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[spacebear3]

I have been on HRT for about 16 months and after we finally got it tweaked I have been doing quite well. Previously I was having huge hormone surges around mid cycle and at end of cycle. These had stopped until last week. I have now had 7 in the past 11 days.
I am at 11 months with no cycle…could this be part of the change or just another part of this horrible experience.
Last January I had the worse PMS symptoms I have ever had in my life and they lasted for 22 days straight with no period. Then I had the biggest period I have ever had in my life in March and that was it, no more.
The hormone surges aggravate my vestibular migraines…I also just had cataract surgery so I am feeling a bit overwhelmed.
Has anyone else experienced a noticeable transition? I believe I have been in Peri for 7 years.
 

[CLKD]

Can't help other than say 'welcome'.  Am sure that someone will HRT knowledge will be along …….

[Dancinggirl]

Hi and welcome to MM spacebear3
Do tell us more about yourself. How old are you? What HRT are your using and what is the dosage? The symptoms you are describing do sound very odd but I doubt if they are actually hormones surges - I think you were experiencing menopause flushes.  Through the peri meno stage our own hormones will fluctuate in the background but usually HRT will override this in time and help us to feel more stable - reduce these horrible surges/flushes. You describe having periods but if you are on HRT you will be having withdrawal bleeds - and these only happen if there is a lining to shed. If you are not getting withdrawal bleeds this might mean you are not on a high enough dose of HRT and this can result in these surges/flushes returning  due to your hormones dropping so low now you are deeper into menopause.
I hope this makes sense. Do read up all the info on this site to get really clued up.  Dg x

[spacebear3]

I am 50 years old and I use compounded creams - Biest (5mg), Progesterone (10%) and Testosterone (10mg). I have not had a period in 10 months.
When my hormones were checked last, back in July…I had a very small amt of estrogen, and almost 0 Progesterone and 0 Testosterone. We raised my HRT and I have felt pretty good until this past 2 weeks. The surges/flushes are coming every day…I used to only get them mid cycle or at end of cycle but they stopped last summer when we adjusted the HRT.
The surges/flushes feel like a small rush of adrenaline that lasts about 10 secs. They tend to come in the evening when I relax or when I am really stressed.
I believe my peri started back in 2009 and I began having irregular periods in 2010…I have had no sign of a cycle except I still have some mood swings and the surhes or flushes. No other signs since Jan of last year.
I have read so much, it seems that there is no “clear” way of knowing exactly where you are at in this crazy roller coaster ride.

[Dancinggirl]

Ahhh!!!! spacebear3 - I assume you are in in the USA?  The compounded hormone treatments available in the USA are not widely regarded as a good idea (particularly here in the UK) as these hormones have not been extensively tested so effectiveness and safety can be an issue.  As I suspected, it sounds as though you have gone deeper into menopause with ultra low oestrogen and the hormones you are using will not be addressing the problems. You are still young to be so low in oestrogen so I would  advice you seek advice from a gynaecologist who will prescribe proper HRT that will address these flushes.  We often describe flushes and nights sweats as adrenaline surges. 
The blood tests you had done do seem to show you are in post meno and it takes up to 2 years for the oestrogen levels to bottom out after the last period - your levels seem really low so some proper HRT would be really beneficial to reduce the flushes, protect your bones and heart and also prevent vaginal atrophy and bladder problems.  Do look under TREATMENTS at the top of this page to get clued up about the HRT options.  It's worth trying HRT - it may well get your life back. DG xx

[Hurdity]

Hi spacebear3

If I haven't done so already then and I would like to echo what Dancinggirl says about compounded creams which are not really in use UK (there are a few very expensive private practitioners) since most oestrogen we have on NHS is bio-identical and we can get progesterone on NHS too.

Depending on the strength and absoprtion of the progesterone cream this is not usually recommended as part of HRT due to either being too low in dose or variability in absorption which could explain your lack of period. It really is not recommneded to control your cycle. If you are peri-menopausal ie had not been 12 months without a period before starting HRT then a cyclical HRT is recommended - to give a withdrawal bleed.

It sounds to me as Dancinggirl says, that you need some conventional HRT at standard strengths and then the results could well be more consistent.

