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[GypsyRoseLee]

Just over a month ago, Prof Studd prescribed me 3 pumps of oestrogel with separate Utro to be taken on June 1st, 100mg for 7 days. And a blob of testim gel every day (my testosterone level was 0.7).

Well I stuck with the 3 pumps for just over 2 weeks but felt my anxiety was worse so dropped to 2 pumps for just over a week. Zero improvement in my anxiety and low moods.

And alongside this HRT I was taking 200mg of Trazadone.

Anyway.............whilst still using 2 pumps, on days 8-10 of my cycle this month I suddenly felt so much better (and I have read that from day 8 onward your own oestrogen starts to surge).

But then day 11 was pretty bad, and it was here that I stopped HRT. But days 12-13 I suddenly felt much better again (I couldn't really detect any increase in clear mucus etc, but this traditionally should be when I would ovulate).

Day 14 was pretty bad (but I was physically poorly and had barely slept the night before which always wreaks my well being). But days Days 15-16 I felt pretty good still (so perhaps still enough of my own oestrogen on board?).

Day 17 was a bit grim (certainly not helped by some sad personal news). But days 18-19 I felt fine again (I have read that you have another mini oestrogen surge on roughly day 19/20 of your cycle).

But since day 20 (Tuesday) my mood has just sunk lower and lower and my anxiety so bad. The worst I have ever felt, to be honest. Early morning anxiety just unbearable.

As I'm still pretty regular my period should start in 5 days time.

So....................if you have managed to get your head round that, does anyone else think my cycle shows I am reacting positively to the surges in my own oestrogen? The timing seems to really fit.

And is my now much worsening mood and anxiety due to my own oestrogen really dropping, and of course I'm not topping it up with oestrogel.

I just don't know which way to proceed. The 'good' days which I thought my AD was finally giving me, could just as easily be accorded to my own oestrogen rising at certain times.

I have a drawer full of oestrogel and testim prescribed by the leading world expert. Should I just go back to using it?

Please help. I am so confused and indecisive.

[CLKD]

How is your diet?

[GypsyRoseLee]

Diet is pretty average. It could perhaps be a bit better, but I take a good multi Vit every day.

[Keepgoing]

How were you feeling before hrt...maybe start on 1 pump to get your body used to it then up it slowly see how you go...11 days is not really long enough to let your body adjust xx

[GypsyRoseLee]

This isn't the first time I have taken HRT. I used patches with separate Utro last year, and managed to have roughly 2 good weeks per month and roughly 2 bad weeks.

But in the New Year I switched to Femoston 1/10 then 2/10 and it all went very wrong from then. Since end of Feb, I went back to using 2 sachets of sandrena gel for 6 weeks, via Dr Annie. To no avail. Then switched to 3 pumps of Estrogel, via Prof Studd for 3 weeks. To no avail. But I realise it wasn't very long at all.

[dangermouse]

Those days pretty much match how I am - this is what I reckon happened:

8-10: oestrogen at perfect level for you
11: oestrogen too high (as its climbing)
12-13: oestrogen that was too high fell due to stopping HRT so perfect again
14: oestrogen too high again at highest point
15-16: oestrogen perfect as its starts to fall
17: oestrogen too low as it plummets after ovulation
18-19: oestrogen perfect as starts going up again
20-21: oestrogen too high again

Forecast:
22-26: oestrogen may be perfect again
27-5: oestrogen and progesterone may fall to too low
6-7: oestrogen may start climbing again

The highs tend to surge too high and the lows fall too low in peri, so perhaps you could have 1 (or no) pumps on the too high days and 3 pumps on the too low days (or the nights before so it has time to get into your system)?

I am doing this with the pill as I have one that's 20mcg oestrogen and 1000mcg Norethisterone for the oestrogen peak days, and one with 35mcg oestrogen and 500mcg Norethisterone on the low days. It's working for me quite well.

[GypsyRoseLee]

That's so interesting dangermouse. Thank you for plotting that for me, it has made it clearer to see.

The last few months I have averaged a 26 day cycle.

I have never heard of oestrogen being adjusted in this way, but it makes perfect sense when your own cycle is is still regular.

I've never heard of the BCP used this way either? Did your GP suggest it?

[dangermouse]

I was deciding which one I preferred and kept swapping about, once I'd got through the initial settling in period, and then realised I had such different results on different days as my own hormones were so volatile. It's much the same as if you have a triphasic pill and the GP said it was good idea.

I still get the normal cycle changes on the pill and I think because it keeps progesterone levels high, you end up with an exact 28 day cycle every month. (I read that younger women are put on progesterone when they have irregular cycles and it gives them a 28 day cycle).

