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[Pippa52]

Hi lovely knowledgeable ladies
I would love some opinions/help/advice please.  I have been all round the houses re HRT types(patches 2 sorts and spray) and doses due to both the shortages and also not being able to tolerate others.  Cutting a very long story short for the last 2 weeks I have been back on Oestrogel which is what I was on happily for over 20 years.  I was always on around 2 1/2 - 2 3/4 pumps over the years and am now on 1 1/4 pumps in the morning and same in the evening.  My last Oestrogen blood test level was only 91 so quite low (I am post menopause and had surgical menopause due to severe endometriosis many years ago so no ovaries).  I have never been right over the last year with all the swopping and changes but recently I have been really rotten.  My symptoms now are acute anxiety coming in waves to the extent sometimes they are more like panic, very little or no sleep most nights now due to the panic and anxiety I just can't switch off ..some episodes of fast heartbeats (been checked out by a cardiologist last week and both heart and BP ok and not the cause) feel jittery, weak, headachey, some hot flushes and now pretty low mood as I am totally not having a life really.  Logic tells me that probably my levels are too low but when I was on the patches I felt like it was far too much. (50 sometimes 62 on a patch)  I have read various reports that the latest Oestrogel bottles appear to be delivering a somewhat weaker dose?  I have the bottles with the yellow square on. I would be so grateful for some input - I am just at a bit of a loss really and bordering on desperation as probably the dose is too low but I am now really worried about increasing and making the anxiety even worse as it's pretty uncopeable  with right now and once the gel is on it's on - there is no ripping it off if things become worse over 24 hours. Would be so grateful for some input/other people's experiences.  I should add I am very sensitive to dose increase or decreases so would only go up or down incredibly slowly.  Thanks ladies xx

[Gilla999]

Pippa it sounds absolutely awful and I just wanted to send you some love. My reaction would be that it would be hard to see how it could be that your estrogen is too high at that level, but I understand the worry about increasing it after what happened last time. I do think different people absorb different products differently so it may be that you were really absorbing quite a lot of the patch vs the gel for example. I also think when you've got so far into a hole with not sleeping and anxiety etc that your body can get locked in a viscious cycle of it separately / in addition to the hormones. If it were me I would try slowly increasing and see if you notice any difference. I don't like to "advise" on this kind of thing but have you thought about also trying something for the anxiety and sleep? (Not instead of addressing the hormone issue, but as well as, just to get you out of this hole). There are a couple of good antidepressants out there that you could start off slowly on. Again I'm not saying this is what you should do, just posing the question! I really hope things start to improve for you soon xx

[Pippa52]

Gilla999 thanks so much for your reply I really appreciate it.  You are absolutely right re the vicious circle with sleep it just compounds it.  Tonight I am going to take some Bach Rescue Night remedy - put lavender on my pillow and light a lavender candle. I do have some Kalm tablets but think they are daytime ones so might get some night ones on Monday.  I am not great with drugs to be honest and I am going to be referred for some CBT which I would rather use to help but I totally understand pills are a lifeline and help so many but I think I would prefer to try the prescription  drug free route first.  Silly thing is I feel really confident if I could just get the dose right on my oestrogen I would be fine.  Its not surprising my system is all over the place and I do know that it can take several months to get used to HRT and if the symptoms were minor then that would not be a problem.  I know if I don't try going up slightly on the dose things won't change so I may well bite the bullet and increase the dose very slightly soon in the morning.  Thanks again so much for your input xx

[sheila99]

Given your levels I also think it's extremely unlikely to be from too much oestrogen. They are exactly the symptoms I had from oestrogen deficiency. Every time I try to reduce the dose the anxiety and insomnia returns. I don't think you get hot flushes from too much oestrogen?

[Pippa52]

Given your levels I also think it's extremely unlikely to be from too much oestrogen. They are exactly the symptoms I had from oestrogen deficiency. Every time I try to reduce the dose the anxiety and insomnia returns. I don't think you get hot flushes from too much oestrogen?

Thanks Sheila …. very interested to hear that when you reduce the dose you get anxiety and insomnia. Thanks so much really appreciate your input x

[joziel]

I do agree Pippa that it sounds like it might be too low a dose. I seem to remember someone saying that the estrogen in the patches is something-hemihydrate 17b (someone help me here) and that the estrogen in other products can be something different. So maybe there is a difference between patches and gel.

