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[vintagefiend]

Can anyone tell me if altering oestrogen dose, according to where you're at in cycle, is a therapy? I'm sure I've read about it somewhere- possibly on here.
I manage relatively well (the term "relative" is important!) from roughly day 7 to day 22, but things slide thereafter- highly anxious  and moderately depressed few days prior to period and depressed for some days into it.
I'm only on a 25mcg patch- which has made a difference- also highish dose venlafaxine which helped generally, but less so pre and during period.
I have tried increasing patch by v small amount at about day 25 but it feels totally excessive after an hour or so!
I'm obvs very sensitive to small changes in oestrogen- also i suspect that the patch gives an initial hit even tho i know it's meant to be a level dose.
I'm thinking of trying a wee bit of oestrogel at "danger" times.
Has anyone else done this? Can you use oestrogen in this way or am i being oversimplistic?
Thanks for any help

[Dancinggirl]

I found that patches gave me a big hit on day one and then there was a dip after that. I found Oestrogel gave me a consistent dose. Why not simply try using just Oestrogel and start with one pump per day - this could give you the consistency you are looking for? If you are still peri meno then getting the balance right is very challenging. What are you using for the progesterone? DG x

[vintagefiend]

thank you dg- you were so helpful before- seem to remember you wre pivotal in my decision to try low dose oestrogen.i
and it's made a real difference but, as i say, still not great around period.
i hadnt thought about having solely oestrogel but if it's more level i think that's v interesting and will prob ask for it! knew i wasnt imagining that hit! so presume 1 pump roughly equivalent to 25mcg patch?
very astute of you to ask which prog i'm on- i'm not at the moment which i know is a bit cavalier but i have regular heavy bleeds and really cannot tolerate prog- properly suicidal! i have discussed this with my neighbour- a gp- and she felt it was ok as low dose oestrogenand regular periods- but it's on my radar to do something about- been offered hysterectomy and may well do this but obvs cautious re this! my gp doesnt know cos v slack- doesnt ask!!
sorry just one other thing- if u have the time!- do u think i could raise oestrogel just before and during period to buffer the effects of lowered oesrogen? the patch really has done wonders for me but i need a better time pre and during period! Thank you x

[Dancinggirl]

If you are getting regular and quite heavy bleeds then I wouldn't increase the oestrogen  - this could make the bleeds worse. You may need to use maybe half a squirt of Oestrogel - which will be difficult to gage but worth trying - a full squirt would be higher than the 25 mg patch.
I am really not convinced that varying dosage is a good idea - consistency is the best way to go. As you are not controlling the bleeds with progesterone then I am wondering if your bleeds are just a shedding because the lining becomes too thick or you have a natural period because your own cycle is still strong??!!!! If you are still getting natural periods regularly then I do wonder why you need the oestrogen?? Have you had a scan lately?
I assume you are seeing a specialist gynae?  I assume you have tried a Mirena?  Have they thought of shutting down your own hormones with injections and possibly trying Tibolone to replace the hormones?  Tibolone is sometimes used as it is different to normal HRT and doesn't have the progesterone that gives so many women problems.
I am not an expert so please only take my thoughts as suggestions.  I also think you may need to look at some different types of ADs/SRRIs if the PMT is truly bad.
Don't tweek the dosage - I doubt it will help.  Dg x

[vintagefiend]

thanks dg for a really informative reply! i have tried everything- short of surgery including mirena and zoladex- both of which did not suit at all! unfortunately i thought it was the tibolone that made me feel bad, but now i'm fairly certain it was the zoladex alone and quite possibly tibolone may work for me- but! i've been thru the mill psychologically and really cant face trying trying all that again (i barely left the bedroom for about 2 months)...maybe sometime in the future
i am still having a natural cycle- i can very much feel it, but i do find the oestrogen patch very helpful- in fact i am the best i've been for a very long time- i look forward to things- hurrah! however, i'm still far from the person i once was, primarily around period time. i was kind of "misreferred" to a pms specialist who wasnt gynae and i havent had the will to chase up gynae referral with my gp- but you've nudged me and i know it's something i must do. Thank you, dancing girl- you've been fab x