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[Rose B]

I have been advised to switch the route of my oestrogen by my gynae as my blood test levels are so low that it's as if I wasn't on HRT at all.   She has suggested I consider a switch to Oestrogel.  Wondering what others experience of this is? I am concerned about switching to something that appears to be so much less convenient to use. I don't really want to go back to oral route as had side effects previously and seem to remember reading somewhere that worse for blood lipids.
 
I've been using oestrogen only patches for about 18 months, initially Estradot 25mg, then increased to 50mg, and currently on 75mg (with a switch to Estraderm due to manufacturing problem with Estradot), with daily Cyclogest 200mg pessaries for progestogen element. Also trialling testosterone gel to see if it helps libido. 

To be honest, I am beginning to feel fed up of the whole thing.  I am post menopausal and have been on HRT for 2 years as I couldn't cope with the amount of hot flushes I was getting, and for cardio vascular protection (on recommendation by Nick Pannay's team).  My hot flushes are still under control, though I am generally bit sweatier!  I am beginning to think this is more trouble than its worth – this week I have had nurse appt for repeat bloods, ultrasound this afternoon as I have had some spotting, GP apt tomorrow to get results and gynae appt on Monday.  And don't get me started on how long I spend at the pharmacy as everything seems to require a special order that may or may not arrive when they say it will. 

Sorry, for the rant    I am def more irritable and my memory is rubbish again, so maybe I should persevere a bit longer ………..

[clare663]

Hi Rose B, I sympathise with you! Thought I found the answer in patches (Everol conti 50) but afetr 6 weeks I was suicidal! I had a break from them for 4 weeks then the flushes came back so I had another go with them. Its 3 weeks later and the flushes are still there even though they went after 3 days last time!! I have just got a prescription for the oestrogel and utrogestan to see if that is better. I am also due to get the testosterone gel if my libido hasnt come back! reading on this forum it seems that the ladies who use this method are very happy with it. From what I understand is that your hormones are fluctuating but are low enough to cause the menopause and for your periods to stop but we must get to point when they stay at a low and maybe that is when we need to increase the oestrogen. Im 5 years meno and Im hoping that I can adjust the gel to suit when my hormones fluctuate.

[donnacrichton]

Hi I was on estradot 37.5mcg and had at estradoil 77 and have upped to 50mcg. Three weeks and still flushing quite bad been advised 3 months before upping again . Feeling your pain xxx

[Mary G]

Rose B and clare 633 (you might both find this useful) having used patches and Oestrogel myself, I would say there is no contest, the gel is much, much better.  I never could get anything like enough oestrogen out of the patches, they never stuck properly, left a horrible itchy rash and frankly, I hated having the thing stuck to my backside.

Oestrogel is brilliant, it is flexible meaning you can easily adjust the dose to suit your needs.  I get very good oestrogen blood readings with the gel and like yourself, the patches hardly registered!  I have felt a million times better since I switched. 

I don't find it inconvenient to use at all, you simply rub into your arms or legs and it dries within a minute or so.  I do a split dose of one pump in the morning on my inner, upper thighs (which has really helped with VA) and one pump on my upper arms at night. 

Definitely go for it, you having nothing to lose.

[Rose B]

Thanks ladies.

Update -  I got my latest blood test results yesterday and to my surprise, my oestradiol level had tripled since last one in May. I think its still a bit low, but GP couldn't interpret so will see what my HRT consultant now advises when I see her on Monday.  My prolactin level has tripled too, so GP unhappy about that. (I have ongoing high levels due due to pituitary microadenoma) Will probably mean an extra visit to Endocrinologist, who advised me not to bother with HRT at my age (then 56)!!  My scan results were normal so that's a relief.  Sounds like oestrogel would be worth a go.

[Kathleen]

Hello Rose B.

I think I may be in a similar position you. I have been using Evorel Conti 50 mcg patches for a year. I experimented with Oestrogel but only for two months before trying patches again. As I was so confused about my absorption rates  I had my oestrogen levels tested when I resumed the patches and was told my oestradiol measured 94 pmol/L. My consultant said this was sub optimal but didn't comment further.

Can I ask if you think my result is low and what level you think we should be aiming at? I will also make an appointment to see my GP but I doubt he will have the answers.

Many thanks and I hope  you don't mind me picking your brains!

Wishing you well and take care.

K.

