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[Charlotte ...]

Hi everyone,
I just started HRT three months ago, I'm on three pumps oestrogel/utrogestan, at my first blood test my estradiol level was under the measurable margin, so very low, I just had my results through last week, it's now at 1871 - I did call to ask if there was a decimal point missing but they said no. It seems really really high, even though it's  measured in pmol/l, I don't know much about all of this so thought I'd ask here. Thanks

[Charlotte ...]

Thanks for the answer, my last period was about two and a half years ago, i don't think I was producing any but I'm just scarping my knowledge together, certainly it was so low it couldn't be measured three months ago.

[Charlotte ...]

Oh and I'm 51 and post menopausal, so ...probably not?

[Charlotte ...]

I wondered if it was too much, I'll be seeing my consultant on a few weeks, thank you.

[Charlotte ...]

It was done on the NHS. I feel great, I wasn't having too hard a time anyway, but all of my anxiety has gone, could do with more sleep but that's about it.

[Hurdity]

Hi Charlotte

That is definitely far too high I would say, to have in post-menopause and very strange for you to be prescribed 3 pumps of gel from the outset when you are post-menopausal? Usually women are advised to start low and then slowly increase over a few weeks.

The problem is that I doubt it is advisable to have levels this high long term and if your body acclimatises to this level it could prove very difficult to reduce. Also there is the danger of tachyphyllaixs ( might be spelt wrong) where excessively high levels have the reverse effect and oestrogen ceases to be effective. if your blood test was taken at a particular time close to when you applied the gel this could account for it as blood levels of oestrogen do vary enormously.

Good that you feel great but you will probably also feel good on less than this! You are likely to need a high dose of progestogen to compensate - what are you taking or do you not have a womb, or maybe have a Mirena?

Hurdity x

[Charlotte ...]

Hi Hurdity,

Yes I  just read about tachyphylaxis, I'm a prof Studd patient and will be seeing him shortly but this just made all of my alarms bells ring. GP seemed quite oblivious but it seems terribly high.

[Dawncam]

Hi Charlotte - I'm also a Studd patient and was prescribed 3 to start. I'm having bloods done next week so we'll see.

Prob best to wait for Studd's response or you could email him if you're worried? I've emailed him a couple of times recently and he's sometimes tardy in replying but he always does. Or you can call his secretary.

Dxx

[Charlotte ...]

Hi Dawn

Let me know if you are super high too! I'll see him soon enough, I just thought it seemed high.
How are you getting on with it all?

[Tempest]

Hi Charlotte!

Just a wee question. Where do you apply the gel? The reason I ask is if it's arms, you can get an unnaturally high blood level reading when your bloods are tested which is not representative of your true systemic level.


I found this out from some interesting posts on transgender forums of all places (believe me, I research EVERYTHING about hormones)!

[Charlotte ...]

Hi Tempest,
Oh yes it is my arms, where is the best place to rub it in?
I went over to the transgender forums too, trying to understand it all, we're all in it together!

[Tempest]

Aha!! This could very possibly be the problem. This has certainly been noted over at the TG communities and they probably get blood tested more than we do!

A lot of folk here (me included when I used the gel) use inner thighs. It's handy there too as it means you can still apply your lovely body lotions to your arms.

I would mention this at least to the Prof. when you e-mail or phone him.

[Maryjane]

It should be as far away from breasts as possible , so inner thighs.

I do outer thighs as well.

[Mary G]

Charlotte, I almost wonder if someone has accidently put a "1" in front of that figure!

I am a patient of Professor Studd too.  I use 2 pumps of gel everyday and my last oestrogen blood reading was 238 pg/mL which is about 873 pmol/L and that is considered fairly high for someone post menopause on 2 pumps of gel.  My gynaecologist thinks this is because I take 25mg DHEA everyday and I am producing my own oestrogen again.  I feel very good on this dose and intend to stick with it because I feel as good as I did pre-menopause.

The Oestrogel leaflet says you can put the gel on your upper, outer arms and shoulders and/or thighs.  I split my dose by using 1 pump every 12 hours and do one in each place and I have found that my very slight VA has improved since putting 1 pump on my inner thighs. 

[Hurdity]

Ah yes Tempest - thanks for reminding us about that (where you apply it and blood tests) - I seem to remember you telling us that not so long ago I think but my brain did not retain the info!!!

The gel is not supposed to be rubbed in as such but applied to wherever you put it - according to instructions. I use testosterone gel which is applied in the same way. I just spread it on.

All the other transdermal oestrogens - ie all the patches and Sandrena gel - say to apply it to the lower half of the abdomen whereas estrogel is alone in saying the upper half of the body can also be used.

As Maryjane says I would not use any oestrogen product on my arms or shoulders due to proximity to the breast and concentration gradient from the arms - especially from shoulder and inner arm. - and surely this is borne out by the caveats re blood tests? If application of gel to the arm is likely to give a falsely high serum reading from blood samples in proximity - surely this also might apply to other tissues close by eg the breast - ie levels could also be higher than in other parts of the body?

Interesting about the transgender forums!

Hurdity x