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[Chrislm]

Hi

I have been taking Elleste Duet 1mg for just over 6 months and I have generally been very happy (or perhaps relieved) with the way that it has allowed me to enjoy my life again. Over the last month or so though some of symptoms have started to creep back, particularly swings in blood sugar levels, tiredness and stiff muscles.

I wonder whether the higher dose Elleste Duet would help. Does anyone have any experience of this?

Thank you

C

[Hurdity]

Hi Chrislm

I haven't taken tablet HRT so can't help with this but I have experienced ( and still do) swings in blood sugar levels. In the past for me this was always related to progesterone I think because it always happened in the second half of my cycle. Sometimes the sensation was extreme and I would suddenly feel very dizzy and shaky only minutes after just feeling hungry. The key to blood sugar is eating slow release foods with low (Ithink that's the right way round) glycaemic index - complex carbs, eat little and often, apples, oats, protein etc, and limit the amount of refined sugar/flour etc in your diet.

Where are you in meno - are you still peri-menopausal? If you are then it may well be that your own hormones are still fluctuating.

Tiredness can be due to decrease in oestrogen, withdrawal of progesterone or the progesterone itself, as well as all sorts of other things. Do you symptoms feel worse during the second part of the cycle? Also have you had thyroid levels checked too and were they well within normal range?

Many women find as they go further into menopause and their own hormone levels decline overall, that a higher dose of oestrogen is needed - so you could try a higher dose see if it makes a difference after a few weeks>

I am sure someone with experience of Elleste will be along at some point!

Hope this helps and keep us posted.

Hurdity x

[Chrislm]

Thanks Hurdity.

I am still in the peri-meno phase I think, at least I was before I started taking HRT.

It does feel like my natural hormone levels are swinging around and this is what is making me feel rubbish!

It is interesting what you say about progesterone levels. I had problems with low progesterone levels before I went into the peri-meno phase, and the way I am feeling at the moment is very similar. I am taking the estrogen only tablets at the moment so I wonder if this could be the problem. Doubling the dose of estrogen would only make it worse if so! 

Perhaps a conti type of HRT would be better for me?

Is this something that I could take even if I am still in the peri-meno phase?

I would love to hear from anyone who has any thoughts.

And thank you to everyone for this wonderful forum!

[Chrislm]

For info, for the last two days I have taken two of the estrogen pills (so 2mg rather than 1mg) to see if this helps. I feel slightly worse - slightly more nauseous, slightly more breathless when I'm running and I've just had my first warm flush (not quite a full blown hot one thank goodness) for 6 months.

Looks like taking a higher dose isn't the answer! I will discuss with my GP although both doctors I gave seen have been very honest about how it is all really trial and error

[Dancinggirl]

Just a thought chrisim. If you are still peri then your own hormones will be fluctuating.  I was peri from mid 30s and found the HRTs I was given at first didn't always suit me.  One I tried, which was stronger, actually made me feel more flushed.  My theory is that too much oestrogen can bring on flushes as well as too little.  I could be completely wrong on this.  Anyway, I ended up on Oestrogel with 12 days of progesterone pills to induce a withdrawal bleed each month.  The Oestrogel allowed me to adjust according to need.  I found through my peri stage I only needed one pump of Oestrogel per day and then after a few years (obviously when my own hormones were not coming through any more) I increased to just under two pumps per day.  You can use up to 4 pumps per day if need be.
I have to say that the symptoms you are experiencing  - tiredness, aching muscles etc. may not be to do with the meno.  You mention these symptoms emerged quite recently. You mustn't discount the possibility you have caught a virus. Sometimes there are insidious low grade viruses going round that can lay us low, bring on aches and pains and make us feel rotten. These can lead to some post viral fatigue which just needs some R&R to help you to recover.
As Hurdity suggests, look at your diet and eat small amounts often.  Get some extra rest.  Also don't forget to take high doses of Vit D - It is now known that Vit D deficiency, due to lack of sunshine in winter, causes fatigue and low mood.  DG x

[Hurdity]

Hi again Chrislm

In answer to your question about conti HRT - this is not meant to be taken by peri-menopausal women because you are likely to get bleeding at unpredictable times whereas the cyclical HRT is better if you still have a cycle because there is generally less unscheduled bleeding (although you can still get spotting if your cycle kicks in!).