[vickypk]

Hi Kathleen. 
I'm using the Evorel Conti patches, I been using those for about a year now and am okay with them. I tried oestrogel and utrogestan before that and couldn't get on with that regime.  Just wondered why you stopped using the gel.  Hope you are okay.
xx

[Kathleen]

Hello vickypk.

I tried the gel and Utrogestan orally for two months but didn't feel any better than the patch. I started to worry about the side effects of Utrogestan but the fact that I started on one pump of Oestrogel instead of two probably didn't help.

I've gone back to the patches for now while I think what to do next. This whole business is very frustrating.

I think the  normal range of oestradiol for post menopausal women is between 100pmol/L and 200pmol/L   and mine came out as 94pmol/L, so either the gel or the patch wasn't working properly  or perhaps neither? As I say, very frustrating! Could also be I have a hide as thick as a rhinos that nothing transdermal can penetrate so at the moment I'm not ruling anything out!

Wishing you well.

K.

[vickypk]

Hi Kathleen
Thanks for your reply.  I tried the gel and utrogestan for about 3 months, I had bad side effects with the utrogestan.  Yes I know it is very frustrating with different HRTs and wanting to get the best one.  There really isn't much help with the GPs unless you pay and see a specialist.  I paid to see Studd a couple of years ago, but still don't seem any the wiser with this HRT thing.  Hope you get on okay.  Let me know how it goes, thanks.
xx

[matildamouse]

I feel for you all as I can so relate!

RoseB, are you taking progesterone pessaries 200mg each night? Fellow forumites, help me if I am wrong, but it sounds like a high dosage for continuous dose?? It is usually 100mg continuously or from day 1-25 with a 5/6 day break. But maybe because you are on a 75mg patch, your progesterone dosage must be higher? Did your Dr say anyting like this? I have read on here and experienced myself when I did not take the break from the progesterone, it felt like the progesterone build up in my system and I then experienced that sweatiness which is AWFUL!!

It sounds like the patch is enough to keep your flushes under control so sounds like your absorption is good. What need to be addressed then is why are you still sweaty...?

And I get you re the the HRT somedays feel like such a hassle...especially if still not feeling right. I tried to go off twice but within 2 weeks my flushes were so bad that I went back on it again...sigh..

[Rose B]

So...
had my appt with HRT consultant. I was told that my oestradiol levels are still too low and that to get the full benefit from HRT, needs to be at least 250. I have been prescribed 100mg patch, with repeat bloods in 8 weeks.  I asked about oestrogel, since that's what the nurse who runs the clinic's patent helpline had suggested, but consultant thinks patches are better as they give a more consistent and measured dose than gel. She also thinks my high prolactin level could be inhibiting my oestrogen absorption. I need to follow this up with my endocrinologist.  I may start a new post about this, so I have some grasp of it before seeing endo.  In meantime, thanks for your replies and good luck.  I will persevere a bit longer.

Kathleen - see above, I was told oestradiol needs to be at least  250 for optimal results. My GP wasn't able to interpret my results at all.  Personally, I feel much happier having my HRT managed by a consultant, at least until things are stable. 

Matilda mouse - yes I am using the 200mg progesterone pessaries (Cyclogest) every night. Consultant advised me to use continuously.   I did query the dosage when I switched from Provera 5mg tablet. I as told that as its a micronised  form of progesterone, the dosage is quite different and not comparable.   I do also have ME, which I have had for years, and poor temperature control has always been one of my symptoms, so the sweating could be related to that, i suppose.   

[linz57]

Hi Rose B, I was just popping onto  the site to post about my hrt seemingly not working so well anymore and I  saw your post. I haven't had my levels checked yet but I can definitely feel things aren't as good as they were when I first started using a 50mg conti patch back in February 2015. I did wonder if it's like with a lot of medication and that our bodies get used to a dosage  over time and this results in needing ever increasing doses. I've also had spotting for a few months too and investigations have ruled out anything sinister, so I'm now wondering if it actually could be due to me not absorbing the estradiol and levenorgestrel so well as time goes on.
I've thought about increasing to a 75 mg patch but I'm concerned that I'll get used to that too and have to increase even more.
It is a minefield isn't it? Just as you think you have it cracked it all starts to fall apart.
It's interesting to read what you said about prolactin levels, I daresay my gp won't have a clue about any of this.....yet again😕but I could mention it to her in vain hope of getting something done.
Good luck and I look forward to seeing how you get on!