Print

Please login or register.
1 Hour 1 Day 1 Week 1 Month Forever
Login with username, password and session length

[djkittens]

Hi I have been perimenopause for some time now and haven't had a period for 10 mths.  I have hot flushes ,depression and anxiety issues.  I have decided to try HRT to see if it will help but would like to go down the bio identical hormone route. Before I try HRT, i have just had my saliva test results back Estradiol 2.0 pg/ml and progesterone 95.9 pg/ml.  My progesterone/estradiol quotient (ratio) is 40,7:1.  .  They said the result indicates I have  estrogen dominance.  I wondered if anyone could help explain this too me because I don't understand how I can be estrogen dominant when my progesterone levels are much higher then my estradiol levels. If anything I thought I would be progesterone dominant according to how I read my results.  I was going to get some natural progesterone cream , but now I don't know what to do as it looks like using that would only increase my already high levels of progesterone even more, so should I just use a estrogen patch on its own instead ?.  I would be grateful for any information as I really want to make a start on something its really getting me upset.

[Dancinggirl]

Hi and welcome to mm

It's well worth trying hrt but if you haven't had a period in 10 months then I very much doubt you are oestrogen dominent. The saliva tests are very far from reliable.
The oestrogen dominance theory is used by alternative practicianers and is not actually appropriate in your case. In peri meno then there can be a lack of progesterone because of missed ovulation and this will result in erratic and/or heavy bleeding.

Your best way forward would be to pop to your GP and have some proper blood tests done and discuss the symptoms you are experiencing.
Write everything down so you don't forget anything and ask if you could try some hrt.
Look under Treatments on this site and print all the sections off to help with your discussion.
Most prescribed hrts have bio identical oestrogen now and there are a variety of progesterones to try and it's about finding an HRT regime that suits you.
Do start with a sequential hrt first (this will give a monthly bleed) as this will be right for you at this stage and allows you to see if a particular progesterone suits you or not.  I would ask to try something like Femoston 1/10 first as it has a kinder progesterone which is often tolerated well.
I'm afraid most GPs are not up to speed on treating menopause so one does have to go to the appointment armed with the right info and questions. Most GPs will simply prescribe the cheapest option (usually Elleste) so one does need to be clued up. There is a bioidentical progesterone (Utrogestan) and this can work well for many women but this involves separate oestrogen and progesterone and I'm afraid most GPs don't know about this and won't prescribe unless you have seen a specialist gynae or menopause clinic.
I personally found Utrogestan very problematic.
There are many options and hrt can work very well for many women but it is trial and error till you find the right regime.
I do urge you not to buy compounded creams - only use prescribed HRT from a proper doctor.
Keep us posted. DG x

[Hurdity]

Hi djkittens

  from me too!

I agree with Dancingirl.

Oestrogen dominance is a red herring - in fact invented by someone to sell progesterone cream so I understand.

Saliva tests tell you nothing about your hormone levels (only dubiously useful as a tool to look at relative changes on progesterone for women who are trying to conceive and want to know if they are ovulating  ie the changes throughout the cycle).

If you are 45 or over, your periods are few and far between ( like yours ie none for 10 months), and you are experenceing menopausal symptoms - you do not need blood tests at all - you are peri-menopausal. You haven't said your age? If you are under 40 then blood tests ( hormonal and others) will help to rule out other possible reasons for your lack of periods and diagnose peri-menopause.

Yes all bio-identical hormones can be obtained from NHS - it is what I have always used apart from first 3 months of HRT, and I've been using for 11 years +. I use oestrogen patches and utrogestan.

Don't buy the cream!! It's not what you need!

What symptoms are you wanting help with? HRT can help with the classic symptoms of flushes and sweats as well as many others such as low mood, joint aches etc.

If you are under the natural average age of menopause (51/52) and are well on the way then it is best to take HRT at least until this age.

Yes trial and error is good!

Hope this helps and do ask anything more you want to know and we might be able to help!