I know from my own experience that my body does not experience estrogen I give it, in the same way that it experiences the estrogen it makes(!!). Yours doesn't either, because there must have been times when you were pre-menopausal and had very high estrogen levels and then much lower levels. And I'm assuming you didn't get these symptoms then. Because that is part of every woman's cycle. So I don't understand how this can be 'body identical' and yet here some of us are, having to be so careful about minute changes - when our bodies go low to super high to low again with our own cycles, pre-menopause. Ergo... there is a difference. What that is, I wish someone would figure out 

Basically I know this stuff is all supposed to be body identical, but my body knows the difference and isn't getting the memo there  ... So I'm sure different products make a difference as well, and then there are the absorption differences which affect dosages individual women get too. I think some of us are much more sensitive than others to all this.

[Gilla999]

Pippa I totally understand, and no drug is without side effects so definitely worth trying prescription free routes first and only going for that as a last resort! I wouldn't even normally suggest it to someone, it's only that I know from experience just how awful the no sleep-anxiety cycle can be and my heart breaks for anyone going through it, whatever the cause.

I agree with the other ladies on the cause - it's hard to see how it could be anything other than low estrogen, but I also 100% agree with Joziel and feel that my body knows the difference between my own E and HRT as well!

Have you always split the dose? I'm just wondering if applying it in the evening could be contributing (I always avoided doing that as tried it once and got a bit of a rush which affected my sleep). However I know from here that some ladies do it just fine. If that's a new thing could you try switching the dose to in the morning and seeing if that helps? And then increase to perhaps 3 or 2.75?

[Kelrob12]

Hi lovely knowledgeable ladies
I would love some opinions/help/advice please.  I have been all round the houses re HRT types(patches 2 sorts and spray) and doses due to both the shortages and also not being able to tolerate others.  Cutting a very long story short for the last 2 weeks I have been back on Oestrogel which is what I was on happily for over 20 years.  I was always on around 2 1/2 - 2 3/4 pumps over the years and am now on 1 1/4 pumps in the morning and same in the evening.  My last Oestrogen blood test level was only 91 so quite low (I am post menopause and had surgical menopause due to severe endometriosis many years ago so no ovaries).  I have never been right over the last year with all the swopping and changes but recently I have been really rotten.  My symptoms now are acute anxiety coming in waves to the extent sometimes they are more like panic, very little or no sleep most nights now due to the panic and anxiety I just can't switch off ..some episodes of fast heartbeats (been checked out by a cardiologist last week and both heart and BP ok and not the cause) feel jittery, weak, headachey, some hot flushes and now pretty low mood as I am totally not having a life really.  Logic tells me that probably my levels are too low but when I was on the patches I felt like it was far too much. (50 sometimes 62 on a patch)  I have read various reports that the latest Oestrogel bottles appear to be delivering a somewhat weaker dose?  I have the bottles with the yellow square on. I would be so grateful for some input - I am just at a bit of a loss really and bordering on desperation as probably the dose is too low but I am now really worried about increasing and making the anxiety even worse as it's pretty uncopeable  with right now and once the gel is on it's on - there is no ripping it off if things become worse over 24 hours. Would be so grateful for some input/other people's experiences.  I should add I am very sensitive to dose increase or decreases so would only go up or down incredibly slowly.  Thanks ladies xx

Hi lovely knowledgeable ladies
I would love some opinions/help/advice please.  I have been all round the houses re HRT types(patches 2 sorts and spray) and doses due to both the shortages and also not being able to tolerate others.  Cutting a very long story short for the last 2 weeks I have been back on Oestrogel which is what I was on happily for over 20 years.  I was always on around 2 1/2 - 2 3/4 pumps over the years and am now on 1 1/4 pumps in the morning and same in the evening.  My last Oestrogen blood test level was only 91 so quite low (I am post menopause and had surgical menopause due to severe endometriosis many years ago so no ovaries).  I have never been right over the last year with all the swopping and changes but recently I have been really rotten.  My symptoms now are acute anxiety coming in waves to the extent sometimes they are more like panic, very little or no sleep most nights now due to the panic and anxiety I just can't switch off ..some episodes of fast heartbeats (been checked out by a cardiologist last week and both heart and BP ok and not the cause) feel jittery, weak, headachey, some hot flushes and now pretty low mood as I am totally not having a life really.  Logic tells me that probably my levels are too low but when I was on the patches I felt like it was far too much. (50 sometimes 62 on a patch)  I have read various reports that the latest Oestrogel bottles appear to be delivering a somewhat weaker dose?  I have the bottles with the yellow square on. I would be so grateful for some input - I am just at a bit of a loss really and bordering on desperation as probably the dose is too low but I am now really worried about increasing and making the anxiety even worse as it's pretty uncopeable  with right now and once the gel is on it's on - there is no ripping it off if things become worse over 24 hours. Would be so grateful for some input/other people's experiences.  I should add I am very sensitive to dose increase or decreases so would only go up or down incredibly slowly.  Thanks ladies xx

