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[Amanda64]

Hello, am hoping someone can relate/help? I started on hrt (Elleste solo 40 patches with Utrogestan) about 6 or 7 months ago, and felt fantastic within a few days, mood lifted, and all hot flushes/night sweats gone within 3 weeks - but when we had the really hot weather i started to get a rash so was changed to Sandrena gel, which was a fairly easy transition but over the following 3 months my symptoms have gradually crept back despite upping to 1.5 sachets. I asked if I could change to Oestrogel and the Dr (reluctantly) agreed.
So I started taking 3 pumps daily, almost a week ago .....I feel pretty rubbish still but worst of all EVERY day at about 3pm i start feeling AWFUL, really really depressed, & very very tearful. It lasts a couple of hours - will it be temporary? I can't begin to tell you how wretched it feels, i even rang my husband (we are separated) and cried, told him my life was so shit (bet he loved that!) Today I was at work and cried too. I've also started getting really disturbing dreams .....I feel worse than I did before going on hrt!!!
Should I try & stick it out - does it mean the dose is too high? Should I lower it? Any advise?

[Butterfly22]

Hi that's awful, I'd suggest one pump for two weeks and then go up, I'm not that clued up myself but the doctor has always started me on lowest dose so ease into it. Three pumps to start I'd think is quite a lot and could explain the dreams and crying. Poor you! Can you maybe go back to the doctors? If not personally I'd do one pump a day but that's just me. Sending hugs xxxx

[Joaniepat]

I have just changed from Tibolone to Oestrogel, and was told to use one pump for two weeks, then increase to two pumps after that and see how it goes. Three pumps is a medium/high dose. Did the doctor tell you to use three pumps? It sounds a lot to me.

[Amanda64]

Well i'd been on Sandrena 1.5 sachets which (i think) is quite high, and although it started off well, i could feel it was working less and less as time went on. I asked if i could try Oestrogel, so she said to try 2 or 3 pumps, esp as i had 'dryness'  starting as well. I think I'll go down to 1 or 2 and see how it goes..... Thanks, I did wonder if it was because it was too high a dose. Funny how I feel fine again this evening, it's only in the afternoons!
Don't really want to moan too much about it to the Dr unless I have no choice, as her preference is tablets and she wanted me to try them instead, but i'd rather stay with transdermal if poss.. She's a very "strong" woman in her late 50's, who i chose to see this time thinking she would understand, BIG mistake! She more or less said that it isn't that some people have an easier menopause, but more a case that some people are better at coping with it than others. 
On the plus side - just today after almost a week on it, the dryness issue has resolved!!! 

[Hurdity]

Hi Amanda64

1.5 sachets of  the 1 mg Sandrena is equivalent to 2 pumps of oestrogel ie 1.5 mg estradiol so is the standard medium dose HRT. It is more concentrated than oestrogel so absorption may be different and will also depend on the area spread, to some extent. Some women also absorb much better form patches then gel - others vice-versa. Without a blood test ( which are themselves unreliable) you can't tell how much you are absorbing. A good rule of thumb though is to go by symptoms so if flushes are creeping back it suggests the dose is too low. I'm not familiar with the concept and sensation of too much oestrogen. I presume this occurred for me at times during peri-menopause but I was blissfully unaware of it!  Is it possible for your to try Estradot patches which are very small - since you know you absorbed oestrogen well from these? There are some supply issues with this product though (I use it!).

Sorry - I don't know how old you are or where in menopause as this will have a bearing on your response to HRT to some extent. Also are you taking Utro continuously, orally, vaginally, what dose etc?

How DARE your doctor say such a thing! This does not bode well for women's services does it? This should be the most basic starting point - that all women's experience of menopause and response to oestrogen deficiency and hormonal fluctuations will vary. For a start there is a huge range in normal oestrogen throughout the menstrual cycle anyway, so it is very unscientific of her to state this because we start from slightly different levels!

Glad your dryness has improved. If you reduce oestrogen you may find that you need some vaginal oestrogen too - in order to keep tissues plumped...

Hurdity x