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[Salad]

I'm hoping I can't be the only one who has absorption issues, so wondering how many others out there are using above the 'normal' dose 

I'm currently wearing two 100 mcg Estradot patches and it's still not enough.

I am due to see a Specialist next month but trying to do a bit of reading up before I go.

[racjen]

How do you know whether it's enough or not? Have you had your estradiol level measured several times on this dose? I'm on Evorel 100, still not feeling great after nearly 3 months but was told it would take quite a long time to build my level up (was<44 pmol to start with).

[Salad]

Hi racjen

My last blood test in October when I was using 150 mcg was 195 so I increased to 200 mcg, but I'm still having lots of symptoms 
And that has dropped from my previous blood test in April when the level was 253.
There was a time a couple of years ago when I was using 75 mcg successfully.

I'm hoping the Specialist will be able to help me get more stable.

[racjen]

Do you have to take a correspondingly higher dose of progesterone on this dose of estrogen? I'm a bit confused about how that all works - can't work out if it's just a standard dose or if it depends on how much estrogen you're on.

[Hurdity]

Hi Salad

I don't use a high dose but it does look like your absorption may not be brilliant if you are only achieveing those levels on 200 mcg patch. Am I right in thinking you've had a hysterectomy with ovary removal? From what I gather the women without ovaries need a higher dose of exogenous oestrogen (ie from outside the body not made internally) because they are not making very much at all, whereas I understand that the ovaries do continue to produce some oestrogen even after menopause so women who still have them will need less (exogenous oestrogen) to achieve the same level. Does that make sense? Therefore it might not necessarily be absoprtion - just that you need more! Have you thought of trying gel in case you absorb less well from patches? I don't think you need to be unduly worried by what seems like a high dose if your actual systemic levels are not high as these are what are important if you are taking a seemingly high dose.

Hurdity x

[Salad]

Hi Salad

I don't use a high dose but it does look like your absorption may not be brilliant if you are only achieveing those levels on 200 mcg patch. Am I right in thinking you've had a hysterectomy with ovary removal? From what I gather the women without ovaries need a higher dose of exogenous oestrogen (ie from outside the body not made internally) because they are not making very much at all, whereas I understand that the ovaries do continue to produce some oestrogen even after menopause so women who still have them will need less (exogenous oestrogen) to achieve the same level. Does that make sense? Therefore it might not necessarily be absoprtion - just that you need more! Have you thought of trying gel in case you absorb less well from patches? I don't think you need to be unduly worried by what seems like a high dose if your actual systemic levels are not high as these are what are important if you are taking a seemingly high dose.

Hurdity x

Hi Hurdity - thank you for your reply, much appreciated and yes it does make sense 
I have had a hysterectomy but kept my ovaries - I wonder whether that is some of the reason for being a bit unstable eg my ovaries are still producing oestrogen sporadically.
I had to change from using just gel as my GP thought I absorbed that too quickly and then the level slumped in the afternoon. I had a blood level of 2300, two hours after my morning dose, so I was swapped to patches.

I have found some information on Professor Studd's site which said 100 mcg should give an approx plasma level of 500 and 200 mcg a level of 800 - so I will take that with me to show my GP. Maybe I should slap on another patch 

I am relying quite heavily on getting some guidance from Nick Panay's Clinic when I go next month - fingers crossed.

Thank you again x

[Salad]

Do you have to take a correspondingly higher dose of progesterone on this dose of estrogen? I'm a bit confused about how that all works - can't work out if it's just a standard dose or if it depends on how much estrogen you're on.

Thankfully I'm only using Oestrogen as I have had a hysterectomy - I dread to think how difficult it must be with balancing Progesterone in the mix too 

[Lanzalover]

Hi Salad

Could you possibly go back to the gel but perhaps split the dose over the day to try and keep your levels even.

I would ask at the meno clinic next month as they obviously have a greater knowledge of these things than me. Hoping you find a solution to this problem and do let us know how you get on.

Lanzalover x

[Salad]

Hi Salad

Could you possibly go back to the gel but perhaps split the dose over the day to try and keep your levels even.

I would ask at the meno clinic next month as they obviously have a greater knowledge of these things than me. Hoping you find a solution to this problem and do let us know how you get on.

Lanzalover x

Hi 
The gel worked well for about 18 months then it seemed to stop. I tried splitting the dose between morning and evening but I was never symptom free in the day unless I applied the whole dose in the morning. My other problem was the gel would take 20 minutes plus to dry.
Thank you Lanzalover, I will let you know how I get on x

[Hurdity]

Oh dear - how strange to have such extreme levels - much too high on gel but very low with the patches.  I wonder if they could suggest having a bit of each eg 100 mcg patch and 1 pump of gel - but if drying the gel each day is a problem then that's out of the question I suppose. What symptoms are you still experiencing?

I hope you manage to sort it out!

Hurdity x

[donnacrichton]

Hi I am on 200mg and only getting level of 254 waiting the 3 months to see if it levels. My consultant is quite happy with that level if symptoms settle. Only time will tell hope you get it sorted x

[NinaH]

I'm on a high dose Premarin 1.25mg. Great!

[Salad]

Hectic week so only just checking back in - thank you for your comments 

I've been back to my GP today, she's printing off all my blood levels since I started HRT and ordered a new check today so I can take them to my visit to the Specialist.

Hurdity - My unresolved symptoms are varied but this week have been joint/tendon pain- elbow, wrist, hip, knee, foot (eg hip pain waking me) palpitations, night sweats.
Last week included lethargy, headache/muggy head too.
Approximately 2-3 days a week I feel great, no symptoms - I would be settle for a couple more good days 

Roll on the 20th!

[Meeka]

I use 4 pumps of oestragel and latest blood test shows a oestradiol reading of 135.    My Gynae wanted me to get it higher than this to protect my bones as I already have osteopenia.  Not sure what he will advice when I see him in January.   I feel fine with no meno symptoms .  I do get anxious but manageable and I have always been slightly anxious anyway.   I always apply it on my inner thighs on clean skin after a bath in the evening. I always let it dry before putting clothing on......4 pumps takes quite a while to dry .

[Salad]

I use 4 pumps of oestragel and latest blood test shows a oestradiol reading of 135.    My Gynae wanted me to get it higher than this to protect my bones as I already have osteopenia.  Not sure what he will advice when I see him in January.   I feel fine with no meno symptoms .  I do get anxious but manageable and I have always been slightly anxious anyway.   I always apply it on my inner thighs on clean skin after a bath in the evening. I always let it dry before putting clothing on......4 pumps takes quite a while to dry .

Hi Meeka - It's good that your dose relieves your symptoms but I guess you have to follow the advice of your Gynae to keep your bones healthy. It'll be interesting to hear whether you're advised to use more than the current 4 pumps with that lowish blood level in January.