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[vintagefiend]

This is a really niche question and I appreciate it may not be answerable other than through trial error with HRT.

My SHBG has risen by 50% over 4 weeks since starting a regime of oral bio-identical progesterone and oral oestrogen (it's all in one capsule called Bijuve)

I'm absolutely thrilled that my shbg has increased because it was too low before and meant that any oestrogen I took ran amok- it was taken up too quickly, crazy high levels- you need reasonable shbg to moderate the effects of sex hormones, particularly testosterone but also oestrogen

I have had surgical meno by the way- 3 years ago

I don't actually need progesterone as no ovaries but was having such problems with oestrogen hrt alone that I decided to try balancing the oestrogen hrt with prog. I had read that progesterone increases shbg but I don't think there is much info out there on this

I have also read that oral oestrogens increase shbg -certainly conjugated (whatever that means)- I'm not sure about the other types?? bio-identical? are they even different? it's not clear to me

I had tried oral oestrogen hrt before- elleste solo- but couldn't make it past day 3 when my shbg was too low (and I wasn't on prog)

So, without a doubt, my adding progesterone to the mix has enabled me to stick the oestrogen out for the last nearly 5 weeks!

But I'm at a point where I don't feel great- oestradiol quite low at 190- progesterone normal for follicular phase and I don't know what to do now!

I don't want to jeopardise my higher levels of shbg by, say, lowering progesterone if that is what's caused the higher shbg in the first place (but I do feel quite sluggish and think that might be progesterone related)

But it might be that the prog just enabled me to take the oral oestrogen- for whatever reason, and that it is the oral oestrogen that's pushed up my shbg and the prog may be less needed now?!

i should say my shbg is 78 which is great but i wouldn't want it any lower- i want to add testosterone at some point and that will definitely need an shbg buffer!

in hindsight, i wish I'd had transdermal oestrogen which is supposed to have no effect on shbg- any increases would therefore clearly be down to progesterone therapy

does anyone know which part of my regime is the most likely cause of rapidly increased shbg?

I suppose I don't know that my shbg hasn't stopped climbing yet! it's all guess-work unless I have bloods done again- which I probably will

thanks anyone

[Kathleen]

Hello vintagefiend.

Yes that is a niche question if you don't mind me saying lol.

I can't really help you but your comment about SHBG and transdermal oestrogen intrigued me.  Since starting HRT I have been using patches or gel but when I added testosterone I was told that I needed to have my SHBG level tested to make sure it is in the normal range. The level was found to be okay and I continued with the treatment but after a while I gave up on testosterone so I haven't used it for about a year or two. My point is that my Meno clinic (Newson Health) felt that transdermal HRT did impact testosterone levels and thought it required testing.

I hope this doesn't add to your confusion but I thought that my experience was worth mentioning.

I hope someone will be along soon who can answer your question and wishing you well.

K.

[vintagefiend]

Hi Kathleen,

thank you so much for responding to my niche question!
Actually it is really helpful to have input of any kind as I think this is not a well-researched area.

Can I ask you a couple of questions?

Are you on a progestogen of some sort?
Do you know what your levels of shbg actually were (as ever normal range is big!)?
What prompted you to stop? did the T just not work or did it feel actively awful?

sorry! lots of questions

[Kathleen]

Hello again vintagefiend

I'm pleased that my comments were of some help.

To answer your questions:-

The progesterone I am using is Cyclogest. It is a pessary that is usually prescribed for fertility treatment and comes in 200 mg and 400 mg doses. I am with Newson Health and they advised me to cut a pessary in half to reduce the dose to 100 mg and to use it on alternate nights.

I can't remember my actual SHBG number but I was told that it was on the normal range for women.

I gave up on testosterone because I never really felt much better and I noticed some irritability and aggression which I didn't like. I also noticed the growth of long dark hair on my thighs where I put the cream, this was just a cosmetic issue so it didn't really bother me but it did confirm that I was absorbing the cream. I gradually reduced my testosterone and when I stopped using it the hair growth disappeared after a few weeks.
By the way the testosterone I was given is an Australian product called Androfeme  and is an Australian product.

