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[Angelasurrey]

Hello All,

I am on Sandrena gel, 4 mg per day (split am and pm) . My symptoms from Ovulation until Day 2 of my period are still not managed. I have many  PMS symptoms (low mood , lower back pain, irritability) so I started to use the 4mg daily (from 10.3.22).. Is there a way to suppress ovulation through HRT?

2) Please see this factsheet. https://www.newsonhealth.co.uk/uploads/2022/02/What-is-reproductive-depressionfinal-with-links.pdf.

Here is an extract of what’s relevant in my case. It may be that I may need more estrogen. I do think Sandrena is helping me. I need to get it optimised.

Helping reproductive depression with HRT
The use of moderately high doses of transdermal estrogen (that taken through the skin in a patch, gel or spray) is often recommended to suppress ovulation in women with PMS, postnatal depression and depression in the perimenopause. Common doses for these types of depression would be 200mcg patches (twice weekly), or 4mg daily of estrogen gel. This approach often balances out the profoundly fluctuating estrogen levels to help stabilise your body’s reaction to the hormones and lessen symptoms.

3) How soon should I consider increasing the Estrogen again? I read somewhere ( Dr Nick Panay) that adding further  estrogen can flood receptors so in some cases going over a certain amount doesn’t work? Is this true ?

4)Should I optimise my estrogen first, before starting the Androfemme?  My understanding from listening to Dr Newson’s podcast is that if I don’t have sufficient estrogen, any Testesterone I apply will convert to estrogen. Is this correct?

5)My blood results for Testesterone, it showed 0.1, is this low?

6)What are the side effects of androfemme?

7) Should I apply androfemme in the morning and how long does it take to dry?
I’m worried it will rub off or be removed with clothing. How soon after can I have a shower or is it better to wait?

  As I am taking 4mg Sandrena, do I have to increase the vaginal progesterone? I am currently taking 100mg vaginally for 12 days ( Days 15 -26). 

Thank you so much

Angela xx

[ATB]

I take Androfemme, have you been prescribed it yet? Usually your doctor will tell you when to start, my understanding is yes you start estrogen in whatever form for a few months and then add testosterone. I was on estrogel ( later patch ) and Utrogestan for 8 weeks before adding my Androfemme which I rub on my thighs, changing area every day, and it takes like 5 minutes to rub on. I thoroughly wash the applicator each time or it will be a pain to use next time. You should apply after a shower on dry skin, no other creams, but if you can’t then you have to wait a few hours before swimming or showering. The testosterone level, is that the free testosterone? My Dr said the aim is 2-5%. My doctor gives it 3 months before looking at a change in dosage and has altered my estrogen since I started testosterone, I don’t think it needs to be absolutely right before taking the T.

[Louise2010]

Hi Angelasurrey
4) I was on oestrogel for a long time before starting testim so I would say waiting to see how your body goes on the oestrogen may be a good thing before starting Androfemme but that’s my opinion based on my experience which had a positive impact.

5) it’s my understanding that if that is free testosterone that yes that is low. Around the 2 marker is considered optimum ( please correct me anyone if I’m wrong?). Are you having symptoms of low testosterone? Brain fog? Fatigue? Loss of libido? Dry eyes? It can be confusing when you are starting a regime to see the wood for the trees which is why it may be an idea to see how you go on the Sandrena dose first and then reassess what symptoms you are still getting. Then address them.

6) as far as I’m aware the side effects of too much testosterone would be acne and hair growth in places you’d rather it didn’t. However I’ve not had any side effects from testosterone. In fact my hair was falling out on my head and it’s improved since taking testosterone.

7) this is a good question about timing. I apply mine in the morning and have wondered whether that’s because our hormones naturally would peak during the morning and so it’s a natural follow on that we’d apply them during the morning. However I split my oestrogel dose am /pm to stop night sweats so I’m unsure about splitting testosterone or if you should or can! Maybe someone will be along later to address that? 🤞🏻

As far as increasing progesterone I would say in my opinion that if you are tolerating progesterone well at that dose and you can have regular scans to determine your womb lining thickness, that you shouldn’t mess with the dose. That said some might say if you are taking a high dose of oestrogen then up the progesterone.
How are you feeling when you take the progesterone generally?

Sorry I haven’t answered first 2 questions. Looking at your symptoms I’d take a guess that you do need more oestrogen.
It’s such a trial and error thing and everyone is so different which compounds the issue. I keep a v brief daily journal/diary to keep a track of mood what I eat sleep and symptoms. It’s a job in itself but helps so much to track fluctuations. You may already be doing this don’t want to assume anything.
Hope this helps a little and things get a little easier for you. 🤗xx