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[ATB]

Do you think that can happen from physical stress like the fluctuations in hormones? They say it can be electrolyte imbalance also but I feel you would have ruled this out already. Is it because your estrogen was raised too quickly? I can’t see back as I write this to your original comment but from memory, there wasn’t 7-12 weeks before each increase was there? It’s horrible but I wonder if you don’t adjust anything, if this would pass in a few weeks.

[joziel]

I definitely think the stress isn't helping but I don't think it's the cause. Because I was quite relaxed about all this to begin with and didn't even realise it was related to blood pressure. Like when I thought the bed was moving under me and realised it was actually me, I thought that was funny and some weird quirk involved in starting HRT.

So it has really been weeks and weeks before I've begun to be stressed about it. Definitely the stress then makes it worse and compounds it and makes it harder to get out of the state once I'm in it, but it's not what's causing it...

I haven't heard about electrolyte imbalances or looked into that. Should I get some electrolyte replacement powder stuff and see if that helps? We do filter our water at home with a distiller, which removes everything from it - including the 'good' minerals. (We tried to replace these afterwards but it made it taste gross so stopped!)

I was at:

25 - 2wks
50 - 7wks
75 - 1wk
62.5 - now

I was told to start at 25 for 2 weeks and then go to 50. After that, every 4-6wks, to increase if I felt I still had symptoms. So I actually waited a week longer at the 50 before increasing. But perhaps I am just super sensitive and needed to go very slowly.

Yes, my goal now is not to adjust anything and to see what happens if I give it a full 12 weeks at 62.5. I have a video review with my Newson dr this Weds - and in 2.5wks I have an in-person double appointment with this new menopause GP who is doing a training with the BMS.

Meanwhile, I've emailed my blood pressure results and an email explaining what's happening to the intake GP I saw and said I think it is due to the estrogen in the HRT....

[joziel]

Well, I had a follow-up with my Newson doctor today via video.

She agreed that with the progesterone/endo situation, I should next try switching out the Cerazette for double the utrogestan (200mg continuously) and just see if that is enough to keep the endo away so I can stop the Cerazette. If it doesn't, return to 100mg continuous and re-start Cerazette and have a re-think. I could just stay on Cerazette until menopause when hopefully my ovaries will become inactive anyway - otherwise we'll need to think about a completely different regime. And she agreed with me that the current research suggests that transdermal estrogen is best so reluctant to come off that.

With the heart palps and estrogen, she thought it was overkill to start doing 48-hour holters and echocardiograms at this point and she was not at all freaked out hearing about my trip to A&E last week  but I should just be aware that I'm very sensitive to changes in estrogen and we need to increase very gradually and remain at each dose for a good length of time before increasing again. I'm to stay at 62.5 (!) for many more weeks until all these symptoms stop (meanwhile I can be experimenting with the progesterone as above!) and then increase very gradually - she is sending me some 25 patches along with the 50s so I can cut the 25s in half - but I can also cut them into quarters if I want to increase even more gradually. So we just eke it up very gradually at least to 75.

My testosterone levels are perfect so I'm to keep doing the same thing there, which is a pea-sized blob of Testogel so each sachet lasts 10 days.

The appointment was supposed to be 30mins but we spoke for at least 40mins and I didn't feel rushed. If anything, I was trying to end before her because I felt like I was keeping her too long! Compare this to the 10mins you get with a GP to discuss all this 

BUT... OMG the cost(!!!). The follow up plus prescription fee was £267 and then 6 months of meds was £450    I am trying to find a doctor locally but it is taking some time (I have an appointment in a couple of weeks) and I also don't know what will be in stock locally, HRT wise - whereas I feel like Newson have their hands on everything and make it a priority to source it all because it's all they do...But logistically it means that annually to do this will cost about £900 in meds + £267 in fees - that's with the minimum of one appointment a year.    It shouldn't be this expensive to get your own hormones back    Not when contraception is free. 

[ATB]

Oh that sounds like you had a great appointment and she seems to really understand what’s needed. I know it’s hard to stay on the same dose when you have symptoms, but hopefully soon things are much better for you. Newson is so expensive and it’s hard to not get frustrated we have to pay for that. It’s an unacceptable and unfair situation. Free health care my a**e. After being on HRT 6 months I went to my new GP and because it was working she agreed to write the prescriptions for Evorel & Utrogestan, so I just need the Androfemme from Newson which require just a yearly appointment. Thank goodness! So for me Androfemme will be £240 a year plus one consult and prescription charge- which is the biggest rip off ever! My doctor is lovely but doesn’t work out my needs properly and I end up needing an extra one every now and then and have to pay that charge again! They’re really raking it in at Newson now, a lot of doctors and a lot of video appointments.

[joziel]

It's true, but when there is a lot of demand for something one way to reduce it, is to put prices up - although how that sits ethically with helping people, I'm not sure. It works for other businesses. Perhaps if they charge more, they attract more doctors who want to work for them, so they can then provide more help....

