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[heavenlyblue]

Been to see a private GP, she did a hormone test on me as I told her being on 50mcg Evoril Conti for past 20 months was not getting rid of severe migraines, fatigue, hot flushes and zero libido.

Oestradiol      <44 pmol/L
SHBG             64 nmol/L
Progesterone  <0.2 nmol/L
Testosterone  <0.4 nmol/L

She is changing me to body identical, wants to up my oestrogen and has prescribed me Testogel.    I have a follow up with her in January.

Just how low are these results, does anyone know?   I can email her but will cost me £30.....(I know, I'm being cheeky...but you ladies are so knowledgable).    And why did no NHS GP ever ask me to get this test done?

[KiltedCupid]

heavenlyblue - your Oestradiol is on the floor. I felt absolutely awful with a similar level. Hopefully your change of hormone delivery will help to increase your E. The norethisterone in Evorel Conti can have a detrimental effect on oestrogen levels and might be preventing you from upping your level. Good news that your doc is changing your hrt.

I'm not familiar with what other levels should be but hopefully some ladies will be along soon.

[heavenlyblue]

heavenlyblue - your Oestradiol is on the floor. I felt absolutely awful with a similar level. Hopefully your change of hormone delivery will help to increase your E. The norethisterone in Evorel Conti can have a detrimental effect on oestrogen levels and might be preventing you from upping your level. Good news that your doc is changing your hrt.

I'm not familiar with what other levels should be but hopefully some ladies will be along soon.

Is it?  I feel so annoyed with myself I didn't do something about this earlier.  I just trusted in the NHS GPs.  Thought it was something I had to put up with.  But after reading this Forum...I realised I had to take matters into my own hands.   

Thank you for that, it has really helped.   :-)

Does anyone else know what the other levels tell me?

[KiltedCupid]

heavenlyblue - your Oestradiol is on the floor. I felt absolutely awful with a similar level. Hopefully your change of hormone delivery will help to increase your E. The norethisterone in Evorel Conti can have a detrimental effect on oestrogen levels and might be preventing you from upping your level. Good news that your doc is changing your hrt.

I'm not familiar with what other levels should be but hopefully some ladies will be along soon.

Is it?  I feel so annoyed with myself I didn't do something about this earlier.  I just trusted in the NHS GPs.  Thought it was something I had to put up with.  But after reading this Forum...I realised I had to take matters into my own hands.   

Thank you for that, it has really helped.   :-)

Does anyone else know what the other levels tell me?

No probs heavenlyblue - it's difficult to find a GP with good meno and hrt knowledge so it's not your fault. You've done the right thing and will hopefully start to feel a lot more perky once the oestrogen starts to rise. I'm sure there's lots of ladies on here in your position who'll be interested in your progress.

Good luck.

[Hurdity]

Hi heavenlyblue - don't be annoyed with yourself.  The NHS is wonderful but there is very patchy knowledge about menopause and HRT – and that is why we have to educate ourselves when we encounter problems.  Hence this website and helped by the forum too – so that women can feel empowered to challenge their GPs.

The fact that you still had hot flushes on the Evorel conti would normally indicate (if no other medical explanation) that your oestrogen levels were insufficient for you and therefore an increase in dose would be advised - without needing a blood test. As Evorel conti only comes in one dose your doc would either have to prescribe an extra oestrogen patch (eg 25 mcg) off licence or you would need to take separate oestrogen and a progestogen. Your GP should have been able to prescribe you something different on this basis but for you this did not happen.

As discussed on this forum and many websites etc women do not need to have hormone tests and many women on here have never had them. Except under some particular circumstances docs should go by symptoms. I realise it seems to be normal practice with private GPs - but of course is extra expense!  As you probably know estradiol levels vary from hour to hour and day to day so only give a snapshot of the levels at that particular moment.  As you are on patches I wonder when was the blood sample taken in relation to when you last changed the patch? On pacth change day mine were surprisingly low but mid-patch they were double and approx the range I would expect  However it is interesting to see them...

Even allowing for some variation that is undoubtedly a low estradiol result but as you were still getting flushes on the dose of oestrogen you were taking – you probably knew that anyway – ie that you needed more oestrogen.

