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[Shell babes]

Hello lovely ladies - quick question - I have just returned from the Gynaecologist to check that the marina coil is still in place - it is.  I mentioned that I am still struggling with anxiety and insomnia and am using Estradot patches 75.  I have tried to increase the dose to 100 but it sent my anxiety through the roof.  He said that I need to try a lower dose, maybe 75 is too high.  So, either a 50 Estradot patch or oestrogel, 1 pump to start with.  I did try oestrogel not long ago but applied 3 pumps and it was too much so put the patch back on. 

Not sure which to try and am I better waiting until my patch change day, ie either Monday or Thursday.  I am very sensitive to hormone changes and feel scared but maybe it's worth a try.

Any advice will be much appreciated.  Thank you in advance.

[Hurdity]

Hi Shellbabes

Wow I didn't realise that you had to go to a gynae to check Mirena. I thought it was done either at the local GP or family planning clinic? Anyway sorry to hear about your ongoing symptoms. How long have you had this Mirena and have you had one in the past?

Do you have  any idea where you are in menopause? 75 mcg is not a very high dose if you are post-meno but if you have your own cycle going on maybe the level becomes higher than it would normally be around ovulation. I'm not familiar with the idea of too much oestrogen because as I said around ovulation it is very high and most women feel at  their best then. However round about menopause it can spike so the fluctuations do seem to affect some women more at this time.

If you are stable with patches then I would stick with them (!) so to speak. You don't have to reduce to 50 mcg at least not straight away. You could try cutting off a small amount to give 62.5 which is what I use.  This would mean the reduction would not be quite so severe if you are very sensitive to hormonal changes? When I could get Estradot I made a small cardboard template by working out what 62.5 mcg would be and used to cut off a bit of the patch each time I changed. I still do this now with Elleste Solo but it's easier as they are larger and there are dots on the backing flim showing sections of the patch. You could also change patch every 3 days to give a more consistent amount so that your levels don't drop off quite so much by the 4th day? Again this is what I do.

Good luck and let us know!

Hurdity x

[Shell babes]

Hi Hurdity and thank you for your kind reply.

The GP surgery would not check the marina coil due to lockdown, therefore, my gynaecologist offered to do this instead.

I had the marina coil fitted on 14.03.20 and it is my first one.

I am 51 years old and my last period was June 2019.  I began HRT in September 2019 on Evorel sequi 50 but as my symptoms continued, the GP increased to Estradot 75 and Provera in October 2019.  After a terrible time, I was diagnosed as being progesterone oral intolerant and therefore, finally in March 2020, the marina coil was fitted. 

I did change over from Estradot 75 to Oestrogel on Tuesday this week but it was a disaster.  My hot sweats returned, I felt all over the place, insomnia and anxiety even worse and didn't know whether I was coming or going. 

Consequently, I have reverted back to the Estradot 75 patch and even though the last two days have been awful, it has made me realise that maybe the patch is working and some of the anxiety stems from my worrying about ?is this the correct regime for me.??  Everyone is different, but evidently for me, the patch must be giving me a consistent flow. My main problems have been depression, anxiety, insomnia and brain fog.  After reading Professor's Studd's site on reproductive hormonal depression (at menopause) and having had PND in 2004, I definitely fall into this category and am progesterone oral intolerant.  Very sensitive to any change in hormones.

With that being said, I will try to accept that this may all be starting to work if only I would let it.  In December 2019 my oestrogen level was ?high normal? - not sure what that really means....  but the gynaecologist seemed happy with that. 

The gynaecologist said that my testosterone was virtually nil so inserted a testosterone implant which lasts 6 months so I return for another blood test in June to see if I need another. It did explain why I had extreme fatigue and no energy.

Thank you for reading this long rambling tale. I do appreciate any advice that you may have.

[sheila99]

If you're happy with the patch that's fine but if you used one pump you got a third of your previous dose so hardly surprising it didn't control your symptoms. I use gel and I like being able to change the dose easily so I can find the dose that's right for me without having to get a different prescription. I've had a testosterone implant and wouldn't have another one. It took a month to work then stopped at 4 months so I only had the benefit for 3 months. I hope yours will be better. I use Tostran now. It definitely helped my fatigue so hopefully you'll feel better. If it doesn't help perhaps check mirena isn't the cause, I use Utrogestan cyclically but I get fatigue when I'm on it.

[Shell babes]

Yes, I see what you mean. I'm too scared to try again. I tried the gel once before (3 pumps) at once and anxiety and insomnia  sky rocketed so I probably applied too much at once. What a mind field.

I didn't notice much difference with the T implant but I can't get any T gel where I live. The GP says no, one gynae offered the implant and the other gynae said no as it's not licensed. Thanks for your reply.

[sheila99]

Are you in the UK? Ask for a referral to an NHS menopause clinic, they should be able to prescribe it. They will only give it to you for low libido though. How is your libido? If it isn't low (mine was zero) perhaps look for another cause of fatigue. It's one of those things that can a number of different causes so it be hard to get to the bottom of it. You need a menopause specialist rather than a gynecologist who often have little knowledge of it.

[Sammiejane]

hi shell babes

i use the gel but i have found the more estrogen i use my aniexty got worse so it might that your gp is right and that the dose needs to be reduced however it also need to control other symtoms . i recently upped my gel from 2 pumps to 2.5 however found i hot flushes back bloated and boobs swollen , however didn't effects my aniexty however when i went to 3 pumps aniexty through the roof , i didn't have aniexty before taking hrt ! i have to take progesterone to stabilize estrogen cause i was awful on the gel on its own and although i am post memo due to surgical meno hysterectomy and 2 pumps isn't that high a dose i can't tollerate any more my body dosent like it all though had no issues on the combined pill contraception which is a lot stronger but again had progesterone in it .

it is all about finding your sweet spot .
but sometimes more estrogen isn't always the answer i take 2 pumps which protects my bones and levels were good last time i had them checked and i've just started tesosterone so i?ll see how i go but if this dosent work i?m giving up cause i've spent 18 mths trying to sort right regime and felt my life has been hold whilst doing it xx hope u get it sorted x
i may try estradot my self if this dosent work x

[Shell babes]

Sammiejane - sorry to hear of your struggle, it's so bewildering trying to balance out our hormones. It makes it increasingly difficult as nothing is instant so you have to give every change you make time. I also feel my life is on hold, I used to be so outgoing and multi tasking. Now everything seems such a dread as I can't rely on how I will feel. Good to know I am not alone in this nightmare. Hope you get things sorted. It sounds like a balancing act too. Let me know.

[Shell babes]

PS / I agree that for me, too much oestrogen causes my anxiety to go through the roof. The symptoms for too much replicate the symptoms of too low a level, no wonder it's confusing!

[Shell babes]

Sammyejane - I just re read your post. Interesting that when you upped the gel dose, your symptoms came back. As you say, it's about finding the sweet spot .....