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[NorthArm]

Hi here and there

Do they have oestrogen only patches in SA? Because you could try that before a pill, it gives a more consistent dose.

About gel application I'm not so sure - some say to just apply but no rub in, whilst others say differently. How are you going on the three pumps?

[hereandthere]

Thanks NorthArm
I'm not sure about an estrogen only patch, but I will definitely ask thanks for the tip, as the patches seemed to work well except for my progesterone hair loss problem. I've only done two days with the extra estradiol pump so not sure. I did feel some flushing at one point last night, but slept quite well. Probably got to give it a while.

[Ladybt28]

In the UK you can go up to 4 pumps of the oestrogel.  I am post meno and I need 4 pumps.  On the forum here there are ladies who have posted that they have been advised 6 but I think this group of women are quite in the minority.  Conventional prescribing is usually up to 4.  One of the things I like about the gel hereandthere is that you can play around with it without asking the GP all the time.  Obviously when you up the dose you need repeat prescriptions more frequently but at least you can see how you feel uping it yourself and then go back to the GP and say "well I increased my dose and it's working so can you increase my prescription...".  Or you will be abele to say uping the dose doesn't make any difference.

[hereandthere]

Thanks ladybt28. I asked my gynae when he called with my results if I should try 4 pumps and he was ‘no, that would be double!' but I see here as you say that others are doing 4.

I'm a bit confused about my result of 113 for oestrogen, as it seems incredibly low compared with others, but maybe it's a different measure. At least I'm getting no spotting, which supposedly going off Evorel Sequi was maybe going to do. My periods are well and truly gone!

[Ladybt28]

Interestingly it was my GP who said 4 was fine and so did my meno consultant. I believe the starting dose is 2 pumps but the main max prescribing dose is 4 and for special cases as many as 6.  Its a bit concerning that the gynae didn't know this.  I think that there a doses listed in Professor Studds papers if you go to his website.

Sorry I can't help with blood levels I have never had a blood test. My consultant and GP go on the "control of symptoms". There is a lady on here who is very good with that sort of thing maybe she will be along?

Glad no spotting, at least that is one off the list, you are probably going in the right direction hereandthere.

[Hurdity]

Hi there - just a quick question - yes as said it is important to know the units of measurement for estradiol as they are different. In UK it is pmols/l but in US ( I think?) pg/ml and to convert from pg/ml to pmol/l you multiply by 3.67 so results will look very different to what we are used to discussing if in pg/ml. However if your gynae says your result is low at 113 then sounds like it could be pmol/l? Once we have the answer we can advise better if you need any more help?

Hurdity x

[hereandthere]

Thanks Hurdity
I've mailed my gynae as I can't work it out and will tell you. He did say 170 would have been ok.
We are normally thesame as the U.K. so the metric system for example applies- properly - we don't say pounds and stone. Some of us oldies like me do say feet for height. 😂
I've done an extra/3rd pump application two days now and I feel even more bloated, but my gynae said this would be the progesterone. So it doesn't make sense if I'm taking in more estrogen and getting bloated, but maybe as only two days and on low levels, this is the relatively high progesterone effect. Does this make sense?

[hereandthere]

Just saw this from Dangermouse- ‘When estrogen is surging and progesterone is low, water is diverted away from the bowels to protect more important organs and it causes excessive bloating and slow transit. Apparently in pregnancy this is a good thing as it allows more nutrient absorption due to the slower journey through.'
So maybe the extra pump is having an effect. But I've been bloated just not as bad since starting my new regime where I'm supposedly not absorbing enough estrogen, so all very confusing.

[Ladybt28]

hang on in there    hereandthere, if the bloating is not as bad then you may just have to wait for it to settle.  I dropped a complete dress size in the first 3 months of my new regime.  But the adjustments don't happen quickly but if you are seeing something well...just hang on in there!

[Hurdity]

I think increasing oestrogen can cause a bit of bloating (water retention) - so I've read - but would be accompanied by nausea perhaps and tender breasts (?) - and would settle fairly quickly? Bloating due to progesterone tends to stay around more I think. I find I get bloated when on the prog part of my cycle but I'm only ever on it for 12 days at a time so no idea if it would settle.

Hurdity x

[hereandthere]

Thanks guys, I'm guessing it is the relatively high progesterone. I'm not nauseous and usually I am quite a bit.
Will see after a week or so if the extra estradiol pump.

[hereandthere]

Hi there - just a quick question - yes as said it is important to know the units of measurement for estradiol as they are different. In UK it is pmols/l but in US ( I think?) pg/ml and to convert from pg/ml to pmol/l you multiply by 3.67 so results will look very different to what we are used to discussing if in pg/ml. However if your gynae says your result is low at 113 then sounds like it could be pmol/l? Once we have the answer we can advise better if you need any more help?

Hurdity x

So Hurdity I got confirmation that it is indeed pmol/l that it's quoted in. Do you have any other comments now that you know this?

[Hurdity]

I know blood tests are inaccurate but if that result is an approximation to your level then it is low if pmol/l which is what your gynae said anyway. Sounds like you might not be absorbing it that well? Has the extra pump of estradiol gel improved things? If not maybe try patches again - but you would be able to have a higher dose than 50 mcg as you are now doing separate oestrogen and progesterone.

Hurdity x

[hereandthere]

Thanks so much for your comments Hurdity xx
It does seem better with the extra pump though still getting some flushes and so thinking of m just trying 4 pumps to see how it goes. Previously on the Evorel Sequi patch the flushes first cleared up immediately but then had crept back slightly, presumably as my estrogen was falling dramatically at that time. Not sure what to do about the bloat which is worse than ever and likely due to the utrogestan capsule. If the estrogen is increased, should this help balance the progesterone? Feeling hopeful 

[hereandthere]

Just wanted to add I got this awful heads on the weekend sort of shooting pain in the side front of my head whenever I stood up. If this can relate to the estradiol a bit scared to up the pumps. I never had this sort of headache before.