I or someone else may have mentioned on your other thread (haven't gone back over it all) that the migraines and fatigue could be down to low oestrogen but also the continuous norethisterone can cause these symptoms - headaches and migraines in some women and progestogens have a sedative effect at best, and depressing exhausting effect at worst, when taken all the time. As far as I know this does not affect oestrogen levels though - just has a negative effect of itself - but can also interfere with the beneficial effects of oestrogen in some respects.

Progesterone testing is unnecessary - it is always low in post-menopausal women. It is normally only used to test fertility so I'm not sure why this one was included?

Some gynaes suggest that testosterone tests before replacement are also deemed unneccessary and inaccurate because they are not sensitive in women whose levels are very low because the test is designed for men with lack of libido being a more reliable indication - especially if older, and if you are not on oral HRT nor taking ADs.  However your low result does confirm that although low libido is the clincher! ideally once you have started the testogel T levels (along with SHBG) should be tested after a few months to make sure they are within the physiological range for women - and should then be higher!

Great that you are increasing oestrogen and have been prescribed testogel (presumably the 1% sachets?). I presume you will be taking progesterone ie utrogestan? Have you been prescribed this cyclically or continuously? Although continuous combined HRT is the norm for post-menopause I would strongly suggest you try oestrogen only for a few week and then introduce utrogestan cyclically for 12 days monthly or whatever your consultant has suggested. Downside is you would have a withdrawal bleed but only then will you know how you feel on oestrogen only?

I find it somewhat shocking that your private GP has not interpreted your results and expects additional payment in order to do so! I would have thought as least a basic explanation should be provided now you've gone to all that expense!

Anyway – you've now taken action to improve your health! Hopefully you are on the road to feeling a lot better, and can get any future prescrptions on NHS. I presume your private GP will write to your own GP with the recommendations and prescription?

These are just my thoughts - but obviously you should be guided by your docs.

Good luck and let us know how you get on!

Hurdity x

[heavenlyblue]

Hi heavenlyblue - don't be annoyed with yourself.  The NHS is wonderful but there is very patchy knowledge about menopause and HRT – and that is why we have to educate ourselves when we encounter problems.  Hence this website and helped by the forum too – so that women can feel empowered to challenge their GPs.

The fact that you still had hot flushes on the Evorel conti would normally indicate (if no other medical explanation) that your oestrogen levels were insufficient for you and therefore an increase in dose would be advised - without needing a blood test. As Evorel conti only comes in one dose your doc would either have to prescribe an extra oestrogen patch (eg 25 mcg) off licence or you would need to take separate oestrogen and a progestogen. Your GP should have been able to prescribe you something different on this basis but for you this did not happen.

As discussed on this forum and many websites etc women do not need to have hormone tests and many women on here have never had them. Except under some particular circumstances docs should go by symptoms. I realise it seems to be normal practice with private GPs - but of course is extra expense!  As you probably know estradiol levels vary from hour to hour and day to day so only give a snapshot of the levels at that particular moment.  As you are on patches I wonder when was the blood sample taken in relation to when you last changed the patch? On pacth change day mine were surprisingly low but mid-patch they were double and approx the range I would expect  However it is interesting to see them...

Even allowing for some variation that is undoubtedly a low estradiol result but as you were still getting flushes on the dose of oestrogen you were taking – you probably knew that anyway – ie that you needed more oestrogen.

I or someone else may have mentioned on your other thread (haven't gone back over it all) that the migraines and fatigue could be down to low oestrogen but also the continuous norethisterone can cause these symptoms - headaches and migraines in some women and progestogens have a sedative effect at best, and depressing exhausting effect at worst, when taken all the time. As far as I know this does not affect oestrogen levels though - just has a negative effect of itself - but can also interfere with the beneficial effects of oestrogen in some respects.

Progesterone testing is unnecessary - it is always low in post-menopausal women. It is normally only used to test fertility so I'm not sure why this one was included?

Some gynaes suggest that testosterone tests before replacement are also deemed unneccessary and inaccurate because they are not sensitive in women whose levels are very low because the test is designed for men with lack of libido being a more reliable indication - especially if older, and if you are not on oral HRT nor taking ADs.  However your low result does confirm that although low libido is the clincher! ideally once you have started the testogel T levels (along with SHBG) should be tested after a few months to make sure they are within the physiological range for women - and should then be higher!

