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[Keep On Swimming]

Hi girls,

Hope everyone is as well as possible!

Here's a question: my night sweats/nausea/Big Dipper whooshes of anxiety and dread have made a reappearance these past 5 mornings. How long should I wait and see if this passes before I ask to increase my oestrogen gel?

I've been back on the gel for 3 weeks - I was made to stop it for a week after 3 weeks for the TSH blood test. The same thing happened after the first three weeks I took the gel.

Not sure if this is making any sense. Pretty shattered to be honest!

Thanks.

[Keep On Swimming]

Sorry, I forgot to say that 1 pump of my gel (I'm in France) = 0.5mg of estradiol. Is that already quite a lot?

[Dotty]

One pump is a very low dose. The “ average” dose is supposedly 2 pumps.

[Zoe]

Hi Keep On Swimming

As Dotty says, it is a low dose of oestrogel. Maybe you were started low due to suspected thyroid issues?

Not sure if your test results came back OK or not. You could always go up by half a pump at a time and see what helps if you were nervous about going up to 2 pumps.

You can  either depress the pump to halfway, or pump out one whole pump and discard the half you don't use.

Alternatively, if you find things don't get better by increasing the gel you could decrease it to half a pump and see how you do with that.

I know it's all a bit of a faff but hopefully you will soon find what's right for you. X

[Keep On Swimming]

Thanks Dotty and Zoe! That's really helpful.

I meant FSH, sorry, not TSH! My estradiol level was 145 (can't remember exactly) but I know that's not reliable when we're in peri.

I think I'll ask my gyne if I can increase because the early-morning horrors are making me feel sick and wiped during the day.

xxx

[Zoe]

Ah, FSH - quite different! 

Blood tests can be notoriously unreliable as you say but at least you know your oestrogen is dipping to 145 pmol/l (am assuming not pg/ml).
That is somewhat helpful since many women, it seems, need to be at around 350 pmol/l to feel normal. For me, I need to be around 600 or my sleep goes downhill.

Ultimately it is about symptoms, which can be affected by a level that is too low for you or too high.

Your instinct that you need a small increase seems right. As Dotty said, 2 pumps is the usual starting dose. You might find that makes a difference if you increase to 2 pumps.

[Keep On Swimming]

Hi Zoe,

Thanks for explaining all that! I feel like I'm learning more and more about the meno/HRT day-by-day!
 
Just got my results out (5 Dec) and it's 158 pg/ml (580 pmol/l)! So that was actually quite high! If the blood test can be considered reliable? Do we usually talk in pg/ml or pmol/l?

But... the gel really made a vast improvement on my horrendous symptoms after only 5 days and, as I say, 3.5 weeks later and they're making a vicious comeback.

I emailed my gyne yesterday after your messages and she rang me. She said ok to add a half a pump in the morning (so that's 1.5 pumps which is 0.75mg of estradiol per day - is that a high dose?) but when I mentioned that I'm spotting she said oh là là, come in for an ultrasound in 2-3 weeks. You see, my gyne explained to me yesterday that she has gone off license with me because she doesn't want to add in extra progesterone on top of the POP but that she will closely monitor me with ultrasounds (all free in France, phew!).

And I thank her for that immensely. But here's what my gyne doesn't know... In Nov, after realising that if I was in the UK I would have been given extra progesterone on top of the POP, I got very worried that I wasn't being looked after properly and sought out some specialist advice from the UK which confirmed this and was given Utro 100mg to take every evening orally. I tried it ONCE two weeks ago and I was really sick for 2 days. I will never swallow another Utro again! A week later I bled very heavily/terrible cramps for the first time in years (have been on the POP for 3 years) and felt really awful again for a few days. I think it was the Utro that did this? And since then I've been spotting... I also went to see a different gyne in France for a second opinion about the POP + gel = extra progesterone but she didn't know what to tell me (in France they don't really treat peri women). But she did give me an ultrasound and my womb lining is 2.6mm.

So, if the spotting keeps up I'm kind of preparing myself that my gyne may want to give me the extra progesterone after all... She really wanted me to have the Mirena but I tried that 12 years ago after baby number 3 and it gave me contractions.

All I know is that I love the gel and don't want to stop!

I'm really sorry because I put this in a different thread a week or so ago!

Thanks for the support and for reading this very long message.
xxx

[Zoe]

Sounds like you have had quite a journey but good that the gynaecologist is doing a scan. Sometimes if we use progesterone intermittently or in different combos it can bring on spotting.

Your womb lining was fine at the last scan and highly unlikely to be problematic with being on just 1 pump of oestrogel. But always good to have a free scan!

1.5 pumps is a low to average dose. 580 pmol/l is also not too high in peri. I am in very late peri but during mid peri my oestrogen levels were all over the place, sometimes as high as 1,500 pmol/l and as low as 125 pmol/l. My menopause specialist said, fear not it will all calm down and you are not bleeding heavily and your boobs are not swollen. And she was right. Things are much more stable (and consistently lower now), especially after she moved me to continuous utrogestan.

