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[Flan747]

I have been on Sandrena 4mg for 6 weeks now and symptoms practically remain the same! I am a poor absorber and was wondering whether to increase to 5! I’m day 22 of my cycle ( although I had Mirena coil fitted 2 weeks ago) I can feel mood anxiety and palpitations increasing! As I’ve posted many times before getting fed up of feeling rough everyday!
Any suggestions welcomed !
I am under a specialist who I emailed Friday but no response as yet?

[Uptick]

Hi again, Flan747. Two things could be happening, you might be a poor absorber, and in that case you should change to a patch instead of increasing to 5 sachets, and Mirena could be opposing the action of estradiol, in that case you need to wait until your body adjusts to levonorgestrel.

Doctors are very busy people 

[Flan747]

Thank you Uptick I don’t feel like the coil has changed anything i feel the same as before having it fitted! I have tried Everol and it sent me manic for whatever reason I’m not sure! Although I did go on 50 for a week then up to a 100!
Yes doctors are very busy i work with them haha 

[Uptick]

Hi Flan747, I guess it's too early to know what could be wrong, if there's anything wrong. It usually takes 12 weeks for HRT to settle. I would wait a bit longer. Have you got that email from the specialist?

[Flan747]

That’s true! This is my 4th 12 week wait  so will keep going ! No haven’t heard back yet! To be honest I get more help on here so not going to stress about it !
Thank you for your replies they really help

[Uptick]

I see that you have decided to increase the gel. You're a poor absorber. It won't make a huge difference and you can be intoxicating yourself with so much alcohol from 5 sachets. Why are you not keen on trying a patch? Have you tried them before?

[Flan747]

Hi Uptick. Yes I increased to 5 as symptoms were bad and need to be doing something but I really do know what you mean maybe it’s just not going to make much difference. I tried Everol 50 for 2 weeks then went up to 100 for about a week and had to rip it off as symptoms went through the roof! Do the patches absorb differently to the gel?

[Uptick]

Yes, patches and gels have completely different pharmacokinetics. And different patches can also differ in fillers and matrix design that affect absorption rates. You can try 75 mcg Estradot or 80 mcg Estraderm. The important thing is to wait for them to achieve constant levels (3 months) before despairing and changing regime again. It's not easy, but that's how it is.

[Flan747]

Ok thank you for that! Your knowledge is mind blowing and I feel more than the specialists  I do feel at this time the patch would now be a better route but again nervous of change even though this isn’t working if that makes sense! I will wait for the specialist to get back to me and see what she says! I know one thing I can’t go any higher with the Sandrena!! May I ask in your opinion if my levels are higher now than when I last tried the Everol would that help should that help with the change over to patches ?

[Uptick]

I understand you don't want to change before 3 months, but 5 sachets is just too much. Even if you feel better after this time you might need a future tweak which is often the case with HRT and you would probably end up having to change regimes, because 6 sachets... Let us know what the specialist says.

I'm not sure I have understood what you're asking. Have you had your estradiol blood levels tested when you were on Evorel 50 and 100? Your levels could have fluctuated during the transition from one regime to another and maybe that's the cause of your symptoms (manic, anxious, having palpitations). To achieve steady levels is the ultimate challenge, imho.

[Flan747]

Totally get what your saying about the Sandrena and yes will definitely let you know what the specialist says!
Sorry what I meant was when I tried the latch my levels were a lot lower so if they are now higher would the transition be a little easier if I were to absorb the patches better than the gel!
Thank you again for your replies

[Uptick]

I've just read some of your posts, you're in perimenopause. Maybe your ovaries are producing estradiol (albeit erratically) and that's what's causing the symptoms. HRT sometimes is not enough to override these fluctuations.

Are you still taking melatonin? It can stimulate aromatase expression and estradiol production in the ovaries.

It depends on the patch, they're not the same. Trial and error, I'm afraid.

[Flan747]

Yes I am peri normal regular periods! No I stopped the Melatonin a while back as it didn’t make any difference to my poor sleeping habits! Will keep you posted on what I decide and how it all goes 

[Uptick]

Maybe discuss a BCP instead of HRT? Have you ever taken them?

[Flan747]

That has never been mentioned? Does that effect your estrogen levels? Would that help with symtoms? Sorry I don’t know anything about BCP! Stopped taking them when I was 21!