By the way, with the testosterone, Testogel is much cheaper than AndroFemme if you want to save a bit. It is something like £20 to AndroFemme's £80 for the same amount. Plus the ingredients are better - there are parabens and hydrobenzoates in the AndroFemme, which are pretty nasty things to put on yourself every day for the rest of your life(!). I checked them all out and the Testogel had the best non-active ingredients so I went with that. (I told my NEwson doctor that I got a rash with the AndroFemme and asked to switch to Testogel.)

[ATB]

The reason I chose Androfemme is it’s designed for women, isn’t that right? And it’s the only one?

[joziel]

It's designed for women but all that means is it's less concentrated. Instead of using a big measurement of cream (which you pay more for!) you use a tiny pea sized blob of Testogel. Which is cheaper. But you're getting the same amount of testosterone (active ingredient) either way. Testosterone is testosterone, whether it's for men or women, it's the same hormone. It's just about how strong/concentrated it is and so how much of it you need.

[joziel]

(I said to my husband, they should just rebrand it TestoGAL and put in a pink sachet. Job done.    )

[ATB]

Oh that’s interesting. I might raise that with my doctor. I hate to change it if it’s working though even when I know it’s the same active ingredient. Different brands of thyroid replacement hormone, with same quantity of T3 & T4, affect me really differently. I use 0.5ml blob, pea sized?

[joziel]

It's a bit rough and imprecise compared to the estrogen dosage  It takes you a couple of sachets to work out roughly what size blob gets you 10 days out of it. I squeeze a sachet into a little make up pot and then use a small syringe to suck up what I need.

[joziel]

Jeeze, another shitty time with these palpitations   

Woke up at 4am (as often seems to happen now, no idea why, I used to sleep so well before HRT) to feel that my heart was beating fast and fingers throbbing again. I tried to sleep but I can't reason with myself about how I'm feeling if I'm not awake, I just get anxious - so I let myself wake up properly and tried to do some breathwork exercises. (Never seems to do much.)

It's early afternoon now and the heart palps seem to have stopped but I still feel like my pulse is fast and I probably have high blood pressure. Feel like I'm running on high octane fuel and have had multiple Red Bulls again. It's really hard to concentrate and work, I feel so jittery.

I have a kind of deja vu feeling about all this because when I was about 20 (long time ago!) I tried a combined pill, it was Microgynon, and I think I felt similar to this then. So I just went back to the doctor and went on a POP (Norgeston) and all was fine. It's not so easy to see a way out, now. You'd think that, this being body identical estrogen and transdermal instead of oral, my body would be better with it... I just can't figure out why it's causing this. I mean, my own natural estrogen levels during my adult life have easily been this high (only 233nmol!) and higher, without these symptoms. So why does taking exogenous estrogen cause this?!

I'm not so much worried that this is some heart issue as I am that, if it doesn't all go away and resolve, they're going to make me come off HRT. Or go on more meds like beta blockers. Which I really don't want. I am probably worrying again.

[ATB]

I’m sorry to hear you’re getting continuous symptoms like this, it’s exhausting for you.

Regarding your sleep. What time do you take Utrogestan when you take it?

Are you on, have you tried, magnesium glycinate for sleep and anxiety? Helps a lot of women.

[joziel]

I take the utrogestan before going to sleep, so probably about 11pm. I have no problems falling asleep in the first place and seem to sleep well until about 4 or 4.30am each day. I don't know if I've become really sensitive to dawn(!) as it also seems to be when it's getting light and I can hear the birds etc - although this has never been a problem for me earlier in life.

Even if I don't have the heart palps etc, I still wake around 4am but I can then usually go back to sleep again if I don't have them. Just not sure what's so 'magic' about 4.30am!? Seems lots of women experience this!!?

Yes, I'm on a pretty high dose of magnesium glycinate. I take it throughout the day in 3 doses, maybe I should try taking a double dose later in the day instead.

On the plus side, constipation is a thing of the past and I'm pooping very well consistently, with more estrogen (Wish I was a bit less windy, but that's less of a concern than not being able to poop!)

[ATB]

Try taking the Utrogestan earlier- we are discussing it on the other thread!

I was liking magnesium but then I wasn’t sure where my palpitations were coming from, a new symptom for me at the time, and I was going through a process of elimination. I took out magnesium and lowered my thyroid meds which tests indicated. Then I didn’t feel as bad and no palps the next month. Either my estrogen is optimising, my thyroid was causing it, the magnesium was, or some combination of those. Most likely I think it was related to estrogen & thyroid as it accompanied burping which was a long standing problem well before adding magnesium. Both the burping and palps eased at same time. Thyroid and low oestrogen can cause low stomach acid and that can cause GERD- which is often accompanied by heart palps.

[joziel]

Hmm, that's very interesting!

How would taking the utrogestan earlier help? Would it not just wear off even sooner and wake me up even earlier?! 

And if I should try this, how much earlier should I take it? 8pm??