Print

Please login or register.
1 Hour 1 Day 1 Week 1 Month Forever
Login with username, password and session length

[EllaAurora]

Hello ladies,
Seeking your smart advice again.

I had a check with gynae following my recent move to Patch 50mcg. I wanted to see her as unfortunately my symptoms have not really improved still and I wanted to understand what's going on. I've had the feeling that my own oestrogen would be very low and that most of my oestrogen would be coming now from the patch. As my symptoms have continued, I hypothesised that perhaps the 50 mcg patch is too low and we agreed with gynae that I may try 75 mcg patch and see if I get on better with it.

To my surprise, the blood test result just came and my estradiol was 480 pmol/l, which in my scale is high. Previous readings have been somewhere around 160-240 pmol/l. Now I'm really confused as to what to do next. I doubt that I should be going even higher with estradiol, so I'm wondering if I should just stick to the 50 mcg patch until my next visit to gynae in a couple of weeks, or even consider cutting down the dose a bit? It seems that contrary to my own feeling, there must be some endogenous oestrogen production in my body, as otherwise such a high reading with 50mcg patch doesn't seem to make sense.

Any experience on this level, is 480 as high as it seems to me? And would you keep the current patch at this time or increase/decrease?
Unfortunately I will not be able to speak to the gynae before second week of August, so I need to decide something on my own now.

Thanks a lot again for your support! xxx

[Nas]

How do you feel in yourself?
These readings are quite a minefield I think and as long as the medics are quoting the 'ideal' levels for protecting brain, bones and heart, I have come to the conclusion that we are going to fixate more on them, than how we actually feel in ourselves?

I say this because I had an appointment with a meno specialist on Monday. I have been on the 75 patch since last August/September and have had loads of bleeding whilst on it. I said I felt my mood was better than on the gel and felt more balanced, but bleeding was getting me down and some symptoms were not really under control. She recomended to begin with, to lower the patch dose from 75 to 50 (with a synthetic progesterone). I am on day 1 today. No idea how it's going to go, but she said we have flexibiliy and options.

So back to you Ella. Your reading seems reasonable. BUT your symptoms have not improved. If it was me and I was not feeling great on the 50, I would be looking to increase to the 75 and monitor how I felt. It may be that your reading needs to be even higher for you to feel good and that is okay. Some women feel well with a reading of 100 or less. Before I even went on HRT, I had a reading of 750 (my own hormones must have been dropping!) I also had a reading of 400 with sky high hormonal anxiety. My last reading wasn't even detectable and I didn't think I felt too bad!

So, I say, ignore readings for now and go on how you FEEL :-)
If you feel grim on the 75, drop back to 50. Or switch to a different patch brand? Or, there is the new (ish) spray to try (Lenzetto). Plenty of options.

Good luck.

[Nas]

Forgot to say Ella, sometimes we have have to take matters into our own hands with our hormonal health and not necessarily wait for the medics to guide us. We know our bodies better than anyone. I am not shy of experiementing with types and doses of HRT myself, simply because you can wait an eternity to see the right people. Then if I haven't given a regime the correct length of time, or I feel rubbish, it is my own fault. I think we need to try and empower ourselves sometimes.

[EllaAurora]

How do you feel in yourself?
These readings are quite a minefield I think and as long as the medics are quoting the 'ideal' levels for protecting brain, bones and heart, I have come to the conclusion that we are going to fixate more on them, than how we actually feel in ourselves?

I say this because I had an appointment with a meno specialist on Monday. I have been on the 75 patch since last August/September and have had loads of bleeding whilst on it. I said I felt my mood was better than on the gel and felt more balanced, but bleeding was getting me down and some symptoms were not really under control. She recomended to begin with, to lower the patch dose from 75 to 50 (with a synthetic progesterone). I am on day 1 today. No idea how it's going to go, but she said we have flexibiliy and options.

So back to you Ella. Your reading seems reasonable. BUT your symptoms have not improved. If it was me and I was not feeling great on the 50, I would be looking to increase to the 75 and monitor how I felt. It may be that your reading needs to be even higher for you to feel good and that is okay. Some women feel well with a reading of 100 or less. Before I even went on HRT, I had a reading of 750 (my own hormones must have been dropping!) I also had a reading of 400 with sky high hormonal anxiety. My last reading wasn't even detectable and I didn't think I felt too bad!

So, I say, ignore readings for now and go on how you FEEL :-)
If you feel grim on the 75, drop back to 50. Or switch to a different patch brand? Or, there is the new (ish) spray to try (Lenzetto). Plenty of options.

Good luck.

Hi Nas, thanks for taking time to respond -really appreciate it!

How do I feel? That is a great question and one that is not straightforward for me to answer. Mentally I feel like I could imagine someone feeling with too much estrogen stimulation (jittery, anxious, fast heart beat etc), but my body feels dry, I've lost weight, and I"m not feeling the slightest amount bloated, so from these signs I'd read I probably have too little estrogen...

