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[Eggcustard]

My estrogen levels on HRT are 88 pmol/L (Evorel 75 patch estrogen only after hysterectomy)

Am I right to think this is way too low??

I also have vaginal atrophy (have vagifem for that which is helping)

Thanks

[joziel]

That is way too low. For bone protection and all the health benefits of HRT, you need at least 250pmol.

Many women do best in the range of 400-650pmol, according to my Newson doctors. That seems to be the case for me as well.

Most HRT seems to be designed to (if you're lucky) get you to around 250, so if you are then one of these women who need a higher dose, you can end up using quite a lot of product. (I am on 11 pumps of gel a day to get around 500pmol.)

With the vaginal atrophy, you can use Vagifem every day if you need to and you can also use Ovestin as well externally. Don't listen to outdated doctors who say it has to be one or the other. When my serum estradiol was below 250, I needed Vagifem every day and Ovestin twice a day (AM and PM). Since increasing my serum estradiol, I don't need local estrogen anymore. Phew.

[Eggcustard]

That is way too low. For bone protection and all the health benefits of HRT, you need at least 250pmol.

Many women do best in the range of 400-650pmol, according to my Newson doctors. That seems to be the case for me as well.

Most HRT seems to be designed to (if you're lucky) get you to around 250, so if you are then one of these women who need a higher dose, you can end up using quite a lot of product. (I am on 11 pumps of gel a day to get around 500pmol.)

With the vaginal atrophy, you can use Vagifem every day if you need to and you can also use Ovestin as well externally. Don't listen to outdated doctors who say it has to be one or the other. When my serum estradiol was below 250, I needed Vagifem every day and Ovestin twice a day (AM and PM). Since increasing my serum estradiol, I don't need local estrogen anymore. Phew.

That’s what I thought about the levels, I had read the same. I have been far worse since changing patch over lockdown because of shortages, I didn’t have atrophy etc before.
I don’t know my estrogen levels before hysterectomy but it’s no wonder I feel awful.
Every time I try to increase it though I get horrible side effects and end up giving up. I get very bloated and really angry which with a teen with mental health issues I just can’t be so I go back to what i’m on now.
Going to try new GP first and see what she says
Thanks for the reply

[buffy26]

Hi Eggcustard,

I feel for you, all this experimentation with dosage is so stressful. I am a few years in and things are still unsettled. My levels hardly changed on patches, when I switched to the gel the dial moved and I eventually reached about 320 approx. The bloated and angry mood sounds like you could be sensitive to progesterone (?) but I have no expertise whatsover, just speculating which is probably not helpful. I used to get those mood symptoms when I was on the pill. I take a supplement called LTheannine - its a simple amino acid, it keeps me balanced and calm. Just thought I would share that as it is natural. So many positive reviews about it everywhere

[Nas]

Hi buffy
Do you mind sharing which LTheannine you take please, as I would like to try it.

Thanks.

[buffy26]

Hi buffy
Do you mind sharing which LTheannine you take please, as I would like to try it.

Thanks.

Here you go Nas, just be sure not to take this with any other green tea products.
https://www.naturesbest.co.uk/amino-acids/theanine-200mg/?sessionid=f8b91220ab1196336a39d231bdeeb045356fa1e4

I have just read the most recent reviews, it seems people are not happy with the new updated product. I hadnt even noticed. What I did notice it when I hadnt taken for several days,( was eeking out the supply I had left) I noticed I was starting to feel quite low again, and anxious too. I experimented with going without as well for a period, I felt less able to cope with stress when off them. I am sure they work well still, but as with everything, we are all different. They are not expensive so worth a try!

[Nas]

Many thanks buffy, I will give them a go! Nothing to lose ( other than lots of £££!) 🤞🤞

[joziel]

Nas I take Source Naturals Calm Serene with Relora, which has L-theanine in, as well as GABA and magnesium and holy basil.

I look for combo products now, after spending a fortune on individual products...