I hope all the above is of help and that you find the answers that you are looking for.

Wishing you well.

K.
 

[vintagefiend]

thanks so much, Kathleen

definitely helps- particularly to know that you're doing alternate nights prog- something I'm very likely to try myself
I've found a stockist/prescriber of androfeme so I'll see how that goes at some point

take care

[Furyan]

I’m just trialling Elleste Solo 1mg to give myself a short-term break from the headache of calibrating transdermal routes. Also to see if the oral route can help with my insulin resistance, as suggested by the research. From what I understand from the research, oral oestrogen potentially raises SHBG levels significantly, which negatively impacts on the free circulating testosterone available. Not in every case, but it’s something to watch and this may account for your levels? I'm personally wary of lowering my available testosterone as I need all I can get to get my libido back! Btw I messaged you x

[Gnatty]

Hi there just to confirm my understanding is it's the oral oestrogen which increases SHBG rather than the progesterone. But I guess our hormones are so intertwined it's difficult to pick apart.  I am like Kathleen in that I take utrogestan alternate nights, but orally.

When you say you don't feel great, what are the symptoms? Do you have the option to add in a low dose patch or squirt of gel and see if that boosts your oestrogen levels?

[Furyan]

Hi there just to confirm my understanding is it's the oral oestrogen which increases SHBG rather than the progesterone. But I guess our hormones are so intertwined it's difficult to pick apart.  I am like Kathleen in that I take utrogestan alternate nights, but orally.

When you say you don't feel great, what are the symptoms? Do you have the option to add in a low dose patch or squirt of gel and see if that boosts your oestrogen levels?

Hi Gnatty - I too thought of the option of squeezing a little extra gel to ‘top up’ the Elleste should it affect my libido. I’m taking enough progesterone to accommodate it. Hoping I don’t have to!

[vintagefiend]

Hi Furyan and Gnatty!! so sorry - luckily i just checked idly and saw that you'd both posted on this thread- thought I'd get a reminder/notification

Furyan
that's really helpful- so it's prob the oral E that's raised my shbg but the prog has enabled me to take it- so much detective work! I'm wondering now whether to try the elleste solo but with utrogestan alternate days. the bijuve i currently take is restrictive in that I have to take the prog every day and it's too much
thank you, I got your message in July- is that the one you mean? i vaguely remember responding but it may well not have reached you- wouldn't be the first time! sorry about that and I really appreciate your input on my struggles!
I think you were on a 25 patch previously- is 1mg oral oestrogen roughly double that? I know it's hard to judge transdermal vs oral sometimes- bit individual, it seems. Good luck with it- I hope it doesn't adversely affect your shbg and that it helps with insulin resistance- has that not got any better? i must say I find oestrogen to help with libido- maybe this will be the case for you.

Gnatty
thank you and you seem to reiterate the point that it's the oral E that's responsible for my raised shbg. I'm in a quandary as I was going to fully go over to oestrogel and utrogestan. I'm currently on bijuve (1mg oral oestrogen/100mg micronised progesterone) plus one pump oestrogel- the latter I started less than a fortnight ago so early days (and looks like you suggested that- good call!). reason for the increase in oestrogel is that I'm flat/bit low BUT at least I can take the oestrogen now so feel I'm on the right path- just bloody calibrating it all- checking bloods- haemorrhaging money!! did try testosterone and started to feel horrible- really need to sort out the other hormones first, I think. ignore my question to you on other thread- you've answered it here- thanks! i'm interested in that lower dose french progesterone

good luck to us all, ladies, and much obliged that you wade through twisty my posts
ooh one thing I will say is that I no longer get those fkn awful 4am palpitations- that's def thanks to prog- now to feel less sluggish

[vintagefiend]

"my twisty posts"  that should read