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[Hoffgrad]

Even after all of these years on transdermal oestrogen HRT, I still get confused (don't we all?) with too much/too little and the symptoms. 

I read that too little can cause anxiety and hair loss and insomnia.  But then I read that too much can do the same.  Argh!  I only need oestrogen, not progesterone, as am post meno and had a TVH ten years ago.   

I've recently upped my oestrogel dose to 2 pumps but I think it might be too high for me as I'm feeling anxiety and my sleep is terrible.  I also have fluid retention around tummy/bum.   I was awake at 4am this morning and couldn't get back to sleep.  I'm so sleep deprived and dizzy with it, that I can hardly type this.   

I find it hard to understand that Prof Stuff (for example) advises women to use up to 4 pumps a day!   I'd be bonkers if I had that much. 

I guess I'm probably concerned about getting enough, and protecting my bones.  I have a VERY small frame.  My wrists are so small.   I take supplements and eat a good diet.  I had a bone scan in 2011 which showed my T score to be 1.1 and then in 2015 it had risen to 1.8.  Then I think about the women who choose not to take oestrogen and wonder how they protect their bones, without taking biophosphates.   

I'm waffling... so so tired but wired. 

x

[Dancinggirl]

Hoffgrad - welcome to MM

Basically, you use as little or as much oestrogen as you need to control your flushes and night sweats.  I never did well on a high dose of oestrogen - between 1-2 pumps per day were ideal for me but some women need more. The dose of oestrogen is unlikely to affect hair loss, anxiety etc. Essentially we are all different so will react differently to different doses. Testosterone can sometimes effect hair and skin I believe.

Make sure you get enough calcium, Vitamin D and Magnesium in your diet and supplement if necessary - Vitamin D supplements in winter are usually essential unless you have had a lot of sun though the summer. Lack of Vitamin D will cause, fatigue and low mood!!! Weight baring exercise is also crucial and this can simply be good brisk walks each day. Brisk walking is very good for reducing low mood and anxiety.
You sound very anxious about all this - try to stop worrying - your insomnia is probably more to do with you anxiety.  Learn to do some relaxation technics, do more exercise and eat small amounts often through the day and you may find your sleep pattern improves. Stick to a medium dose of oestrogen  - 2 pumps of Oestrogel ( try doing one in the morning and one at night or just do 1.5 pumps per day) - this will keep you on an even keel and this will also help to protect your heart and bones. It may take a bit of time for your body to adjust to this slightly higher dose of oestrogen.   DG x

[Hoffgrad]

Hi Dancing girl

No....not anxious and I'm definitely not the worrying type. Quite the contrary.  You're not to know though so, thanks for your words.

I'm very clued up in terms of integrative health as I am therapist/consultant  so yes, vitamin D essential for all. Ditto other sups.

Yes....all different. Just like to know others experiences.

Thanks again.

Hoffgrad

[Dancinggirl]

Sorry if I sounded patronising - difficult for me to gauge how clued up you are from initial post. I really think it's about finding the ‘sweet spot' with HRT.  So the amount of oestrogen that keep the flushes under control with minimal side effects.  It does take a bit of time for the body to adjust and welcome the hormones, so I would suggest you just gradually increase with extra little squirts, from the one pump per day to 2 pumps per day and see how that goes.
I had a premature meno that started in my mid 30s, I am now 61 and only ever had quite a low dose of HRT (could never manage high doses) and my bone density isn't too bad.  I am an ex professional dancer with small bones but I now do a lot of brisk(power) walking that really helps I think.  I came off HRT about 18 months ago and my joints have definitely got a lot worse - spine issues with degeneration between L3-L4 vertabrae!  Oh, the joys of getting older. At least my 25 years of HRT have helped. DG x

[Mary G]

Hoffgrad, it's a difficult one but you are lucky that you don't have to take progesterone which complicates the issue and opposes oestrogen of course.

I wonder if it might help if you could have some blood tests to establish the amount of oestrogen you are absorbing from the gel (apologies if you have already done this).  Absorption rates vary tremendously and some women soak it up like a sponge while others don't absorb it very well.  An oestrogen blood test would at least confirm your levels and you might be surprised either way, they could be very high or they might be very low but at least you will know what you are dealing with. 

Finding the right oestrogen level is quite challenging and what works well for one person will not necessarily work for you.  For example, when my oestrogen level was 95 pg/mL (348 pmol) it was ineffectual (I had endless sweating, migraines and low mood) but others find this level is fine - I need to be somewhere in the 700s to feel good and keep the migraines away. 

You mentioned Professor Studd prescribing 4 pumps of gel.  This is his preferred regime for women who suffer from hormonal anxiety and depression and for this he aims to get oestrogen blood levels in the 800s - it works well for a lot of women but not everyone needs that much. 

If you can establish your oestrogen levels it would be a good starting point and give you something to work with.  Dizziness and insomnia are often a sign of low oestrogen. 

Like you, I am on 2 pumps of gel but my oestrogen levels were lower in my last set of blood results so I might have to increase my dose. 

I hope that helps.