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[Annie0710]

Not necessarily , a higher dose might sort you

I was on max dose for 13 years with no symptoms, then wham a bunch appeared that I didn't have prior to hrt, despite quite high oestrogen levels

[edelweiss]

Yes Annie, indeed an increase could help Pinkfizz. I shouldn't apply my experience to anyone else. I hope it fixes you very soon Pinkfizz. xxx

[Annie0710]

I only say that because if there's a higher dose available and symptoms have returned then increasing the dose could be the solution.  My case is completely different as they were new symptoms and I was on high dose

I wish there was an answer as to why this happens

[edelweiss]

Yes exactly Annie, the higher dose is the thing to try Pinkfizz. That's what consultants said was most likely in all my chats.

"I wish there was an answer as to why this happens". Me too, Annie, me too. xxx

[Pinkfizz]

Thanks ladies, I appreciate your replies. I have another 6 weeks on this dose, I will wait a couple of weeks and then go back to the doctors.

My reluctance has been, I didn't think I would need to increase so quickly... especially when it was going so well.

Question...do most women move up to the higher dose? When I went to see my doctor at the start, she said that she doubted I would move up in dose.

Regards xxx

[Annie0710]

I get confused who I've told my story to but originally I started on 1mg elleste solo, within 4 days it'd stopped all symptoms but about 2 weeks later they started returning so I was given 2mg and it took symptoms away again

[Pinkfizz]

Well in that case...I will make an appointment. Thank you xxx

[Annie0710]

Weird because when my doc put me on 2mg she said she thought I'd need it but chose to start me low dose first

[Peacegirl]

(I'm 57 post meno) Reading this thread has made me realise that worn out receptors was what the horrible, judgemental gynae I saw 6 months ago was trying to say I had. After 7 years successful HRT (Prempak I'm afraid) symptoms began to return to my GP switched me to evorel sequi/conti.  I was absolutely fine on this except for excessive hair loss so that kind of puts paid to her theory. I then entered a period of trying different types if HRT and having nasty symptoms and side effects. Now though I've been on Utrogestan and estrogel for around a month and I've been feeling really well. Fingers x'd the gynae had it wrong then.
I am thinking about cutting the estrogel down and seeing how little I can get away with and therefore how little progesterone as that's giving me side effects I'd rather not have.  This thread is very interesting reading!

[edelweiss]

Hi Peacegirl, how interesting! What symptoms came back on Prempak? You're so lucky they went away again on a different preparation! How brilliant. I hope that you stay really well. xxx

[Tempest]

So IS there such a thing as worn out receptors?!? I'm thinking there is SOMETHING and ladies suffering jolly well need to know! It makes women feel as if they've gone mad if things just stop working. Surely to God the experts know something about this?!? 

[babyjane]

I haven't commented in this thread as I know nothing about HRT but find it all interesting.  I think I read somewhere on this forum that the body can get used to things, start to recognise them and therefore not react properly to them.  I think this was mentioned in conjunction with anti depressants but I can't remember where. 

[edelweiss]

Hi Babyjane,

I think it was me? I think I said tachyphylaxis (which can also be referred to as acquired resistance, or downregulation), can happen with ADs too - it is a very well-known thing. Americans refer to it as 'poop out' - as in Prozac poop-out.

Regardless what it's called, it all means the same result: the hormone or drug doesn't work/or work as well.

If it happens with ADs the first line is to increase dose. The second is to switch to another AD.

Like Tempest I'm just baffled why this possibility is never discussed or mentioned in any literature in relation to HRT. A google search reveals virtually nothing - except Studd's earlier papers, and women on this site and others saying 'my HRT has stopped working'.

Is it just me that thinks it's weird? xxx

[Tempest]

I bet the estrogen receptors respond in a similar way to neurotransmitters  and if we look at the 'poop out" of AD's we can probably apply a similar science (if there even is any science. I'm sure the experts have no idea why this happens either)!

An interesting thing I read about Premarin recently is that receptors either modify or you develop new ones (!?!) in response to conjugated equine estrogens. Some women are able to respond to this type of HRT, others not and some are not able to then switch to estradiol after prolonged use of CEE's as their receptors have become 'modified'. (You can see I've been researching everything)!

So, I'm going out on a limb here but have you ever tried Prempro Edelweiss? It might be that you need to try something totally different to estradiol. And the other option of course is Tibolone. I think that one may very well be well worth a try - don't be put off that some of us haven't done well on it, just as many here have had a good response. I'd certainly give it a thought at least and it has a calming action too in most women. xxxxxx

[Rhiner]

This may be unrelated, but thought it worth adding to the responses and experiences, I felt I experienced a major drop in levels of oestrogen over the xmas period, many symptoms returned, I had been a little under the weather, but this lasted for 6 to 8 weeks. I did nothing, no increase in dose and eventually went back to 'normal', I was quite worried during that time. I had my oestrogen level checked after this time, but had nothing to compare to before as not had tested.
Rhiner