I’m the same as you very sensitive which makes it hard to keep changing.
I’m 43 surgical and on patches. When I was on slower dose the anxiety was definitely worse and low mood. The hot flushes definitely are low estrogen but the other things can be too low or too high so it’s so hard. There is a 25 patch too or like the other said cut patches I do that x
X

[Pippa52]

Pippa I totally understand, and no drug is without side effects so definitely worth trying prescription free routes first and only going for that as a last resort! I wouldn't even normally suggest it to someone, it's only that I know from experience just how awful the no sleep-anxiety cycle can be and my heart breaks for anyone going through it, whatever the cause.

I agree with the other ladies on the cause - it's hard to see how it could be anything other than low estrogen, but I also 100% agree with Joziel and feel that my body knows the difference between my own E and HRT as well!

Have you always split the dose? I'm just wondering if applying it in the evening could be contributing (I always avoided doing that as tried it once and got a bit of a rush which affected my sleep). However I know from here that some ladies do it just fine. If that's a new thing could you try switching the dose to in the morning and seeing if that helps? And then increase to perhaps 3 or 2.75?

Hi Gilla … thanks so much for your reply. You are spot-on in the fact that I only started splitting the doses when I went back on Oestrogel this time. When I was on it previously I used to do it in the mornings so you make a very salient point. The only reason I changed it was because it was suggested it would give a more even level throughout the 24 hours however I will certainly take on board your suggestion.
Seeing everybody’s lovely comments on here regarding their opinions that they also think it is low oestrogen levels  I actually upped the dose a bit last night and I will do the same this morning. I did actually get some sleep last night and so far this morning the anxiety is less  but whether that is a coincidence because I can’t think it could’ve kicked in that quickly but I do feel better for having had some sleep.  I will continue on the slightly higher dose for another week and see how it goes because hopefully that will have given it some time to kick in. Thank you so much for your support and I hope so much all is well with you? Xx

[Gnatty]

Am about to put spanner in the works, but I  am better splitting the dose! I don't know whether it's because I have no ovaries, but I just feel on a more even keel with the split dose.

[Pippa52]

Am about to put spanner in the works, but I  am better splitting the dose! I don't know whether it's because I have no ovaries, but I just feel on a more even keel with the split dose.

Gnatty not a spanner at all .. really helpful information. I have no ovaries either ….like you I thought splitting the dose would even things out over the day. Really interesting food for thought. I think maybe what I might do is put my oestrogen on a lot earlier in the evening so say I will do it at 7 pm and 7 am and then hopefully by the time I go to bed the first hit will have dissipated somewhat. I’m so wary of changing too much too soon at the moment so I may try this first rather than trying to swap over to the morning and see how it goes. If I’m still having problems sleeping at least it’s something else I can try. Thanks so much for mentioning really appreciate it. It really is so true that what suits  one person may well not suit  another it truly is horses for courses xx

[Gnatty]

Do you feel that you notice a bit of a hit then after you apply the gel? I shall pay attention and see if I can spot it! Do you feel it quite quickly? It is awful trying to get these hormones balanced esp as without ovaries we are so beholden to hrt to get what we need. On the positive side once you get stability hopefully it should stay that way as we are not subject to bodily fluctuations.....

[Pippa52]

Do you feel that you notice a bit of a hit then after you apply the gel? I shall pay attention and see if I can spot it! Do you feel it quite quickly? It is awful trying to get these hormones balanced esp as without ovaries we are so beholden to hrt to get what we need. On the positive side once you get stability hopefully it should stay that way as we are not subject to bodily fluctuations.....

Gnatty….  I used to get a mega hit for the time I was swopped onto patches. All the years before I was on Oestrogel I never noticed it.  I just thought it may be best if I don’t apply
it just before going to bed maybe? I will experiment 😂😂 As you say having no ovaries in one way does mean once the level is level it seems to stay right. Over the 20 years I was on Oestrogel before I never had to alter the dose so fingers crossed for us both on that one 🥰 xx

[Gnatty]

I do remember my Meno doc saying to take the gel all on one go in the morning so as to get a good boost. This was ok for me for a while but then I found I was unable to physically fall asleep which was just awful. Things got better once I started splitting the dose and I also reduced the number of pumps slowly from 5 to now 3.5 per day. But what I would say is that testosterone makes a huge difference to how I feel.

[Pippa52]

Gnatty … that’s really interesting regarding the testosterone. The meno
consultant did mention it to me but she said to get level on oestrogen first. I have what I hope will be my final appointment in September so I will ask her about testosterone again then xx