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[Cookie25]

Hi Ladies

I've recently noticed twinges in my wrists again like mild carpal tunnel symptoms. My initial reaction was - wow it's a long time since I've felt that.

 So my mind then started wondering if my oestrogen levels have changed. The question is, too much or too little oestrogen? What is the cause in your experience ladies?

From reading, my interpretation was 'too high, but as this week has gone on my mood has rapidly decreased which for me is a sign of too little oestrogen.

My mood is getting very bad so I feel tomorrow I may try adding a bit more oestrogel to see if I perk up, but wanted your advice first please.

Thank you!
Peri
Hrt 2 years
Current regime 4/5 pumps oestrogel
Tostran
Vagifem
Utrogestan 12 days

Cookie xxxxx

[CLKD]

Carpal Tunnel Syndrome is common during pregnancy.  Perhaps do a GOOGLE for CTS ?

[Hurdity]

Here is a link to a relevant study - which is a review of other studies:

"Hormone replacement therapy in women and risk of carpal tunnel syndrome: a systematic review and metaanalysis"

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10260719/

Thius is the abstract:

"Methods

A search was conducted in the PubMed/Medline, Scopus, Embase, and Cochrane databases, from their inception through July 2022. Studies which reported on the association between any type of HRT use and the risk of developing CTS in postmenopausal women compared to a control group were included. Studies which did not include a control group were excluded. Of the 1573 articles extracted from database searches, seven studies involving 270,764 women were included of which 10,746 had CTS. The association between CTS and HRT use was evaluated using the pooled odds ratio (OR) with a 95% confidence interval (CI) under random-effects modelling. Risk of bias in each study was assessed using the Newcastle–Ottawa Scale (NOS) and version 2 of the Cochrane tool for assessing risk of bias in randomized trials (RoB 2).

Results

HRT use showed no statistically significant association with a higher risk of CTS with pooled odds ratio (OR) 1.49, 95% confidence interval (CI) 0.99–2.23, and p = 0.06, although high heterogeneity among the studies was observed (I2 97.0%, Q-test p-value < 0.001). Subgroup analysis of groups in non-randomized controlled studies showed a significantly increased risk of CTS, while groups in randomized controlled studies showed a decreased risk of CTS (pooled OR 1.87, 95% CI 1.24–2.83 versus pooled OR 0.79, 95% CI 0.69–0.92, respectively) with the p-value of group difference < 0.001. The risk of bias in most of the included studies was estimated to be low.

Conclusions

This meta-analysis supports the safety of using HRT in postmenopausal women with potential risk factors for CTS."

Hurdity x

[CLKD]

Many women do complain of symptoms both during pregnancy - condition disappears within 2 years of delivery - as well as in peri-menopause.  Any idea how evidence using a 'control group' can be gathered ......... would these women be much younger?  As with much Research, Papers etc. are difficult to wade through!

[Hurdity]

For a trial study to include a control group, it should be randomised and placebo controlled. So a whole population of women would be selected for a trial - whatever it was, and would all fall between certain ages. Then a group of women would be randomly selected for treatment (maybe 50 %?) - say a pill containing the treatment to be investigated,  and the others would received a placebo eg a dummy pill. Analysis of the data would then show what effect was due to the treatment and what was due to placebo - ie where the desired effects happen because women believe it will happen - a recognised and powerful effect. A study without a control is not valid.

Even observational studies need to compare finding to a control group - so in this case - just looking at studies of women taking HRT and assessing how many got carpal tunnel syndrome - doesn't tell you anything because you need to know how many women NOT taking HRT also got carpal tunnel syndrome - ie the background incidence in the population being studied.

I had CTS during pregnancy with first child but not with any of the others, and never since either!

Hurdity x

[CLKD]

 

[Cookie25]

Thank you Hurdity and CLKD   

I find it so hard to know when I have low or high oestrogen. My mood being low made me suspect it must be low but my instinct with the CTS symptoms was to think it must be too high. It's all a guessing game & trial and error this business! 

Thanks again for your responses and the very interesting article
Cookie 

[CLKD]

Is this cyclical?  If so at which part of the cycle? 

[CLKD]

Searching to find out if it's a particular hormone that produces CTS in pregnancy: Many patients notice symptoms after 30 weeks' gestation.. which doesn't tell me much as I don't know what may be happening in the body at this time 

[Cookie25]

Hi CLKD

Not cyclical no. Something I had before but not for a while, so I can't recall when in my HRT journey I had it before. So my lack of recall means I can't work out if I had low or high oestrogen at that time!

Xxxxx

[CLKD]

Lack of recall is common  .