[Nas]

Thanks joziel, I will certainly take a look. Does that one you take, help with your sleep and overall sense of calm?

[bombsh3ll]

Are you sure the units used are pmol/L?

Some labs use picograms, which does translate to a much lower number.

For example I am on 1.5mg oral estradiol. My levels are about 380pmol/L which is about 100pg/dL.

Before you make any changes just double check the units your lab is using!

[joziel]

Something is definitely helping my sleep although I do still have difficult nights, usually 2-3 in a row - then things go back to being better again.

It is probably my higher estrogen dose which is helping as I'm on 11 pumps now. I'm going to get bloods done via Medichecks in a few weeks to see where I'm at, for future reference and in case I switch products from gel to something more practical.

My sleep stack at the moment, is taking cortisol lowering supplements around 7pm. That includes Alpha GPC (which is v good for your brain as well), zinc and ashwaganda.

Then an hour before bed, I take the Source Naturals Theanine Serine with Relora, plus apigenin 100mg, plus melatonin 3mg and 3000mg of taurine. (I use the taurine powder from Bulk which makes weightlifting supplements because it's cheaper.)

Then I take 300mg of oral utrogestan just before bed.

Even with all of that, if my estrogen is messed up, I'll have a bad night. I will lie there in a light dozy sleep, unable to get into deep sleep until eventually I give up trying to and then am completely awake. I don't know if the amount of gel I absorb varies or if I can't absorb more than a certain amount or if my ovaries still spurt some out or what, but I think there's some fluctuating going on...

If I really can't sleep and it's the middle of the night, I take 50mg of trazodone. Even then it's not perfect.

But I am much much better than a year ago. I cling to that bit of hope. Because in the night, it's neurological symptoms like my heart beating hard and fast, inner tremors etc... I was just not getting any sleep at all a year ago, 3 hours of light sleep was all I could manage. It was life changing in a bad way. And now I can at least manage and usually get at least 6 hours, sometimes more.

[RebJT]

Hi

Post hysterectomy my sis in law takes 2 x 100 estradot patches to get her levels to around 500 ish, she then has leeway from her gynae to top up with extra gel.  She also takes T.

On 75 Evorel for two weeks my levels were 320 (after another month or so on 100 they are 650).  We all absorb differently and any good gynae should know this.  88 pmol is brutal!

Depending on your doctor (mine's lovely) sometimes a beg for forgiveness rather than ask for permission approach is better - in your shoes if you have the spare patches, I'd up your dose, and then tell them you feel better and ask for a script.  That or go private and find someone not in the dark ages.

x

[Kathleen]

Hello ladies.

In my experience blood test results are great but can also be confusing.

At a recent  test I learned that my Oestradiol level was <74 pmol/L. The  same blood test six months ago was 174pmol/L. I am post meno and both times I was using one 1 mg sachet of Sandrena gel, though I had reduced to half a sachet between tests.  Amazingly although I continue with emotional ups and downs and my VA symptoms are now more noticeable, I don't feel much different.

When I was a patient of Newson Health my highest recorded Oestradiol was 600pmol/L and I felt fine for some of the time but I still had dips in mood and some panicky surges.

I understand that women who are not taking HRT usually have an Oestradiol level of up to  118 pmol/L.  I assume they feel okay at those levels and I wish I knew their secret!

Some ladies here prefer to focus on how they feel rather than blood test results but I can see how physical measurements can be a useful guide.

Take care ladies.

K.

[joziel]

The only problem with bloods is that before menopause and occasionally during the early years after it, your own ovaries can contribute some estrogen when the bloods are done. This then leads to a higher blood result - which makes you think you are getting that from HRT. Then, randomly, your ovaries stop making it and you get dips. But you don't realise this because you don't happen to test during a dip...

So LOW blood results should always be heeded because that is reflective of where things are cutting out to. HIGH blood results during peri might be meaningless because you could be low a few hours later...