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[Sweetie4444]

Hi all.
I am new here and have been reading a few of the posts.
Just wondering if anyone has any advice for me.
I am currently on Estradot and Utrogestran for 7 days a month.
I started the treatment about 18 months ago. Initially I was very intolerant to the utrogestran so have gradually had to increase my estradot to 125mcg.
At the end of my last period I was feeling pretty horrific so I stupidly stuck another half a patch on.
I phoned panay's clinic who I am under and they wanted blood tests. The results of which showed my oestrogen levels to be 1121!!!
This was taken at the middle of my cycle.
I immediately had to reduce my patch back to 125mcg and it was time for my utrogestran which I take as a pessary.
I am now on day 5 of the pessary. My anxiety is through the roof, I feel depressed and cannot sleep very well.
The pessary seemed to help for the last two days but am feeling awful again today.
I am also in a panic that once I stop the pessary if this is what is levelling me out at the moment that I will have a massive fall out of hormones when I have my bleed...
Does anyone know if the utrogestran will lower my excess oestrogen? Or is it just a case of it counters the effects of oestrogen?
If it is the latter I assume when I stop the pessary I am going to go back to oestrogen being in excess and still feel awful.
I am on two anti depressants as well and have been told they are max doseages. I feel as though I have no where to turn at the moment.

[Dancinggirl]

Hi and welcome to MM Sweetie4444

Gosh - that's a high level of oestrogen!!!! Why has Panay got you on such a high dose of oestrogen?  Is it to suppress your cycle?  How old are you and where are you in your menopause journey?

The progesterone part of any HRT regime is used to protect you uterine(womb) lining and whilst progesterone can counter the positive effects of oestrogen, to a degree, it does not actually lower oestrogen.  Progesterone is used to prepare the womb lining for the shedding process.  Progesterone can have a negative effect on mood and give PMT symptoms and the withdrawal effect, when the progesterone is stopped and the bleed begins, can also bring side effects. The important thing that progesterone does is to ensure the lining sheds properly so you don't get thickening of the womb lining resulting in erratic bleeding and the possibility of womb cancer developing.
If the hormone treatment isn't giving you the mood balance you require and even with 2 types of AD things are not stable, then a review is really needed. If Utrogestan gives such bad side effects then maybe a different progesterone type may be worth trying e.g. Provera? I personally always felt worse on high doses of oestrogen so possibly drop down to 100 mcg or even lower to see if things improve - however, you need to follow what Panay is suggesting, so I think you need to report back to his team for advice.  Most women do well on just 50mcg patch!!!

You may be needing a change with the ADs as well?
DG x

[Sweetie4444]

Thank you DG.
I was hoping that the progesterone would help to bring the oestrogen down but you have confirmed what I thought that it just counters the effects.

I am supposed to be on 100mcg estradot, to suppress my cycle as I am progesterone intolerant. Every few months after using the utrogestran I would have recurring symptoms so the clinic suggested to up it each time.
They originally started me on the 50mcg.

The last time I increased to 125mcg in October, they have now said they advised I only do this for a month to counter the utro then go back to 100mcg. I wasn't aware of this and they didn't follow up with a letter etc to confirm so I remained on the 125. I guess my levels have been creeping up and up without me realising.

I have only been doing 5/6 days of utro a month as I would start bleeding a few days into the pessary so I would stop. I carried on with it once throughout my bleed and this made things terrible for me. So it could be that I haven't had enough utro to counter the oestrogen.
I don't know its so complicated.
The clinic have told me to reduce and then reduce again in a couple of weeks and they want to see me again for blood tests.

The day of the blood test would have been just after ovulation for me so I'm wondering whether this would have made my bloods higher.... but I would have thought I am on enough oestrogen to stop my own cycle coming through.
Guess I'm just clutching at straws.

[Dancinggirl]

Just follow their instructions.  I'm sure they will review things as the regime really isn't working.  Keep us posted.  DG x

[Salad]

Hi Sweetie4444

Such a struggle getting things balanced isn't it - my highest Oestrogen level was 2300! 

I'm also at Nick Panay's Clinic and they requested I get my Vitamin D and B12 tested - having read up a lot recently the symptoms are very similar to Menopausal symptoms, so if you haven't had yours checked it might be worth doing. Have a read about low Magnesium too.

In the meantime I agree with Dancinggirl's suggestion of following the Clinic's instructions. It might be an idea to complete a Menopause Symptom diary so you can see if there is a pattern.

Hang in there 

[Sweetie4444]

Hi Salad.

Thank you for the reply! Oh my 2300!!! What did you do? Did you feel worse when you were that high?

[Salad]

Hi Salad.

Thank you for the reply! Oh my 2300!!! What did you do? Did you feel worse when you were that high?

I was using Oestrogel and that reading was 3 hours after my morning application - my GP felt with a level like that I was absorbing all the dose and peaking my level but by 4 pm in the afternoon it dropped so my symptoms all came back. I felt great on the high dose and horrendous with the drop 

I was then swapped to Estradot patches and I am more stable on those but need a high dose (200 mcg) to get my Oestrogen up to a good level.
It's a juggling act and I'm an Oestrogen only user so can't imagine the difficulty you have with Progesterone in the mix too.

Stick with the Clinic guidance but document the effects so you can show them at your next review.
Good luck 

[Sweetie4444]

Wow sounds like you have been through it. Yes last dose of progesterone tonight then withdrawal bleed.... Not looking forward to it.

Thanks again xx