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[sheila99]

I am in Peri. My GP admits he knows very little about HRT so he prescribed Everel Sequi and I have an appointment with a more knowledgable GP at the end of the month, so I'd like to be prepared for it.
  They've tested LH & FSH levels but not oestrogen or testosterone which I believe Prof Studd does test. NHS nurse said oestrogen is too variable in Peri so they don't test so they presumably prescribe a 'standard dose'. Does Studd use the oestrogen level to prescribe the dose or does he start with a standard dose too? How do I know if the dose is either too high or too low?
  I think it's likely I would benefit from testosterone - zero libido, permanently tired, get up & go has got up & gone. If I can get GP to test it does anyone know what level Studd would prescribe it & at what dose? Or can you point me to any articles about it?

   

[Annie0710]

I think I've read that Prof Studd goes by oestrogen levels BUT, my advice would be to take the hrt you've been given, if it's correct for you, I have no experience of this hrt.  I do think gradually increasing dosage is good as and when you feel you need it.  This regime may give you back your life without testosterone but if not it's always worth asking your gp before going private

I've never been prescribed a dose based on my levels, just my symptoms and now I'm on gels I can really have control over dose x

[sheila99]

Hi Annie, I've only been taking it for 6 days so probably too soon to tell - there hasn't been much change so far. As they're patches I can't change the dose so I'm hoping they just need a bit longer. I read that 93% of Prof Studd's patients are prescribed testosterone which makes me think many more women would benefit from it.  I'm hoping I can be tested without going private. Given how much trouble other people seem to have with their GPs I'm not expecting an easy ride.

[Mary G]

sheila99, I am a patient of Professor Studd and I took my own blood tests results with me on my first visit.  They may not be useful in terms of knowing where you are in the menopause but they do indicate how much oestrogen/testosterone you have in your system which is well worth knowing, particularly if you find your oestrogen levels are rock bottom.  If your testosterone levels are very low then he would prescribe it.  With regards to oestrogen, he likes to keep oestrogel levels quite high for maximum symptom relief and would normally prescribe 3 pumps of Oestrogel every day and probably 4 pumps of you were suffering from hormonal anxiety. 

[sheila99]

Mary G were you in Peri or actual menopause when he tested your oestrogen? I'm in the NW so sadly Prof Studd is too far. The way I feel at the moment I'd spend my last ha'penny to feel normal again.

[Mazza27]

Hi sheila99,

Have you tried tony mander hes north west? Hes been great with me

Mazza

[Mary G]

sheila99, I had a sudden menopause so I was post menopause by the time I saw Professor Studd.

[Hurdity]

sheila99 - whereabouts in peri-menopause are you - what was your cycle/periods doing before startng HRT? It isn't actually necessary to have oestrogen levels measured - most doctors will go on symptoms alone combined with your cycle when you start HRT. Sometimes it's necessary for those without a cycle ie those who've had hysterectomy - but there are no absolute oestrogen levels that are right for every woman. Some are fine and happy on  say 200-250 pmol/l - like me, whereas others need much higher levels especially those who suffer from severe reproductive depression. If you want to suppress your cycle then much higher doses are given. Also there is no need to test for T either - you need to get your oestrogen levels right so that you feel good, make sure you are not taking prog all the time, and then if you still have no libido and are getting fatigued and muscle aches etc after exercise then adding T might help. Oral HRT can dampen libido. I really wouldn't waste your money - if you want to change to the Studd regime - he is not the only one to prescribe it - gel and Utrogestan are available on NHS - but prescibing T is hit and miss. There will be a consultant nearer than London if you can't get T on NHS but think you might benefit - eg as Mazza27 suggests.

Wait a little while and see how you get on with this one - hopefully you will see and improvement really soon!

Hurdity x

[luna66]

Hello sheila99

I'm a new-ish patient of Professor Studd's. I went to see him in late October 2017, when I was technically, just, in menopause.

He did a bone scan and took blood for testing at the first appointment, but gave me my prescription to start immediately before the blood tests were through. So, I'm guessing, he based the prescription on my reported symptoms, but also in my case on my bone scan (which produced immediate results) because it showed that I have severe osteoporosis in my lower spine. He prescribed 3 pumps of Estrogel, and & 7 days of Utrogestan (100). The Utrogestan has now been increased to 10 days as of this (my fourth) month of HRT. He also prescribed Testim (one pea-sized blob a day), which sent my sex drive through the roof... A bit inconvenient really since I'm single at the moment...

Hope this helps,

Luna x

[sheila99]

Thanks for the suggestion Mazza. I'm going to try the NHS route first but will certainly try him if things don't improve.
Hurdity - Given my age (57) I think I must be close to the end. There was nothing noticeable about my periods til the last 6 months - 4 shorter than normal, then skipped one. I first went to my GP over a year ago because I was so tired. Nothing diagnosed but with the benefit of hindsight I think it was Peri. I can live without the libido, it's the tiredness, lack of motivation and feeling fed up that gets to me. I have all the symptoms of low T except headaches. Day 8 of Everel Sequi and I have had felt less like the walking dead today so I am hoping it's starting to work. The 'try it & see' approach all seems a bit hit and miss to me, I'd expected it to be a bit more scientific.

[sheila99]

Thanks for the info Luna. Did you have any idea you had osteoporosis? I haven't asked for a bone scan on the (perhaps misguided) assumption that I should be OK if I'm still having periods or on HRT. I shall ask the GP at my next appointment.

[luna66]

Thanks for the info Luna. Did you have any idea you had osteoporosis? I haven't asked for a bone scan on the (perhaps misguided) assumption that I should be OK if I'm still having periods or on HRT. I shall ask the GP at my next appointment.

I had no idea at all and was shocked and very upset. I have a great diet and exercise plenty and get out in the sunshine (such as there is in London!) several times a day to make sure my vitamin D is good.

I originally went to see Professor Studd because I'd been suffering symptoms for about four years and was managing them with acupuncture and nutritional medicine with mixed results. My GP was useless - wanted to give me anti-depressants for anxiety and anti-histamines for poor sleep (!), and I asked if there was a menopause clinic to which I could be referred, only to be told 'no'. Terrible.

When I went to see Professor Studd I originally went for advice and wasn't intending to make a decision about HRT (I prefer natural remedies where possible), but when I had the osteoporosis diagnosis it seemed like a no-brainer and clinched it for me. I had to do it. He prescribed a Vit D supplement alongside the HRT.

[sheila99]

I'm so sorry you had this diagnosis Luna, it does seem unfair when you've looked after yourself. I think I have a healthy lifestyle too but I guess it just doesn't guarantee good bone health.

[luna66]

Thank you sheila99. From what I understand bone health is partly down to weight during teenage years. I was asked if I was very thin as a teenager (I was fairly slender), and Professor Studd suggested I put on weight now. I'm not as thin as I used to be and I definitely don't want to put on extra weight!

To be honest, I'm not worrying about it now. I'm doing what I can to take care of myself and my bones, and I put it out of my mind for the most part. But I guess I won't be doing any more snowboarding (which I started about three years ago, not very successfully to be honest)!