Due to my bodily sensations I was inclined towards being on the low side with oestrogen, as I know anxiety etc can also be caused by low oestrogen. But now seeing the reading with 480 I'm likely to think maybe it is the other way around...

Interestingly, during the time I've had estradiol measured, I've felt best (mentally) when it was 90 (before HRT). But I obviously don't want to go that low again, as I do want to get the benefits of HRT for brains, heart, bones etc. So I'm trying to figure what would be the lowest amount that still provides this protection, but would allow mental stability as well. Or does such level even exist..?

So true this is a minefield and the only way we can manage is to take ownership like you say!! I'm currently inclined towards keeping the 50 mcg for a little longer, and see if it starts to settle. If not, I might experiment going slightly lower first, and if it leads to worse, then moving up towards to the 75.

Hopefully you'll get on well with the 50 mcg patch and the bleeding will be controlled! Please keep us posted on your journey and good luck!
xxx

[Nas]

How long have you been on the 50 for Ella? If it is a very recent increase, then you will have to give it time I expect.
I am wondering whether the hormone receptors are starting to wake up for you, but you are not quite there yet?
I guess that is why they say start low and slow with HRT, so you can really monitor how you feel for a good amount of time.

I think it is very hard to strike that balance and I have no idea how women do it.
Symptoms off high oestrogen can also replicate that of low oestrogen and I am never sure of how that works??

Time is off the essence on the HRT journey Ella... just sit back and try to ride it out (I keep telling myself that too!)

xx

[EllaAurora]

Hi again Nas,
I'm now 3 weeks on the 50 mcg patch, so it is short time.. but I'd assume enough to get a directional insight as to whether its going for better or worse... The thing is though that I have no clue. I switched from gel, which became a nightmare (I was absorbing too quickly and it caused huge swings up and down), so compared to that I am for sure more stable. So based on this, I can say that patch seems to be a better fit for me than gel. Beyond that, impossible to say. I'm thinking now that perhaps when I switched I should have started with even lower dose (37.5) and built from there, rather than going straight to 50. But I am where I am and as said, if it doesn't stabilise with this dose, then need to decide whether to decrease or to increase.. Perhaps I'll give this dose another week, so then it would have been full 4 weeks.

And totally agree, I don't get how other ladies strike the right balance!! Or maybe it is that many women are quicker to adjust to a given dose, even if its not the perfect and ideal, whereas I seem to be the sensitive type who needs exactly the right amount in order to feel well. 

Riding it out is a great advice and pretty much all we can do, so I'm trying my best to be patient. Its just that its already been so many months that have been almost completely ruined because of this and I'm starting to be really tired -would just love to be at least a bit more like myself and enjoy life a little, with the summer holiday and all.. Sorry for the burst...just feels so good to let the frustration and self pity out somehow!! 

Thanks again for your support and take care of yourself too! xxx

[Nas]

Yes I hear your frustrations Ella..
I was the same on the pump gel, hence the switch to the patch.

Hindsight is a wonderful thing, but you are on the 50 now, so as you say, try to ride it out a couple more weeks. I know they say 3 months, but going back to my MS on Monday, she said 4 weeks and you should start to know where you stand with the dose.

I think put the levels aside for now and concentrate on your daily well being. I am going to keep a diary of how I feel day to day. If after a couple more week, your main symptoms are still dragging you down, then think about increasing? Will you have your appointment by then? Is your GP taking charge, or a specialist in menopause?

Hang on in there, we are all on this ride together ! xxx

[pepperminty]

Hi,

just thought i would add that it is a good idea to have a diary as changes can be subtle. The balance app can be useful to track symptoms also. It took me 3 months to feel better on a regime and once stabilised I tried a bit of minor tweeking by increasing tiny amounts - quartering tablets  . Dear lord the things we have to do.

PMxx

[Floo36]

Hi Ella,  try not to focus on blood estradiol levels it’s about treating the symptoms.  I’m peri and bloods misled me for the last 2 years into thinking my Estrogen was too high but in fact they were just fluctuations, I did a number of tests over a couple of weeks on the same dose of HRT and the bloods ranged from 400 to 5000 which proved to me they were not the HRT but my own spikes and drops.  I now go on symptoms.  We are all different in what our levels need to be.  On the menopause doctor website there is a fact sheet about Estrogen blood levels that is worth reading. 

I get jittery, panic, shaky, anxiety and it’s because of severe fluctuations and low Estrogen. 

[EllaAurora]

Hi,

just thought i would add that it is a good idea to have a diary as changes can be subtle. The balance app can be useful to track symptoms also. It took me 3 months to feel better on a regime and once stabilised I tried a bit of minor tweeking by increasing tiny amounts - quartering tablets  . Dear lord the things we have to do.

