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[Joesmum]

I have recently been put on 4 pumps of Estrogel by my gynae. He removed my ovaries and uterus 5 years ago and used implants. He has now switched me over onto Estrogel.

As I have nothing to compare this too I can't figure out of this is a very high dose? I used 50mcg EVOREL patches for a couple of weeks supplied by my GP to tied me over.

I've been using the Gel now for a couple of weeks. The crying has stopped along with the dizziness, insomnia and other awful symptoms.

I would really appreciate hearing from other ladies on Estrogel.

I was incredibly symptomatic with an estrogen level of 220 p/mols which was surprising. That's about 60 pg/ml.

I don't seem to be having any adverse reactions to the Estrogel but was wondering whether I should lower it to 2 pumps a day?

Many thanks.

[GypsyRoseLee]

Hello Joesmum

I think all women need differing levels of oestrogen in order to feel their best. So if 4 pumps has made you feel much better then I would stick with that for a good while until you feel totally stabilised, then you could always try reducing it gradually?

On Prof Studd's site he talks about some women needing estradiol levels of 800 pmol or more to feel alright again.

I had my bloods last done at Xmas, whilst wearing a 50mg patch and my level was 305 pmol, but I didn't feel good to be honest. Had been feeling pretty flat, with background anxiety for several weeks. My main peri symptoms are extreme mood swings, and intermittent anxiety and very low moods.

I suspect I'm one of those women who benefit from a higher dose than average. I am still peri menopausal though, with my own hormones fluctuating quite a lot. I think the only times I feel 'good' are when my own oestrogen is rising and adding to the dose from my patch.

I see Dr Annie Evans next week, she's a very well respected endicrinologist and she says she sees lots of women who need levels of 600+ pmol to feel their best.

In your shoes, I would tend to think if it ain't broke don't try and fix it.

[Dancinggirl]

The normal dose of Oestrogel is 2 pumps per day but we are all different and some women need less or more.  The good thing about Oestrogel is the fact you can adjust your dose.  If you are feeling good at the moment then I would stick with the 4 pumps per day but in about 4 weeks you could try going down to 3 pumps per day and see how you feel and then, if you feel OK, reduce again after 2-4 weeks until you find the minimum amount that maintains your health and wellbeing. If you saddening chop and change the amount you sue then the fluctuations may give you adverse reactions.  Keep posting  Dg xx

[Dancinggirl]

Joesmum - your original question was about whether 4 pumps per day was too much and frankly 2 pumps per day is considered the recommended dose for most women so it is very likely that 4pumps is too much. I would try applying 2 pumps, perhaps one pump in the morning and one before bed to see if this is better - I believe this would be about the amount you would get on a 50mcg patch. You could even try just one pump per day - I do very well on this amount as too much oestrogen does tend to give me more side effects..  Keep us posted.  DG x

[Hurdity]

Hi Joesmum

I haven't used oestrogen gel myself but just to say it isn't a more "aggressive" form of HRT - it is just estradiol the same type as in the patch and the tablets. However transdermal oestrogen (patch or gel) absorbs straight into the system and women differ in how well they absorb the different preparations so I imagine from what you are saying that you are one of those who absorb it very well!

There is a possibility with oestrogen that if levels get too high ( ie higher than would occur physiologically even at ovulation when they peak) you can get a phenomenon known as tachyphyllaxis whereby symptoms return and it is no longer effective. This is a known phenomenon that can happen with implants and presumably can also occur with very high amounts of gel. It is doubtful this would be the case for you though as 4 pumps is the maximum listed - but just thought I'd mention!

If you take thyroid medication then it may well be that some adjustment is needed here too - there can be an interaction but from what I read this is with oral HRT and thyroid levels need to be monitored reguarly during the initial stages of taking HRT. However I not very clear about this! Perhaps check with your doc and have your thyroid levels monitored too?

This is what it says about estrogel and thyroid:
http://www.medicines.org.uk/emc/medicine/19898/SPC#POSOLOGY

"Oestrogens increase thyroid binding globulin (TBG), leading to increased circulating total thyroid hormone, as measured by protein-bound iodine (PBI)), T4 levels (by column or by radio-immunoassay) or T3 levels (by radio-immunoassay). T3 resin uptake is decreased, reflecting the elevated TBG. Free T4 and free T3 concentrations are unaltered. Other binding proteins may be elevated in serum, i.e. corticoid binding globulin (CBG), sex-hormone-binding globulin (SHBG) leading to increased circulating corticosteroids and sex steroids respectively. Free or biological active hormone concentrations are unchanged"

Hurdity x

[Melbury]

Hi,

I am hypothyroid and take 50mcg levothyroxine and 20mcg liothyronine per day along with 2 pumps of Oestrogel.  I am not convinced that my thyroid meds are perfect, but there doesn't seem to be a lot of interest in thyroid problems in the medical profession.