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[SueLW]

Hello Ladies

I use a 50mg Estroderm patch.  I don't think it's quite enough.  I have been experimenting with adding some gel to it, but I get very obvious anxiety and depression when my oestrogen levels fall so although I feel good in the morning and afternoon with a bit of extra gel, I will then start to panic as it wears off in the evening (I don't know how some of you can come off oestrogen for a few days sometimes, it makes me feel terrible stopping).  After a couple of days adding extra gel to the patch I start to get very sore nipples and I blow up with retained water.  I just can't pee!

The only oestrogen I have found that doesn't have this anxiety effect on me is the patch.  (I wish it were easy to get a pellet here in the UK).

To go from 50mg patch to 75mg seems a big jump.  So I could try cutting a 25mg in half and just adding that half to the 50mg. But before i do that I would like to try adding gel to the same total mg dose a day.  I'm just not sure how to work it out.  Does anyone know?  How much Estrogel would give the same dose over the day when used in conjunction with the 50mg patch as a 12.5mg patch increase?

Another question: Do you find that you need to increase your oestrogen doses if you get sick?  I've had real flu and possibly walking pneumonia, at the same time as a lot of stress due to my elderly parents both landing in hospital at the same time.  Then 6 weeks of visiting and sorting out the house to make it more easy for access with walking aids.   I feel really fragile and very worn out.  I wondered if we used up more oestrogen in such situations or not?

[Annie0710]

I'm not sure whether we use more oestrogen during stress

I've read on here many times about oestrogen dipping throughout the day but personally I've never experienced it to my knowledge.  I'm on patches and I chop and change dose no end (sometimes my choice but mostly because pharmacy/doc prescribe wrong dose) sometimes I even forget to change the patch on the specified day ! But when I try 100mcg patch I'm all jittery and nervous.  But am fine on 50 and 75mcg.  I'll never get my head round how sensitive hormones and bodies can be. 

X

[Dancinggirl]

Hi SueLW
Now! I may be completely ‘off the wall' here but I have some of theories regarding oestrogen. I am no expert but having used HRT on and off for nearly 25 years I can speak from personal experience.
Firstly, our bodies do store some oestrogen so I doubt levels drop that quickly during the day to actually cause mood to change so quickly - a drop in blood sugar levels will be the more probable cause of your problems - you should eat small amounts often and get some relaxation if possible.  I am also aware that absorption and retention of oestrogen varies greatly from women to women so I do suspect that you may need to slightly increase the dosage on a daily basis - using Oestrogel alone would allow you to increase by a small amount.
My theory is that, if one is using a consistent dose of oestrogen that controls flushes and night sweats then this should also keep menopause low mood and anxiety more or less on an even keel  If one does chop and change the amount of oestrogen you use on a day to day basis then this is possibly more likely to result in fluctuations in mood and anxiety.
My experience of patches resulted in a big hit of oestrogen in the first day (resulting in flushes and feeling jittery) and then by day 3 I felt as though things were dropping - so for me the patches didn't give a constant dosage. Many women do really well with patches.  I have used Oestrogel for many years because it does seem to give more consistency and flexibility - to avoid any fluctuations one can simply apply one pump in the evening and one at night.
The physiological element of HRT is very strong - so many of us are convinced that HRT will solve all our problems and that simply increasing oestrogen will sort everything - I personally think this is the wrong way to look at HRT treatment. Treating meno symptoms, especially anxiety and low mood, is about a range of strategies which should probably include HRT.
It sounds to me as though you are going through a very tough time at the moment and in fact by tweaking your HRt you could be making things worse.  Have you tried relaxation techniques, do you get enough ‘me time'???  I have learned that the best way to control my low mood and anxiety has been to practise Mindful Meditation and to actually say no to being  ‘all things to all people'.  If you have been so ill then your body needs some R&R not extra oestrogen.
Do take care of yourself - be a little more selfish.   DG xxxx

[SueLW]

Hello Dancing Girl

I have never felt good on the gel alone.  I really can feel it making me feel better in the morning and then dropping in the evening. 

