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[Stellajane]

Does anyone have any information on why it takes so long for the full effects to kick in once you stop taking oestrogen?

I used to take Elleste Solo 1mg and have checked out the product information which says levels return to baseline approximately 24 hours after you stop taking it. Yet for me, when I stopped, my worst symptoms didn't return for about 3 months. I am well post menopause so my own levels should be consistently low, not up and down as you'd expect in perimenopause.

I've recently switched to Oestrogel but two pumps daily was giving me breast discomfort so I reduced this down to one pump daily. I didn't notice any difference at all in terms of hot flushes etc.  For the past week I haven't used any oestrogel at all and am still not experiencing any side effects ... but for how long?

I have heard that oestrogen can hang around in fat cells .. but I'm not that enormous!

[Hurdity]

Hi Stellajane

I haven't looked into this, but if you think about it, then oestrogen is responsible for a myriad of effects in the body and these aren't going to be reversed instantaneously, just because the blood serum levels reduce.

For example if you think about vaginal tissues and the effect of Vagifem - it works by thickening the vaginal epithelium so amongst other things there will be cellular changes, presumably the cells change in themselves, and become more numerous ( I'm sure there is info about this - I just haven't time to look it up right now!). So - when you stop using Vagifem for example, then the levels there go to zero pretty quickly, but the effects (the increase in cellular layers and the changes in the tissues) may last for some weeks perhaps before reverting completely to what they would be without oestrogen.

I imagine this is what happens in the body after withdrawal of oestrogen - gradually there are physiological as well as physical changes, some of which become apparent very quickly and others take longer. Some, such as thinning of bones may take even longer. Added to that there are difference in how each woman's body responds to reduction of oestrogen and how quickly. Some women get hot flushes whenever the levels fall (re gel and tablet HRT).

That's a bit of a ramble off the top of my head but hope it makes a bit of sense!!!!

Are you hoping to stop completely? I did notice the effects of reducing from a 50 mcg patch to 37.5 mcg in a couple of months.

Hurdity x

[Taz2]

I've found that it takes around three weeks for the first symptoms to begin to reappear. Maybe the odd "warm" moment - like a hot flush trying to start but failing. After six weeks the hot flushes/sweats begin in earnest and dry skin, vaginal discomfort and poor sleeping make themselves known.

Taz x

[meno lesley]

I recently tried reducing hrt as thought it was causing a lot of my aches and pains. It took only 4 days for my head to feel so odd that I couldn't function. I'm now back on 2 pumps of estrogel and head ok. During those 4 days my pain did subside but have to weigh up not functioning versus pain. I am 56 and it worries me that one day I may have to give up and be carted off to the funny farm.

Lesley x

[Ju Ju]

I have been told I can remain on the low dose HRT for the rest of my life. HRT started age 60.

[Taz2]

That's great news Ju Ju - I think I will arrange a transfer to your doc!!

Taz x 

[Hurdity]

I'm feeling like you at the moment Stellajane. I've had enough of it all - the progesterone bleeding thing I mean, and the whole cycle palaver. Even on a long cycle you still have to take the stuff. I often get a migraine and feel low while taking it (well only for about 6 days - I shouldn't complain) but this time the withdrawal bleed was heavier than usual and went on and off for just over a week, so I'm worried that maybe the v small fibroid the doc wasn't worried about last year might have grown bigger, so will have to go to the doc and they'll probably say stop HRT etc etc. At 61 it is a right pain but I don't relish the alternatives - ie stopping HRT completely. Personally I wouldn't want to stop and then start when the symptoms come back ie stopping and starting.

I can't remember what you are taking now Ju Ju? Sounds good! Are you on continuous combined and if so which progestogen/dose etc?

Hurdity x

[Ju Ju]

Hi Hurdity,

It's thanks to you that I persisted in seeking help. Otherwise, I would be labelled with CFS, and sent on my way.

I have evorel 25 patches, 2 a week, plus Climaval 1 mg at night, which will change to kliovance with the next prescription. I will be adding Testagel soon into the mix. I'm hoping progestogen won't worsen hormone related symptoms, as I have responded well to low doses of oestrogen. I have been told I can add an extra patch if IBS is particularly bad, as this interferes with absorption. I still have bad times, mainly related to IBS, with extreme exhaustion, but have been able to do so much more the rest of the time.

 I was given a lot of useful advice. Unfortunately, I have had to get this help privately, but I do have the support of the GP I have seen in the last few months.  Ju Ju xx

[Morwenna]

I'm actually not put off by the "stopping and starting" idea Hurdity - its worth it for those few blissful months between leaving everything off and symptoms kicking in again! I just have so much more energy - can't describe it in any other way than that the "real me" breaks through for a while.

A lot of women feel that HRT gives them the 'real them' back again - are you saying you feel better and more like your old self when not taking it? The reason I ask is because although HRT has helped enormously with the myriad of physical menopause symptoms over the three years I've been on it, I've feel the 'real me' has gone forever. My partner agrees I'm just not 'the same girl' I was. I'm wondering whether to ask to try a lower dose of HRT - although I do suffer from VA and am worried that this would get worse if I reduced the amount of oestrogen I'm taking? 

[Hurdity]

Stellajane - it's great you are working out what's best for you!

