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[Tempest]

Hi ladies!

Yes, as you may know I'm back using Estrogel again so that I can raise my levels ahead of hopefully having an implant. The Estrogel was considered the best method of doing so by Professor Lumsden.

I'm running into problems again, and won't be able to reach the Professor until well into next week due to her commitments. I also don't want to phone her with every niggle, so I thought I would ask your very kind opinions.

I used 2 pumps PM for a couple of weeks, and all was OK except the dose was running out after approximately 12 hours. Still very low mood and tearfulness at this time. I upped to 3, 1 AM and 2 PM but the jittering and dizziness was severe so had to drop back down to 2 again. I'm now 10 days further on on 2 pumps, and I'm getting crippling anxiety again approximately 11 am onwards. The low mood and tearfulness is considerably improved though. I apply my dose at 7.30pm. The anxiety is really awful, exactly as before when I tried the gel previously.

I'm trying to figure out what to do. I'm thinking my best bet would be to try upping my dose again (going to wait until Hubby is off work again on Tuesday for a bit of support), but I'm very nervous of making things worse as as you may know, my mental health is generally very fragile at the moment.

The gel just doesn't seem to stick around with me! As I've had chronic urticaria in the past (which is controlled by a high dose of cetirizine), the patch is probably not a good idea as I really don't do well with adhesives.

So, should the dizziness settle on the higher dose? Is it worth another try at this stage? Any advice would be very welcome. Thank you!

P.S. Oh, and I tried splitting the dose 1 pump AM and PM previously and this actually resulted in my symptoms returning! Professor Lumsden says this can often result in lower blood levels if the dose is split.

[Annie0710]

Oh no 😢

I have zero experience with oestrogel but wondered if maybe doing doses throughout the day might help ? I know this wouldn't work for many women with Work etc but it'd give a smaller dose more often

Girl I wish things would just go your way for once xxxxxxxx

[Tempest]

Oh, Annie! Thank you so much. Yes, it's a struggle! I keep plodding away at it and just try to keep positive. I'm also trying not to panic and play around too much with doses so that I can stabilise. Maybe. Eventually. Who knows???

[Maryjane]

If I use mine ( sandrena ) in the evening I wake with anxiety , but if I use it am I am fine .

Suchni faff the whole flipping thing.

[Rhiner]

oh dear Tempest, its not easy is it.

 I am on a transdermal patch, so obviously not the same, but  I kept chopping and changing the dose, as anxiety, dizziness was creeping in.  The meno specialist told me to pick a dose and stick with it for a month, irrespective of how I feel. So I had the dizziness anxiety, feeling faint and weakness etc but eventually it did settle, I was very tempted to tweak the dose again during this period,  but didn't and it worked. During this time, I was tempted to contact the specialist, but like you I didn't want to appear to be a pain, but he was right a month was what it needed to settle.

Obviously with transdermal its a constant amount all the time, unlike the gel. It will be good to get feedback from gel users.

Hope this helps a little bit, good luck!
Rx

[Tempest]

Thank you so much, Maryjane. This may be my next move if the anxiety doesn't ease.

Dear Rhiner! We're in the same boat, aren't we? I'm so glad things have settled well for you and yes, I have all of those symptoms just as you. I'm encouraged that it did settle! I am so tempted sometimes to insist on a trial of the patch regardless, but Professor Lumsden did say that the gel is designed to last 24 hours but we surgical ladies are much more sensitive to dose fluctuations.

This evening I've added in a good pea sized blob on one arm as I know she wants me on 3 pumps of gel based on my levels now and what I achieved after 7 weeks on the gel last time and how symptomatic I still was then. If I can creep up the dose, this may be easier I think. My reason for initially using in the PM is because my night sweats are so horrific that I wanted to ease these so that I get some sleep, as I had gone so long without any real quality sleep and my psychiatrist said this was paramount to helping my mental health.

I'm finding that all the Menopause Consultant's I've seen (3 now) all love the gel due to its flexibility but as Professor Lumsden said, it's only as good as your ability to absorb it so we will be checking again to make sure that I am indeed doing so effectively.

I just pray tomorrow is not like the last two days - the anxiety has been a beast!

[GypsyRoseLee]

Hi Tempest

Just want to wish you a calmer, more centered day tomorrow. I have felt horribly agitated since my period arrived yesterday. Feels like I'm clinging onto self control by my finger tips.

Yet, have just enjoyed 12 days straight of feeling nice and normal.

At least you know you're in very good hands now.

Hope you sleep well tonight too.

[Dana]

I don't have any experience with gel, but I'm wondering if a patch might work better as the dose will be a lot more consistent.

