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[Ljp]

Hi,
I'm coming to the end of my third month using both Estring and oestrogel.
My worst symptoms of menopause being bladder/va/urgency and frequency, followed by anxiety and night sweats and brain fog.

I have mirena coil, and estring, and have tried both one pump of oestrogel, and two,pumps.

With one pump I feel less flat, better mood, but do get an occasional hot flush on waking in the morning.
On two pumps, I have no flushes, but find I have a feeling of tiredness, feel flat and moody.

The idea was to try two pumps then see if I could manage without estring, but I am feeling that one pump plus the estring, and suffer an occasional morning power surge, is perhaps what works best for me?

Is it better health risk wise to use estring and just one pump oestrogel systemically? Rather than two pumps oestrogel and try without estring!

Thank you, I'm due to see GP next week to discuss

[Dancinggirl]

Oh Lisajp - you are over thinking all this.  If you feel generally good on one pump of Oestrgel then stick with this - you haven't been using it for that long and things improve over time - you can't tell if a dose is right until you have been using it for at least 4 weeks - if you have been chopping and changing then this will give fluctuations that could effect your mood. 
As for the Estring - that is in place to get your bladder issues under control more quickly and until you feel things have improved I would leave it in place. If you need to keep using local oesogen then with the Mirena in place you can use both systemic and local oestrogen quite safely for the long term - once the Estring has run out at the end of the 3 months, you could switch to using Vagifem twice a week if you wanted until your bladder is really better. In terms of risk, you are probably on one of the best regimes that any one could use - this is why so many gynaes offer this as first line treatment. If you are in less discomfort and sleeping better etc then this is all improving your health and wellbeing.
Has the bladder been improving ?  DG x
 

[Ljp]

Thanks DG I know I overthink, another terrible menopause issue for me! Sorry 😟

I tried two pumps for three weeks, and felt horrible, so I reduced to one pump.

Bladder is generally better, although I do have days when I still have to pee a lot, and urgency can be bad, but not quite to the extreme it used to be, it's mostly at its worst on my 5:2 fasting days, I use 5:2 to control my weight, but have definitely put on about 4 pounds since starting HRT.

I rare,y have to get up in the night these days which is a positive

[Ljp]

My anxiety re health risks has been exacerbated as my SIL has recently had a small stroke, she is the same age as me (51) and has been on oral HRT since her hysterectomy 20 years ago.

[Dancinggirl]

Lisajp - I'm afraid the 5/2 diet will not be helping things.  Your blood sugar levels will be so low on the fasting days this could really throw you out in terms of mood and anxiety.  HRT shouldn't actually make you put on weight unless you are eating more - one can get a little more plumped up and muscle structure can improve which is a good thing but will add a bit of weight because muscle is heavier.  I actually loose weight on HRT because I have more energy!!! I think one would naturally want to drink more on a fasting day so that won't help either.
To keep ones weight down the best diet is to simply eating healthily and reduce the amount you eat - not just temporarily but permanently!!! I'm afraid as we get older we simply have to reduce intake - I now eat about one third less that I did 5 years ago and I still struggle to keep a flat-ish tummy!!!
I would try reducing portions and cut out as much sugar as possible - I've never been convinced that dieting works. DG x

[Maryjane]

I am ten weeks into the estring and 1mg of sandrena and 7 xs days of utrogestin . I'm not there yet but have just taken it and gone with the flow until 3 month check up which I think I will need the sandrena upping. I walk lots and eat the very best good quality food I can afford and cut out all rubbish I have lost weight doing this.

[Ljp]

5:2 suits me, it's two days a week and I know how to keep my blood sugar level. It's not just for weight control, it's also excellent for health as in switches off the insulin producing hormone, and puts the body into a state of repair, giving it a break from constant digesting.
I am very used to the regime, been doing it for three years.

[Ljp]

Thanks Mary Jane, I started in one pump, alongside the estring, and mirena coil.
At the advice if my GP, I upped it to two pumps in January, but reduced it again after three weeks as the extra oestrogen didn't agree with me.
I'm now back to one pump, and due to see my GP next week as that will be the end of my first three months, and need to discuss/decide what to do re local oestrogel, whether to try without, or continue with another estring or even go back to using estriole cream which is what I was originally using before the whole HRT issue started

[Dancinggirl]

lisajp - You could try Vagifem for local oestrogen as it is less messy and easy to use. If you are using systemic oestrogen like Oestrogel you may find you just need to use it once a week to help keep things healthy.  I still use some vaginal moisturiser like Multi gyn Actigel that helps to keep everything healthy and lubricated and reduces the risk of bacteria taking hold that might cause a UTI.
Pleased to hear things are improving - over time it should get even better.  DG xxx

[Ljp]

Thanks DG, it's strange with me, it's very much bladder related frequency and urgency, that's the main problem. I presume these issues are forever? And will always need local oestrogen?

[Dancinggirl]

lisajp - have you asked to be referred to the special clinics that are supposed to help with incontinence and frequency? Whilst incontinence isn't an issue for you, they may be able to give advice about how to prevent the frequency issue.  Sometimes it's about training the bladder to hold more and doing the right exercises etc.
I get up at least twice every night - have done for many, many years.  I can go 4-5 hours during the day if I haven't drunk too much tea but I'm careful to drink plenty of water and usually don't hold on too long as I'm frightened of getting a UTI.  I also make sure I fully empty my bladder when I go - when I'm sore I'm aware that I clench and I think it's then difficult to fully empty everything. I'm not on systemic HRT at the moment but using Vagifem every 3 days and so far I've been relatively OK - a bit sore today though.
The whole bladder thing it so difficult as it's psychological as well - it's difficult to forget about it and get on with life. DG x

[Ljp]

Agreed, it can become way worse if I focus on it. Night time has really improved, most nights I don't get up at all now.
I have tried bladder training, almost impossible to hold on, when your bladder is screaming need the loo!

How are you doing off the oestrogel now? Have your flushes returned? And or other symptoms?

[Dancinggirl]

lisajp - I've been off HRT before a couple of times so I know what to expect - it's not too bad at the moment.  For me it's not so much flushes but the way my body reacts to temperature changes.   In winter I can go hours with nothing but then walk into a warm room and break out into a sweat or overheat.  Being winter things are not so bad - it tends to be summer that is torture.  What is really plaguing me are the headaches - which are awful - while on HRT I don't get nearly so many!!!
The VA and bladder issues are OK for now - I'm using Vagifem every 3 days - but I had a bad day yesterday and I don't know why!!??? I feel my body is craving the oestrogen now but is it worth putting up the problematic bleeding? DG x

[Ljp]

So difficult making decisions, weighing up all the options, and finding a regime that suits you isn't it? As if we don't have enough to contend with at this stage if our lives!

Was the problematic bleeding from utrogestan your reason for taking a break?

Hope it all settles and works out well for you xx

[Dancinggirl]

Yep, the bleeding and the cramps. I always suffered with bad periods pains before I went on the pill at 17.  I came off PCB at 30 to start a family and the period pains returned with vengeance - my poor husband used to find me in the small hours of the night writhing in agony on the floor of the bathroom throwing up in the loo.
The period pains were not nearly so bad after I had my first baby (apparently this is often the case) but I started to get bad cramps for a few hours with the withdrawal bleed in my late 40s when I had been on HRT for about 10 years which was strange.
I got some episodes of cramps when I had the Mirena but nothing bad.  The cramps I got on the Utro weren't terrible but I had some nights when I had to take pain killers and really couldn't sleep!!!.
I think my poor uterus doesn't cope so well now!!!  DG x