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[Moz]

Hello, I am almost 41 and my periods stopped 5 months ago after 3 years of horrific mental health that was resistant to medication which suddenly improved as my periods stopped. Blood tests and scan show I am entering menopause. I have been given Utrogestan pessary 200mg and Sandrena gel sachets 0.5mg. My question is this: I am reading a lot that early menopause women require a higher level of estrogen gel to reach optimal oestrogen levels for bone/heart health. Can anyone advise me on this? My GP seems nervous about increasing the dose. She has also said further blood test not necessary and if I feel better that's the sign it's working. But how do I know if I have optimal level!? My mum had early meno and was refused HRT and now she has severe arthritis and diabetes aged 60 so I am determined to try and achieve optimal oestrogen dose. Thanks so much for reading.

[Bobidy]

Hi

Yes expect to need higher doses of oestrogen when you are younger. Don't be too worried about this. Your body should be producing higher levels up to the average meno age of 51, so you are just replacing it to that level.

I am mid 40s post hysterectomy and now need the equivalent of 6-7 pumps of estrogel, gradually building up from 2 over 12 months. This is under the guidance of Dr Newson.

Let your symptoms guide your amount and leave it a few weeks in between raising your dose to let things settle.

You really need to protect your future health.

Getting your gp to prescribe at a high dose may be problematic as they are nervous about it anyway, particularly anything over 100mcg or 4 pumps. I'm having that battle with my gp at the mo. The best thing to do is speak to your gp and provide the evidence.

Lots of info on The Menopause Doctor about this and useful podcasts.

I wish you all the very best with this x

[Moz]

Thank you for replying 💛 Yes my problem is that my GP is nervous. I simply have no idea how to assess the best dose. Hot flushes are few and minimal, the major symptoms for me were poor mental health, weight gain and aging skin/hair which both of which have changed a lot since my periods stopped.

[Tc]

Moz. Have you checked out the "daisy network"

https://www.daisynetwork.org/about-poi/what-is-poi/

You might find it useful. Xxx

[Emerald2017]

Hi! I started hrt at 41 and am on 2 years on it.
I had the same questions with you regarding the dose and the amount of estrogen I need.
My gyn and my endo said that if I am symptom free, that is the evidence that I don't need to increase my dose.
Take care! 💐

[CLKD]

   browse round. 

[Shannonplussed]

Add me as another early menopausee (at 42) who's been refused estrogen testing. My OBGYN just this morning, via telephone appointment, again refused to test to check where levels are, and said to go by symptoms only. This was harder initally, because my symptoms weren't the classic hot flushes. But over time, and it did take time, I noticed my sore coccyx find go away, my foot pain ease, etc.

[Kathleen]

Hello Moz and welcome to the forum.

I don't believe that your mother's arthritis and diabetes are related to her having been refused HRT so you are unlikely to suffer the same fate. Chronic inflammation is the main part of both her conditions so anything she can do to reduce inflammation with lifestyle changes will help her.

Wishing you well.

K.

[Bobidy]

I think the oestogel is great for starting out and when we are younger as it can be easily increased for symptom control by half a pump at a time. I think 2 pumps is the minimum for osteoporosis prevention? And that is the usual starting dose. I felt great initially on 2 pumps and then it started creeping in again so gradually increased half a pump at a time leaving a few weeks in between.

Ask if you can try Oestrogel and let your symptoms guide the dose.

Obviously you'll need progesterone if you have a womb.

Take care x

[CLKD]

Blood tests are reliably un-reliable  my Gyanae goes on symptoms.

Do you keep a mood/food/symptom diary?

[Sammiejane]

hi moz

i had full hysterectomy at 35 ovaries removed too
i had no hrt for 4 yrs and i am 41 this year i've had a battle the last 18 mths of hrt mainly being estrogen alone didn't suit me felt awful i now take combined gel and utro daily and only use 2 pumps and my estrogen level after 5 weeks was 435 pmol which according to menopause is excellent , i used to before use the gel on my thighs but couldn't asorb it very well and my level on 2 pumps stayed at 115 roughly which was low if that helps at all .

but i?m not quite there yet i?m better but need tweaking and few other side effects appearing and few flushes back so it may be i need to increase by half pump