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[Louise2]

Hi all,

I wonder if I could ask your advice again? My problem is trying to identify the right dosage of estrogen that I need - I was prescribed elleste 1mg and think it was a complete over-dosage, which had a terrifying effect on me. I took it for 6 days and thought I was going psychotic.

My GP has advised that I stop tkg anything and then have another blood test in order to identify my natural hormone level. I have booked this for next Tuesday, at which point I won't have taken anything - elleste or the contraceptive pill - for 8 days.

Is this long enough for the huge dose of synthetic hormone to have left my system and give a "true" reading? I'm desperate to sort this out properly - and if it would be better to wait longer then I will do so, despite my dread of all the symptoms hitting me again at full blast. What do you think?

btw, I will be 46 in Oct so still relatively young. (if feeling bloody old).

Thank you all.

Louise

[honeybun]

Sorry to say that blood tests are very unreliable and can change by the hour let alone the day. A lot of doctors won't do them for this reason preferring to go on symptoms alone.
It can take a lot of trial and error to find an HRT that suits. The general rule is to take for three months before changing which has obviously not been possible in your case.
I really don't know whether a blood test will give you the answers that you are looking for but it may give a small indication of your levels on that day but as your hormones fluctuate you will have to take that into account.

Honeyb
X

[jo61]

Hi Louise
I am a new member to the forum, I read your post with interest because this happened to me with elleste duet 1mg. When reading other ladies posts on here they all seem to say that their symptoms are caused by lack of estrogen or that estrogen is needed to maintain health but for me it sent me psycho within the first week and that is an understatement. I have a gp who totally dismisses HRT and when I told him I was having problems with menopausal symptoms at 52 years he snapped back at me that if I was still having periods albeit erratic and extremely heavy I was not in menopause and gave me nothing . It was the practice nurse who gave me elleste duet and when I returned to her and told her they sent me loopy she told me she had not heard of this before the problems are usually with progesterone and  to persist which I did and have tried over a space of 3 months with exactly the same result. You seem to have a very understanding GP so I hope things go well will you please keep us informed what happens.

[Louise2]

Thank you all, especially Jo. It's good to know that it isn't just me having that reaction to elleste - not that I wd wish it on anyone.

it's so tricky knowing what to do isn't it? One GP at my practice is swearing by the blood test, and the other has said she considers them "useless". They are understanding and lovely but it all feels like shooting in the dark. Everyone seems to have a different opinion - and the trial and error in terms of trying different treatments is enormously physically and emotionally wearing (and expensive). And frankly, it was wearing enough previously!

I'll keep you posted...

All best,

Louise

[Taz2]

Hi Louise - I agree with Honeybun that the blood test will only give you a result for that particular day. It is very frustrating trying to find the right dosage when you are in peri because the levels fluctuate so much. What meno symptoms do you have? Also which Elleste were you taking as you mentioned that it had the same progesterone as you had used before so that wouldn't be a problem but if you had only been taking them for six days you shouldn't have started the progesterone part so I was a bit confused - not unusual for me though!

Taz 

[Louise2]

Hi Taz,

My meno symptoms are: light periods for last 18 months, needing to pee all the time (for 18 months), difficulty sleeping and getting enough sleep (3 years), exhaustion (tired for 2 years then tipping to exhaustion this year), thinning hair, rapid weight gain without a change in eating habits/lifestyle, and increasingly extreme emotional volatility. But I only put all these together in June and realised it was in all likelihood perimenopause - and blood tests have ruled out thyroid, diabetes etc

I think with the elleste I may have had a bad reaction to it, but also that the dose was simply too high: I went from 35 micrograms estrogren (contraceptive pill) to 1mg...

Any other comments you might have gratefully recd!

Thank you,

Louise

[Hurdity]

Hi Louise

Maybe as you are still having fairly regular light periods you still have a fair amount of oestrogen of your own - but also as you say with the contraceptive pill also giving you oestrogen your body may have reacted badly to it.

As you are having some meno symptoms, have you thought of a low dose oestrogen patch such as a 25 mcg patch which will boost your oestrogen without the sudden hit that you get with pills, and the oestrogen does not have to go through the liver first? Patches deliver a very consistent dose of estradiol directly into the system, once they are stuck properly.

You would still need additional progesterone and unfortunately there is not a low dose combi patch you can use while still wanting a cycle.

However you could try Utrogestan (as the progesterone) for 12 days per month. However they would probably try to give you 200 mg which is the standard dose for cyclical HRT, but with a low dose oestrogen patch of 25 mcg I imagine 100 mg dose would be enough. It would need a specialist gynae to prescribe this though as most GPs would stick to the prescribing guidelines.

Hope this helps

Hurdity x

[Louise2]

Thank you so much for this expert advice Hurdity - so much appreciated. I also had an appointment at our dedicated Menopause Clinic this week (sadly only open once a month) and that was helpful.

