Print

Please login or register.
1 Hour 1 Day 1 Week 1 Month Forever
Login with username, password and session length

[Elaine90]

I wanted to share my experience with the forum in the hope that it helps other ladies avoid the problems I've had.

I had endo surgery 8 years ago, in which my ovaries and womb were removed. It took 2 years to get over the surgery (sleeping issues, temperature regulation problems, the usual stuff) and, as expected, my oestrogen level dropped by over half from over 700pmol/l to 300pmol/l.

This level of 300pmol/l had been stable for 7 years post op, without HRT, so the adrenals must have been working pretty well because I no longer have ovaries,  but I'd started getting some long term deficiency symptoms (eg osteopenia, muscle loss, dryness..) so 10 months ago, started HRT.

Since starting HRT, I've been trying and failing to get the balance right. I've gone from post menopausal to menopausal - withdrawal symptoms every day, no sleep, palpitations, temperature problems at night....So I got my levels tested again and got a review today.

So, result is that my once stable oestrogen level of 300pmol/l tested just prior to starting HRT has DROPPED to 140pmol/l with Oestrogel - it was supposed to increase the levels, but it looks like it's stopped my body producing it's own oestrogen.

The gynae didn't seem bothered that my levels were half of what they were prior to the Oestrogel. He didn't know why it happened and when I asked how common this was, said that he didn't know as they usually didn't test levels prior to giving HRT!

I'm going to move to oestrogen patches, see how I get on and then probably wean myself off HRT altogether and hope that I can recover.

Has anyone else had their levels tested before and after HRT and discovered something like this?

[CLKD]

Firstly: blood tests are reliably un-reliable
2ndly : a gynaecologist may not have the menopause expertiese required so I would opt for a referral to a dedicated menopause clinic

Let us know how you get on?

[Elaine90]

Thanks for reply CLKD

To clarify, they were venous blood tests - they are supposed to be reliable (although I'm aware that at home capillary tests aren't)

Also, the gynae is considered an expert in menopause/hormones and is a member of the British Menopause Society - although given his attitude, it looks like I need to find someone else

[Pippa52]

Hi - I was on Oestrogel for over 20 years happily no problems however something in Oestrogel has definitely changed since then.  I also have had a full hysterectomy and ovaries removed. After the shortage when I went back on to Oestrogel and I felt awful and on a (venous) blood test my oestrogen level was only 55 and the Meno consultant said I might as well not be on HRT at all as I was not absorbing it at all. I realise blood tests are not the most important thing to follow but  I felt really ill with hot flushes, palpitations and anxiety and insomnia etc.  I was changed on to Estradot patches which seem to work well for me and I am absorbing them well in fact they work better as I am now on a lower dose than I was originally with the Oestrogel.  I have seen many posts on here from ladies saying Oestrogel doesn't seem to be working for them either.

[Banjo1973]

I would second what Pippa says...

New Oestrogel isn't working for many.

If you like gel, I suggest trying Sandrena, I switched and I have no issues.

My friend switched to Evorel patches very happily.

Good luck x

[Elaine90]

Thanks for the replies Pippa and Banjo, that's really interesting to know. I've got a prescription for Evorel, so I'll give that a try

What was really worrying me, was that not only did it not raise the oestrogen level, it dropped it to half of my natural, long term, pre-HRT level within a few months, so was stopping me producing as much natural oestrogen.

[Abba Fan]

I recently changed from Estrogel to Sandrena too, since 2020 my estrogen levels have been lowering until I was back to having panic attacks. my last blood test had me at 120 pmol and that was with 4 pumps of Estrogel. I ordered Sandrena online because I wanted to be sure it was absorbing well before going back to GP to ask her to change. It took me 1 month to feel like my normal self again, I’m using 2 x 1mg sachets of Sandrena and plan to go back to take another blood test to see where I’m at then hopefully ask my GP to change it. I use testogel daily and this went from 3.9 to 0.4 so my body was using the testogel and converting it to estrogen, I don’t feel like I was absorbing the  Estrogel at all anymore. It’s terrible that this is happening to so many women.