Great that you are increasing oestrogen and have been prescribed testogel (presumably the 1% sachets?). I presume you will be taking progesterone ie utrogestan? Have you been prescribed this cyclically or continuously? Although continuous combined HRT is the norm for post-menopause I would strongly suggest you try oestrogen only for a few week and then introduce utrogestan cyclically for 12 days monthly or whatever your consultant has suggested. Downside is you would have a withdrawal bleed but only then will you know how you feel on oestrogen only?

I find it somewhat shocking that your private GP has not interpreted your results and expects additional payment in order to do so! I would have thought as least a basic explanation should be provided now you've gone to all that expense!

Anyway – you've now taken action to improve your health! Hopefully you are on the road to feeling a lot better, and can get any future prescrptions on NHS. I presume your private GP will write to your own GP with the recommendations and prescription?

These are just my thoughts - but obviously you should be guided by your docs.

Good luck and let us know how you get on!

Hurdity x

Firstly, thank you so much for taking the time to send me such a detailed post.   Really helps to have things explained so fully.

What a morning, I have a 12 hour BP monitor strapped to me at the moment.  Very frustrating, can't get my oestrogen upped until my BP comes down!  I asked the private GP to do a letter to my NHS GP, to keep him in the loop, so she has done one and emailed me a copy, with the hormone test results so I am taking them with me on Monday, just in case they haven't been received, when I see him to get the BP results.  I hope I can get future prescriptions on the NHS.  I haven't had an NHS referral appt yet, so shall tell him that I was recommended this private GP so decided to see her. 

Re the blood sample, it was taken on a Tuesday morning, I change my patches on a Monday and a Friday. 

She has prescribed me Evoril 50mcg patches (not in stock yet) and 100mg Utrogestan capsules, which she has instructed that I take each night.  I understand what you are saying about not taking the Utrogestan all the time but I feel loathe to go against the Private GPs instructions, initially.  But at least if I don't feel any better after a few weeks, I can tell her I would like to try taking the Utrogestan cyclically. 

Re the Testogel, I am not sure what the strength is, the chemist has my script.  But they are sachets and I have to put a thumbnail on lower abdomen or outer thigh.  One sachet should last 7-10 days.     My Private GP had to ring the Chemist to say she was ok for me to have an unlicensed product.  She said it's the first time she has ever had to ring a Chemist, she couldn't understand why the Script wasn't enough.  That should be in stock by Monday.   Should I start taking that now, whilst I am still on Evoril Conti, or wait til I start my new regime?

Re self help, I have gone 3 weeks without a migraine, which is a record this year!  Saw a Herbalist just over 3 weeks ago.  She went through my diet and we had a long chat about what was going on in my life.  She went through my supplements, gave me a tincture and asked me to try eliminating wheat & keeping my sugar low.  Which I have.  It's no effort at all.  Wheat free is not the same as gluten free so it's quite easy to do.    So not sure whether any of that is responsible for not having a migraine for 3 weeks but I will stay with it!  :-)

Thank you Hurdity, your advice and all you ladies are on here, is really invaluable to me.  Both of my sisters are coping pretty well with it, have hot flushes but don't feel they need HRT.  I don't know anyone else going through it and even though my other half has been amazing (deserves a medal these past 3 years!), it's not the same as sharing with people going through the same thing  :-) Just want some semblance of that 49 year old me back...…….

[Mary G]

heavenlyblue, I started having silent migraines when I reached menopause back in 2004 which were caused by synthetic progesterone and oestrogen spikes.  I've finally found a continuous combined, bleed free HRT regime that works but it was not easy.  I use oestrogen, testosterone and a bespoke, body identical progesterone every day.  I needed hormonal stability and now know that it was my own produced progesterone that stopped the oestrogen spikes during my reproductive years.

It's important to know your migraine trigger i.e. low oestrogen, oestrogen spikes, synthetic/high levels of progesterone or fluctuating hormones?  This will help you to identify the right HRT regime.

