Interesting link - but I can see the devil is in the detail and a few more specifics would be interesting. eg some of these studies were talking about Premarin - which as we know is not bio-identical but a mix of horse oestrogens (including some estradiol) which are more potent than our own - and many women do indeed experience problems on this particular one.
So if you had a bad reaction in the past and to the birth control pill - well it might have been Premarin you were given, and the birth control pill again contains very strong synthetic oestrogens - so cannot be compared with estradiol. Similarly if you took HRT orally then you may well be reacting to the metabolites and whatever happens to the excess oestrogen after it's gone through the liver - so it's not as straightforward as it seems.
For me the starting point is the basic fact - we are designed to "like" oestrogen - this is our gender hormone. Most women feel at their best during the middle part of their cycle when oestrogen is at its highest and progesterone very low. By several years post-menopause oestrogen has decreased to a low level - and this is established to be responsible for low mood, anxiety etc (though not of course in everyone).
During peri-menopause ( and possibly the late reproductive phase too?) oestrogen levels fluctuate hugely so may be suddenly abnormally high ( though nowhere near as high as they are during pregnancy) - and maybe this sudden increase to higher-than-normal-for-you levels causes some anxiety also in some women? I don't think there is enough information on this.
Added to this there is the overall pattern of oestrogen falling as peri-menopause progresses ( even though there may still be spikes?) - and all sorts of reactions occur - hence the wilderness women find themselves in trying to work out what's what as periods and cycles start to become erratic.
As I said on another thread - replacing oestrogen from outside (exogenously) doesn't seem to always do exactly the same job as our own endogenous oestrogen - not least of which I presume because there are so many other hormones coming into play as well.
In addition those like babyjane who appear super-sensitvie - many women experience initial side effects from sudden increase in oestrogen - but many of these do subside after a few days or weeks leaving women feeling much better in the end - and the sensitivity is reduced by using transdemral estradiol ( ie patch or gel). If you don't need progesterone then all the better - that is out of the equation! Lucky for those women!!!
My view is that peri-menopause lasts for fewer years than post-menopause - if we are lucky to live a long time - so we are more likely to be without it for a long time. Therefore it is worth riding out the initial side effects if you can find a non-medical way of coping ( ie without drugs like ADs and BBs!) - so that you can benefit in the longer term.
Also - those who have tried it when not yet in peri (ie still having regualr periods) and given up because it doesn't work for them - I would say don't give up for ever - you may well find you benefit later on when your hormone surges have lessened and ceased.
Oops got carried away yet again - but hope you get what I mean?!
Hurdity x
