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[wuzzie]

Good morning again ladies,

I've just had a blood test back with estradiol levels of 416 pmol (post menopause, Prof Studd's HRT regime).  I still have some slight symptoms and wondering whether to increase the dose.  My question is how does this level compare with pre-menopausal levels and where does this number sit within the range for postmenopausal levels on HRT....?

Grateful as ever for your knowledge.

[Tinacros]

That seems a good level. I'm post menopausal and just got back from the gynae myself. He wants me to change from sequential hrt to continuous   I had my oestrodol levels done about 18 months ago (I was on femoston 1/10) and mine were 284.  Xx

[bear]

Hi wuzzie,

I don't know which lab performs tests for Prof Studd's Clinic, there are some different methods to test oestradiol levels with different ranges, including 'normal' levels for postmenopausal women.

https://www.southtees.nhs.uk/services/pathology/tests/oestradiol/ 'Post-menopause: Less than 118 pmol/L'
https://www.gloshospitals.nhs.uk/our-services/services-we-offer/pathology/tests-and-investigations/oestradiol/ 'Postmenopausal < 505'
https://www.gpnotebook.co.uk/simplepage.cfm?ID=570818627&linkID=24801&cook=yes '< 130 post-menopausal'

As Tinacros says, 416 pmol/L is a good level, but symptom control depends on individual responses to oestrogens. How long have you been on this HRT regimen?

BeaR.

[wuzzie]

I've been on it coming up to a year and feel pretty good just a touch of anxiety on waking and no longer able to enjoy alcohol!  My blood test was via the gp.

[Hurdity]

Hi wuzzie

Regarding pre-menopausal levels - oesrogen varies throughout the menstrual cycle and what was normal will vary from woman to woman.

As you can see from the GP notebook ref ranges that bear linked to (also on Wikipedia) that is a very healthy oestrogen level! Of course when taking HRT you don't get the ovulatory peak but nor would you wish to be at that level all the tme.

re post-menopause and on HRT - how long is a piece of string? This will be dose dependent - the higher the dose the higher the level and the usual advice is to go by symptoms rather than any particualr level per se. If protection against osteoporosis is desired I read a paper somewhere that a mimnimum of 160 p mol/l is preferable ( if I recall correctly) but most gynaes would prefer over 200 - 250 - although again even very small amounts of oestrogen give some protection.

By contrast I don't think my post-menopausal oestrogen levels have ever been much over 200 (once I was well past meno ie the two years period of time following last period - which I didn't know as was on HRT!). Symptom wise that's fine for me.

The other thing is are you peri or post? If peri then the results are meaningless - really as they are just a spot result. If post - also inaccurate as levels vary from hour to hour and day to day , and depend on time of day as well as where on body the blood sample was taken and how long since gel application ( I think) or patch change!

If you feel well enough for most of the time - then sounds good. I don't think an increased dose will make any difference to alcohol tolerance - most of us can only enjoy a little once post-meno even on HRT - still  enjoy a small amount though.....key - don't drink it too late (eg after 9 pm) and if wine drink plenty of water too!

Can you cope with the anxiety and does it have other causes - and does it disspiate once you're up and about? If so and you are otherwise well I would leave well alone!! Perhaps if on gel try a smidgeon extra and see what happpens (not sure if you can pump out that small amount!

Hurdity x

[wuzzie]

Thanks Hurdity. I am post meno and the bloods were taken middle of the day.  I think I can manage the anxiety levels as they are; you are right they do dissipate during the day - it just isn't very nice to wake up feeling as if something terrible is going to happen!  But I can cope with it I think.  I'm keen to take the minimum required to control the symptoms.  Finally learning that two small glasses of wine is all I can realistically manage without it having adverse effects  but that's not the end of the world is it?!  I am due to see Prof Studd on Monday and will see what he recommends. 

[bear]

Hi wuzzie,

I had the morning anxiety thing, mine was around 4 am, all sorts of intrusive thoughts, awful. It's gone now, thank goodness. I can't drink alcohol and I'm not on HRT. How was your appointment with Prof. Studd? I hope you feel better soon. 

BeaR.

[Hurdity]

Thanks Hurdity. I am post meno and the bloods were taken middle of the day.  I think I can manage the anxiety levels as they are; you are right they do dissipate during the day - it just isn't very nice to wake up feeling as if something terrible is going to happen!  But I can cope with it I think.  I'm keen to take the minimum required to control the symptoms.  Finally learning that two small glasses of wine is all I can realistically manage without it having adverse effects  but that's not the end of the world is it?!  I am due to see Prof Studd on Monday and will see what he recommends. 

wuzzie -  re the wine!! Two glasses is amazing! I am pleased that I can tolerate any of it! Like I said if I drink it after 9 pm it is more likely to affect me adversely but before that and with plenty of water I can probably happily manage a couple of (small) glasses or a G + T and glass of vino.

Will be interesting to hear about how your appt with Studd went. He often likes women to be on quite high oestrogen levels but his speciality is reproductive depression which is somewhat of a special case - and likes women to be on something like 800 or at least I think says some women don't feel well unless they're on levels like this from what I recall reading his blurb.

The downside if you are post-meno and on a very high oestrogen dose is needing to take a correspondingly high level of progesterone which is a no-no for many of us! That's just it - it's all a compromise isn't it this HRT lark?! Sometimes we have to settle for a bit less than the best in order to feel well for most of the time

Hurdity x