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[Jolo]

Hi All,

I've been lurking extensively for well over a year, but am yet to post. I've learnt so much!

I'm 49 and in peri. I've been on the same HRT for 11 months (Everel Sequi) because my Dr thinks that there's no point in changing to a different method of delivery for oestrogen or trying micronised progesterone 

Anyway to cut a long story short I managed to get a registrar at a menopause clinic to direct the GP to do a blood test for Oestrodial level. The result was 320 pmol/L.

My question is two-fold:
  Is this level too low?  (I'm still getting symptoms) what I mean is it an appropriate level to have if you're on evorel sequi?  And...
  If you're on HRT does it make any difference which day you have the blood test on? The registrar said no, but I can't get my head around that, considering levels fluctuate so much during peri.

Thanks in advance.

Jolo

[Floo36]

Levels of Estrogen in the blood and what level makes us well is very individual, some may be well on 300 others may need 1000pmol.  You are right in peri there can be wild fluctuations, I did 6 tests over 10 days and they ranged from 400 to 5000 so very chaotic.

Can you ask again to try a higher dose or different type?

[EllaAurora]

Hi Jolo,

The blood test per se seems OK, not very high but also not particularly low. BUT, as discussed here many times, the levels are just so individual that what works for one person doesn't work for another. If you continue having symptoms, then it would indicate you need perhaps a higher dose.
In terms of time of the day for blood test, I haven't heard it would make any difference.

Can you get referred to a menopause clinic if you doctor is reluctant to reassess your situation?

Take care! xx

[Hurdity]

Hi Jolo

 

That is a perfectly respectable oestrogen level objectively - and for osteoporosis protection but to alleviate symptoms, as has been said - you may need more. Also as you are still young I would say aiming for a bit higher oestrogen dose .

However in terms of the test - more important than time of day, I would suggest, is the point in the patch change cycle when the test was done - just after patch change, halfway through or when it was due to be changed? Mine varied enormously - was around 90 pmol/l at patch change time and almost 200 half way through or just after patch change.

What are the symptoms that are still troubling you? If you are still experiencing flushes or sweats then you definitely need a higher dose of oestrogen if no other reason for these. If so also do they occur at a particular point in the cycle? What were your periods/cycles doing before you started hRT - were they irregular?

Answers to these questions may help us to help you better.

Hurdity x

[rebeccalockwood]

I also need advice about levels. My estradiol is 87pmol/l. I’ve been advised to up to 3 pumps of estrogel but I feel tired all the time. This seems low. Don’t know where to turn tbh. And wtf is an androgen index of 1.3%🤦‍♀️

[EllaAurora]

Hi Rebecca,
sorry to hear you're not feeling well.
While we shouldn't get too fixed on the estradiol levels (in the end its the symptoms that matter), objectively speaking your level is low, especially if you're on Oestrogel. This could indicate poor absorption and it would be good to speak with a doctor to assess if change to another type of transdermal might be helpful. I was also thinking if there's something related to how you apply the gel. Are you applying on clean, dry skin (no moisturiser before), and doing it consistently every day?

I don't unfortunately know what androgen index is -but there're lot of smart ladies in the forum so I hope someone will be able to help with that.

Hope you'll feel better soon & let us know how you get on! xx

[rebeccalockwood]

Many thanks for your reply. I'm going to go back to my GP and look in to changing to the patch. My symptoms are pretty bad but I'm especially lacking in energy and my brain fog is off the scale.

[juliemargaret]

Same here Rebecca. 8 weeks on gel and for 2 of these weeks I’m on 4 pumps of gel. Feel awful. Jittery as if I’ve been plugged in and waking with migraine on left side of eye. I’ve been splitting dose - x2 morn x 2 around teatime 5/6ish  but realised last night that about 3 hours after application and when get in bed I feel like - hard to explain - but like an inner buzzing and my body and mind are calmly awake !!!! So I’m sleeping but not! I’m either on too high dose of estrogen and the gel isn’t for me (2nd try with same gel) or the evening application isn’t good for me or both!!! I’m reducing to 3 pumps today as don’t feel well. I hope you manage to get patches and feel better soon. I’m going to try get them too. Very disheartened as wanted the gel to work but I don’t feel right .