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[Mustard1]

HI there,  My levels were tested and sent to my Meno. doctor - who unfortunately is off work at present.  I have tried to interpret my levels unsuccessfully I think.  If anyone understands these I would welcome any insight.  FSH 27.7 ul           Estradiol .41 nmol/l              Testerone 1 nmol/l
I am currently on 1 pump of Estrogel and Everol Conti 50mgs patch.  However, anxiety & depression still loom.  I am sorry as I seem to be asking so many questions on this site but I do find the wealth of experience here so helpful.  M xx

[Daisydot]

Hi Mustard1 sorry I can't gelp you with the info you need I'm sure one of our other ladies will help you out there but just to say don't worry about asking questions that's what everyone tunes in for, help and advice ,same as you so don't be shy xx

[warwick01]

Hi Mustard

Your levels are very low and estrodiol should be in the hundreds i.e anything above 300 should help you feel better. It may be you don't do well on gel or patches so try tablets they may work better for you. I liked Angeliq conti HRT only stopped after 10 months due to some side effects.However felt my mood was better.

Take Care Wx

[Hurdity]

Actually that's incorrect - the level is not low! It is important to take note of the units of measurement for the oestrogen. Mustard's oestrogen levels were measured in nmol/l whereas they are usually measured in UK in pmol/l (or sometimes pg/ml). That being the case: 1 nmol/l = 1000 pmol/l and so your estradiol levels Mustard are 0.41 x 1000 = 410 pmol/l which is a very respectable level! So right there Warwick - they should be in the 100s and they are!!

The raised FSH level just shows that you are peri-menopausal - somewhere along the journey - but you can't tell exactly where since they can go into the post-menopausal range even while still peri.

Testosterone is normally pretty low and tests are inaccurate for women,. The gynae I saw didn't do them initially and went by symptoms - although most gynaes recommende testing for T once you start to replace it to ensure you don't overdose, and my NHS GP who subsequently prescribed it, did send me for a T test as i had been taking it for 3 years and had never had a test.

I would suggest that if you are taking  that type of progestogen all the time ( norethisterone) this could well be contributing to anxiety and many women in your position would prefer to change the progestogen and/or revert to a cycle - and preferably a longer one (or shorter duration of progestogen) under medical supervision, to minimise progestogenic exposure and consequent adverse side effects.

This would be the first thing I would do before thinking about adding testosterone - and see how you feel after 3 or more months on a different regime - if you are post-menopausal.

Hurdity x

[Mustard1]

Thank you so much ladies.  It was the nmol to pmol I couldn't work out.  I was a year without periods when I was 44 and I was put onto Kliofem and everything was great.  That was 9 years ago and then I went wonky in January.  So I would have thought I was completely post menopausal.  My meno. doctor is off just now but when she comes back I will discuss the progestogen with her to see if this is a problem.  I noticed that kliofem was only 1mcg of norethisterone and I think the Conti is 1.7 - so quite a bit more.  This reply has certainly made my morning brighter.  THANK YOU.  M xx

[Hurdity]

- glad it was helpful!

Re the dosages you mentioned - you can't compare progestogens taken via different methods in terms of dosage.

Kliofem is taken orally and is 1 mg of norethisterone (= 1000 mcg) per day but much of this is lost to digestion. Evorel conti patches contain 11.2 mg norethisterone and which are designed to deliver 170 mcg per day straight into the bloodstream through the skin. One would need to look at the product data to look at the range of systemic levels obtained from each - ie to see which one was actually lower - but even so you may absorb more or less from one method rather than another.

Both preparations are designed to release sufficient progestogen to keep the womb lining thin - for that dose of oestrogen - for the average woman (which of course we are not always!) - or rather probably for most women. This will be based on studies of dosage and measuring endometrial thickness etc.

The best thing to do is to try a different type or a sequential one - and see if you feel any different after 3 months - but do try to resist the suggestion to take ADs - if this is offered - before trying to get the HRT sorted out!

Let us know how you get on with your doc!

Hurdity x

[Mustard1]

Hi Hurdity - your replies are really helpful.  Unfortunately my GP thought I had had some type of breakdown and prescribed diazapham and 20mg citalopram in January.  I didn't take the diazapham as I was scared but did start the citalopram.  It wasn't until March that I saw a menopause doctor who believed it was menopausal and my first 4 weeks on Everol Conti were quite good but then I dipped again at which point she prescribed 1 pump estrogel.  I am still struggling but better than I was.  I intend to wean myself if the citalopram but think I'd prefer to be stable before I do that.  At this moment I wish  I was a man as the anxiety is awful but there are lots of us in the same boat and it's a case if one foot in front of the other.  Thank goodness for this site. Thanks again. 😀

[Hurdity]

OK sorry I didn't realise you were already taking them - so definitely think about changing the HRT rather than increase the AD dose if you can! That norethisterone may be making you feel worse than you need to!

Hurdity x

[Mustard1]