I don't know how to do the fancy quotey thing, but have to rely on copy and paste
"And what I've learned the very hard way is that increasing oestrogen levels increases the fluctuations because it increases the peak and therefore the drops."
Can you explain how that is? Sorry, I just can't imagine it. If you are adding a stable estrogen dose in each day, then any fluctuations from your own body are reduced. I can't understand how the thing you're describing 'increases the peak and therefore the drops'. The estrogen you take doesn't fluctuate like the estrogen from your body. If you take 400pmol of exogenous estrogen and your body is sometimes spurting out 50 and sometimes spurting out 300, then sometimes you will have 450 and sometimes you will have 700 - but you will never have less than 400. Because that's the baseline decided by the exogenous estrogen.
"THis is directly opposite from what Newson told me when they pushed up my oestrogen levels (which was more in there made it more undulating). Everyone at
Newson (whom I saw first and about whom I was evangelical for ages - recommended to many many people) is all about increasing oestrogen."
That hasn't been my experience. When I first started there, they were very concerned about my initial reaction to HRT and my then doctor told me to slice up patches and very gradually titrate until my symptoms resolved. I never reached the point where my symptoms resolved, so then I was told to stop all HRT and see what that was like (since these particular symptoms had begun after starting it). I did - and 5 months later I still had these symptoms. Having ruled out stopping estrogen and a low to medium dose of estrogen, it then was decided to go the other direction and stabilise me on quite a high level. I'm now on 9 pumps of gel - which is only taking me to around 430pmol - and sleeping the best I have in the last 2 years.
I haven't heard anyone at Newson want to increase estrogen for the sake of it, it's about increasing it to the point that symptoms resolve or at least trialling a higher dose to see if that happens. Seeing these things are not about the amount of estrogen you take but about your serum levels it makes zero sense to focus on doses.
"But i've now learned The BMS became so worried about NH approach that they issued a statement (Dec 22) warning about high levels."
You do know the BMS are ridiculously conservative and would still be singing from the WHI hymn sheet if it weren't for pressure to get with it from the likes of Newson, Davina etc? Personally I wouldn't be worried at all by any statements the BMS offer. They have clinicians still saying 'take the least amount for the shortest time' crap.... Their warning about doses is a case in point. Some people have 430pmol from 2 pumps of gel. I have 430pmol from 9 pumps of gel. The dose itself is irrelevant.
"I was put way beyond 200 by them, and it made me very (very) ill indeed"
Unfortunate, but at least you got a chance to try a higher dose and to see what it did. Had you never been allowed to try it, you would never have known. I have a friend (not with Newson but with another private menopause clinic) who needs her estrogen to be 1300pmol to be symptom-free. What Newson DOES say, is that this should be an individualised process where everyone should have the
right to access the hormones they need to feel better.
Just because being put 'way beyond 200' made you ill, doesn't mean that the same is true for every woman. Personally, I need to be over 400 to be symptom-free and to sleep. I would not want the right to be well to be taken away from me because
you personally tried over 200 and it made
you feel ill.
It's all trial and error until you find what works. You need the right to 'trial' the dosage you need. And there will always be more 'errors' before you find what works. That's not the fault of the clinician. It's part of the process.
