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[Tc]

Hiya, ladies. I had the estradiol  implant inserted yesterday.at C and W Panay clinic.  I seem to be one of only a  few here who've tried it so I thought I might share my experience.

Bit of background and quick update  I'm 54 and 18 months post surgical menopause uterus retained.
Despite trying eastrogel 6 pumps and various high dose patches my E blood level remained low. And symptoms not controlled at all.
 
I switched from 2x 100 .estradot patch to 3mg sandrena in late  October and my  blood was around 130pmol  . Yesterday it  was 358pmol.!!!!   I've never absorbed anything that well but was stunned by that . as guess what? .. I havent felt one tiny bit better for it.. I would never have thought it possible it could more than double and I wouldnt feel the difference,  , that  with a decent level like that the would be zero improvement.

The doctor said "some women just need more"  so we went ahead as planned. With..

The implant
 lasts  6 .months .aims for between 300- 600pmol   She said most women get into the upper range.   but it can go much higher, maybe even.too high in which case they dont put a new one in until levels decrease.

It cant be removed so  if you have to reduce eastrogen quickly, for health reasons then some form of  inhibitor would be needed. . .

Blood levels can remain elevated after its reached the end of its life and may possibly stay that way  for some time.during which if you have a womb you  must remain on progesterone until your bloods are in post meno range.. it doesnt just drop like it would with other methods

 I've been so desperate to feel better for so long   I would try anything but Im aware of these risks. all the other risks are much the same as transdermal.

You must be on continous progesterone and as I cant tolerate utrogestan conti  the  doc wasnt  happy for me to have the implant unless I had a mirena fitted. . So..

.yesterday.  I had the coil  fitted  then the implant  it's a pellet not much bigger than a grain of rice . local anaesthetic into my lower  tummy.  Small incision  and its inserted under the skin into the fat. One dissolvable stitch and dressing.  It's not painful. (Wish I could say the same about the mirena!!)

It will take between 2 and  3 weeks to fully kick in. So I've got to still  use the sandrena, tapering down, and see how I feel after 2 weeks.
 
 I can have the testosterone implant too. But I said I want to research it further so meantime I'm still on the testogel.

 I feel apprehensive  like I've just got  on a ride I know I cant get off til the end and I'm waiting for it to start,  but it's a bit exciting too. I just hope it doesnt crash.

I  Will post updates if and when theres anything to report. Xxx

[Ladybt28]

Oh Tc  - so pleased that at last there is a plan and someone is listening and actually doing something!
Sounds interesting and yes I suppose it is a bit scary as it is an implant but I too have everything crossed that it just makes you feel better xx  What is the follow up?  Will they do regular testing or want you to report how you are feeling?

[Lanzalover]

Do hope everything works out for you Tc good luck.
Please keep us updated

Lanzalover x

[Alicess]

Finally something has been done after you struggled for so long.. I'll keep everything crossed for you! 🌷

[Tc]

Thank yo so much ladies.

Ladybt   I've got a,follow up appointment in may. I will need to get blood tests for that.

Xxx

[Salad]

Great news - love it when a plan comes together 
Hope all goes well.

[CLKD]

Do discuss at the next appt. how the inhibitor will be administered if it becomes necessary.  Do you keep a diary of progress which might be useful?

HORMONES    - at last you have been listened to!

 

[Jeepers]

Hi Tc

Good luck with your journey, really hope this is the beginning of you feeling good, after all this time..

Jeepers xx

[sheila99]

I hope you feel better soon. I've had a testosterone implant but now on Tostran. I would advise transdermal unless you don't absorb that either. Mine took 3 weeks to work then stopped at four months, and there's the worry of what happens if you can't tolerate it. Two implants every 6 months will add up to an awful lot of scars.

[Tc]

Thanks ladies. Sheila.

I have heard about women feeling that the implants run our after 4 months.its called tachyphylaxis.  It's a diminishingg response despite eastrogen levels being high. Some doctors then replace the pellet too early and it exacerbates the problem.  I've been told it's not uncommon to have to "top up" with gel or patch in the last few weeks of the pellets life.

I'm not worried about the scars if it works . But with the T I am nore hesitant.  Theres so little information from research about the long term effects of T replacement. At this point in time. Plus. Having more E might leave more unconverted T  to do its job and I might then need to use less testogel than I have been. I use a sachet a week at present.
.
Thanks for all the good wishes ladies.

I'm feeling a bit rough.from the  mirena cramps  and it  seems to have upset my bladder.  I hope I can get on with it as I had awful problems with utrogestan and would hate to have to switch back.

Xxx

[Alicess]

Tc,  what do you mean when you say "Having more E might leave more unconverted T  to do its job and I might then need to use less testogel??

To my understanding oestrogen raises SHBG which binds testosterone. So with higher E you will have less T available?

Did C&W gave you recommendations on your use of Testogel?

Levonorgestrel orally ( progestin in Mirena) can lower SHBG but I don't know if if does the same when it's inserted as a coil.

[Tc]

Alice. Thank you. I'm thinking that because I was told by my previous gynae that when E levels dont meet the bodies needs we convert Androgens to eastrogens.  Leaving less available to address the testosterone needs. Or as I clumsily put it "do its job" 😀  She said thats why  ideally E should be replete before starting T  therapy.  And that does seem contradictory or confusing to the effects of E on  SHBG binding T. 

Have I got it wrong?  I am a bit confused over it still.  It's one of the things in HRT that I've never completely wrapped my head around.

The doc said I can continue using a sachet testogel a week. She didnt test.  Maybe because I've got no ovaries there is less chance of Overdoing it. Dont know if it works like that   I've been on it  since about last April.  The doc who originally prescribed it said if you've had oopherectomy you will definitely need T replacement. But I must admit I havent felt any of the expected benefits of it in all this time.

I've just looked it up and you are correct. Levenogestrel has been shown to decrease SHBG in all its forms. 

Xxx

[Perinowpost]

Hi Tc

Just wanted to say I really hope this works for you. I've followed your story and know how you've struggled.

Re the SHBG thing I've never got my head around it either, but I do know the mirena kaiboshed my libido/response, and that it returned to normal (with a vengeance) within 48 hours of having it removed. Like you say though the T implant is always an option if you so choose.

Please keep us posted re your progress. Wishing you well xx

[Tc]

Thank you perin.  My libido did a,disappearing act along with my ovaries!! I  so I probably wont notice any difference. I  wonder why the mirena has that effect.  Xx

[Alicess]

It's confusing, isn't it!  Our own testosterone ( endogenous)  can convert to oestrogen, yes. That's where we get part of our oestrogen from; the conversion from testosterone to oestrogen ( aromatase)

If exogenous testosterone, Testogel and others, will convert to oestrogen in women is not clear yet. It does in men though.

Oestrogen raises SHBG,  SHBG binds to testosterone and to a lesser extend to oestrogen. More testosterone can lower SHBG.
Levonorgestrel has more androgenic properties then other progestins so maybe that's why it can lower SHBG
I think of SHBG as a kind of gatekeeper, trying to keep the balance.

I feel it depends on a indiviual's needs and responses if one needs higher oestrogen levels before introducing testosterone. It's so complex and so much is still unknown.

I would go with your doc's advice. If you change anything else right now it will be very difficult to know what's causing what. You've had so many changes allready.

I really hope you will start to feel the benefits soon!

Alicess XX