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[DottyP]

I hope someone on here can help me figure this out….

My back story: A huge amount of stress and covid in 2020/2021 caused me to crash last September.  I could barely function.  After many tests coming back clear (heart/lungs/bloods etc.) I started HRT in October.  Oestrodose was given to me and at one pump I was a changed woman.  The Utrogestan didn’t work orally but vaginally was ok for part of the cycle.  Next prescription was Oestrogel and a lot of my symptoms came back so in Jan this year I was moved onto Lenzetto and told to work up from one pump to possibly 3.  After a few weeks a lot of my symptoms settled on two pumps but there were still some there so I upped to three pumps and after 10 days I crashed again.  i was in all sorts of trouble, as if all of my peri symptoms had come crashing down on me at once and magnetised by a million.  The meno specialist said she thought I was on too little and maybe the spray had stopped working or was faulty.  She advised me to go up to 4 sprays and if that made things worse, to go down to two.  In my mind I was wondering if it was actually too much Oestrogen rather than too little so I went down to two sprays and after a week things started to settle…until I neared the end of the bottle again and the symptoms all started to come back until I opened a new spray and things settled down again.  My trust in the Lenzetto had gone after this happening again and the consultant agreed I should change and try Sandrena.  Then I got covid again.  Pretty badly (not hospitalised) and was in bed for 10 days. 

After a couple of weeks I started the Sandrena - 1 x 0.5mg sachet a day.  The consultant said to start on that and work up to two sachets as she thinks I’m on a low dose even though my last bloods were 500 (I think) which isn’t too low as far as I’m aware.

Where I’m at today is that I have been housebound since catching covid.  The gp thinks its covid recovery but now I feel I am crashing again like before with the oestrogen issues.  I am on 1 sachet and an extra dot and my heart is racing, I’m jittery, full of panic, my head feels like it might explode, I feel constantly sick, had migraines and I’m totally on edge again.  I can’t drive, I can’t look after my son, I can barely feed myself.  I cannot go on like this and I am pretty sure it’s the Sandrena causing this now (5 weeks post covid) but I don’t know if it’s because I’m having too much or too little and no one else seems to be able to tell me either.

What should I do?  Has anyone else experienced anything like this?  I’m at my wits end.  My son shouted that he wants to see a therapist at the weekend and I’m so worried about him now but not in a position to be able to help or do anything or think straight without it causing huge panic. 

Sorry for the long post but I really don’t know where to turn.  I’m a single parent, no support, his father lives in Canada most of the time but isn’t any help when he’s here anyway.  Family don’t help me.  Friends are all busy etc. 

[ATB]

I’m sorry for your health problems, it’s truly hard stuff to deal with.

What were your symptoms before HRT?
Have you ever had extensive hormone testing, a full womens hormone profile? Checking thyroid, sex hormones, adrenal, everything? It may help to do something like that?
I don’t know enough about the various types of estrogen, I’m on Evorel. Hopefully someone with more experience comes along soon.

[DottyP]

Thank you @ATB.  My symptoms pre HRT - I realise now - had been building for a number of years.  There must have been about 30 at least.  Ranging from dizziness, anxiety, panic and racing heart to chills, extreme fatigue, terrible itchy skin, VA in the second half of the month, tinnitus and sore eyes.  I had all the bloods checked last September/October before I started HRT and the fact that every single thing disappeared on one pump of the Oestrodose made me realise that it must be the lack of Oestrogen. 

[ATB]

My understanding is that some people do not tolerate some forms of HRT so that may be your issue.

[sheila99]

Usually if you have a problem with a paerticular hrt it's caused by progesterone. The meno symptoms is a matter of getting the oestrogen dose right. Some symptoms of too much oestrogen can be very similar to those of oestrogen deficiency so it can be difficult assuming you're still peri you can have your own peaks and troughs too. One pump oestrogel/oestrodise is a low dose so I don't think you will now need a high dose. It's a pity you were changed to other types as this muddies the waters, it might have been better just to increase the dose a little until your symptoms went. I would suggest you use a dose equivalent to 1.5 pumps oestrogel for a few weeks and see how you are on it. One pump wasn't enough but you don't do well on a high dose so probably you need 1.5 - 2. It would seem sensible to start lowish and work up slowly. I believe 0.5 sandrena is equivalent to one pump oestrogel? So perhaps it is a little low.
  Covid does seem to put a spanner in the works. My hrt stopped working for a month just because of the jab, I think the same thing can happen after covid.

