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Author Topic: Hormone fluctuations on tablet HRT?  (Read 3640 times)

ancient runner

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Hormone fluctuations on tablet HRT?
« on: May 04, 2017, 10:32:21 AM »

Hello experts!
I'm on Femoston 1/10 and estring for my bladder/vaginal problems. Things have improved a lot since I was allowed to start using the Estring again, but after a brilliant couple of weeks it's more up and down again. I take my pill at about 8.30am and can feel everything improve below by about 10.30, have a good day on and off and it all seems to wear off in the evening. Am supposed to be going back to the GP on Monday and am wondering if I should either ask for the higher Femoston dose or suggest that patch or gel might keep things more stable. Any thoughts please? And how do patch/gel dosages compared to pill please?
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Dancinggirl

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Re: Hormone fluctuations on tablet HRT?
« Reply #1 on: May 04, 2017, 12:44:47 PM »

If you are referring to your urogenital atrophy - burning etc getting worse through day - in my experience this happens regardless of what you are doing. Sitting, getting too hot or having a bit of upset tummy, can all make my burning start.  I am convinced that hormones alone can't solve everything - we have to make sure we eat and drink the right things to reduce irritation and maintain the 'be kind to your lady bits' regime.
As you are using the Estring, this should give a consistent amount of oestrogen where it is needed. I assume you have had advice from a urologist? DG x
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ancient runner

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Re: Hormone fluctuations on tablet HRT?
« Reply #2 on: May 07, 2017, 07:51:29 AM »

I am using the Estring, yes, which has really helped. And I am kind to my undercarriage, yes - usually avoid caffeinated tea and coffee, try not to sit for too long, have a "cushion" which is actually a neck support cushion, keep drinking, use sylk and multigyn. It's noticeably better though mid morning though and then worsens.
No urology referral, no. Was referred about 3 years ago to a guy who wasn't interested in hormonal connections - even though I could show the pattern of peaks and troughs when using estriol cream locally - just suggested either TVT op or mesh repair for not-very-bad rectocele.  With the recent publicity about mesh ops am very glad I swerved both of those.
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Mary G

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Re: Hormone fluctuations on tablet HRT?
« Reply #3 on: May 07, 2017, 03:24:36 PM »

ancient runner, my instinct would be to go for a higher dose of Femoston and see how that works.  From what you have said, it sounds like you need more oestrogen and your current dose is quite low.  When I was on Angeliq (1mg oestrogen) I hardly noticed any difference and might as well have not been using HRT. 

In theory, 2 pumps of gel is the equivalent is a 50mcg patch or 1mg tablet but in my experience, the reality is very, very different and the gel delivers the oestrogen far better.  So personally, I prefer Oestrogel and nothing else I have tried has ever come close.  I now split the dose by 12 hours to keep an even level of oestrogen and I also split the location of the gel.  Since using one pump per day on inner, upper thighs, I have noticed that I no longer have any itching, burning, bladder or other problems down below - it really is a massive improvement. 

It might not work for everyone but definitely worth a try if you are a gel user. 
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Tempest

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Re: Hormone fluctuations on tablet HRT?
« Reply #4 on: May 07, 2017, 04:41:49 PM »

I'm working up to the split dosing if I can just tolerate HRT at all this time, Mary G! Thank you for sharing your regime. xxxxx
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Mary G

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Re: Hormone fluctuations on tablet HRT?
« Reply #5 on: May 07, 2017, 05:51:28 PM »

Tempest, keep persevering with the gel and you should eventually get to the stage where you know how much you need - it might take a while.  From what you have said, it sounds like an oestrogen implant would be the answer for a consistent level once you know what you need.  The good news is that once you have found your ideal level, you can stay on it risk free for life. 

You will get there in the end.
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Nina

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Re: Hormone fluctuations on tablet HRT?
« Reply #6 on: May 07, 2017, 06:06:22 PM »

For me a patch delivers the most stable dose, plus it's far less messy and time consuming. Slap it on and forget for a few days.
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Tempest

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Re: Hormone fluctuations on tablet HRT?
« Reply #7 on: May 07, 2017, 06:47:23 PM »

Thank you so much for your kind words and encouragement, Mary G! xxxxx :thankyou:
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Hurdity

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Re: Hormone fluctuations on tablet HRT?
« Reply #8 on: May 07, 2017, 08:45:21 PM »

Hello experts!
I'm on Femoston 1/10 and estring for my bladder/vaginal problems. Things have improved a lot since I was allowed to start using the Estring again, but after a brilliant couple of weeks it's more up and down again. I take my pill at about 8.30am and can feel everything improve below by about 10.30, have a good day on and off and it all seems to wear off in the evening. Am supposed to be going back to the GP on Monday and am wondering if I should either ask for the higher Femoston dose or suggest that patch or gel might keep things more stable. Any thoughts please? And how do patch/gel dosages compared to pill please?

Hi ancient runner

I don't think taking the oral HRT tablet would affect your vaginal area in terms of diurnal changes. The oestrogen works as a long term thing and you are getting a very consistent dose locally through the Estring mainly but basic systemic oestrogen levels from the tablet HRT.

I have always found that patch HRT gives me a very stable and consistent dose of oestrogen - luckily for me the 50 mcg patch along with vagifem (used to be Ortho-Gynest estriol pessaries) keeps everything OK.

It's a matter of preference really re patch or gel - and if you aren't getting hot flushes - you are only looking to use it to increase your systemic levels. So choose a patch if you want to stick it on twice a week, then forget about it (but having something sticking to you), or choose gel if you want something invisible - but you have to apply it every day (or even twice a day) and wait for it to dry - your choice really. Both methods you would have to have a progestogen which could be the downside. Women also vary in how much oestrogen they absorb from the different methods - so you can't say categorically which one would be better - although I would always go for transdermal personally.

Hurdity x
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ancient runner

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Re: Hormone fluctuations on tablet HRT?
« Reply #9 on: May 07, 2017, 09:41:20 PM »

Thanks very much all - lots to think about there. I will go to the GP tomorrow feeling a bit more confident that there are options. It feels most peculiar that the Estring plus femoston combo was great until I came off the progesterone/oestrogen tabs and back onto oestrogen only but I think I've still got some sort of cycle (getting period pain and heavy spotting every few weeks) and well, who knows?
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