It's not blood sugar, I have that well under control. 

If I don't take oestrogen for a day for some reason I feel very unwell very quickly.  So perhaps I just haven't been able to fill up my body's stores.  Patches have been the only method that make me feel calm and consistent.  But I do suspect they run down ahead of time on the 4 day changeover.  I may just set alarms and change them every 3 days.  See how that feels.

Yes I'm stressed.  I run my own small business. Importing from the USA and selling to the UK and Europe.  It's 9 years of hard work.  Suddenly the pound has crashed against the dollar making all my imports cost a lot more so I've had to increase sales prices and the threat is now that once we are taken out of the EU my European customers will no longer be interested because of the extra cost and delays.  I fear for my very future.  I have nothing to fall back on.  This is my world, my job and my expression of myself.   

To have that happen at the same time as having Mum break her pelvis, Dad getting pneumonia (knowing they both voted to leave the EU) and me having flu has been terribly hard.  I am an only child.  I have to look out for them.  They live 25 miles away.  I have to make their house more easy to manage and to do that I have to get rid of a lot of furniture and 60 years worth of "stuff".  So there isn't much "me time" and neither can there be until it's done.  But I think it was the flu that was the real hammer blow in all this.  This time last year I could not have coped with any of this.  My HRT adventures have helped immensely.  I just can't seem to get it all quite balanced.  I hardly ever feel happy and I have no stamina.

Oh well, at least I know I don't need to stress dose oestrogen in hard times.  I wasn't sure.  Thank you.  I have never really suffered with conventional hot flashes and sweats.  That has not been menopause for me.  It's all about mood, wellbeing, energy and weight gain.  I feel like an old, fat, has-been. 

[cubagirl]

Not sure if this helps or not but I was told a 37.5 patch was equivalent to 2 pumps of gel.

Too much oestrogen would give me huge & painful boobs.

[Tempest]

I'm a 'surgical menopause' lady too Cubagirl and not been having much luck with Estrogel (to put it mildly)! Do you like the patches best, and do you have many fluctuations on  them around the time you need to change or if the patch is a little wrinkled? I realise the wrinkling is less of a problem with Estradot because of the smaller size, and these would be my preference if I can go down this route.

[cubagirl]

Estradot are still hard to get hold of due to manufacturing problems.  So using evorel instead. However, not noticed any massive fluctuations. I do prefer the patches though as less messy.

[Mary G]

SueLW, have you thought about splitting your gel dose?  I use 2 pumps everyday and split each dose by 12 hours and that has really helped.  Perhaps it would be worth a try.

To my knowledge, 1 pumps of gel is roughly the equivalent of a 25mcg patch, 2 pumps a 50mcg patch but in my case, the reality is very different because I absorb the gel much better than patches. 

I know what you mean about the worry of leaving the customs union and the single market, we have our own business and hate all the uncertainty, it is the stuff breakdowns are made of so the last thing you need is worry over your HRT regime.

[Tempest]

Thank you, Cubagirl! I've rung around a couple of pharmacies here in Scotland this afternoon, and both my local independent and Boots can get all patch sizes of the Estradot. The pharmacist at Boots thinks the problem of supply is resolved.....for now, at least!

[SueLW]

Hm, I had another consultation with my hormone doctor and she suggested we try drastically cutting my dose because she thinks we may have missed my sweet spot.  When I started using HRT I was weaning off thyroid T3 and I experienced all sorts of horrible anxiety, depression and other symptoms. 

I was nervous but decided to try and Bingo!  I'm feeling a lot better.  I think I may need a tweak in a couple of months, that this is probably a bit too low, but the anxiety and depression has gone and I feel like my brain works again. 

I shall see how it goes.  But so far, so good.  Although I've been feeling ill this weekend and it looks like I have some sort of urine infection.  The surgery has sent off a specimen to the lab tonight.  That might explain a few things.