What I have decided to do, for as long as it works, is stick to the trinovum contraceptive pill which is levelling me out and allows me to function (thank god) although doesn't deal with the lack of energy or sleep problems, taking it for 3 cycles at a time. I've also been recommended anti-depressants, (although I am not what I think of as depressed) as apparently this also helps relieve some symptoms. I haven't been taking these long enough to feel a specific effect from them yet.

At the moment, this is working well enough - I am not at optimum, but I am so scared of experimenting again that for the time being, "well enough" is a relief and something to be grateful for. I'm aware that this is a short (ish) term solution - and  that I will have to start again at some point.

I am so grateful to have had your advice, Hurdity, as well as the meno clinic's (who I think could make the recommendation to my GP for the progesterone dosage you suggest) - at least I am now very much more prepared for the next stage and have a better idea about what to do.

This is an amazing site btw - don't think I've mentioned that yet, or said thank you to the organisers!

Best,

Louise

[KimmyH]

Hi all

I'm also new, and new to the menopause.  I had a hysterectomy in 2011 (TAHBSO), and was taking Elleste until we discovered it was the wrong type of HRT and had caused my endometriosis to return    Until then I had no problems on Elleste, life was great.

My GP told me he was happy for me not to take the HRT because my endometriosis calmed down when I came off it.  Even though when I had the surgery I was told I'd have to take it because of the risk of osteoporsis because I was only 41.  When the hot flushes got really bad I tried my GP again, he gave me Dixarit which is a blood pressure drug supposed to help hot flushes.  I had a bad experience with the side affects, light headed, dry mouth, and once time so dizzy I fell over!  So I stopped taking them but my GP couldn't offer me anything else. 
So now I have all the menopause symptoms, the worst being the VA and the lack of sleep & headaches.

I'm currently trying accupuncture out of desperation, but i keep reading that it's efficacy is not proven, has anyone else tried it?

After reading about all the help you ladies are getting from your GPs/nurses I've tried my surgery again and asked if they have any kind of menopause service so I can get some more advice,  but they don't, and apparently they don't even have anyone that can advise specifically on the menopause, so tonight I am seeing a young female GP (my GP is a middle aged man).  I'm taking a list of all my issues in the hope that she'll actually try to do something to help, as my own GP doesn't really seem to be interested :-(

Kim

[Hurdity]

Hi KimmyH

 

I am answering on this thread but maybe you would like to introduce yourself in the new members section too?

Just to let you know that this is what it says on this site about HRT and endometriosis - under A-Z of health conditions: http://www.menopausematters.co.uk/atoz.php#GlossE

Endometriosis   
    There is a small risk of reactivation of endometriosis with HRT use and any recurrence of symptoms should be reported. If a hysterectomy has been performed for endometriosis, the choice of HRT use thereafter should be influenced by the extent of endometriosis at the time of the operation. Since hysterectomy often causes a premature menopause, it is often advised to take HRT until the average age of the menopause; 51 years. HRT after hysterectomy usually consists of estrogen only. However, in the presence of endometriosis, estrogen may cause stimulation of residual deposits and consideration should be given to using continuous combined (estrogen plus daily progestogen) therapy, or tibolone, though little research has been done on the effect of different types and duration of therapy. Medical treatment of endometriosis often involves ovarian suppression which, along with ovarian removal, may increase the risk of osteoporosis.

Thsi means it might be possible for you to have HRT with a continuous progestogen in it to prevent the oestrogen stimulating the areas in your body with the endometriosis. You would need to take it continuously which some of us find quite tricky - but if you find a type that agrees with you then maybe this would be OK. It would be a case of weighing up how you feel on the progestogen, compared to the potential long term health issues due to lack of oestrogen.

If there is no menopause service at your practice and no specialist advice they should refer you to the nearest menopause clinic - and if your lady GP is not happy to prescribe HRT in your situation - given the possibility from what it seems to be saying - I would definitely push for this. You can find out where they are by looking under the "Find a Specialist" menu and clicking on where you live. All the specialists come up and whether they are NHS or not. This is your right - to be given the best possible treatment given your circumstances. Of course only the docs know the precise details of your endometriosis but specialist wouldhave acess to this info.

Good luck and keep us posted.

Hurdity x

[KimmyH]

Hi Hurdity

thanks for the reply.  You're right, combined HRT is what I should have had, sadly my gynae prescribed me the cyclical estrogen only HRT by mistake, and we didn't find out for a year, I was then put on the continuous but by then it was too late, the endometriosis had grown back and spread to my bladder (and that's a whole other story & set of symptoms!).  Hence why I think my GP took the easy option and took me off everything, saves them money too I guess!

I've googled menopause clinics but I didn't know about the list on here so thanks very much for that, I will check it now and add that to my long list to discuss later!

Kx