It's handy as I know exactly what symptoms I'll have on each day, one of them being skin itchiness, and it's like clockwork on the same day each month!

[warwick01]

I would just start with one pump every day. The good things with gel is you can add accordingly. It's such a tricky time during peri that too much or too little can cause you to feel worse.

Have you a follow up with Prof??

Wxx

[CLKD]

I mentioned diet because NAPS suggested that I eat every 3 hours, 24/7 to keep blood sugar levels even.  A sudden fluctuation can cause anxiety 

[Hurdity]

I really don't know that you can adjust oestrogen levels to that fine degree ie daily - because taking it exogenously  (ie from outside the body) is very different from the body's own complex and fine-tuned endocrine controls. That's not to say that the body does not respond to the rises and falls because it clearly does - and some women are more sensitive than others - but to re-create this though adjusting your estrogel dose I doubt will do the same thing. The key thing with HRT is try to ensure the oestrogen is as constant as possible? I can see that in a regular cycle you could try taking an increased dose for the last week and first week of the cycle - when oestrogen on average is at its lowest - and the body could register this change - but on a day to day basis I don't think this is possible due to metabolism within the body (but I stand to be corrected if there is evidence of this working!)?

Dangermouse - I've never heard of you system and can't understand why you are doing it like that? The whole point about the Pill is that is suppresses ovulation and your cycle so any fluctuations in oestrogen will be negligible?

GypsyRoseLee - sorry you are still not sorted yet - but I wouldn't stop and start oestrogen like that. Yes I would go back to using it. Either at the very high doses to suppress your cycle so you don't get the highs and the lows - surely this is Studd's regime? Or perhaps differing doses during last week and first week - as a crude way of evening out your oestrogen ( but I would run this past a gynae!)

Hurdity x

[GypsyRoseLee]

Thank you Hurdity. Wise words as always.

Yes, Studd's regime was 3 pumps of estrogel a day, with 100mg of Utro for 7 days, starting June 1st (he wanted me to just use estrogel for a good 6 weeks first).

Having said that, despite using the 3 pumps for just over two weeks, I still went on to have my own natural period, which arrived spot on time and was of normal duration and flow etc.

This s also happened whilst on Dr Annie's regime of 2 sachets of sandrena gel. I never got chance to use Utro as my own period arrived before I got chance. Both months!

But maybe 2 sachets weren't enough to supress my cycle?

And maybe I didn't use Studd's 3 pump regime long enough for it to get chance to supress my cycle in time (I started his regime on day 15 of my cycle).

Or maybe my own cycle is too strong to supress with 2 or even 3 pumps?

Today is day 22 of my cycle, so I have applied 3 pumps + a blob of testim. My period should arrive on Monday, so just don't know what to do about Utro?

I suppose it can't do any harm to take it from June 1st, even though my own period will have just finished a few days earlier?

[dangermouse]

I pretty much do the high oestrogen pill for a week and then the low one the rest of the time, so not actually changing every day now I've worked it all out.

I know the pill is meant to stop ovulation and keep hormones stable but my own peri fluctuations are so severe that they still produce an obvious cycle. The GP said this can happen with strong surges and some women still ovulate. They recommended first a triphasic pill where the oestrogen was 30 on some days and 40 on others, they said to take it in any order to suit my needs for that day, but it was Levonorgestrel and made me feel rubbish.

If I don't switch the pill as I do then I get bad nausea around Day 14 and I get more severe adrenaline rushes at end and beginning of cycle. The pill works very quickly with me, I once had horrible nausea for 2 whole days where my stomach was moving so much it looked like an alien was in there, and then when I switched to the low oestrogen / high prog pill it all went even crazier for half hour and then suddenly stopped an hour after I took it!

[Hurdity]

Hi GypsyRoseLee - if you started the 3 pumps on Day 15 you will probably already have ovulated that month, and so the corpus luteum will produce progesterone etc as normal, and prog levels will drop as the corpus luteum dies off, triggering a bleed despite having subsequently increased oestrogen. That is my basic understanding of it anyway.  If you only used it for two weeks then that probably isn't long enough and maybe not a high enough dose to suppress ovulation - I thought 4 pumps was recommended? High oestrogen should suppress FSH but needs to be high enough I understand. If you've only just re-started the Oestrogel maybe you won't need the utrogestan this month as you will have ovulated (probably) but start in Day 15 or 16 whenever you normally do ie the second half of the cycle next month? - sorry don't know what to suggest here.

Hurdity x

[warwick01]

Hi

Hurdity is correct. Studd recommends 4 pumps of oestrogel to suppress ovulation. He usually recommends 2/3 for symptom control.

It's possible you either require the high dose to supress ovulation or a low dose to top up your own estrogion.

All the best Wxx