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[Jennifer1234]

Hello ladies

Please can I ask for some advise on oestrogen only HRT.

Just in brief I had a hysterectomy 3 years ago ( womb and cervix taken ... Ovaries intact ) and about 2 years ago I started into the menopause ..... Hot flushes , dry skin, feeling very low especially in mornings , dreadful nausea am and weight gain.

I did firstly begin to use isoflavones with did help with the sweats and flushes for about a year but then my skin started to get so dry and I had problems with dryness below. So I went to doctor and was given vagifem ( which I researched on this site  ; thank you ladies ) ...... She did examine me at this time and suggested that I might like to consider HRT ...... But I decided just to go with the vagifem to start. To be honest that did definately help below ..... Although the maintenance dose of twice a week is not great. So back to doctors and decided to try HRT.

To be honest I did read as much as I coukd around oestrogen HRT but there is so much info on which one is best. So in the end I plumped for Premarin 0.625 which I take daily. I am now in month 3 of taking this and due back to doctors next Thursday.

My problem is whilst this has definately helped the morning nausea I don't think it's helped at all with dry skin, general low feeling in morning , sleepless nights etc. One bonus is I have found its definately helped me to drop a few pounds which is great. ( I'm not overweight but since hysterectomy I'm shall we say slightly more padded generally  )

I was just interested to hear other ladies advise on maybe a different type of oestrogen ..??

And also I'm thinking of changing from vagifem to the estring ..? Thinking it may give a better daily dose rather than the tablet twice a week.

Any advise would be gratefully received. Many thanks.

[ancient runner]

Can't advise on the general HRT but the Estring is great. It gives you the equivalent dose of 5 vagifem a week and is constant - once it's in place you can and do forget about it. The only thing is that your GP might possibly not want you on that higher dose of local HRT plus systemic HRT - mine was very iffy when he prescribed Femoston for me and told me I would have to remove my Estring. As it happens, things improved and the Estring is still in and the Femoston still unopened on the windowsill. Good luck!

[Dancinggirl]

Hi and welcome to Mm Jennifer1234
It is really a good idea to use oestrogen after having a hyster as I believe it actually reduces the risk of breast cancer. The risks are only with non hyster ladies, who still have their womb, so have to use progesterone - although the risks are still very small.  Oestrogen will also protect your heart and bones in the long run and help to prevent VA and bladder issues.  Local oestrogen like Vagifem can be very effective but adding in systemic oestrogen as you are doing is even better - the oestrogen will get to areas the local stuff won't. 
I would suggest you try transdermal oestrogen in either patch or gel form as this is far more effective and if you use Oestrogel you can even adjust the dose to your needs - in other words gradually increase the dose over 3-4 months until you feel good.
The combination of the systemic oestrogen plus Vagifem 2-3 times a week will do the trick I'm sure but all this will take at least 3-6 months to really take effect - so I'm afraid it's about being patient. I would also add in some Omega 3 oils to help with dry skin and you will find your sleep gradual improves although I do think we need to accept that, as we age, good sleep often eludes us. Nausea would improve more if you use the Oestrogel instead of pills - perhaps have peppermint or fennel tea first thing in the morning?
It's good to hear you getting some good advice from your GP - so many are really boot put to speed on HRT.
Keep us posted.  Dg x

[Jennifer1234]

Evening ladies

Thank you dancing girl and ancient runner girl for your replies .......

I'm swinging more to try the oestrogen gel ( in a pump ) as reading on here it seems to be popular and self adjustable so to speak. Just wondering how it works exactly ? Do you apply it after bath / shower and does that mean you can't also apply moisturiser ? ( my skin is so dry !!  can't imagine not using it ) ........ I'm thinking for me patches might not work as I love hot baths and showers  so stick ability might pose a problem. Also are there different forms / types of this gel ?

I do also take sea buckthorn oil to try to help with the dry skin ( only been using about 3 weeks so far ).

I will ask about the estring along with the gel and see what response I get. My doctor did say when I went on Premarine 2.5 months ago that I probably wouldn't need vagifem after a while but I've not found that the case ...... But it could be simply because the dose of 0.625mg is too low ...... Or not be absorbed enough ..?? Hence why I think the Premarine may not be working as well as a gel would.

Personnel question re the estring is anyone can help me. I used to use the contraceptive cap few years back now so familiar with things flipping into place down there  but can it be felt during intercourse because the cap could be by my partner ..??


 .

[Mary G]

Jennifer1234, I would also recommend Oestrogel (that is the UK brand).  It's the best type of oestrogen I have used by far and the beauty is you can adjust the dose to suit to your needs.  You can put it on just before you go to bed - I rub it over my upper arms and it dries within a few minutes.  Alternatively, some women prefer to put it on in the morning before they get dressed, either way, it's very easy to use.

I think your current HRT dose is too low and I would be surprised if it is doing very much to alleviate your symptoms.  I did not find oral HRT to be very effective and I think much of it get lost in your digestive system.  I think you will like the gel and because you have had a hysterectomy, you will not have to spoil the huge benefits it offers by using progesterone. 

