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[Niamh]

Hi GLR when do you see Dr Annie, I'll be interested to see what she says  as I think we are v similar. I think Prof Studd regime is really good and it's just getting the ostrogel bit right, so frustrating as its so close. When I feel good it's better than ive felt  in years hoping Dr Currie can help a bit but I will email Studd too I just expect a brusque reply! X

[GypsyRoseLee]

I see her at the start of March. Can't wait. If she can cure me then I will send her an enormous bouquet!

Also I have a new, really fantastic GP who is very sympathetic but unfortunately isn't very knowledgeable about HRT get, though she is reading up on it a lot as she has inherited lots of middle aged women from previous GP.

She actually listened to me and acknowledged that I knew my own body and symptoms best. She also recognised that some women simply cannot tolerate progesterone and that 'it can send them a bit psycho' (her words).

She was the one who started me on Femoston 1/10 nearly a month ago, as she said it was mainly well tolerated. I've only had 9-10 'good' days on it this month, so it hasn't really worked that well. And these last 10 days on the combined tablets I have felt very low again, with added anxiety, can't relax, no sense of well being etc. I am still functional but it's pretty miserable.

 But I see her again this week and she hinted that I could increase to 2/10 if needed.

[Niamh]

It really sucks doesn't it! Sometimes I wonder if  my expectations are too high and this is as good as it gets but surely not?!? I feel awful today im so confused. I'm emailing Dr Currie today and im seeing when Dr Annie is free I need someone to listen and answer my questions and help me through this there must be a solution. I feel close as the utro part is ok just keep getting these awful dips

I hope your appointment goes well keep me posted

I think ill try 3 pumps again after all surely Prof Studd knows what he's talking about....?!? X

[Briony]

Niahm, just a thought - have you thought about separating the doses, one morning and one evening? It might make it a little easier to tolerate the 3 pumps over 24 hours?

GRL, have you finished the combined bit yet? It will be interesting to see if you feel better or worse when the prog is out of your system. With the higher dose, dont forget that the prog stays the same (I think?) so at least the prog to estrogen ration will be better? Did your new GP mention Qlaira at all? It's very like Femoston 2/10 in some ways, though you get a more frequent prog dose to avoid the ups and downs.



I agree with what you say about our expectations. I honestly thought I'd be totally back to normal once I took HRT/BCP. My only hope is that our problems are worse now because in peri, no two months are the same. Perhaps, as we head into full menopause, things will be more consistent (albeit consistently low!) .

B

[donnacrichton]

I tried as high as 5 pumps and didn't stop ovulation so I was so high it was not tolerable. My own hormones kept kicking in no matter what one I tried. I find high symptoms worse than low headache, sore breasts, anxiety and floods of tears. I hope you get answers but I have found relief going lower I am now on a low dose patch and getting treatment to suppress my ovaries not to ovulate x

[Niamh]

Hi Donna thats really interesting ive had a reply from Dr Currie and she has potentially suggested this, what treatment did you have to switch off your ovaries?

Interestingly from yesterday afternoon my mood lifted significantly and slept much better, it's like the 3 pumps is too high, I react to this and react to the drop back to 2, it stabilises after a day or two and I feel better, well that's my theory!
 
GLR this is Dr currie reply might help you too, btw im seeing Dr annie on 4th March at 11.30 if all this is ongoing im worried about trying 4 pumps as I react to 3 so sticking with 2 and if things still go very up and down Dr annie it is, I'm emailing Prof Studd too about it all!

Thank-you for your question and I am sorry that you are having these problems. This stage can be very difficult with changing hormone levels. At times the estrogen can be topping up hormone levels and at times suppressing. It can be so difficult to understand whether the stage is PMS or leading into perimenopause and it may require time to see how it evolves. PMS often worsened with the hormone fluctuations of the perimenopause.
To fully suppress the hormone ups and downs, you often need a high dose of estrogen, eg 4 pumps of gel or a 100 strength patch. It would be worth trying this. The beauty of using a gel is that you can adjust the dose easily.
The Utrogestan is to protect the womb lining from being stimulated by the estrogen (apologies if you know that already!). It does sound as though you have sensitivity to progesterone and so it is good that you feel OK when taking the Utrogestan. The usual dose for protection of the lining is 200mg taken for 14 days per 4 week cycle. It is likely that the lower dose has been recommended to minimise your exposure to it. If you have a regular bleed after taking it then it is being effective.
Therefore, overall, suggest trying higher dose of gel to provide steady estrogen levels. It is trial and error.
If this proves to be unhelpful, it is sometimes useful to take treatment to switch off the ovaries altogether --this leads to a temporary menopause but at least ensures stability and no hormone fluctuations. HRT can then be added back in in a medium dose, rather than needing high dose.
I hope this is helpful.
Best wishes
Heather

[Nina]

Thanks for sharing that Niamh 

It's true that it's all trial and error isn't it. I think even 'settled' ladies still have good and bad days, that's just life isn't it 

how about trying 3 pumps one day and 4 the next? remember I said that 100mcg was too much for me but 75mcg isn't quite enough?