My view is that in general, the real "me" whatever that is - disappears for ever after menopause! HRT relieves some of the worst symptoms but depending on what you take, there are some downsides too - for most women due to the progestogen (either taking it all the time and what that entails, or having a cycle and what that entails!)

With very low oestrogen and declining testosterone, and no cycle - one can never be the same as before and it's a question of balancing everything to find what's right for each of us!

The real "me" or you, depends on very high levels of oestrogen cycling between lower levels, and enough testosterone to give you libido, energy and zest for life. Our fertile bodies are very different and the physiological changes affect our mental state. Finding the right HRT will help you get some of the "me" back but I don't think it can ever be the same.

Different reactions to different types HRT will affect how we perceive this - and taking it externally can never quite replicate our natural cycle.

JuJu - your prescription at the same age (ish!) is very encouraging, and so glad you are seeing an improvement in your symptoms. I do hope that you continue to feel the same when you add the progestogen into the mix - it might take a while to acclimatise!

Hurdity x

[meno lesley]

I agree with you Hurdity. For me the last 4 years have been a rollercoaster of meno symptoms, changing hrts with me constantly searching to be like I was before. 4 years down the line I have come to the conclusion that I am probably not going to be the same again but have just tried to accept a sort of balance if that makes sense. I still have to work, look after my granddaughter and function on a daily basis and therefore sort of cope with the side effects of hrt rather than the full blown meno symptoms. My only concern as I said earlier is that my new gp is anxious to get me off of hrt before 60 but I will cross that bridge when I come to it.

Lesley x

[Morwenna]

That's exactly it! I was just explaining to my younger sister (who hasn't reached menopause yet) when she couldn't understand why I don't want to stay on it for ever if it's keeping all the bad symptoms at bay, how I feel that HRT is keeping me well by artificial means. I just want to live life as I did before, not have to think about it, and be naturally well. I really do think in terms of 'before menopause' when I look back to when I last felt normal. Some women talk about 'coming out the other side' though - what do they mean by this I wonder? 

[Night_Owl]

I don't equate the "real me"  with the "younger me". I've never wanted to turn the clock back and am happy growing older.

What I mean by the "real me" is the 60 year old woman free from all the HRT baggage - rubbing on gels, shoving in capsules and pessaries and poring over the calendar trying to plan my next bleed. I love being free from all that. That's what I find energising.

The truth is when I'm pumped up on HRT it feels like I'm "synthetic me"!

Stellajane - I couldn't agree more.

This is exactly how I'm feeling at the moment. 

I'm tired of HRT (mainly progesterone) after all these years of trying different regimes - for me it has never done what it says on the tin - the 'pay off' effects of estrogen have never been that great.

The last use of Utrogestan 100mg was particularly horrendous and I've decided to have a break from HRT - apart from Vagifem. 

So, I've booked myself a HRT-free holiday and I'm 2 days in.

[My 'tailored' ultra low HRT regime is: half of 25 Estraderm patch, Utro 100mg x 10 days every 6 weeks, plus twice yearly endo scans, no bleed on this, just maybe brown discharge sometimes -  but I so DREAD taking the Utro - and so does my partner, for how it transforms me into an absolute witch.  Literally he only has to breath (whistling through one nostril) for me to lose my rag.]

Due to progesterone intolerance I have never found one that I am able to take - and still function.

Taking my usual supplements and lots of fish oil.  Last time I tried this was c.2 years ago and after 3 months I was a wreck.  Maybe this time it will be different. I would like my body to settle naturally and adjust to low levels. 

At last meno clinic appt, I discussed with the consultant that at nearly 52 years and  c.7 years post meno - how would continuing declining levels of estrogen affect me.  I was told that my estrogen level had dropped to a consistent low of c.155 - my body had 'done its worst' - and that the natural level would stay more or less the same.

[Re: hair loss - in individuals genetically predisposed to female pattern baldness - I was also told that natural estrogen acts as a 'protective cap' on the head and that when levels decline, even if estrogen is supplemented with HRT, the tiny amount of testosterone still produced converts to DHT on the scalp and miniaturises each hair.  Great.]

Anyway, I'm hoping the Vagifem will keep VA at bay - and that I can last without having to go back on patches/prog.

Stellajane - have you found some use of Utrogestan worse than other times.  (It's always bad for me but last use was exceptional, the clear message from my body was: toxic, stop this).


Night_Owl
x

[hotstff]

StellaJane - I know what you mean!

Life seemed so uncomplicated Pre-HRT.

I have just started HRT and I must admit, I'm not that impressed with it!
Yes, it has kicked the hot flushes into touch, but that's about it in my case.
I no longer have hot flushes, (and therefore sleep better) but I DO have (which I didn't have before HRT):-

Anxiety
Low Mood
Low Libido
and a little bit of Hair loss (but I could be imagining it) My hair needs cutting  .

Not much of a trade off so far.
(although I'm only 1 month in to a 3 months supply - so who knows - things might improve?)

At the moment I'm trying to weigh-up the options.

(I must admit it's great to have a good night's sleep............... )

decisions, decisions

[hotstff]

Stellajane am taking Elleste Duet 1mg.

My hair does need cutting (layers have grown up), so I could be imagining the hair loss (hope its that and nothing else).