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[helenmelon]

Hi Ladies,

Advice needed again 🙄 please

So originally I was given Evorel 50 Sequi but due to the progesterone causing problems I was convinced by meno specialist and GP to have Mirena.
Have had Mirena since 11 May, at was fine at first. When I had my 6 week check the GP said my insides looked a bit red, swollen and angry so took swabs. She said is infection she'd ring me. That was a few weeks ago, heard nothing.
I feel like I'm going backwards and wonder if I've got too much progesterone.

One of the reasons for the Mirena was so I could slightly increase my estrogen but GP says stay on this, now Estradot 50 for another 3 months.

My old symptoms seem to be slowly returning, sweats at night, a bit anxious, but nothing like I was, waking during night, IBS has returned along with a bit of reflux.

Just don't want to leave it till I have all my symptoms back again.

Any suggestions???
Thanks again

[Dancinggirl]

Do you think the very hot weather has an influence on you sweating at night?
Why not ring the surgery to ask about the results if the swab? This would probably reassure you?

It takes 3-6 months for the Mirena to fully settle but it could be worth asking to try a slightly higher dose of oestrogen.
Do you practise Mindfulness or other relaxation techniques - I find this essential to keep my mind from dwelling on things or getting anxious.

Hrt won't fix everything. How do you deal with the IBS? Do you eat small meals regularly? Have you tried digestive enzymes? Have you cut out caffiene, fruit juices and alcohol? Do you drink lots of water?

Be patient and concentrate on improving your lifestyle - it's often a whole range of strategies that help us cope with the menopause - hrt is only one of the strategies. DG x

[helenmelon]

Thank Dancinggirl.

I don't think it's the hot weather, its not a case of just waking up feeling warm, it's the drenching sweats that spelled the beginning of peri. Although I'm generally a bit warmer in the heat.

I started HRT in December 2017 and at first I felt fantastic. It was only after a few months the progesterone started causing problems.
I just want a return to those early days. My menopause specialist said if I had the Mirena then I could try different estrogen doses but my GP who is generally very good says no as the Estradot 50 is a medium dose.
I also had problems with the original patches, Evorel 50 staying stuck on so switched to Estradot, at the time I asked if I could try the gel instead but my GP said she didn't recommend it because you could never be sure of how much you were getting. I suspect that the cost may be an implication?

I take symprove for my IBS and I don't have caffeine, eat small meals but I do like wine, I drink water and excercise regularly. It's just odd that with my initial dose of HRT all of my symptoms calmed down and now I'm seeing a return.

I know HRT isn't a magic wand but it seemed so much better at the start.

Thanks for your reply xx

[Dotty]

Hi Helen

I would say that if your symptoms are coming back then you need a higher dose of oestrogen. I don't know where your GP has got the information from to say that you don't know how much you are getting from the gel! That's rubbish as each dose is carefullg metered and it doesn't cost more than other hrt. It could be that you are not absorbing from the patch as well as you were or it could be that your oestrogen levels have dropped.

I must say that for me HRT has been a magic wand. Good luck x

[Dancinggirl]

I think you and Dotty are right. You may be deeper into the menopause and so you simply need a bit more oestrogen.  Sometimes absorption is an issue so I would ask to have your oestrogen levels  checked the see if you are absorbing enough oestrogen.
Your Gp is being very pedantic - perhaps ask to to be referred to a gynae or meno clinic for advice about disage if he/she won't let you try a higher dose. There wouldn't be patches in higher doses available if woman didn't sometimes need them.  DGx

[helenmelon]

Thanks Dotty and dancinggirl.
Long may the magic wand keep doing its magic Dotty xx

[pepperminty]

Hi,

I didn't know that it is possible to ask your GP to check your estrogen levels to see if you are absorbing it properly. That sounds like a good idea.

Pepperminty

[Dancinggirl]

When I was seen by a private gynae  he wrote to the GP asking her to check my hormone levels after 4 weeks on a particular regime. He wanted my oestrogen to be over 500. DG x

[Mary G]

I had a 50mcg patch with a Mirena coil and it was completely useless.  Blood tests confirmed that I was hardly absorbing any oestrogen and the patch didn't stick properly either. 

Although most of the progesterone from the Mirena is confined to the womb, enough of it gets into your overall system to cause side effects and you need a higher dose of oestrogen to counter those side effects.  Too much progesterone will drown out all the good work the oestrogen is doing and this is probably why you have the symptoms.  Your coil is new so it will be pumping out a lot of progesterone so oestrogen dose flexibility is all the more important.

From my experience, Oestrogel absorbs far better and I think it would be more effective with the coil and give you the dose flexibility you need to make this combination work.  With gel, it is so easy to quickly adjust the dose when you need to so try to switch to it if you can. 

I had my coil removed but if I had known about Oestrogel back then, I would have persevered with it because I think that combination would have worked for me.

It is at times like this that blood tests for oestrogen levels are really useful and I would definitely have one as soon as possible. 

[Hurdity]

Are you post-menopausal helenmelon? If not then measuring oestrogen levels won't tell you a lot - they are somewhat unreliable anyway and the fact that your symptoms have come does indicate you would benefit from a higher dose - so it is this rather than actual levels that are important.

In my opinion and for me Estradot patches are fab! If they did work initially and you now need more oestrogen then yes you can increase the patch dose. I am in mid 60's and am on 62.5 mcg (75 mcg cut down a little). You could try this for a few weeks and then if this doesn't do the trick then go for the whole 75 mcg patch. If you are able to order them a bit before they are due - can you accumulate a few patches and try this yourself - this is what I did for a year or so? I cut 50 mcg patch into 4 and added an extra strip each time. It may be too small to notice but you could start with this. However your doc really should allow an increase in patch dose without testing anything at all - based on your symptoms alone! Can you see another doc in the same practice? I presume you make sure the skin is clean and dry - no creams etc?

Personally I would try an increase in patch dose for a few weeks - up to 75 mcg before changing to the gel but do whatever you feel is right for you based on what has been recommended here! I can't remember how old you are?

Hurdity x