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