As KiltedCupid said, your oestrogen levels are very low and I wonder if that could be why your blood pressure is raised.   Low oestrogen often leads to high blood pressure, it happened to my aunt and my mother post menopause.

Hormone blood tests are very definitely beneficial post menopause because it's the only way to know how well you are absorbing HRT.

I hope you find a regime that keeps the migraines away.

[Hurdity]

Hi again Heavenlyblue

Hopefully your BP will come down if you are less stressed and at home!

re the blood sample - ah then it should have been higher at this point in the patch change cycle - even though one result might be inaccurate - your symptoms do reflect this (the low oestrogen result).

I would suggest y if the Evorel does not come in, you get the Evorel prescription changed to Estraderm or something similar - or at least one that is in stock as Evorel manufacture I think has temporarily ceased while they get another facility going or something. Some pharmacies may still have stock available but when it's gone it's gone. If they can get it initially then great! I expect the pharmacsist themselves will suggest an alternative. I thought it was Evorel conti where you still had symptoms ie Evorel 50 mcg? If this is the case then why have you been prescribed the same dose? Sorry if I've misunderstood.

Testogel sachets are 1% and these are the best to use as the dose needed is so small that you are less likely to give yourslef too much by mistake whereas Tostran is double the strength. This is what I use. Personally I would start low and slow and I think many on here would say the same so a pea-sized blob (is that smaller than a thumb-nail?). My sachets last way longer than that. Probably more like two weeks but then I'm much older. Also don't be tempted to increase too quickly. I'm sure you were told that the effects of T can take some months to be full realised.

Brilliant re the migraines! They are the pits! I have recently gone gluten-free. It may well be that this is what you are also doing by cutting out wheat - or rather low gluten - because most gluten containing products you have been eating previously will be wheat based I imagine ie bread, pasta, cereals, pastries, cakes etc? Unless you are coeliac then it's not an allergy but just an intolerance so you could see benefits from a drastic reduction. I have re digestive issues - from going gluten free. Also stabilising your blood sugar by reducing or eliminating added sugar (and presumably refined carbs?) from your diet can only be beneficial.

Good luck and keep us posted. I'll try not to forget next time when you start a new post!!

Hurdity x

[KiltedCupid]

heavenlyblue, I started having silent migraines when I reached menopause back in 2004 which were caused by synthetic progesterone and oestrogen spikes.  I've finally found a continuous combined, bleed free HRT regime that works but it was not easy.  I use oestrogen, testosterone and a bespoke, body identical progesterone every day.  I needed hormonal stability and now know that it was my own produced progesterone that stopped the oestrogen spikes during my reproductive years.

It's important to know your migraine trigger i.e. low oestrogen, oestrogen spikes, synthetic/high levels of progesterone or fluctuating hormones?  This will help you to identify the right HRT regime.

As KiltedCupid said, your oestrogen levels are very low and I wonder if that could be why your blood pressure is raised.   Low oestrogen often leads to high blood pressure, it happened to my aunt and my mother post menopause.

Hormone blood tests are very definitely beneficial post menopause because it's the only way to know how well you are absorbing HRT.

I hope you find a regime that keeps the migraines away.

Mary G - that makes so much sense; the spikes, I feel, are what cause me most problems and is why I prefer a conti regime. You have what appears to be the perfect conti combo and it's really great it's sorted your migraines. Balance, as with most things, is key and it makes perfect sense that adding and subtracting one hormone would cause major flux systemically leading to nasty side effects. More so as we age and particularly when post meno, the addition of prog in sledgehammer quantities then abrupt cessation seems madness, not to mention the embarrassment of buying sanitary products when we're quite clearly too old for them.

Reminds me of a fabulous sketch by the late Joan Rivers where she was ripping women who ‘accidentally' drop a tampon from their bag in an attempt to appear younger than they are. Sad, really.

Long may your regime keep working for you. We all need some of that.

[Hurdity]

Mary G - that makes so much sense; the spikes, I feel, are what cause me most problems and is why I prefer a conti regime. You have what appears to be the perfect conti combo and it's really great it's sorted your migraines. Balance, as with most things, is key and it makes perfect sense that adding and subtracting one hormone would cause major flux systemically leading to nasty side effects. More so as we age and particularly when post meno, the addition of prog in sledgehammer quantities then abrupt cessation seems madness, not to mention the embarrassment of buying sanitary products when we're quite clearly too old for them.

