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[matildamouse]

  I found a lovely GP who works in a holistic clinic and is very open to discuss HRT options which will suit you best. After being treated by a menopause centre since Oct 2015 with daily estradiol and progesterone, she did bloods and saliva tests. She also changed my HRT to Estradot 25mg patch and progesterone 100mg every night (for the moment as that is what I was used to) which I only started a week ago. The results shocked us both....my estrone (E3) levels are "extremely high" and I also have elevated levels for Estradiol, progesterone and DHEA. THe only thing which is normal is my testosterone.

SInce the last 2 weeks I also feel as though my hot flushes are returning, though still not nearly as bad as it was. I many times get a itchy skin at night and feel as though my bodycore temperature is elevated (which apparently can be related to progesterone build up)

I still have an uterus, so have to take the progesterone. Before I went on HRT I had no periods for 18 months and thought I am post menopausal. She says my bloods show that I still have "some hormones" floating around hence we discussed changing to a cyclic progesterone with a bleed. On the continuous progesterone I had minor breakthrough bleedings which settled. My recent ultrasound showed a 3mm lining and multiple fibroids which will be monitored.

She is of opinion that the problem is with the estrogen metabolism in the body or liver and a blocked pathway. She referred me now to a very experienced naturopath who is part of the clinic she works at to address that issue. I feel like I just want to stop everything cold turkey as I am really scared now BUT I suffered with relentless hot flushes and max about 2 hours sleep a night before I went on HRT out of desperation. I am very sensitive to minor changes and has tried to decrease my already low estrogen dosage in the past, just to find the hot flashes to return.

I know it sound shocking but I said to my husband this morning I am willing to take the risk of the cancer but I just could not cope with the quality of life before I went on HRT.

Any advice or opinions from your knowledgeable ladies on here please. Thanks.

[Kate50]

Why did you change your hrt? 
Your lining Is only 3 mm so that's good and even though you have fibroids unless they are growing out of control that won't be a problem.  They won't go now that you on oestrogen.  Sounds like you are having too much progesterone which may be causing some problems.  Progesterone causes me to have itchy skin.  Don't get how  you can read from blood tests that you have hormones floating around??  DHEA  is a precursor so that will be high if others are.  I don't see you have to take any risk with cancer cut your progesterone down to 2 weeks and I can't see why you won't be OK.  I take only 100mg for 7 days like a lot of ladies do.

[Mary G]

I can't think why you should be at risk from cancer.  I agree with Kate50 and also think you are talking too much progesterone and that is why you are getting all these symptoms.

Why not move to a cyclical HRT and give yourself a good run of oestrogen for a while.  The itchy skin at night and high core temperature are classic symptoms of low oestrogen and I think you also need to up your dose.

Why not switch to the Oestrogel, it works better and is flexible. 

[matildamouse]

Thanks ladies.

To answer your questions, she changed my prescription from oral estrogen to patches to bypass the liver which I am happy about as my liver enzymes were elevated. I am on a similar dosage as I was before, just the route differs. I no longer make use of the menopause centre as all (Drs consultations etc) was done via phone 5000kms away from here as I am in Australia and Utrogestan is not available here. Via the menopause centre I could get it the compounded version and that was the best I could do with the current system here. This GP uses only one specific compounding pharmacy she trusts and has worked with for many years.

Her statement re the hormones "floating around" was about me possibly still being peri-menopausal with a cycle my own hormones cycling at the back and not as postmenopausal like I thought. MaryG I nearly killed my cat after she was accidently exposed to my estrogel by laying in my arms and on my bed. I do not want to take that chance again...she is the only thing keeping me sane on the rollercoaster ride of menopause!

[Dana]

After my experiences with a naturopath and menopause, that would be the last person I would seek advice from. Sorry, but that's my experience with them.

[CLKD]

I agree.  What's a 'blocked pathway FFS'  .  The body does everything automatically in that it takes in and discharges what it no longer requires, either as sweat, pooh or urine.  The liver is the only organ that can regenerate itself.  Hormones don't float per se but it can be a figure of speech  ……… are you keeping a mood/food/bleed diary?

