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[allie007]

Evening ladies

Am pretty new to HRT,  started using Estrogel on 23rd March this year, 1 pump in the evenings. After 2 weeks i felt like the old me was back, i had energy, didnt fall asleep by 7pm, slept through the night for the first time in as long as i can remember, the anxiety, very low mood and snappiness  all disappeared. 2 weeks later it all came back so i upped the dose to 2 pumps, 1 in the morning about 7am and 1 in evening about 10pm. Again, felt ok for a bit but gradually all the symptoms are getting worse and i now feel exactly as i did before i started using the gel. I spoke to the.GP and she doesnt want me to up the dose to 3 pumps so im at a loss what to do. I cant go on feeling like this. Do i ignore the docs advise? Do i change the times of application? I feel fine when i wake up in the morning but come late afternoon im wrecked.

[Mary G]

The maximum dose is 4 pumps I believe.  How old are you and where are you in the menopause?  If you have suddenly become post menopause for example, chances are your oestrogen levels have dropped further hence the return of symptoms.  A lot of women experience a real dip when their ovaries finally give out.

Why did the doctor say you can't increase to 3 pumps of gel?

[Tempest]

Hi, allie!

I really do despair at GP's! The guidance is 'lowest EFFECTIVE dose', and your dose is not effective so therefore you need more! Why do we have to be put through this rubbish?

Btw - are you using estrogen only and have you had a hysterectomy? Just in case there is a prog. issue? xxxx

[Tempest]

Mary G, 4 usually is the max in natural meno. but can be more under professional guidance for POF and surgical meno. (as you would expect). The only problem is finding enough body parts to apply it to! (Sorry to threadjack a bit, Allie)! xxxx

[allie007]

Thank you for replying everyone 
Ive just turned 47 and it is natural menopause. I havent had a period for approx 2 years, probably more as i had a Mirena coil fitted about 4 and a half years ago, am on waiting list to get it replaced. Ive only had my bloods taken once at the end of February to see if i was menopausal and it came back that my FSH level was 70. The GP said it indicated i was post menopausal but couldnt be sure because of my coil. She said to carry on with the 2.pumps for another few months and if no change the next step would be to try patches.

[allie007]

Sorry, she said not to increase the dose because the more estrogen the higher the risks.

[Mary G]

allie007,that sounds completely wrong to me.   For a start you have a Mirena coil which even at over 4 years old will still be protecting your womb so you can increase the gel dose now.   Why on earth have you got to switch to patches if the current dose of gel doesn't work?   From my personal experience, it's far easier to get good quantities of oestrogen into your system via gel and there is no reason why you can't go as high as 4 pumps. 

[Mary G]

Risks, what risks?   Sounds like nonsense to me.   Tempest is right to despair!   It is perfectly safe to increase your dose with a Mirena.

[allie007]

Mary G thats what I thought. 2 pumps from what I gather is still a lowish dose. Im so impatient though, i just want it.to hurry up and work. Ive been feeling lousy for a year now but put it all down to work stress and being a mum x

[Annie0710]

If you suit the gel, stay with it.  Patches could set you right back or you could like them but don't meddle unless you really have to.  Increase dose gently, I'd personally try 2.5 pumps and see how your symptoms are go up 0.5 pump at a time x

[allie007]

Will do.  Would you suggest morning or evening? Im doing 1 of each at the moment.

[Annie0710]

Again it's what suits the individual.  I do my 2.5 pumps each morning, but am on day 3 of trying 3 pumps each morning.  Some ladies can't deal with it all at once so split twice in the day.  Try all in one go as it's easier but if you feel it's too much try some am and some pm x