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[KaraShannon]

Hi everyone

I used to get facial flushing at the start of the pandemic just before I was put on evorel sequi. 

Once on it, the flushing seemed to stop.  It wasn't like a hot flush, I was never hot and I'd had this going on for about 7 years beforehand anyway, so it started when I was about 43.  The doctor ignored it, even once saying that if it happened while I was drinking tea, perhaps the tea was too hot.  I think I would have thought of that.  At the time I was trying to explain that it happened with food and drink only but he misunderstood.  I mean did he really think I was that daft I'd not notice if hot tea / steam was the cause, lol. 

Anyway, I went on evorel even though I was still having periods, I just thought things were changing somehow, muscle mass, some pelvic floor issues, just a number of small but obvious things if you put them all together. 

I noticed the flushing stopped.  It would happen rarely if I was late taking my thryoid meds, but otherwise it didn't happen.

Well this week I'm on the oestrogen phase of the patches.  I don't have any large ones left so I've just put four estradiol 25's on for now.  I figure its all the same as having my normal 50 patch and 50 supplemental patch?  I suppose I should look properly at the ingredients etc, but I thought they were all the same. 

It's just that I've got awful facial flushing.  I was dehydrated today, perhaps it's that.  Also salt craving and I was very late taking thyroid meds, it's was nearly 4pm, because of work pressure.  Maybe it's that.  Just thinking out loud really, wondering if it's lack of oestrogen if anyone knows what the options are?  Go up to 75 on the supplemental patches?  Is that safe enough or is that a lot of oestrogen?

Thanks.  Hope everyone is doing ok  :-)

[Hurdity]

Hi Karashannon

Personally I would not take even more extra oestrogen without additional progesterone as it could cause your womb lining to over thicken and lead to abnormal bleeding. You probably don't know whether you are still ovulating and if you don't then the only progesterone you will have is from your patch which may then be insufficient even for 100 mcg oestrogen since the licensed patch is 50 mcg oestrogen.

I presume all this is under medical supervision and you are being monitored by doc?

The change could be due to differerent batches - eg are they all in date the 25s? Also there is a greater number of egdes with 4 patches so possibly uncurling slightly leading to a lower dose which you may be more sensitive to?

Although I am not a thyroid expert in any way I would have said altering the timing of these meds may well have a far greater effect than the patches (though I have no idea about this!)- so personally I would just carry on with what you are doing and see if it all settles and then try to ensure you take your thyroid meds on time if you can?

Sorry I can't really help

Hurdity x

[KaraShannon]

Thanks Hurdity

You have helped as it's helpful to hear other's thoughts. 

I think it's time to review with the doctor, she did say I could increase the oestrogen from 50mcg to 100mcg if I wanted to try it, if I felt symptoms were coming back, but I didn't know the drug is only licensed for 50 mcg, I would have liked to know that.

Thankyou, I'll leave things as they are for now but will arrange to talk to the doctor.  I have wondered for a long time about seeing an endrocrinologist due to the thyroid as well...

[KaraShannon]

Update, I'm on my final oestrogen patches for this month and the last 3 - 4 days, lots of weird 'surging' sensations, heart symptoms (cardiologists have told me all tests are normal) like a bit of fluttering / skipping, and if I get up from sitting, a lot of head pounding.  I've always had that at certain times of the month, but I'd say now it's a lot stronger an issue than it was before.

I had all this before starting HRT 2 years ago, and now I've started getting it again.  I don't know if the 'surging' is because my body is trying to ovulate, which i think it might have been before the HRT was taken, or if I'm taking too much oestrogen.

I know it's been discussed above, I am going to talk to the doctor but still curious on other's thoughts or experience too.

I've had a bad cold and I sometimes get heart skips with that sort of thing too so that might not have helped.  Thanks for listening :-)