[Pippa52]

I am so sorry to read that so  many women are being affected by Oestrogel not working for them.  I thought originally it must be only me but seeing many other posts of women also having issues and going by my  own experience Oestrogel has without doubt changed from the original version which I was on for over 20 years with no problems whatsoever.  Thought I was going mad at first but clearly my experience is  not an isolated one. I am relieved to be on another type which I am absorbing well. I hope so much that you all find an HRT which works and suits you x

[joziel]

Just to say that different women absorb different products differently(!) and just because the OP used Oestrogel and couldn't absorb it, it doesn't mean that everyone can't... it also doesn't mean it's anything to do with the new Oestrogel situation. It might be, but it might also just be an individual absorbency problem.

It's pretty unusual to have an estrogen level of 300pmol with no ovaries, I'm not sure what can have been happening there... but I wouldn't assume that starting Oestrogel is what stopped that situation. Perhaps your body just normalised. Most people without ovaries and HRT would have levels around 30-50.

As for "probably wean myself off HRT altogether and hope that I can recover" - why on earth would you do that? Why stop protecting your bones, heart, brain, joints and muscles? Why voluntarily increase your risk of cardiovascular disease, dementia, osteoporosis and more...?

Weaning yourself off HRT is pretty WHI-old-school and not supported by science anymore. Best to assume you'll be on it lifelong to live your best and longest life possible. Not everyone can take it, but if you can, the evidence is pretty clear...

[sheila99]

I agree with joziel, 300 is really unusual in someone (effectively) post meno. Your levels were already falling when you went on hrt so most likely the decrease continued. I don't know of any evidence showing hrt causes a loss of your own production. Levels fall anyway even post meno. I think it's extremely unlikely they will recover whether you are on hrt or not. You don't say how old you are but it's important to stay on it until at least 'normal' meno age to protect your heart and bones. I intend to stay on it until I die.

[Elaine90]

joziel and sheila

Venous blood testing showed that prior to surgery I had a level of around 700pmol/l
And after surgery I was 297pmol/l and 7 years later I was 309pmol/l.
Ovaries aren't the only source of oestrogen and levels of oestrogen do vary between individuals.

It might be higher than 'normal' because I had severe endometriosis and women with endometriosis have altered oestrogen production and metabolism. (Eg, endo creates it's own oestrogen and impairs the inactivation of estradiol to estrone)
Added to that, as everything was fused together with adhesions and my ovaries were stuck to my bowels, it's possible that a small ovarian remnant was left (although nothing was found on a subsequent MRI) some endo was left for sure.

Given my starting value of 300pmol/l, dropping to 140pmol/l on Oestrogel is very odd, but fitted in with my symptoms. Perhaps my blood test results were mixed up with another patient or something went wrong with the test - I'm going to ask for a re-test and take it from there.

Unfortunately, I'm not aware of any research which has been done on the effect of HRT on endogenous oestrogen production in women, although similar work has been done for TRT replacement in men.

[joziel]

Ovaries really are pretty much the only source of estradiol. The type of estrogen made by fat in the body, is estrone. Blood tests can measure all three types of estrogen, but because it's estradiol we're interested in, they only measure that... I'm actually not sure what type of estrogen endo produces but doubt it's estradiol...

" it's possible that a small ovarian remnant was left " -

I think that is the most likely explanation, be sure to always take sufficient progesterone (which you probably are anyway with a history of endo).

"Given my starting value of 300pmol/l, dropping to 140pmol/l on Oestrogel is very odd, " -

it's more likely that the ovarian remnant you had left, which continued to produce estrogen for a while, failed shortly after the hysterectomy. It's very common when women have a hysterectomy which leaves the ovaries deliberately, that those ovaries subsequently fail in the few years after surgery. Something about the blood supply to the ovary being affected by the surgery, we think.

"Unfortunately, I'm not aware of any research which has been done on the effect of HRT on endogenous oestrogen production in women, although similar work has been done for TRT replacement in men." -

that's because men produce testosterone throughout their lives (or should/can do). Women obviously are starting to use HRT at a time when their own estrogen is failing. Attempting to determine whether it is failing because they are using HRT or whether it would have failed anyway, is a bit irrelevant because pretty soon they're going to have none of their own, due to menopause....