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[Blue Kingfisher]

Hello everyone,

I've just got my latest oestrogen blood test result. Previously it was 298 (77 - 2400) a after being on 5 pumps of oestrogel. I've increased it to 6 pumps & my latest bloods are 464 (77 - 2400).

Considering I'm now showing positive for oesteoporosis i see the increase as a positive step!

I am generally feeling better on the higher dose but really struggle on days 10 - 15 of my cycle. I've written to my gynaecologist who is at the Studd clinic & waiting to hear back. I'm anticipating they will say I need longer on the 6 pump dose which makes sense to me looking at how my symptoms have at least improved since I've increased the dose.

Does anyone have any insights on any of this? I'm wondering if they will advise me to go up to 7 pumps. They would like me to have an oestrogen implant but I had one previously & for some reason it just didn't work & I was left feeling terrible on very, very low oestrogen! I also like the element of control you have with the gels....I mean what if the implant worked & that amount of oestrogen made me feel awful?! Or, it didn't work again.......it could put me back months like it did last time!

Any views greatly appreciated :-)

[Hurdity]

Hi Blue Kingfisher

Are you taking any progesterone ie do you have  a womb and still fertile/ovulating?

Hurdity x

[Blue Kingfisher]

Hi Hurdity,

Yes, I take 200mg progesterone for 7 days a month. I take it as a vaginal pessary.......

[Hurdity]

Where are you in menopause? It may be that if you are still peri-menopausal then the high dose of oestrogen is suppressing your cycle (ie as per the Studd regime) - although  in which case you would not achieve the very high levels of oestrogen as you would throughout a normal menstrual cycle. However if you are still experiencing a cycle this may not be the case, although taking progesterone cyclically induces an artificial cycle wherever you are in menopause. When you say you struggle from Days 10-15 - do you take the progesterone every calendar month and do you take progesterone on Days 1-7 of this same cycle? It could be progesterone withdrawal you are still experiencing (or the negative effects of the bleed maybe?) - some women don't feel the effects immediately as I read that progesterone can be held in the uterus after vaginal use so takes a bit longer to reduce. When is your bleed?

Do you have residual symptoms for which you feel you need a higher oestrogen level?

Seven pumps sounds like an awful lot - where on earth do you spread the 6 pumps?! Have you considered changing to a patch - Estradot for example (OK I'm a fine because this is what I use) but it may be that you would absorb more from a 100 mcg patch or even 150 (which would involve two patches) than all that gel...?

Hurdity x

[Blue Kingfisher]

Hi Hurdity,

I'm 49 years old (50 next month) & still having a bleed so I presume that makes me peri-menopausal. I use the progesterone on days 1-7 of each calendar month & my bleed comes on day 11 of the month.

I'm not sure what you mean by residual symptoms? Days 1-6 of my menstrual cycle are quite hard going, I then improve on days 7-9 & then it's pretty dreadful on days 10-14. Day 15 onwards things are fine.

I spread the gels on as follows: one on each buttock, one on each inner thigh, one on each back thigh & an residual on each hip.

No, I haven't considered changing to a patch. I know nothing about patches as all I've tried is an implant (disaster!) and oestrogel via the Studd clinic. How would I phase onto a patch? Is this something I could try via my GP rather than the Studd clinic? Is there a risk it won't work as well as the gels? I know nothing is guaranteed......just trying to work out the risk factors. I'm worried about changing the type of HRT as although things aren't good at certain times of the month.....ive crawled out of a very dark place & im not keen to go back! I'd also risk not being able to work as low oestrogen makes me feel very nauseous & extremely exhausted as it upsets my hypothyroidism.

Presumably, is ease onto the patch or patches whilst easing off the gel at the same time? Do you wear one patch or two & where do you wear them? Is it personal choice?

[Hurdity]

Hi again Blue Kingfisher

I'm a bit confused by your cycle and the prog days.

If you are peri-menopausal then presumably your own hormones are kicking in but if you are taking prog on 1st  - 7th of each calendar month - this must mess with your own cycle sometimes?

Howe are you counting the days of your menstrual cycle if you are counting the prog calendar monthly and how do you know it's your menstrual cycle? Sorry I think I'm being a bit slow here.....