Give it a try.

[Jennifer1234]

Hi Mary

Thank you for your reply. I'm more and more convinced the gel will be the way forward for me and I'm hoping the doctor will be happy to swap me over as I've been on Premarine almost 3 months 

[Dancinggirl]

Re. using moisturisers - you can't use moisturiser on the area where you apply the gel - you apply the gel after a bath or shower to clean dry skin but if you use the gel on the inner thighs before bed (as I do) you could then put some moisturiser on that area in the morning - you have to leave the Oestrogel to dry for around 10 mins (you can then get dressed) and avoid washing or any other products in the area for 2 hours after application.  I would recommend using a simple unscented vegetable soap to clean the area which will ensure good absorption of the gel   The important thing is to make sure there isn't any moisturiser on that area when you apply the Oestrogel as it will stop absorption. Many women do love the patches and I don't think there are problems with adhesion if you use the smaller ones.
You may find after 6 months of systemic oestrogen you might not need so much local oestrogen. DG x

[Hurdity]

Just to add to what's been said - yes I use patches - a very small one Estradot - which sticks well. I don't have a problem after bath or showers - but I do give it an extra press down afterwards (and when I use the loo) just to make sure it is always stuck down well.

Similarly as with the gel, you can't use moisturisers where you apply the patch - because it will limit absorption but otherwise I am very happy with them.

Re the gel - just to add you must avoid skin to skin contact for at least one hour following application to avoid any transfer so if you apply it to your thighs at bedtime or any part of your body that might rub against your partner...... then you must avoid this!

Other than that - transdermal - patch or gel - is the way to go and wonderful not to have to use progesterone

Hurdity x

[Jennifer1234]

Morning ladies

So just an update on changing my HRT tablets. Saw the doctor this morning and said whilst I'd been taking Premarine for almost 3 months I haven't really felt any benefit and asked to change to oestrogel. She tried to encourage me towards the patches but I said would prefer gel so I could tweet it so to speak. She was very reluctant ( although very nice ) as she said it's very expensive and although she's prescribed me 1mg X 28 she said it's unlikely she woukd be able to prescribe me again ...?? 

Never come across this before ..?? Does that mean that I could pay for it myself if I wanted it ?? Or if the surgery says no then that's it  ?

[Dancinggirl]

Expense shouldn't be an issue - you may only need 2 pumps per day and it is the best way to get the balance right. Oestrogel is NOT EXPENSIVE. Print off the TREATMENTS section from the top of this page - it shows the prices and I actually think Oestrogel can work out cheaper, or at least pretty comparable, than the patches!!!! DG x

[Jennifer1234]

Hi dancing girl and stellajane

I've just never come across " it's too expensive " before  maybe I'm a big naive ..?? Lol.

She be fair she did try to get me to try patches ....... Do they basically contain the same oestrogen as the gel ?? So it's just slow release gel in a patch rather than self applying ? She did mention a lot of ladies have skin reaction to the patch. She said try it and see so maybe if I do like it and push it she may get the OK to prescribe  more

So she's prescribed me 24x 1mg ( got to collect later as chemist has to order them in ) ....... Is this a low dose ?? She tried to say first apply it once a week !!!! Seriously Lololol. I said I'd read this forum and def once/ twice a day  . She said they are individual sachets. 

What is a bit of a pain is 28 dates takes me up to just before I leave for holiday ..... So this could be a disaster if it works and she won't prescribe again 

[Mary G]

Oh, so that's why GPs are always trying to fob women off with cheapo rubbish that doesn't work, not very impressive is it. 

I'm not sure about the type of gel you have been prescribed but I prefer using Oestrogel everyday (1 pump every 12 hours) to get an even dose. 

I honestly don't think the patches are as good as the Oestrogel.  For a start, I didn't get enough oestrogen out of them, they are not flexible, I found they don't stick very well and left and dirty mark, I found they left a nasty, itchy rash and last but not least, I don't like going around with a patch stuck to my backside.

Why don't you just buy the gel yourself either online or over the counter somewhere like Spain where it costs about €4.00.  Where are you going on holiday?

[Cassie]

Thats nonsense! Its a fantastic HRT much safer and more "user friendly" than the older HRTs such as Premarin and its transdermal so much safer as well, she must prescribe it long term....

[Jennifer1234]

Hi ladies
Ok I'm pretty mad now as I asked her for oestrogel ....... I hope she hasn't prescribed something else !! Prescription with chemist now so can't check till pick it up later ..... Stupidly didn't read it as we had been discussing oestrogel not sandrena (?) .....

Actually I'm going to Spain .... Go every month or so as have a place there. Can I actually buy it there ? How come ?? That might solve my issue if I can ........ Wonder how much I can buy in bulk 

[Kate50]

I'm going to spain next week Mary G so will get some extra oestrogel as been to docs today and she said she can't prescribe more than enough for 2 doses a day without say so from a gynae?  I had been using extra as I know a lot of ladies experiment too.