preferred?

Hurdity x

[southerngirl]

I've had my appointment with the doctor this morning.
I went in armed with lots of information and not sure what to expect.
I told her I was there to discuss changing my HRT. She commented that now I was 54 (last week) that I should try a no bleed HRT for 6 months and, before I could say a word, said to me that she'd like me to try Angeliq as it was a very good form of HRT and had a very gentle / more natural form of progesterone. I was so surprised as this was my first choice of a conti HRT. So I'm one happy bunny today 
Here's hoping I'm OK on it.

Southerngirl
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