Hurdity x

[spacebear3]

We were doing cyclical HRT until the periods stopped all together. Once they had stopped for 5 months we went to an HRT level that would just keep me steady...and it worked fine for the past  5-6 months. No issues, no problems and then all of a sudden I had the surges all lumped together this past 2 weeks.
I see a specialist here in Texas that is highly regarded as on of the best. She has been honored and achieved some of the highest medical awards such as Named “Best Doctors in America” 2001-2013 (Best Doctors in America is the largest peer to peer survey of the medical profession in the world. Started by Harvard physicians in 1999.  Only 5% of physicians are ever selected)
I am having my hormone levels rechecked tomorrow and will see her next week...hopefully she will have some answers for me. I have not had one in 2 days so....hoping they have subsided for a while. I have a dog in Emergency care at the moment and my stress levels are out the roof.

[spacebear3]

I am also curious as to why you feel conventional HRT is better than BHRT....other than it is not readily available in the UK. BHRT is widely used and preferred in the US for many reasons.
Bioidentical hormones are an exact match to hormones produced by the human body, so they are metabolized and used just as efficiently as they body's own native hormones.
Conventional HRT is considered much more dangerous and risky than BHRT and has steadily declined in use.
All 3 of my physicians use or recommend BHRT...my GP, my neurologist and my gynecologist. 
I am just curious as to where you get your info from.

[Dancinggirl]

Hi spacebear3 -
I am so sorry to hear about your dog - we have lots of dog lovers on this site  (I have a wonderful Border Terrier called Stanley) and we know how traumatic it is when they are sick - they are our best friend and part of the family - I do hope he/she recovers soon.

If you are under the guidance of a highly regarded specialist then I suspect the hormones you are being given will be properly prepared and safe to use - you are also being monitored closely which is essential.
There is a good deal of scepticism here in the UK regarding the safety of some of the compounded hormones that are used around the world; the term compounded BHRTS usually refers to hormones produced by independent chemists and not properly processed in a laboratory, therefore these HRTs have not been rigorously tested to ascertain whether they are safe to use - so essentially one cannot be certain what is in them.  I am sure your doctors source your HRT from a reputable laboratory.
In the UK we have a health body, called NICE, that ensures that all treatments offered in the NHS have had proper and rigorous testing so benefits, side effects and risks are fully known and can therefore be prescribed by our medical profession accordingly.
The Conventional Oestrogen we get here in the UK is mostly now bio identical and we also have Utrogestan (known as Prometrium in the USA) which is a bio identical progesterone - you may read on this site that many of us are already using BHRT - usually oestrogen, as either patch or gel, together with Utrogestan and this can be used as either sequential or continuous hormone treatment depending on where you are in your menopause.  The BHRT we are prescribed has gone through many tests and trials and is produced in a lab to ensure the quality so it can be allowed on license. I'm sure your doctor will be familiar with these BHRTs.  I suspect you will be needing a higher dose to reduce your symptoms.
I do hope you feel better soon.  Dg x

[Hurdity]

Hi again spacebear3

Just to echo what Dancinggirl says. We can tweak the doses of HRT to some extent and especially if we use separate oestrogen and progesterone as I do ( on NHS).

Notwithstanding Dr Kinney's (I presume she is your doc?) eminence in her field, The Global Consensus Staement on Menopausal Hormone Therapy does not recommend custom compounded bio-identical hormone therapy - it's not just in the UK. This statement is endorsed by all the leading menopause societies including the North American Menopause Society. http://www.menopause.org/docs/default-source/2013/ims-ht-ps-2013.pdf

The NAMS also produced a report of a survey into the use of compounded hormone therapy in US - I haven't read this yet, as it's not really relevant to the UK but you might find it interesting!
http://www.menopause.org/docs/default-source/2013/ims-ht-ps-2013.pdf

In UK there is less emphasis on hormone levels because as you will see from reading on here there is no level at which one can say a woman will experience symptoms and we all vary hugely in this respect, as well as the fact that oestrogen levels vary throughout the day and the cycle. Sometimes it can be useful as a rough guide though I think.

Unfortunately in peri-menopause you can't tell where you are and especially once you start HRT - you only know if you stop and then don't have another period! Once you are on a fixed dose of standard HRT and your levels stabilise then you shouldn't notice the horrible hormonal surges any more - which does come as a relief!

Hurdity x