Also is it usual to take progesterone every day  - I thought the whole point of HRT was to follow the 'normal' pattern, i.e. oestrogen treatment followed by a short course of progesterone at the 'end' of the cycle to encourage a bleed to avoid build-up.

Who suggested cancer  ………. I had it, still here  .  10 years after a very short course of HRT and I mean short - 3/4 months, can't actually remember.  Quality of Life is the main consideration Girls, QoL!

[Hurdity]

Sounds totally crazy to me and typical of non mainstream so-called medicine - sorry!

Of course you have hormones "floating around" - if you have been taking progesterone then these will show up in a blood test - nothing to do with the stage of menopause you are at.

If you did not have a period for 18 months then you are post-menopausal. Very occasionally women might get another period after this but I very much doubt you still have a cycle - the results will be due to the HRT you have been taking surely?

Salivary tests are not accurate  - and cannot tell you actual levels of any hormones.

Estrone is not usually tested - it is part of the metabolic breakdown of oral oestrogen and provides a reservoir for re-conversion to estradiol in the body (this is from memory). It is no mystery nor a revelation that oral HRT is metabolised through the liver in such a way.

You would benefit from going to a mainstream gynaecologist and obtaining transdermal oestrogen through them. I know Utrogestan is not available in OZ but I'm sure Dana will let you know how to get hold of it - unless your 100 mg progesterone is a capsule the same as we have here in UK? You really don't need to spend a fortune on naturopaths, compounding pharmacies etc .... The reason you are feeling hot etc is that your oestrogen is too low - not necessarily because the prog is too high. You need at least a 50 mcg patch - I have used this since late peri-menopause at aged nearly 54. Now 63 and still using it. I never get any sweats or raised temp.

There is unlikely to be a problem with oestrogen metabolism in your body - why would there be?

I can't remember how old you are?

Hurdity x

[CLKD]

Let us know how you get on! 

Maybe see a menopause specialist?

[Dana]

I know Utrogestan is not available in OZ but I'm sure Dana will let you know how to get hold of it - unless your 100 mg progesterone is a capsule the same as we have here in UK? You really don't need to spend a fortune on naturopaths, compounding pharmacies etc ....
Hurdity x

If you really want to get a hold of Utrogestan in Australia it's actually very easy. I used to use a site called Goldpharma. Quite reasonable prices for product and shipping and I never had any problems receiving it. I seem to remember just one month's worth, plus postage, used to cost around $30, but you can order a few month's worth at a time to save on postage. It's all quite legitimate. You have to answer some medical questions and an on-line doctor will arrange the prescription. It is often shipped from countries like Spain and Germany (from memory). I personally choose not to use it, but if you want progesterone there is absolutely no need to use the compounded stuff, which is not proven to be strong enough to oppose estrogen.

I would personally run a mile from all these doctors and "menopause centres" in Australia that prescribe non-regulated hormones. They just use fear tactics about regulated HRT to make bucket loads of money. Also, as Hurdity said, don't bother with saliva tests. They are pointless. Even blood tests aren't that reliable, and saliva tests are even less so. "Estrogen metabolism" is a common catch-cry used by naturopaths and "holistic" doctors. I've heard it all. Just see a regular doctor. You will get a lot less mumbo jumbo. Standard estradiol (patches, gel and tablets) is available from any GP. You don't need to see a gyno.

[babyjane]

I am in the UK but years ago I spent a fortune that I did not have travelling to consult with various therapists and practitioners searching for a cure all for my problems, both physical and emotional.  Looking back I achieved nothing apart from a sadly depleted bank account and frustration.  I came to realise that you just cannot buy physical and emotional well being, it has to come from within.  It has taken me a long time but I am now getting better but only since confiding in my own very supportive GP and ditching the quacks.

[Hurdity]

I am in the UK but years ago I spent a fortune that I did not have travelling to consult with various therapists and practitioners searching for a cure all for my problems, both physical and emotional.  Looking back I achieved nothing apart from a sadly depleted bank account and frustration.  I came to realise that you just cannot buy physical and emotional well being, it has to come from within.  It has taken me a long time but I am now getting better but only since confiding in my own very supportive GP and ditching the quacks.

