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[evey]

Hi, I am 56 and post menopause 2 years, I use estrogel and utrogestan, I recently had blood tests and my serum oestradiol levels are 110 pmol/l , I have been using this system for 9 months approx but the last 3 weeks I have started feeling hot flushes and very emotional and extremely fatigued, I have been trying to google levels but any advice very much appreciated.

[Dancinggirl]

Hi evey and welcome to MM
How much oestrogel are you using? I am not entirely sure but an oestrogen level of 110 sounds very low.  When I was using Oestrogel I started with one pump per day when I was still peri menopausal and then later upped that to 2 pumps per day when my own oestrogen levels had bottomed out.  After your last period it can take up to two years for your own bodies oestrogen levels to bottom out so I suspect this is what has happened to you and you may need to use a little more Oestrogel.
Are you using this regime sequentially or continuously? What dosage of utrogestan do you use?
DG x

[Hurdity]

Hi evey

  from me too!

I agree with Dancinggirl - that does seem like a low reading although the results of one blood test on its own doesn't mean a lot - and the 2 year thing is about right. You can cope with less added oestrogen when peri-menopausal because you still have some of your own.

More important is to go by symptoms especially at such low levels. I would say yes you do need to increase your dose - but also depending on how much you are using, you may not be absorbing it very well?

If you do increase your dose of oestrogen you may also need to up the utrogestan - depending on how much you are takng now and by what method (orally or vaginally).

Hurdity x

[evey]

Thanks so much, I did not know this at all!  I had made an app with my Doc this week as I was so confused.  After trying 200 mg utro for 12 days orally and vaginally, terrible side effects.   Then I tried 100 mg utro for 25 days of the month, did this for couple of months but felt too sleepy all the time, then tried 100mg for first 7 days of the month but didn't get a bleed, tried this for few months, had 2 months approx off utro just used the gel, had a vaginal scan last month and lining is thin and is ok, this month I started utro 100mg, starting on the 15th day of a 28 day cycle and wanted to use for 12 days to see how I get on with this regime, however on the 6th day I started bleeding so last night (7th) day I stopped utro and I am now having a bleed. I will start this regime again on the 15th day of a28 day cycle and am keeping notes in my diary of it all. Used gel this morning all over inside of arm and shoulder rubbing well in, but still very hot, I always rub on my arm. I am slim built and about 8stone, I use the gel 2 pumps a day.  Thank you so much for answering so quickly and for welcome.

[Hurdity]

Just a quick reply re application of the gel.

Personally although I think the instructions say OK to use gel on the arm I would not use it anywhere near the breasts and therefore not on the upper body. I seem to remember reading there is a concentration gradient away from the site of application and the shoulder is close to the breast. All the instructions for other transdermal HRT - patches, and the other type of gel - Sandrena - say to apply to the lower part of the body.

Hurdity x

[Val56]

  help can't find how to put a post on I'm new to this.

[Dancinggirl]

Val56 - welcome to MM
If you want to start your own thread just go to the section under 'Forum' you want e.g. All things Menopause' - click on this and then there is a green bar at the top of this section with a small blue bit above on the right  -
new topic  notify  mark read.  Click on 'new topic' and fill in the relevant sections.  DG x

[evey]

Thanks for replies, so helpful, it does sound like I am using enough gel ie 2 pumps so maybe it's the way I am applying and not absorbing properly, I will also start rubbing on my inner thigh and see what happens. I am using the utro vaginally, I don't tell my Dr though as she says I should take orally.