I always think that it's great there are varying strengths of hrt but not QUITE enough. For instance, thyroxine comes in differing strengths doesn't it? And people are always having their dose adjusted 

[Hurdity]

That's great Niamh (ie sharing that answer) - I think we need to pin it up somewhere!

Nina - oestrogen patches and gel do actually come in as many doses that you want really - patches go from 25 mcg to 100 mcg and sometimes more than one patch can be used. Gel can be used from half a pump up to almost unlimited (within reason)!

There is no doubt that pretty well all of us feel great on our own oestrogen during our menstrual cycles around the time of ovulation when levels are mostly way higher than HRT. The most difficult thing is trying to find the right amount of exogenous oestrogen ( taken from the outside) that makes us feel good! It would be too much to replicate these levels (ie the high levels at ovulation peak) all the time as we only experience consistently really high levels (much higher than during our cycle) during pregnancy when our progesterone levels are also very high - so this is a particular scenario. HRT was originally designed to provide approximately the amount of oestrogen that is average over the whole cycle - ie not too low, not too high - so I read somewhere. The actual level at which this sweet spot is found also varies. Reproducing this by adding back a constant amount of oestrogen through the skin can only crudely approximate what happens naturally - especially when our whole endocrine system is very complicated with delicate feedback mechanisms etc - and is such a challenge!

Good luck to you all in working out what you need to feel better for most of the time

Hurdity x

[GypsyRoseLee]

Thanks for sharing that Niamh. I see Dr Annie the day before you! Shame we'll miss each other.

I have always thought that trying to control our fluctuating hormones with HRT is like trying to pin the tail on the donkey, while riding in a dodgem. Totally shutting off your ovaries makes good sense because then your own fluctuations are totally removed from the equation.

But I think there's someone on here who tried this treatment and her low mood and anxiety were even worse, which worries me a lot.

[Niamh]

Hurdity..very happy for this to be shared also thank you for your lovely reply I always find your posts so helpful for keeping my expectations in check. You're right no perfect solution and after all we all had good and bad phases before all of this! For me I think 2 pumps is my best dose for now and I'll see what Annie says

GLR oh what a shame I hoped we could say hi to each other....we can share stories after though...agree about switching ovaries off 😳I reckon I'm very close to my best place for now ....I just would like a more supportive consultant through this journey and think Annie might suit me better from what I've heard. I'm sure she'll sort you out too. Im going to actually reduce my testosterone dose now as it came up quite high now in my blood tests and wobder if some of my moodiness, short temper is to do with that or could just be my 2 boys driving me nuts lol x

[Briony]

Niahm  Thanks so much for sharing this. I am sure it will help many people (and I am relieved to see I did advise you correctly re the number of pumps needed to suppress ovulation; I'd have hated to mislead you!).

Donna   Your experience with 5 pumps is really interesting as I think I may be in a similar situation (taking patches equivalent to 4-5 pumps). The weird thing is, I was fine initially, but after about six to eight weeks, I seemed to have suddenly started having weird symptoms which I suspect are due to fluctuations (ie the 100mcg arent enough to control my own stubborn hormones). I have intermittent fatigue, light-headedness, pins and needles in my feet and just a general sense of 'oddness'. Today I noticed I was very emotional/anxious too, which I dont usually get to such an extent. What symptoms did you have when your high dose estrogen wasnt suppressing ovulation?
What have you now taken/had done to suppress ovualtion?

[donnacrichton]

I had the same experience was on 175 estradot and felt great for 8 weeks then it's been a spiral since then. I have the marina coil so don't have to worry about progesterone.  I have been getting implants to shut off ovaries and have been having similar problems. I can be great for a few weeks then go haywire again. My consultant has been amazing and he is nhs. Two weeks ago I started using a nasal spray instead of implant. The only problem is it initially increases estrogen before shutting down which usually takes two weeks. I have had no hrt for 5 days now and waiting to go low before restarting patches at a low dose. I am only 43 and it has been 5 years so I need hrt as osteoporosis also runs in the family. I think in the beginning   I got relief as I needed the estrogen then I had mistaken the symptoms of high estrogen for low and we kept increasing doses. I can now feel the difference between the two. Good luck x

[Niamh]

Donna can you tolerate progesterone ok? Thanks for sharing this its really interesting. X

[donnacrichton]

I had premerin right at the beginning and another conti that didn't work then been on the marina since then. I've not had any trouble with it but I only stopped bleeding a few months ago but I believe this was because my estrogen was too high x