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[Tracylou]

Been on hrt for 18 months. First Evorel sequi then in March 2022 Evorel 75 & utrogestan for 12 days per cycle. Tried to increase to 100 & tried Estradot in May but felt so bad that I put the Evorel back on. A few months ago I've been adding half a pump of gel to try & build up to 100 gradually to try again. Been on Evorel 100 for 4 wks & added one pump of gel per day as felt I needed the top up. Felt awful yesterday so didn't add any gel & feel even worse today. Tight chest, indigestion, dizziness & lower leg pain. My estradiol level before the recent increase to 100 was 420.
I just don't know if I need more or less oestrogen? In all the time I've been on hrt I don't think I've had a single day when I've felt good. I'm 52 & peri.

Any advice appreciated.

[Flossieteacake]

Hello Tracylou and welcome to the forum. Are you under the care of a GP and how knowledgeable are they? It sounds quite like you have been left to your own devices. Sometimes increasing oestrogen is not the answer and if we increase it too quickly it can make us feel unwell as our body has not had time to adjust to it.

It sounds to me like you may be feeling unwell due to the changing. I know for me I need to wait a few months before increasing.

[Tracylou]

Hi, I've seen a private meno dr earlier in the year but my gp since then. She's lovely  and does let me try things but I'm mainly going by my own research. It's just trying to work out how long to give each increase.

[Flossieteacake]

Oh I see. In my opinion you may be going to quickly in an attempt to feel better. I can totally understand that. How would you feel about asking to be referred to an NHS menopause clinic who will be able to help you find the right balance?

[Epona52]

Hi Tracylou ,
I agree with flossieteacake that sometimes it can be too much at once, I'm the same as you if I increase too fast it knocks me all over the place, try half a pump of gel, see how you feel, if ok then increase to a full pump, it is trial and error and we do go through it to get there, hope you feel better soon
X

[Tracylou]

Flossieteacake - waiting list to see an nhs menopause dr is over a year I'm afraid so not really an option.

Epona52 - yes, maybe I'll try half a pump. Thanks

[Hurdity]

Hi Tracylou - sorry to hear you're still not feeling good. Unfortunately if you are still peri-menopausal then your own cycle will be coming into play - maybe unpredictably - so your hormone levels will also vary and that can affect your mood, in addition to the changes you are making externally too.

Measuring oestrogen levels at this stage doesn't really tell you anything because you are peri and your levels will be changing day to day and are just a spot check really.

When you say you felt you needed a top up of gel, or when you increased from 75 mcg Evorel - what were you feeling that made you think you needed more?  Also how are you taking the utrogestan - orally or vaginally and  do you take 200 mg. Also have you kept a diary to see if any of your worse symptoms occur at a particular phase in the utro cycle? Progesterone can cause dizziness for example, and indigestion if taken orally.

I hope you manage to sort things out so that you can settle on a regime that works more of the time than it doesn't!

Hurdity x

[Tracylou]

Thanks Hurdity. I felt I needed a top up as my palpitations were coming back & tiredness & dizziness. I take 100 utrogestan vaginally, couldn't get on with orally, for 12 days per cycle. Having a mirena fitted next month. Finished this cycle of utrogestan on Saturday. I keep a diary of symptoms but can't really see much of a pattern unfortunately but that's peri for you I guess!

[EllaAurora]

Hi Tracylou,
sorry to hear you're not feeling well.
I'm wondering the same as other ladies above. Maybe you are increasing/making too many changes too fast? We're all different and some women are able to increase doses quickly, but for many (myself included), going slow works better. It's awful to just wait and see when you don't feel well, but allowing your body more time to adjust before changing could help.

Estradiol levels can be tricky, especially as you are still peri and the 'feel good' levels vary so much between individuals.More is not always better.

Could you ask Dr Currie? There is an option to send her a question on this site (you have to pay a small fee). I haven't tried it myself but remember other ladies sharing positive experiences.

Let us know how you get on. xx

[Tracylou]

Thanks, I'll look into it x