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[Jobo]

Just a quick question would anyone happen to know is it possible to be prescribed too much oestrogen?  How would I know if I am having too much ? are there any side effects?

I am 45 and have been post meno for 4 years and been battling to try and get things right with HRT, doesn't help that doctors have little knowledge and that I have established I cannot tolerate progesterone through advice received on this forum - its been a life saver for me this forum !

To cut a long story short I have now been prescribed patch Femseven 75 mcg and Utrogestan 100mg (I asked for this doctor had never heard of it)  I am scared to start this new regime for many reasons but am thinking more about the oestrogen it seems a high dose.

Thank you

[Hurdity]

Hi Jobo

That amount of oestrogen is unlikely to be too high in that your blood levels of estradiol will be somewhere in the range they would occur naturally.

However it is generally advised to start lower and then gradually increase with oestrogen to minimise side effects from sudden increase (although these usually settle - but can put some women off if they go on for a while).

As you are young though, it's good to have a decent level of oestrogen because your body would have been producing it naturally at your age. The trick is to find the "sweet spot" because with HRT you are having a constant level of oestrogen all the time whereas with your menstrual cycle it would fluctuate - and give very high levels at ovulation. In pregnancy levels are exceptionally high but then so are progesterone levels too - so this is a special case.

Are you changing from a different type of HRT or are you now starting again after having had none for some while? If so I would start slowly but otherwise why not go for it? If you are nervous you could cut a third off and start at 50 mcg and then gradually increase. I have always been on 50 mcg patch from when I started HRT at around 54 and now in my 60's. There are also several women on here who have 100 mcg patches.

The only thing I am puzzled about is that if you are progesterone intolerant - you are taking the utrogestan all the time. Many of us who don't get on with the progesterone part of HRT, even the bio-identical one like Utrogestan - still prefer to take it on a cycle (but the downside is we have a bleed). However as it is like natural progesterone - you may find that you tolerate it well and it was just the synthetics that you were sensitive to!

Don't be scared - this is the most natural type of HRT you can get!

Keep us posted and hope you feel better very soon 

Hurdity x

[donnacrichton]

Through trial & lots of errors I have had high estrogen my symptoms were severe adgitation and flushes but different to low. It's easier to start low then increase x good luck

[Jobo]

Hi Ladies

Thank you for responding.

Hurdity, I have been on lots of different HRT regimes over the last 4 years, had 3 scans and biopsys because of side effects and bleeding.  I took a break and have not taken anything for a couple of months because I had a very bad experience that I can't really explain but my husband had to phone for an ambulance I was that bad and he didn't know what to do.  At the time I was taking femeston 1/5 with an extra 1mg estradiol, all I can say is that it was described as a panic attack but  I felt like I was having an outer body experience!   I was also having a massive bleed and the only thing I could diagnose myself was that the combination of HRT was wrong in that the progesterone was not enough to compensate with the levels of oestogen, why I felt disorientated and having this stange experience may remain a mystery.

My doctor had to seek advice from a gynea who suggested the no bleed regime was best because of my problems in the past i.e when on sequential regime, monthly would start it wouldn't stop ! 

I had a blood test a few weeks ago and although I had not taken any HRT for 4 weeks my levels of oestogen showed as 288 which the doctor and myself found a bit confusing, that's why I am worried.  I may just try and see but am also concerned with utrogestan because of the side effects and the fact I have to take at night on an empty tummy.  I have to take days 1-25 of 28 month cycle does this sound right to you ? Also do you have any knowledge of Provera ?  This was another that was recommended to me.

Thanks again 
 

[honeybun]

You can use utrogestan vaginally if you want. It does cut down on side effects.

When I tried to up my oestrogen I became very agitated and shaky, it stopped as soon as I reduced down again.
Perhaps if you used a gel you would have better control and it would make it easier to find the exact amount that suited you best.


Honeyb
x

[Jobo]

Thanks Honeybun

I think I will sleep on this before I decide what the best option is.

[Hurdity]

Yes that is quite a good level of oestrogen -  not especially high - but it's much higher than mine ahs been post-menopause. However as I said before you are still young. Are you having a lot of symptoms even with your oestrogen at this level? Personally, I think in your position I would start low and build up but depending on your symptoms.

re the Utrogestan - the licensed continuous dose is not actually continuous ie Days 1-25 out of 28 - and we think this is to induce a small bleed in case there has been any build up - due to the one size fits all dosage - perhaps allowing for that fact that the Prog dose is the same for different oestrogen doses. However many women take it continuously without a break - with the approval of their doctors. I use it vaginally but of course you probably would not want to do this on a permanent basis, if you have an active sex life. Hopefully the side effects will be minimised if you take it at night

Provera is a stronger synthetic progesterone ie stronger in its effect on the endometrium - keeping it thin. Some women prefer it but often those who are progesterone intolerant find all synthetics problematic - and sometimes even progesterone itself.

Good luck with what you decide.

Hurdity x