Hurdity x

[djkittens]

Hi thanks for your messages. I am 53 and the symptoms that bother me most are hot flushes, low mood and anxiety and a heavy head feeling,headaches and tiredness.  I don't like going to the doctors anymore, I feel stupid and they don't take me seriously and its a struggle to get anything, all they want to do is put me on anti depressants, but I don't want too, they have never suggested hrt or offered me blood tests to see what my hormones were up to apart from a test for the fsh levels a while back confirming peri pause.  I keep telling them I don't feel depressed but its the physical symptoms that is making me feel depressed and this all started at the same time my periods started to get irregular.  Now I haven't had a period for 10 months so I must be close to menopause. I did see a new trainee doctor (not so intimidating) and I asked if I could trial hrt .  I have now been on evorel sequi for 2 weeks but it is giving me headaches and making me feel sick sometimes. I wanted to go down the bio identical route and because I cant afford a private doctor, my intensions were to do it myself get the hrt oestrogen patches of my own doctors and because you cant get bio identical progesterone on the NHS (or if you could I got no chance getting it of mine) I was going to get it myself such as pro gest or provela.  I had the saliva test to see where my hormones were at, so it could give me an ideal of how much to take to bring hormones into balance but i havent worked that out yet ?
Kind Regards DJ

[Dancinggirl]

You certainly can get Utrogestan (bio identical progesterone) on the NHS and if you print off the info from this site you could show it to the GP.
However, the Evorel you have been given dies have bio identical oestrogen which is good. It is very common to have some side effects like headaches and nausea in the first few weeks if any hrt regime - sore breasts and some tummy cramps are also common - but al
This should settle in 3-6 months. Your body has to adjust to the hormones. I really wouldn't self prescribe - particularly regarding the progesterone as you need to use the right amount to protect your uterus or you will get rratic bleeding and increase the risk of developing womb cancer.
There are many different hrts to try. I personally found Utrogestan the most difficult progesterone I tried and tried just about everything. The best hrt regime I ever had was the Mirena with Oestrogel but it is often trial and error till you find the hrt that suits you.
Basically I'm telling you not to be too hooked on having Utrogestan ( many women live live it but many do not - we are all different) and definitely DO NOT self prescribe or use progesterone creams or compounded hormones from alternative practicianers as this is not regulated and is far more risky. 
Finding a balance is about controlling your symptoms. The prescribed hrts are put together to give a safe balance but no hrt will be perfect.
Give your current hrt a couple of months to settle and then if flushes are not better or the side effects are too troublesome then you need to try something else. Nausea can be helped by eating small meals often and the headaches should be better once your body adjusts to the oestrogen. You are starting from a low oestrogen kebel so side effects are to be expected.  Femoston 1/10 can be a good one to try if the Evorel doesn't work out or you can ask to be referred to a gynae or menopause clinic where you should be able to get specialist advice.
Don't be intimidated by the GP - go to the appointment with everything written out and have print outs from this site with the info on the various hrts - this way you will feel more confident and more able to hold your ground to get what you want.
I hope things settle on this hrt - give it a chance and don't be sucked into the idea that Utrogestan would be the answer to your prayers it doesn't suit everyone. Utrogestan is worth trying though if other hrts don't work out well. DG x

[Hurdity]

Hi djkittens

As Dancinggirl says - if you want to go completely tdown the bio-identcial ( body-identcial) route then you can get progesterone on the NHS as Utrogestan - here is the link: https://www.menopausematters.co.uk/to_progestogens.php

We don't have either Pro gest or Provela so not sure what these are but be sure if they are not certified products available on NHS then they are not suitable for protecting your uterus (as Dancinggirl said) - please ask for micronised progesterone ( the utrogestan) from your doc for this.

The best way to take Utrogestan is taking it cyclically  - which would give you a withdrawal bleed like a period and may not give you the same side effects as the Evorel - although some nausea and sdie effects are common when first starting HRT.

I have been using Estradot patches and Utrogestan (vaginally) for more than 7 years and before that the same patches and a different type of "natural" progesterone - from the doc but not licensed for HRT - in total for more than 11 years. Personally I have found it a fab combo - have felt well all this time and still taking it now in my mid 60's

Hurdity x

[CLKD]

If saliva tests were reliable or necessary they would be available on the NHS.

Maybe have a chat with the Practice Nurse and see if there is a GP who has an interest in womens' health.  The Qualifications will be on the Surgery web-site so do have a look-see.  You could also see a Pharmacist, they have private rooms these days.

Browse round.  Make notes.  Let us know how you get on.