Print

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

[vintagefiend]

Hi,

i've googled and got mixed results to my question!
i had womb and ovaries removed one year ago
i'm 50 and reached menopause around 47 so was post meno when had op
i'm finding it difficult to manage hrt, particularly testosterone therapy (but also oestrogen)- i absorb testosterone far too easily and have sky-high levels on minuscule amounts.
but i find having low natural levels- due to op- difficult too.
i've been having pivate blood tests and have found that my shbg levels are very low which, in turn, probably accounts for my being over-run with testosterone when i try it.
i've discovered that the main cause of low shbg is obesity and, while i'm not quite in that range, i am overweight, sedentary and have included a fair amount of sugar in my diet over the years
i realise now that in order to metabolise the hrt i so desperately need, i need a lifestyle overhaul!
i have begun this: better diet and and gentle exercising at first as scared of injury- but have graduated this week to you-tube joe wicks hiit sessions (beginners)
i've brought my shbg up somewhat but it's still very low
nevertheless i tried a tiny amount testogel once this week and was quickly overwhelmed by it!!
i've spent the week wishing i hadnt taken the testogel yet- feeling pretty grim- but managing to do the hiit sessions.
i'm getting morning palpitations, difficulty sleeping and just feel like i do when had too much of a hormone medication
i had such a tiny amount testogel and wondered whether the exercise has magnified it?
at the same time i kind of expect exercise to use up hrt?
going to persevere as a healthier lifestyle can only be a good thing
guess i'm just wanting results fast when i'm actually undoing years (decades!) of bad living!!
just wondered if anyone had any thoughts
also- very niche question: what happens to the testosterone/oestrogen that's bound to the shbg? is it ultimately dispensed with or is it released at a steady rate over time?? dr google is not helping!
my understanding is that low shbg means lots of a hormone that is dispensed with quickly
thank you

[Gnatty]

It's so difficult to know what causes what isn't it! Your symptoms of trouble sleeping and palpitations could be low oestrogen. When you say you felt grim after taking one tiny dose of testosterone, what were the symptoms? My understanding was that it took quite a bit of time to build up testosterone. You may remember that I am in a similar position to you in that I had hysterectomy and oophorectomy six months ago. I wasn't in menopause but was already taking hrt, and I'm 55. It was a complete shock to the system! My blood tests have been postponed twice now so still don't know what my levels are. But I take a lot of oestrogel, 5 pumps and also testosterone. The reason for my high dose of oestrogel is because before my operation I was taking 3 pumps and then afterwards despite that got symptoms of low estrogen so needed to increase the dose. I feel mostly ok but I am also taking a low dose of mirtazapine and that may be contributing to how I feel. I don't know about exercise and effects on HRT. So far I am only fast walking and a bit of exercise bike. So far so good. Will be running again in next week or two so will let you know how that goes x

[vintagefiend]

hiya gnatty and big thanks for your reply!!
glad you're doing ok and it really helps to have the perspective of someone in the same- post op- position
totally agree that it's hard to know what exactly is causing symptoms- definitely there is goldilocks zone for these hormones and i don't manage well when too much hrt or too little! but it's finding that sweet spot which i now suspect shifts over time
when i take testogel- i start to feel very bleak, shaky, anxious and when i've had bloods checked they were significantly high (over a month or two my hair started falling out in clumps and i had bad acne)
i think it's the "free testosterone" result that is important overall (as opposed to just testing for total)- because that is what is usable; it's not bound to the shbg. people wth low shbg tend to have high free testosterone (and tend to be fat, like me )- i think it's also a sign of pcos as well but obvs not applicable.
i'm not saying your shbg is too high, by the way; i think, as you say, testosterone is meant to take a while to have any effect and i've always wondered why i'm such a weirdo with it!!
i'm really pleased that you're doing so well so soon and hope you can get back to running- in my head it's a good sign that you need highish levels of hrt- i think it shows that you're healthy!! sound like a bit of an armchair scientist, don't i!
so i'm going to continue trying to eradicate the effects of a misspent youth (and beyond)- i do believe this is the way to go and i've never felt as inclined to get myself into shape as i do now.

[laszla]

Hi vintagefiend,
I can't help much with this but am also interested (aka desperate to know) about the connection between SHBG and absorption of hormones because I have the opposite problem, ie a very high SBGH and a really low level of estradiol in my blood test despite 3 years on HRT, something I've recently discovered and now feel I've lost those 3 years.
My testosterone total level is ok but as you say it's the free/bioavailable amount that counts and my testosterone is low if you approach it that way.