[Hurdity]

Hi Dottyp

Sorry to hear about your HRT woes and effects of covid.

Many thing is - what was your cycle doing before you started HRT in October - how regular were your cycles? How often? Light or heavy? This will tell us where you are in menopause to some extent. Also how old are you?

Hang in there - it will get better....keep talking.

Hurdity x

[DottyP]

Hi Hurdity

Thanks for replying.   I’m 48.  Pre starting HRT my cycle was pretty regular in terms of dates each month, give or take a day or so.  I was having light one month and heavy the next but when I say heavy, I wasn’t really flooding and still mainly using the green tampax rather than orange.  The only strange thing was that the december before I had a period for 17 days that was quite heavy but it stopped and then went back to ‘normal. 

When I started HRT I initially just used oestrogen for a month or two to see how it would affect me.  I then started on the Utrogestan for part of the cycle.  Taking it orally - even one capsule - was horrendous for me. So I started taking one vaginally which was much better.  I would have a period 2 days after the last Utro per cycle.   Then the specialist told me I should be inserting two capsules vaginally for the 12 days.  Once I started doing this, my period takes longer to start after the last Utro - between 3-5 days.

Hope that helps.  Today I reduced the Sandrena to just one sachet of 0.5mg and feel less jittery for it.  My body has always been super sensitive to medications etc and I do think that maybe I just don’t need a higher dose right now?

[Jenny j]

If I were you I would stick to the lower dose for a while and see if you settle better.Try to stick with it I can't tolerate to high oestrogen it took me such a long time to realise but when I did I felt much better I hope you feel better soon it's truely horrid to feel like you do.

[Hurdity]

Hi DottyP - so given that your cycles were regular you were more likely to be in the late repreoductive stage rather than peri-menopause . Obviously it is not a sudden change but generslly speaking, the medical definition of peri-menopause is when the cycles start to vary by at least 7 days each month. Late reproductive stage though, is when hormones can start to go awry and some symptoms can start eg increasing pms. This stage can be difficult to treat from my experience of reading other women's stories on here because just adding oestrogen may not be the answer. It can be the fluctuations in both hormones that can cause the symptoms - oestrogen crashes etc (though adding oestrogen can lessen the effect of this).

Have you thought of the contraceptive pill? There are a couple that contain estradiol, the same as in gel and spray - called QLAIRA and ZOELY. The main thing is they suppress the cycle while giving you extra oestrogen and some gynaes favour these at this particular stage.  It is discussed on this website here:
https://www.menopausematters.co.uk/contra2.php

Another possibility is a low dose HRT tablet like Femoston which again contains estradiol and the progestogen component is very close to natural progesterone. It won't suppress the cycle but may control some of your symptoms. I know some women have found this particular one useful at this stage?

Hope this helps

Hurdity x

[DottyP]

Thank you Jenny J that’s good to know.

Hurdity you’ve just blown my mind 🤯.  Just when I thought I knew all there was to know about the peri menopause you throw ‘late reproductive stage’ into the mix 😂😵‍💫.

I have never heard of that.  I’m paying a fortune to see a specialist at Menopause Care and she has said the exact opposite.  That because my cycle has started changing with the higher dose of progesterone that I may be further alone than originally thought.   I don’t know what to think now.   Is there anywhere I can get more info on this?   

I def feel better on a lower dose of oestrogen though still not anywhere near 100% but can at least function somewhat. 

I don’t know what to do now 😢

[DottyP]

Plus I smoke so the pill and non transdermal or synthetic options aren’t right for me because of the clot/stroke risk