Re progesterone, I am one of those who is fine with utrogestan but many are not. It can be taken vaginally (lots of threads on here) to minimise side effects. Some folk are better using one of the synthetic progestins. V important for keeping that lining thin. Your gynae will have options.

I hope you see some real improvements in the new year! X

[Keep On Swimming]

Hi Zoe,

That's great you get on well with Utrogestan!

Thanks for the info about your peri levels for oestregen. Did you feel the highs and lows in your body? Did you have to adjust your gel when this happened?

I'm a bit lost again... I increased my gel by a half pump yesterday morning and this morning. No horrible night/early morning Big Dipper sweats/nausea/anxiety last night, yippee, but today I feel WIRED and I've just had a few frightening waves of intense anxiety. There is no reason for me to feel anxious today as it is a lovely family day but I just want to go into a room alone and scream/cry/explode...! Who IS this person? Also spotting a bit more and more cramps.

So I'm thinking:

- Have I increased too much?
- Could the return of the symptoms at 3.5 weeks actually be a sign that 1 pump is too much for me? i.e. That my body takes 3 weeks to fully absorb 1 pump? (That's twice that that's happened at 3 weeks but the first time I was made stop the gel + POP to see where I was at.)
- Is my body just adapting to the additional 0.5 pump? (But this didn't happen with just 1 pump.)

Totally lost as to which direction to go in but leaning towards the fact that 0.5 extra is too much. I don't think I should apply my 1 pump this evening.

Also, and this will sound crazy, but when I did the first 3 weeks in Nov I applied the gel in the morning. Now I do it at bedtime (my gyne told me to because my probs are at night, mostly). I just felt better using it in the morning. Is that nuts?

What a head puzzle!

Thanks for reading this, again 

[Zoe]

It is such a roller coaster and if you are perimenopausal then it is difficult to decipher what is attributable to the HRT and what is your own body doing its own merry thing.

Some ladies on this forum talk about feeling anxious when increasing oestrogel, though you are correct that half a pump is very little. I think you have two choices: either to stick with 1.5 pumps and see if it settles or, if the anxiety is unbearable, to go back down to 1 or even half a pump. You might struggle if you take none this evening (or in the morning if that suited you better before).

Consistency is key from my experience. The perimenopausal body is so changeable so HRT doses need to remain consistent for a good number of weeks (up to 3 months) to be able to assess how they will work. But you know your body best and if you feel rotten/anxious since increasing your dose then it might be worth going back down to 1 pump or half a pump and sticking with that until you see the gynae again.

I am sorry there are no firm answers. It is such a difficult time but you will get through it. Keep things as simple and consistent as possible. There might be some other ladies here who have had a similar experience. 

[Keep On Swimming]

Hi Zoe,

Thank you so much for your kind reply.

I get it about consistency - I need consistency because I'm on thyroid medication and I'm ultra sensitive to it. But consistency and peri don't go hand in hand, it would appear...

It took me 8.5 years to get the right thyroid dose and then peri threw that out the window in March. I've been struggling to get the right dose again ever since.

So, my body is trying to deal with a micro T4 increase (+ 6.25mg once a week) and a micro gel increase... Thanks for the sound advice. I'm going to drop back down to 1 pump of the gel and cross my fingers.

Right now I just feel so shaky and weak, kind of panicking about going back to work!

Anyway, onwards and upwards eh!

[discogirl]

hi keep on swimming

i feel terribly anxious when i increase my gel however it usually settles after a few weeks.

i also take magnesium bisglycinate as that helps to calm and relax me xx

[Keep On Swimming]

OMG Discogirl, thanks for sharing. Am sorry to hear that.

Now I'm totally confused as to what to do!

Stick with micro increase, stay at 1 pump, decrease to 0.5 pump? Gaaaaaah! If I wasn't feeling so horrendous I'd have a glass of red 

Is it true that when the flushes/nausea/Big Dippers/low mood come back this can mean too little OR too much oestrogen?

Strewth!

[Keep On Swimming]

Just checked my magnesium. It's Formag: magnesium from the Dead Sea, B6 and Taurine. Not the stuff you mention then?

I've been taking magnesium at lunch non stop for years. If I stop my eye twitches but that would be the LEAST of my problems right now, hahahaha!

[discogirl]

Just checked my magnesium. It's Formag: magnesium from the Dead Sea, B6 and Taurine. Not the stuff you mention then?

I've been taking magnesium at lunch non stop for years. If I stop my eye twitches but that would be the LEAST of my problems right now, hahahaha!

there are different types of mag and glycinate is the best to help you relax etc to help my anxiety i take 1 in the morning and 1 at night.

the ones i have you can take up to 4 capsules to give you approx 303 mg of glycinate but for me 2 is enough

i get mine from love life supplements they are buffered however i didnt want any that were too strong either xx