[Dancinggirl]

Tempest - I really don't think we can expect any amount of oestrogen to work it's magic in such a short space of time.  The body needs to absorb and adjust to the hormones and this takes time. Anxiety is the most difficult meno symptom to control and often requires ADs alongside HRT. In my experience too high dose of oestrogen made me jittery and feel awful - what works fro one person may not work for another - so it's good to start reasonably low and stick with a dose fro at least 4-6 weeks before changing anything.  You have already chopped and changed things so your poor body doesn't know what going on. Patience is the key to success with HRT.
If I were you I would stick with 2 pumps per day - split one in the morning and one at night and do this for at least 3 months. Try to get on with life as best you can  and perhaps look at other triggers fro low mood e.g. low blood sugar levels.  Sometimes we need to eat small amount often to keep our energy and mood OK.  DG x

[Rhiner]

Hi again Tempest, yes we are very similar and as you say small tweaks in dose for us, can make a huge difference.  I found at one point too little oestrogen and I could not get off to sleep at all, yet too much and I went to sleep straight away but then woke after a couple of hours with anxiety and could not get back to sleep. As someone previous mentioned, anxiety (and low mood for me) appears to be the one symptom that takes a while to go.

I hope last night was a little better for you. As Stella Jane and DG say, patience  is a huge thing with HRT.  I found going to work, no matter how rough I felt and no matter how little sleep I had had and trying my best to do everyday things, really pushing myself helped me to come through.  It took my mind off how I was feeling to a certain extent.  Then we had to go over to the USA to take my eldest boy for his year at Uni there which I was dreading. I loved it, there was so much happening that I focused on this event. Yes a felt a bit rough at times, but I was pretty good - I was sleeping at this point though which I know makes a huge difference.

Rx

[Tempest]

Thank you Stellajane and Dancing girl! When I saw Professor Lumsden I was happy to stay on 2 and wait it out, but she insisted that I needed 3 pumps. I tried this for 3 days and knew pretty quickly it wasn't for me so I went back to 2. The drop has made me feel quite ill, so I have been feeling rather desperate. Also, when I drop any HRT it triggers my anxiety awfully. I have learned myself that chopping and changing is a disaster!

In every case when I've seen a Menopause Consultant, they've always wanted to increase my dose immediately regardless of how long I've been on my current dose. It's a jolly good thing I didn't listen to the previous Consultant and use up to 7 pumps  a day 'as and when needed'! I just wouldnt do it, so he then emailed my GP and told them to put me on Premarin which I was not happy about and caused awful dizziness. This was why I sought help for a referral to Professor Lumsden.

I am already seeing a Psychiatrist and see him again in 3 weeks. He wanted me to see Professor Lumsden first before we met up again and the two are liaising as to how best to handle my case. Yes, anxiety is now a separate issue as well as the anxiety caused by hormonal imbalance, and my Psychiatrist wants to see how much my mood improves on HRT before we decide on any medication (as well as not wanting to start two things at once - it would be difficult to untangle what was causing any side effects). I have diazepam on an 'as needed' basis up to 6mg per day, but very rarely use it as I prefer not to unless it's absolutely necessary.

I make sure to eat regularly, particularly low GI foods to try to keep blood sugar stable. I breakfast with porridge, eat oatcakes as snacks with a daily banana and enjoy a main meal of protein, a baked potato and a large mixed salad.

For now I'm going to stick to 2 pumps plus a pea sized blob of Estrogel PM and wait it out I think!

[Dancinggirl]

Tempest - sounds a good plan - stick with it.  Probably wise to see how you do on the HRT before starting any ADs - as you wisely say you need to assess what is working. Good luck  DG x

[Tempest]

Thank you so much, Dancing girl! I certainly will. My Psychiatrist is brilliant and has a very level head when it comes to medications and the timing of them. He's trying to figure out if I indeed have Generalised Anxiety Disorder with accompanying depression, or if some of if is at least hormone related and how best to proceed. I'm not ruling out anything myself at this stage! I am also very medication phobic due to the near fatal anaphylaxis I experienced from another type of medication, and he knows this. If need be, he will bring me into hospital to start anything so that I can comply with the meds and they can help monitor any side effects. I'm happy to do this if the need arises.

Of course, low testosterone could be playing a big part too but that's for further along the way......

[Tempest]

Thank you so much for your kindness, GypsyRoseLee! If you look to your left, that's me hanging on to the cliff of self control right by you! 

I'm so sorry you're having a rotten time too. It's almost too cruel when we have a few good days and then it slides again. Sending you biggest hugs that it improves for you again soon. xxxx