Reminds me of a fabulous sketch by the late Joan Rivers where she was ripping women who ‘accidentally' drop a tampon from their bag in an attempt to appear younger than they are. Sad, really.

Long may your regime keep working for you. We all need some of that.

Embarrassment at buying sanitary products?    Heavens above kilted cupid – this is 2019 not 1960!!! We live in far more enlightened times in all things to do with hormones and sexuality – when menopause and periods are talked about by celebrities on the national news, gay couples can marry and openly shpow affection without embarrassment – and you talk about being embarrassed at the thought of purchasing tampons?!

You might be embarrassed and feel you are too old for them – but those of us on here who have opted to continue with a cycle in our late 50's ( when actually some women are having periods naturally) and 60's (some women even on continuous HRT do get bleeding and spotting even into their 60's and 70's so may need tampons – God forbid that someone actually sees them buying them) are pleased that we have taken our health into our own hands and not prepared to suffer due to potential embarrassment. Anyway older women may be buying them for their daughters or younger sisters – should they also be embarrassed?

There are 4 options re HRT or not – 1) Stop HRT – some of us will remain on it as long as we can and our health permits – current thinking supports this too - in order to keep symptons at bay and to maintain bone and cardio-vascular protection amongst other things.

2) hysterectomy – removing the need for progesterone – bit of an extreme option so only advisable if a medical necessity due to other repercussions.

3) continuous combined HRT – this is the norm for post-menopause – but as you will have read many many women  suffer more from the effects of continuous progestogens than from the rise and fall in this hormone. Also there is still the question mark of the role of progestogens in increased cancer risk particularly synthetic ones. Counter to this is the reduced risk of endometrial cancer with conti HRT but this is more easily detected and the direct causal relationship established

4) remaining on a cycle – the “sad” and “embarrassing” option

"Sad really"? Not quite sure who or what is sad – certainly not the women in this forum who have gone for this latter option in the face of convention and to challenge the norms, in order to be able to function with a good quality of life well into their older age – which could be 40 years post-menopause if we are lucky.

Most of us who do so do not enjoy having to use tampons nor to bleed - actually I hate it - but the decision to do so at the time or age we do it, is our own decision (with our doctors) and is no-one else's business to judge how embarrassing or sad they think it is.

It is brilliant that this forum exists so that those of us who have decided on this path are not usually made to feel like a freak for doing so.

heavenlyblue - I know that wasn't relevant to your blood results but it really did warrant a response in the circumstances. Hope you're doing better today and do keep us updated....

Have a good weekend folks

Hurdity x

[KiltedCupid]

Mary G - that makes so much sense; the spikes, I feel, are what cause me most problems and is why I prefer a conti regime. You have what appears to be the perfect conti combo and it's really great it's sorted your migraines. Balance, as with most things, is key and it makes perfect sense that adding and subtracting one hormone would cause major flux systemically leading to nasty side effects. More so as we age and particularly when post meno, the addition of prog in sledgehammer quantities then abrupt cessation seems madness, not to mention the embarrassment of buying sanitary products when we're quite clearly too old for them.

Reminds me of a fabulous sketch by the late Joan Rivers where she was ripping women who ‘accidentally' drop a tampon from their bag in an attempt to appear younger than they are. Sad, really.

Long may your regime keep working for you. We all need some of that.

Embarrassment at buying sanitary products?    Heavens above kilted cupid – this is 2019 not 1960!!! We live in far more enlightened times in all things to do with hormones and sexuality – when menopause and periods are talked about by celebrities on the national news, gay couples can marry and openly shpow affection without embarrassment – and you talk about being embarrassed at the thought of purchasing tampons?!

You might be embarrassed and feel you are too old for them – but those of us on here who have opted to continue with a cycle in our late 50's ( when actually some women are having periods naturally) and 60's (some women even on continuous HRT do get bleeding and spotting even into their 60's and 70's so may need tampons – God forbid that someone actually sees them buying them) are pleased that we have taken our health into our own hands and not prepared to suffer due to potential embarrassment. Anyway older women may be buying them for their daughters or younger sisters – should they also be embarrassed?