PMxx

Hi Pepperminty,
thanks for your suggestion, and yes, agree -I've kept the diary now for couple of months and its true that as changes are subtle and the human memory is not perfect, its quite helpful to see what has actually happened. I need to check the Balance app, is it the one from Louise Newson?

When looking at the diary I can see that I'm improving vs the spring and patch is working better than gel, which was a disaster. Still not clear if patch is the right solution and if the dose is too low/high -I can feel its not right, but beyond that will need some more trial and error.
Thanks for your support and hope you feel well!! xx

[EllaAurora]

Hi Ella,  try not to focus on blood estradiol levels it’s about treating the symptoms.  I’m peri and bloods misled me for the last 2 years into thinking my Estrogen was too high but in fact they were just fluctuations, I did a number of tests over a couple of weeks on the same dose of HRT and the bloods ranged from 400 to 5000 which proved to me they were not the HRT but my own spikes and drops.  I now go on symptoms.  We are all different in what our levels need to be.  On the menopause doctor website there is a fact sheet about Estrogen blood levels that is worth reading. 

I get jittery, panic, shaky, anxiety and it’s because of severe fluctuations and low Estrogen.

Hi Floo36,
Thanks for your message, appreciate it! And yes, going by symptoms should be the way, it's just that for me the symptoms are also not that clear and I often struggle to differentiate between high vs low (except when very low, then I'll get hot flushes). So I've felt combined with the bloods I've had a bit more to work on, though of course with the risk of overreacting based on the reading. I need to look up the material on blood levels that you refer to!

At the moment I'm starting to suspect that I may not be absorbing the patch correctly and not getting an even dose from it. I had the issue with gel that I was absorbing too quickly and getting really bad reactions 1-2 hour after applying. Then, the dose was wearing off prematurely and I was on a constant up and down fluctuation which caused horrible symptoms. Now with patch it is more stable, but I still feel a small 'rush' a few hours after changing the patch and get a feeling of oestrogen being high, and then on day 3 it feels there's nothing left and I get symptoms which feel more 'low' than 'high' (though as said, for me its only guessing in the end). I wonder if absorbing the patch too fast is even possible, though, as it should be releasing only a certain amount per hour... Perhaps I'll put this question separately in case someone would have more knowledge on this.

Thanks for support and hope you're feeling well Flo36!

[Gilla999]

One other comment to add Ella is that I think Progesterone plays a large part in this too, because of the nature of how they balance each other out. So for example if my Progesterone is higher I am less likely to feel symptoms of high estrogen. It's all a bit of a delicate balance/symphony and I'm still in the process of what works best for me, with both Utrogestan and Estrogen. It can definitely take a while! x

[EllaAurora]

One other comment to add Ella is that I think Progesterone plays a large part in this too, because of the nature of how they balance each other out. So for example if my Progesterone is higher I am less likely to feel symptoms of high estrogen. It's all a bit of a delicate balance/symphony and I'm still in the process of what works best for me, with both Utrogestan and Estrogen. It can definitely take a while! x

Hi Gilla,
this is so true! I'm currently on 100mg continuous utrogestan. I feel it's on the low side and ideally I'd have a bit more. I had couple of weeks on 200mg dose, as gynae wanted to see if higher amount would work better to stabilise the mood and reduce anxiety, but that was again too high dose and I felt very tired and drowsy during the day.  Probably the ideal for me would be somewhere in the middle, unfortunately such dose doesn't exist, so now I'm trying to hang on with the lower dose.

How do you combine oestrogen and progesterone? Are you on continuous or sequential treatment?

Hope you feel well and thanks for support! xxx

[juliemargaret]

Hi all. I recently had estrodiol blood results of 1795 pmol! (Just did a post asking for any help or advise) I am on 100mg Estradot . I started gel but was awful so after 2 months changed to patches and started on 75 upped to 100mg. When i began the patches i decided to have a utrogestan break to see how I was on the patches and if absorbing. I got Covid a week on so wasn’t really able to identify if was feeling good on the increase as was so unwell with Covid!  I have been 2 cycles now without utrogestan but just had a bleed. Need to re introduce it Im Aware. The Meno doc said my estrodiol was high! She mentioned tachyphlixis (however it’s spelt!) but said of o felt ok on 100 to stay on it but if no better to reduce to 75mg for a while! No idea what to do as no real guidance but worried about the 1795pmol result !!! Could it have been unopposed estrogen as missed the progesterone cycles?

[EllaAurora]

Hi Jmargaret,
1795 is indeed high, but I wouldn't worry too much if the doctor didn't and if you feel OK. That's the most important thing, as during peri there can be erratic fluctuations.

If I'd be you, I'd probably try to get another test in the next couple of weeks time to see if the high level persist, just to get a peace of mind. Maybe try to also get a phone call or send email to the meno doctor that you've seen and share with her that you are still concerned?

Take care!! xxx