Have been wearing 2 x 25mg patches since Wednesday. Have had two pretty decent night's sleep, but I am feeling a bit wired and quite ansty. It's been months since I've managed to feel irritable about anything.
Will this be caused by the extra oestrogen? I assumed that on higher oestrogen I would feel more chilled out and calm. Which is how I felt for the first two weeks of this cycle and only taking 25mg.
I only took 4 days of Utro this month then stopped on the advice of my consultant because I want to avoid a withdrawal bleed on holiday.
So today I am on day 21 of my cycle. Not sure if my own hormones will give me a period in a few days time, and this is old fashioned PMS due to higher oestrogen? I used to get very irritable with PMS back in the day but since peri started all that irritation has been replaced with low mood and anxiety.
Hi GypsyRoseLee
Just to clarify that pms is not caused by high oestrogen!!
"Old fashioned pms" is due to a combination of hormonal changes which some women are more sensitive to than others. It is defined as any adverse effects/symptoms that occur during the second half of the menstrual cycle and which often worsen in the few days before a period.
In the second half of the menstrual cycle - oestrogen first drops sharply after ovulation, and then rises again a little and then drops away to a much lower level as the bleed approaches - it then starts to rise again and the positive effects are usually felt fairly soon eg Day 4 or 5 or even sooner - which varies with different women.
Also during the second half of the menstrual cycle following ovulation, the developing egg follicle produces progesterone which rises rapidly over the next few days until it reaches a peak, and if the egg is not fertilised the follicle (in the ovary) shrinks and progesterone production declines until it returns to the previous low level until the next month.
Women react to these changes in several ways -
1 Intolerance to the progesterone itself - these women will experience unpleasant symptoms (fatigue, depression, headaches etc) during the whole of the second half of the cycle (more than just a little bit of bloating/breast tenderness etc - which most women experience)
2 Reaction to the reduction in oestrogen - leading to anxiety, low mood, sometimes depression etc
3 Temporary effects from the sudden drop in progesterone - this is what I call classic pmt ie the headaches, tension, irritability etc -although this is partly due to reduction in oestrogen as well. This doesn;t mean the body needs oestrogen in order to prevent these symptoms - it is just a reversal of the physiological changes in the body produced by the progesterone. Once the progesterone has cleared and oestrogen starts to rise again - during the normal menstrual cycle, most women feel at their best - oestrogen is rising to a peak, and progesterone is low (as it is during post-menopause).
During peri-menopause as you know the hormones are doing their own thing and departing from this classic pattern (There's that article "Perils of the Perimenopause" which I often link to!). Taking HRT is attempting somehow to even out the dips and eventually to replace some (but not all) of the missing oestrogen. It is only a crude attempt really to replace two hormones when actually there are a whole host of others which we know very little about. In addition adding them exogenously (ie from outside our body) has a very different effect from the effects of endogenous production (ie within our bodies from our own organs) - as the body then has to deal with a new source, oral HRT going through the liver, excretion of excess etc etc.
Trying to second guess what the body is going to do during this somewhat unpredictable journey is difficult so there are bound to be days and weeks where you don't feel yourself - but this is the nature of peri-menopause and hormones! The important thing is that when taking HRT you feel better than you did before for most of the time. It is not good to over-analyse how you feel at each point because you won't be able to explain it completely - ie exactly what is happening to you, and you will only end up worryin too much!
Until you have gone through menopause and your hormones become stable - you will continue to feel like this some of the time.
Long answer to your Q!!! Short answer - could be your own hormones coming into play, or it could be a bit of pms from the withdrawal of the progesterone - although I would also expect you still to be producing your own progesterone at this point in the cycle if you are still ovulating. It shouldn't be too much oestrogen at this point because if your cycle is fairly normal then your own oestrogen will now be reducing and what you have added should restore some of this.....
The standard oestrogen transdermal dose for post-menopause is a 50 mcg patch which is sufficient to alleviate flushes and sweats in many women without adverse side effects. Some women need to have higher levels than this in order to feel well. As always the body has to adjust to increases in oestrogen (as well as progesterone).
Oh dear I got carried away again - hope some of this makes sense!!!
Hurdity x