There are 4 options re HRT or not – 1) Stop HRT – some of us will remain on it as long as we can and our health permits – current thinking supports this too - in order to keep symptons at bay and to maintain bone and cardio-vascular protection amongst other things.

2) hysterectomy – removing the need for progesterone – bit of an extreme option so only advisable if a medical necessity due to other repercussions.

3) continuous combined HRT – this is the norm for post-menopause – but as you will have read many many women  suffer more from the effects of continuous progestogens than from the rise and fall in this hormone. Also there is still the question mark of the role of progestogens in increased cancer risk particularly synthetic ones. Counter to this is the reduced risk of endometrial cancer with conti HRT but this is more easily detected and the direct causal relationship established

4) remaining on a cycle – the “sad” and “embarrassing” option

"Sad really"? Not quite sure who or what is sad – certainly not the women in this forum who have gone for this latter option in the face of convention and to challenge the norms, in order to be able to function with a good quality of life well into their older age – which could be 40 years post-menopause if we are lucky.

Most of us who do so do not enjoy having to use tampons nor to bleed - actually I hate it - but the decision to do so at the time or age we do it, is our own decision (with our doctors) and is no-one else's business to judge how embarrassing or sad they think it is.

It is brilliant that this forum exists so that those of us who have decided on this path are not usually made to feel like a freak for doing so.

heavenlyblue - I know that wasn't relevant to your blood results but it really did warrant a response in the circumstances. Hope you're doing better today and do keep us updated....

Have a good weekend folks

Hurdity x

  - you have a good weekend too. 👋

[heavenlyblue]

heavenlyblue, I started having silent migraines when I reached menopause back in 2004 which were caused by synthetic progesterone and oestrogen spikes.  I've finally found a continuous combined, bleed free HRT regime that works but it was not easy.  I use oestrogen, testosterone and a bespoke, body identical progesterone every day.  I needed hormonal stability and now know that it was my own produced progesterone that stopped the oestrogen spikes during my reproductive years.

It's important to know your migraine trigger i.e. low oestrogen, oestrogen spikes, synthetic/high levels of progesterone or fluctuating hormones?  This will help you to identify the right HRT regime.

As KiltedCupid said, your oestrogen levels are very low and I wonder if that could be why your blood pressure is raised.   Low oestrogen often leads to high blood pressure, it happened to my aunt and my mother post menopause.

Hormone blood tests are very definitely beneficial post menopause because it's the only way to know how well you are absorbing HRT.

I hope you find a regime that keeps the migraines away.

Hi Mary.  It's very interesting to know what has worked for you.  I do have a feeling that I need to get the correct balance with everything.  I have spent the last 3 years with NHS GPs telling me my migraines are nothing to do with the menopause so they just kept trying me on different painkillers, preventatives, even Amitriptyline.  Nothing worked.  I just knew it was to do with my hormones.  So that is why I went to a private GP.    I need a bespoke regime for me, which I am sure will need tweaking.    I have an appointment with my NHS GP after work today to see what my BP 12 hour monitor said.  I really hope its ok as I can't get a script from my private GP for higher Oestrogen until it settles.   Thank you replying x

[heavenlyblue]

Hi again Heavenlyblue

Hopefully your BP will come down if you are less stressed and at home!

re the blood sample - ah then it should have been higher at this point in the patch change cycle - even though one result might be inaccurate - your symptoms do reflect this (the low oestrogen result).

I would suggest y if the Evorel does not come in, you get the Evorel prescription changed to Estraderm or something similar - or at least one that is in stock as Evorel manufacture I think has temporarily ceased while they get another facility going or something. Some pharmacies may still have stock available but when it's gone it's gone. If they can get it initially then great! I expect the pharmacsist themselves will suggest an alternative. I thought it was Evorel conti where you still had symptoms ie Evorel 50 mcg? If this is the case then why have you been prescribed the same dose? Sorry if I've misunderstood.