Yes you could try a patch through your GP although you might have problems getting higher than 100 mcg. If you are under Studd regime you might want to explore this option through that clinic - I mean surely it is not usual to need 7 pumps? I'm not saying your actual oestrogen levels are too high but to have to use that amount of gel to feel better when you are not surgical menopause just seems a lot and somewhat inconvenient to me! If you're happy with this and it's working for you then keep on with it as per your specialist advice - but you posted on here so was just giving my humble opinion based on what I would feel - using all that gel - and being a patch fan!! As you say you don;t want to risk rocking the boat....

Patches come in different sizes and most women put them on butt, lower tum or side of thigh. They are changed twice weekly. Some women hate them because you have to make sure they don't come off and leave marks but some hate the gel because you have to apply it every day and wait for it to dry! Yes personal preference and also how much you absorb....

Hurdity x

[Blue Kingfisher]

Hi Hurdity,

I use the progesterone on 1st to the 7th of each calendar month. I then have a bleed like clockwork on the 11th of each calendar month. Therefore the length of my cycle varies slightly from month to month I.e. Feb having 28 days, March 31 etc. However, as I always start the progesterone on the first of each calendar month.....i always start my period on the 11th of each calendar month.

I count the 11th day of each calendar month as day 1 of my menstrual cycle as this is when my period starts. So when I say I struggle on days 10-15 of my cycle.....I mean my menstrual cycle.

Yes, 6/7 pumps is a lot but then my oestrogen levels are still below 500 & apparently not optimum. The Studd clinic believe I suffer mostly on days 10-15 of my menstrual cycle  because my oestrogen levels aren't high enough. I personally don't mind applying that amount of gel....it takes a few mins to apply & then I see to various ablutions whilst that sinks in!

The question for me I guess is around absorption as clearly I don't absorb very well. The oestrogen implant i had in my lower tum didn't work AT ALL (but maybe I was unlucky) & the gels.....well, you can see how much I'm applying & what my oestrogen levels are! I think the rationale for preference for gel at the Studd clinic is around better absorption & if that doesn't work then implants.

I will flag up my latest bloods to the Studd clinic via email along with my symptoms & see what they advise but I suspect they will say I need an implant. The concern I have with this is.....what if it doesn't work again (whole world of hurt for me) or what if it ‘works' but that high level of oestrogen makes me feel bad. There's obviously the possibility that the implant this time will work & i'll feel fantastic but it's a risk & im scared to take it at the moment! If I didn't have a job I'd consider it.....but I do, & also a house to run & a family to look after so it's a tricky old thing!

Thanks very much for the info on the patches, that's very useful & something to consider going forwards.

I will email the clinic & let you know what response I get.

Thank you Hurdity, your support & thoughts are hugely appreciated!! :-) xx

[SueLW]

Hi

I am under Dr Louise Newson.  I also see a lot of Dr Renee Hoendercamp in another forum. Both of these menopause doctors say we should not be spreading the gel and waiting for it to dry, but rubbing it well in until it is dry.  By doing this the absorption is better.  They have both said they see this in their clinical practice.

I have experimented on myself and using 4 pumps spread on and drying, versus 4 pumps rubbed well in, doubled my oestrogen level.  Try it.  But I wouldn't go straight from spreading 7 pumps to rubbing all 7 pumps well in as you might get a shock to the system.  Perhaps try rubbing a proportion of your gel in well until dry and spreading the rest (means you could apply 2 pumps worth to the same area once the first is rubbed in).  Wait and see if you feel improvements, especially in the part of the month you struggle. 

[MIS71MUM]

Hi BlueKingFisher

Do you mind me asking about your 6 pumps please?  I've seen an NHS gyny who has advised me to go to 6 pumps from 4!

I had been splitting my dose, 2 in the morning and 2 at night, but have now increased to 3 at night. 

Do you apply all 6 in one go? 

Luckily I dont have to use a progesterone because of a hysterectomy (kept ovaries), but I seem to struggle for 10/11 days ususally from 25th to 6th!  This is what I'm trying to alleviate by increasing the gel.

[Blue Kingfisher]

I also saw the thread that suggested spreading the gels was better for absorption but we are all different & it's definitely worth me trying to work out which technique works best for me so thank you for flagging this SueLW.

I tried split dosing (3 pumps am & 3 pumps pm) but for some reason this did not work for me at all and I woke up feeling very heavy headed, groggy & a bit comatosed! I'm better if I apply the dose in one go in the morning but we are all different.....