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[jooleea]

I have been taking Premarin for about 5 weeks now after being finally referred to Dr Zenia Haoula at the nottingham medical centre . I had a total hysterectomy 18 months ago and have tried many forms of HRT with estrogel being the best , although not totally effective . Since taking Premarin my symptoms of hot flushes , very little sleep and fuzzy confusion have dramatically worsened. mY follow up appt. is not until mid April and I know I can't go on like this until then . Isaw my GP today who was reluctant to increase the dose of premarin as I have been prone to severe migraine attacks with increased dose of Hrt and said that Premarin was likely to give me a migraine with increase dose . I suggested maybe using estogel as well and he said I could . however Im not convinced , Im rather cynical when it comes to Gp advice Im afraid !I will try and contact the nottingham clinic ( about 50 miles from where I live ) but the clinics only on a Tuesday afternoon and difficult to get through to anyone other than the receptionist for info. In the meantime pERhaps theres someone who could advise me how long premarin takes to work and if it is wise or effective to try the estrogel at the same time .

[Dana]

I suppose if the doctor has said you can mix the two, who am I to argue, although I think you will find things far less confusing if you found one routine that suited you. It will be much easier to tweak doses and know exactly what is working and what isn't.

If you liked the estrogel why not just increase the dose a bit to see if that helps? Your other alternative, which is often found to be more effective, is to switch to a patch. The dose is more constant than with either tablets or the gel so you don't get any peaks and troughs.

The big advantage you have is that you don't need to use progesterone (because you've had a hysterectomy) so you can play around with your estrogen dose as much as you like. Sometimes the experiments you do yourself will work problems out far quicker than waiting to talk to a doctor.

[Hurdity]

Hi joolea

When you had your hysterectomy did you keep your ovaries or did you have a total hyster + BSO? I ask because your body's reaction to this will be different.

If you had total hyster + ovary removal then it is shocking that you were not given oestrogen straight away if this is what happened, unless you tried a different hRT at first? If this is the case ( ie only started oestrogen recently) then it may well take  a while longer to settle. There are other women on here to whom this has also happened - notably Tempest.

This post is in the wrong section but when it is moved (hopefully after the weekend) perhaps it will catch someone else's attention too who is in the same position?

Re the Premarin and estrogel, I agree  with Dana - better really to use one type of oestrogen and if you are prone to migraines then transdermal HRT is recommended anyway. Unfortunately your doctor GP is not a specialist! In your position - I would actually try to change to estrogel (and if you don't absorb this well, then try patches).

Normally when starting HRT especially transdermally (patches or gel) - you should notice an improvement within a few days and symptoms should not get worse. For this reason also I would switch to the estrogel only (it normally works much quicker from what I've read) - but you might experience a few rocky days as you changeover since Premarin contains a mix of horse oestrogens in tablet form whereas estrogel is pure estradiol - bio-identical with the oestrogen in our own bodies.

The other thing is if you have had a total hyster + ovary removal then testosterone replacement may also help - and depends how old you are too.

Good luck and hope it works for you soon.

Hurdity x

[jooleea]

Thanks Hurdity , you always come to the rescue with such good advice. I did have a total hysterectomy with removal of both ovaries. I am 52 years old and was previously on the estrogel . I have a long list of patches I have tried without any success , but as i mentioned with the Premarin its almost as if Im not on any HRT at all .
Don't want to mess the specialist about by doing my own thing , so to speak , before I see her next so Im in a bit if a dilema. Maybe if I go back to the estrogel until I see her next ( the best HRT option I have experienced so far ) although with side effects , mainly itchy feet , hands and the area at the base of my spine . ( this itching did stop when I ceased to use the estrogel ! ) very strange .
regarding the post being in the wrong section …does this mean they you can move it …?I hope so because Im not very good at navigating web sites etc ! thanks again x

[Dana]

Emma will move your post to the right section when she's next online. Probably in the next day or so. If you have trouble finding it you can go to your profile and look at the posts you've made and that will take you straight to it.