Testogel sachets are 1% and these are the best to use as the dose needed is so small that you are less likely to give yourslef too much by mistake whereas Tostran is double the strength. This is what I use. Personally I would start low and slow and I think many on here would say the same so a pea-sized blob (is that smaller than a thumb-nail?). My sachets last way longer than that. Probably more like two weeks but then I'm much older. Also don't be tempted to increase too quickly. I'm sure you were told that the effects of T can take some months to be full realised.

Brilliant re the migraines! They are the pits! I have recently gone gluten-free. It may well be that this is what you are also doing by cutting out wheat - or rather low gluten - because most gluten containing products you have been eating previously will be wheat based I imagine ie bread, pasta, cereals, pastries, cakes etc? Unless you are coeliac then it's not an allergy but just an intolerance so you could see benefits from a drastic reduction. I have re digestive issues - from going gluten free. Also stabilising your blood sugar by reducing or eliminating added sugar (and presumably refined carbs?) from your diet can only be beneficial.

Good luck and keep us posted. I'll try not to forget next time when you start a new post!!

Hurdity x

Hi Hurdity, thank you again for taking the time to reply.

When I read your comment about why I was being prescribed the same dose Evoril, it got me thinking.  I don't really know.  She couldn't prescribe me a higher dose yet as my BP was too high but perhaps she wanted me on at least part bio-identical, with the 100mg Utrogestan capsules, instead of staying on the Evoril Contil 50mcg?

I wish I had thought to ask when I was there.  I was just so finally relieved to have got an appointment and I didn't think to question why she was prescribing me the same dose.  Not even sure how much its going to cost me when the Evoril 50mcg finally gets in stock, my private GP has told me to ask for Oestrogel or Sandrena if the wait is too long.      The Testogel is going to cost me £46.   That is in stock this week.   Seems a bit silly to pay for this Evoril 50mcg prescription when I have loads of Evoril Contil 50mcg at home.  But I just assumed she wanted me on bio identical progesterone straight away.  I'm guessing though.    And if my BP is normal today, I will then get another script off her for a higher dose of oestrogen.  Desperate for the higher oestrogen, now I know how low it is, I feel at least there is some light at the end of the tunnel.....

I'm bringing the letter from my private GP to my NHS GP later today, when I get my BP results.   It explains our meeting and her findings with my hormone results and that she wants to change me to bio-identical.     Hopefully the NHS will pay for the next prescription.   

Sorry for so many questions.  Wish I had thought to ask her these questions, I just went along with it.  Was so excited I was seeing someone who actually specialised in the menopause.   Trouble is, it does say on her website, any emails which require a medical input, after the initial meeting,  will cost £30.   

Re my migraines, still doing ok.  Had a rather tight head on Friday (which was bad timing as I had my BP monitor on) but it didn't materialise into me vomiting all over the place so that a win for me!   Made some grain free low natural sugar blueberry muffins at the weekend.  Will be a different Christmas for me this year, treat wise, but having poor health past 3 years has put everything into perspective, I need to look after myself.  At least weight gain is one issue I do not have.  Throwing up so much with migraines this year and watching my sugar intake, I've actually lost weight!

Thank you Hurdity, your time and advice is very much appreciated and oh, if I still have to have a bleed but it means my migraines have diminished and I have my life back, I will be buying sanitary products with wild abandon!!  ;-)  xx

[Hurdity]

No problems heavenlyblue- glad to be a little help if I can - but really just my thinking aloud thoughts!

How did you get on with the BP monitor? It will be quite interesting to see how you get on with a change in progestogen and presumably she just wants to change one thing at a time? Pity you have to pay for each input but I suppose with e-mail being so easy docs would get inundated with Qs all the time. i would have thought interpretation of results along with sending them would be standard though!

re the tesosterone - it;s not so bad paying for that as if you are given a box it will last over a year depending how much you use - provided they give you enough for men. That was why I didn;t mind hvaing to pay for a private prescrption initially (but thids was 2015 before nICE Guidelines), as my actual prescription meds were relatively cheap....still too costly for some though

Haha re the sanitary products - that's what I feel - who gives a s*** what other people think eh as long as we feel well!!!

Hurdity x

[KiltedCupid]

For me, bleeding and sanitary products are not part of feeling well.

Furthermore, any hrt regime which produces such profound side effects, is not a balanced regime.