The other thing is that conti HRT involves taking a progestogen all the time - which certainly won't do anything to help your tiredness. At best progesterone ( the bio-identical one - ie the same as our own) has a sedative effect which can make you more tired and lead to fatigue. At worst some of the synthetic progestogens can have worse side effects eg headaches, anxiety and depression.

My view is that our bodies are not adapted to have a constant raised level of progesterone all the time so I would prefer to stay on a cycle as long as possible.

The reaction to a couple of nights of taking a higher dose of pills should not be taken to mean that this is unsuitable. A sudden increase in oestrogen is bound to cause some immediate effects but as with all HRT, you are supposed to give it 3 months to settle. Also taking tablet HRT does give more of a daily "spike" in oestrogen levels compared to transdermal methods (patches or gel).

Dancinggirl mentioned the effect of too much oestrogen - this is a phenomenon known as "tachyphyllaxis" where the body has levels of estrogen in the blood higher than would ever occur naturally - ie "supraphysiological" levels.  I would have thought it unlikely this would be happening in your case because 2 mg tablets is still only a medium dose - although if you still have a strong cycle then your own peak of oestrogen at ovulation combined with a constantly increase dose of extra oestrogen from your HRT will increase levels to a certain extent.   Prof Studd talks about this in his article on hormones implants:
http://www.studd.co.uk/implants.php
You will need to scroll down.

Finding the right level of oestrogen ie the "sweet spot", can be tricky but usually with post-menopausal women it's not an issue as high levels are rarely achieved.

How old are you by the way if you don't mind my asking?

You might find that changing to a different HRT such as Femoston might suit you better, as this has a different type of progestogen in it - but this depends on whether you feel worse during the combi pills, or all the time, or just after you change from the combi ones back to the oestrogen!


Hurdity  x

[Chrislm]

Hurdity and Dancinggirl,  thank you for taking the time to reply. It is so helpful - particularly as I have been feeling so rubbish for the last week.

I am 50 in a couple of weeks. I started to notice that my cycles were changing about three years ago but I had a 'normal' blood test last year. I developed proper perimenopause symptoms around last Christmas and had a blood test which confirmed this about 6 moths ago. I have been taking Elleste Duet ever since (and pretty happily until about a week ago).

I don't know if it is relevant but I have only had a proper bleed twice since I started taking it for some reason.

I have just seen the doc who initially suggested changing to Femoston. I declined this however because I seem to be fine with the combi pills.  I felt so bad yesterday that I decided to take a combi pill this morning (even though I am only on day 9) and I feel quite a bit less sick today.

But it could of course be coincidence!  As Dancinggirl suggests, I did have a nasty virus a couple of weeks ago and I haven't really felt 100% since then. But I do feel very much like I did 6 months ago before starting HRT (minus the hot flushes and the insomnia).

My GP suggested that I go back and see one of the two doctors who have more knowledge of HRT. I will do this next week if I am still feeling sick. The gel form may well be better for me.

[Chrislm]

After posting this, I remembered that I had had a virus last Christmas just before the same symptoms started!  Perhaps it is that rather than hormones! Thank you Dancinggirl

[Dancinggirl]

I sometimes think we expect HRT to be a cure-all.
As Hurdity says, finding the 'sweet spot' can be difficult and remaining objective about the way we feel is very challenging.  I find that viruses knock me sideways these days and I take longer to recover.  I also think I am typical of so many women in that I lead a very busy life with a great many responsibilities and stresses so often don't have time to take the rest necessary to bounce back from viruses.
We need to be kinder to ourselves sometimes.
Chrislm - it sounds as though you need to allow a little more time with your current HRT as you seem quite happy with it on the whole and maybe review in 3 months. However, it is well worth trying different methods - as they say 'you often have to kiss a few frogs before you find the prince.'
DG x

[Chrislm]

I was still feeling sick and off the pace at the start of this week so when I went back to the GP on Tuesday she suggested trying to double my dose of estrogen using my current type of HRT and see how I felt after about a week.

So I've been on 2mgs of estrogen per day since Tuesday and started to feel better quite quickly. Today I felt truly great again - properly normal. No nausea, no feeling 'a bit off', full energy, the works! 

Hopefully it was just that my hormone levels had dropped a bit more (not helped by the virus I had had) and this will do the trick.

Thank you again everyone who posted. I have added this in case any women in the future do what I have done lots of times and go searching on this forum for similar experiences.