I  agree babyjane that a lot can be gained by ditching the quacks (and saving money!) and also that a lot of our well-being is determined by our mental/emotional state - and especially anxiety, depression, panic etc. However our mental state is so closely related to our physical state and especially where hormones are concerned.

This thread was about HRT - and its role in improving quality of life. The symptoms caused by menopause/oestrogen deficiency are due to hormonal changes and are not in the mind and therefore in many cases cannot be overcome by purely mental strategies - although using these in conjunction with HRT will pay dividends!!

I am sure some help can also be gained by consulting reputable therapists (through the NHS?) in conjunction with self help strategies to give a boost to coping with the emotional problems caused by the menopause.

Of course if the problems are nothing to do with the menopause or hormones - fluctuations or deficiency - that is a whole different issue.

Glad you have a supportive GP  - unfortunately not everyone does - but I still agree about ditching the quacks - if only women can recognise which they are!!

Hurdity x

[Kate50]

I would never have sorted any of my issues out with therapists that were part of the NHS im not sure if there is any and if there are you would be waiting 10 years to see them. I agree with the need for HRT for the menopause but I suffer with no anxiety or depression due to these so called quacks!
This poor woman came on here openly to share and ask questions and she seems to have been shot down in flames.  Shame on you!

[CLKD]

Well said Dana!  Useful info. and hopefully Matildamouse (love it) will read!

I stand by my usual comment of 'if it ain't on the NHS ……. '.  I have had both private and NHS therapies; talking, relaxation, surgical intervention; in desperation I sought the advice of an alternative therapist in the 1980s who was an NHS GP, had gone to China to learn about acupuncture etc. and sold me something: it was when he told me not to drink coffee or eat anything minty with the preparation that I became suspicious.  He was however sympathetic, he listened, he sold ………. but he wasn't my answer although I could see he believed in what he had learnt in China.  A lot of what he told me certainly could have been useful but not in my situation.  Nor was he recommended by my GP who had never heard of him even though he worked in the next village. 

Shame on who exactly Kate50  ………

[dangermouse]

I think it's also important to understand why compounded medicines aren't regulated. It's purely because they are man made in the pharmacy to get the personal dosage, so this is impossible to regulate. However, most are made out of exactly the same ingredients as the factory made stuff (as we get... well... try to get on the NHS).

I guess it's about where you can get it for the cheapest price.

The problem with NHS therapy is a bit like with some of the GPs. They get paid whether or not they are effective. Private therapists have to be good at what they do otherwise they won't survive and are more likely to go the extra mile for their clients. I have seen a lots of ex-NHS patients who have been disappointed with the lack of attention they received from their therapists. I choose not to work for the NHS because you are constrained to NICE and cannot be artistic with your therapy to suit the individual. Not to mention the paperwork...

However, it's free so I understand why most prefer it and it's a minefield out there in the private therapy world as well. The best advice I can give is to find someone who is like minded via the info you can find on them, website, articles etc. as you'll then have a better rapport and chance of a good match. Probably a bit like finding a partner!

[Hurdity]

This poor woman came on here openly to share and ask questions and she seems to have been shot down in flames.  Shame on you!

If you read the original post Matildamouse asked for our opinions on the confusing treatment and diagnosis she has been given, and rightly so. She has most certainly not been shot down in flames, although her medical practitioner(s) have - there is the difference! There is no shame (and I presume by "you" you mean CLKD, Dana, babyjane and me?) in telling it as it is, recounting one's experience, and using evidence based arguments to comment honestly, as requested by the poster.

I am pleased that you have sorted your issues out, but not everyone can afford private treatment, and indeed as babyjane, CLKD and Dana have said - it is not necessary and costs a lot of money and can do harm.

The best advice I can give is to find someone who is like minded via the info you can find on them, website, articles etc. as you'll then have a better rapport and chance of a good match. Probably a bit like finding a partner!

Unfortunately dangermouse - the internet is full of many websites selling all sorts of unproven treatments designed to draw you in and persuade you to buy - many of which blind you with science ( which is often pseudo-science). it is difficult for the lay-woman to see the wood for the trees I think.

Hurdity x