I've had no real answers (not just from google but also docs) about the link between SHBG and absorption of T or E2.
But I do firmly believe an exercise regime is a great idea in any case and there is practically no condition physical or mental that it wouldn't help so I'm sure you're on the right track there

[vintagefiend]

hi laszla,
thanks for the reply
it's a pain, isn't it? sorry you're having absorption issues (in the other direction)
we really could do with understanding what the hell is going on!! i agree that exercise can only be a good thing but is there a limit to how much and what type should be undertaken?? it's confusing as, of course, professional athletes don't appear to struggle with hormone deficiencies- no obvs outward signs.
i think i've read about prof female athletes' periods sometimes stopping as a result of their sport but this may be a body fat ratio thing maybe?? though i imagine that's all linked to shbg
are you experiencing issues with having low oestrogen levels? menopausal symptoms? mood and/or physical?
from what i've read there seems to be agreement that shbg has a strong affinity for tesosterone- and a lesser but still noticeable affinity for oestradiol
i renewed oestradiol patch this morning and feel a bit overwhlmed on it- i'm sure the exercise i did depleted the previous one as the dose doesn't feel consistent!!
something i gleaned from google was that an ideal female shbg range was between 60 and 80 (forgotten unit of measurement). it was prob just some random on the web but i'm working towards that and will see how i feel if and when i get there!! could you find out your shbg? i do mine using medichecks online finger ****. i know it's kind of playng doctor but i've found it to be helpful
wishing you well x

[laszla]

It is indeed a pain having to train as a medical detective...
Re athletics, I believe that quite intensive resistence/weight training can raise testostetone levels and yes women athletes do sometimes stop geting their periods and get osteoporosis because of low body fat.
I would think you would have to do quite hard core training though to significantly affect your testosterone levels and pretty much all schools of thought advocate a combination of weight training,aerobic and stretchy-type exercise like yoga/pilates.
I hear good things about the Joe Wicks workouts.

My low estrogen is absolutely causing poor quality of life, not hot flushes which I've never had but chronic fatigue, brain fog and strong anxiety. Very very occasionally, perhaps one day every couple of months I feel normal and that brings it home how abnormal it is to feel the way I do most of the time.
My recent blood test confirmed the low estrogen but doesn't help me in the short term because the hospital follow-up is 5 months after the initial appointment and I can only imagine my GP's lack of responsiveness if I go and grill them on SHBG.
My SHBG is about 140 and the reference range given at the hospital where I had it measured is 30-100 so it makes sense that the 60-80 you mention would be the ideal happy medium.
So I will start experimenting with higher estrogen dose and then monitor my blood levels myself if necessary.
All the best x

[vintagefiend]

Hi Lazsla,

sorry it's taken me a while to respond- my son kindly gave me his sickness bug over the last few days!
and i'm sorry that you're having a rotten time- i hear you re just wanting a normal day and occasionally experiencing one which shows that you really haven't been functioning properly all the other days
i'm currently stuck in a cycle of early morning palpitations/anxiety that mean i haven't had proper night's sleep for a while- just colours everything 
i'm hoping, though, that it might be a sgn that my shbg is going up and my oestradiol/testosterone is correspondingly going down- itwould make sense: worse before better
that's interesting that weight training can raise testosterone- it corroborates something i've read somewhere!! i'd be really interested to know whether my lack of ovaries would inhibit production- there's always testogel, of course
it's conusing of course because, at the same time, restricted diet/exercise seem to raise shbg (?lowering testosterone therefore) but yeah, def read that certain types of exercise do different things. long distance running can lower testosterone??- think i've read that somewhere.
at 140 shbg you def have the opposite situation to me! mine was 27 initially - so we just need to meet in the middle!!-  with some dietary changes and some light activity i got up to 41 - it then plateaued so i started the hiit regime
good luck to you with the higher dose of oestrogen- how much are you on? understand what you say re gp and shbg- i couldn't face asking for any of that!
i guess the one good thing is that your blood confirms low oestrogen and that totally explains why you're feeling so rotten. obviously the trick is now to raise it- i have heard of women on here taking quite large amounts oestrogen hrt but imporantly under the superision of a specialist. GPs may well be reluctant to prescribe too much and the private route is often the best way. i've def read about women at the newson clinic for example, having higher oestrogen regimes than you'd expect a gp to feel comfortable prescribing
wishing you all the best x