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[Kelrob12]

Hi,

I know most of opyu guys will go off symptoms not levels but does anyone know wither levels estrogen that make them feel good?
Im 43 surgical menopause. initially was on 50mg patch but levels were low 200pmol. Went to Newson health(who I didn't rate) who upped to 100mg initially. she said I would probably need more. Levels on 100mg were about 400pmol. I still didn't feel 'right" so Newson wanted to up it. Now Im on 150patch. No longer with Newson. seeing an Nhs endocrinologist - who if you see my other posts isn't necessailry great - won't prescribe testosterone. Tested my levels which came back 800pmol and now says its too high and to reduce.
But aren't the symptoms of high estrogen similar to low (anxiety to be one).Newson health give big patch doses and  this specialist says lower is better. Take away the obvious signs of low estrogen - hot sweats, vaginal dryness. The rest could be either too high or too low?

thanks Kelly 

[joziel]

These are my issues with Newson as well. They assume you will need a high dose and it can lead to a total mess for some women.

The best advice I can give you, is to start low, to remain at each dosage for 8-12wks minimum and only to increase if they have remaining symptoms. If they increase and their symptoms don't go or improve, then they should reduce back to the previous dose. That is the advice from BMS.

Forget about blood levels and focus on your symptoms. That is also BMS advice.

You went from 50 to 100, without trialling 75 at all. So when you didn't feel right at 100, was that because it was too high a dose? We don't know... but then you were told to go higher.

As for blood levels, it really varies a lot. Some women feel great at 250, some need 400, some do need to be 800 or more to feel okay. That's why it makes no sense to focus on your blood estrogen and instead to focus on your symptoms...

[Kelrob12]

Hi
Yeah it was one of reason I stopped seeing them I was paying £200 or whatever it was each time to just up my estrogen.
Yeah 50 to 100 . It’s so confusing as some symptoms could be lack or testosterone or could it be the lack of progesterone ratio to testosterone (I know the nhs say progesterone is just for the lining but I don’t agree with this line of thinking).
I just don’t feel like I used to but maybe I’m fighting a losing battle given I have non of my own hormones 🤷‍♀️.
Hot flushes have gone, same as vaginal dryness. I’m tired a lot, have reduced sex drive(not gone totally), joints ache(but bone scan clear). I get headaches a bit and am slightly lightheaded. My skin has aged dramatically in the last two years, saggy face and more cellulite. Definitely get anxiety. Some were worse on 100 some I don’t think I had , which is why it’s confusing for me to go off symptoms I’ve no idea if it’s because of too much or too little estrogen 🤦‍♀️😂.  I suppose the only option is to lower for 3 months and see.
X

[joziel]

Are you on progesterone? You can ask to go on progesterone even if you don't need it. It is very good for skin and hair... (allegedly!).

Lack of libido - are you on testosterone? That would make a good difference there.

Estrogen - well, maybe try the other changes above and if that doesn't help, you could try reducing a bit?

[sheila99]

You're on a dose that would be too high for most people so that, together with the high blood level, would make me think you're on too much. They will usually give you testosterone after surgical menopause so it's unfortunate yours won't. Will they test your levels? I have definitely benefited from it but my libido was zero. I believe there are some women who feel better on progesterone but for many (including me) it makes them feel worse.

[Kelrob12]

Yeah I’m on cyclical progesterone. I do have a feeling I need a small amount daily tho and have thought about compounding for that reason but that’s a whole other discussion 🤣.
Not on testosterone, the specialist won’t do it on the nhs because of the dangers, having had tumours in the past. So I’m hesitant 🤔. And I was wrong before I’m in 125 not 150 🤦‍♀️😂x

[Kelrob12]

You're on a dose that would be too high for most people so that, together with the high blood level, would make me think you're on too much. They will usually give you testosterone after surgical menopause so it's unfortunate yours won't. Will they test your levels? I have definitely benefited from it but my libido was zero. I believe there are some women who feel better on progesterone but for many (including me) it makes them feel worse.

Yes it was newson who said that most surgical women at my age need high doses. They even wanted it higher. One of the reasons I stopped going.(there were others) . I feel better on a smaller amount of progesterone to balance out estrogen but not the high amounts. I think we spoke in my thread about he testosterone and my specialist . I do also worry about the long term effects of testosterone too .
X

[Kelrob12]

You're on a dose that would be too high for most people so that, together with the high blood level, would make me think you're on too much. They will usually give you testosterone after surgical menopause so it's unfortunate yours won't. Will they test your levels? I have definitely benefited from it but my libido was zero. I believe there are some women who feel better on progesterone but for many (including me) it makes them feel worse.

Sorry forgot to add yes my testosterone has been tested and is 0.6 nmol/l x

[Kelrob12]

You're on a dose that would be too high for most people so that, together with the high blood level, would make me think you're on too much. They will usually give you testosterone after surgical menopause so it's unfortunate yours won't. Will they test your levels? I have definitely benefited from it but my libido was zero. I believe there are some women who feel better on progesterone but for many (including me) it makes them feel worse.

