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[Badga]

When I had my bloods done prior to going on HRT (Evorel Conti 50ug) my serum estradiol was 30.  Range for premenopausal women is 200 to 2000, below 150 is considered postmenopausal.  Both my GP and consultant were shocked at how low my level was.  I have just last week had my level measured by the GP.  My current level is 115, so is still below the postmenopausal level of 150.  The reason I had this measured (along with other standard assays - thyroid, LFTs, Us&Es, Hba etc., which were all normal) is due to my continued chronic fatigue.  My question for the forum is, are to 50ug patches yielding enough estrogen, given my blood result?

[Hurdity]

Hi Badga

Last time I had mine measured about a year ago they were 212 and I am on the same dose of oestrogen as you - then aged 59 and about 4-5 years post meno. I take mine cyclically though so not sure if having progestogen all the time will affect the efficacy of the oestrogen?

Although I would prefer mine to be higher I balance this against having to have progesterone and keeping as long a cycle as I can without having to take too much prog!

I can't remember how old you are or where in meno but yes I would say that is low - but blood tests are unreliable too.

Have you been tested for tesosterone too?

Maybe go for a higher dose - but would probably be best to have separate oestrogen and prog in that case?

Hurdity x

[Badga]

Hi Huridty

Thank you for the reply.  I take my HRT continuously.  I have also now managed to get them to stick through the application of a wound dressing over the top.  I am Seeing my GP at the mo to investigate my fatigue that is some days so bad that I cannot get to work.  All the usual bloods are, thankfully, normal so I suspect hormones are to blame.  Interesting question about testosterone, no, I haven't been tested (Studd would have me on testosterone by now).

I am 52, so early PM when hormones crash.  I suspect that it is not a problem with sticking and absorption of the patches, but more the 'one size fits all' approach.  I am very tall and athletic (ex fitness instructor).  My BMI is just under 'overweight', but this is due to my high proportion of lean mass (I have worked as a DXA operator in research and had scans myself).  Every time they weigh me at clinic they are shocked how much I weigh because I look 'lean'.  I also know that estrogen is metabolised in fat, and I do not have a great deal of that.  I also challenge my metabolism with regular strenuous exercise.

I agree that it is a balancing act.  My current prescription has helped with the vasomotor symptoms and the 'PM munchies', by I do not think it has dealt sufficiently with the PM associated fatigue.

I will defo speak to my GP and consultant about this, but not sure how keen they will be to prescribed levels above the 'minimum safe dose'.  Pleased that the fatigue doesn't seem to have another 'unknown' cause though.

Badga x