I’m also struggling to understand what it it’s about 800 pmol that is too high, as this level is a normal level for mid cycle in a premenopausal woman. I can’t figure what symptoms I have indicate it’s too high? If the nhs goes off symptoms? Say I went to newson without having bloods and said I had itchy skin and sore joints would t they up my patch? X

[joziel]

800 isn’t too high if you need that amount to feel better. There are women online and on FB who only feed good when their serum levels are 800.

But if you don’t need that amount to feel better and if you’ve increased and it hasn’t stopped your symptoms then you don’t really want to be taking a high dose which also isn’t doing anything for you….

[Nas]

It’s a minefield to be honest.

Just start low as joziel suggested and stay at that dose for a 3 months ( if you can). If symptoms persist, increase again until you are at the maximum licensed dose.

Then, if you are still feeling rubbish, it would be appropriate to have a blood test to check absorption. If low absorption, it’s probably time to change product and start again.

It can be a slow old process, but I can’t stress enough about maintaining a stable oestrogen dose for a decent length of time. In the last two weeks, I’ve increased, decreased and gone without oestrogen. Fatal mistake!! The repercussions were brutal. Now back on my stable 75 patch and all is okay ( for now). Blood levels are subjective. Mine are 300. libido is through the roof, some anxiety, no irritability, no flushes, don’t sleep well.. just a real weird mix right now.

There’s no way I would introduce testosterone, nothing would ever get done !! 😊 ( libido issue!)

Definitely forget blood levels
( unless you’ve reached the end of the line with a product) and go on symptoms. Keep stable. More is not always best.

[Kelrob12]

It’s a minefield to be honest.

Just start low as joziel suggested and stay at that dose for a 3 months ( if you can). If symptoms persist, increase again until you are at the maximum licensed dose.

Then, if you are still feeling rubbish, it would be appropriate to have a blood test to check absorption. If low absorption, it’s probably time to change product and start again.

It can be a slow old process, but I can’t stress enough about maintaining a stable oestrogen dose for a decent length of time. In the last two weeks, I’ve increased, decreased and gone without oestrogen. Fatal mistake!! The repercussions were brutal. Now back on my stable 75 patch and all is okay ( for now). Blood levels are subjective. Mine are 300. libido is through the roof, some anxiety, no irritability, no flushes, don’t sleep well.. just a real weird mix right now.

There’s no way I would introduce testosterone, nothing would ever get done !! 😊 ( libido issue!)

Definitely forget blood levels
( unless you’ve reached the end of the line with a product) and go on symptoms. Keep stable. More is not always best.

😂 with the testosterone. Sometimes i feel like starting again . Ive been at it for 3 years since my operation and agree went thru a period of swapping too quickly. Ive been on 125 mg for the past year and its onlye last week the endocrinologist asked for bloods and it came back at 800 she said it Was too high. The only symptom I said I had was tingly/pins and needs skin at night. So she's not suggesting to lower based on symptoms she's saying it based on levels. im not totally sure what symptoms I have or if they are related to oestrogen or progesterone or testosterone. So like you say its a minefield. I could be low estrogen based on say joint pain when actually the estrogen is at the correct level and I just need testosterone. Or the estrogen is fine I just have symptoms of estrogen dominance due to lack of progesterone. Its not simple to just change oestrogen when its a balance. I have times I want to try to get it right and other I just think bugger it feel like this till im 50 then reassess. Im also struggling to remember what I was like on the 100mg patch 😂 in order to decide if to lower 😩
xx

[laszla]

I’m also struggling to understand what it it’s about 800 pmol that is too high, as this level is a normal level for mid cycle in a premenopausal woman. I can’t figure what symptoms I have indicate it’s too high? If the nhs goes off symptoms? Say I went to newson without having bloods and said I had itchy skin and sore joints would t they up my patch? X
[/quote]

800 pmol would definitely not be too high for some women; generally women with more strictly physical symptoms might be fine or better with less but for hormonal depression levels of 800 pmol or more are often necessary.

My meno clinic has advised me to get my plasma estradiol up to 800pmol for this reason and although I'm not sure I'll ever get that high as I have difficulty absorbing, a significant increase in levels this year after more than doubling my estrogel has definitely helped my acute mental distress.

[Floo36]

There is this fear of Estrogen amongst professionals, I wonder if they would fear it if they didn’t absorb it well and needed high doses too.  It’s not about the dose but about how much we take in which cannot be established by blood tests in peri. I absorb barely anything whether oral or transdermal so it’s really upsetting when doctors concentrate on dose rather than symptom control. As I am peri I know what my low, fluctuating and high symptoms are which are very different, it has taken me a long time to work out though.

Hi Nas, how you doing? Remind me I’ve not been on for a while, are you peri?

[Nas]

Hey Floo,
I’m post menopause now.
I think you are right in that many professionals do seem to fear oestrogen in high doses. But even the highest Hrt doses, are nothing like what we produced in our younger years!

They definitely need to focus on symptom control and not worry about a level which is in the upper hundreds for example. If that’s what you need, so be it I say.

As you correctly say, you could be on a high dose and absorb only a third of the hormone. There are many ladies who require a couple of hrt types even,to feel well.

It’s not an exact science and there lies the issue amongst the medics i think.