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[Turkish delight]

Hia girls!

I have a couple of quick questions.

I am on my 1st cycle of Oestrogel one pump every other day, and 100mg Utrogestan vaginally for 14 days. All completed but haven't had a bleed and it's 3 days after my last Utro. My question is..Which way should I be tweaking? My Utro up to 200mg is my guess, and believe me it is a guess, and a guessing game, in which I seem to be the sole player, with no GP input
Should add I'm 51 peri meno and had no periods for 5 months prior to starting bhrt.

The other totally unrelated question:

I've read that the minimum effective dose of transdermal oestrogen needed in order to benefit from the risks against heart attacks, alzheimer's and osteoarthritis is 0.05mg daily. Does this sound right? I'm on Oestrogel which contains 0.6mg or 0.75 per 1 pump(I really don't know whether I'm talking complete and utter trash lol)Currently on 1 pump every other day as per gyn instructions due to BC in 1st-degree family member.

Actually, I have one more question.

I also read that there isn't a higher incidence of BC in relation to a higher doses of oestrogen. So higher doses of oestrogen are not associated with higher rates of BC. Does anyone have any insight into whether this is true?

Thanks in advance for any help girls.

TD

[racjen]

Yes I've also read that it's progesterone in HRT that's associated with BC, but Utrogestan is the safest form, being the only bio-identical one.

I agree with Stellajane - you're on a very very low dose of estrogen, that amount of utrogestan should be more than enough to trigger a bleed if the lining is sufficient, I certainly wouldn't increase it and I don't think you're in any danger, I'd just wait and see what happens next month.

[Turkish delight]

                                                  Ah Stellajane and racjen, you are both so wise 

Sometimes I don't even know if I'm making sense to myself in my own brain, let alone when I'm typing, especially when it comes to decimal points  So congrats for knowing what I was actually trying to articulate.

I'm feeling ok on the low dose but bit up and down bcz it's a new regime maybe. I guess I was getting things twisted re cancer progesterone and estrogen. Thinking of when ppl say cancer loves estrogen perhaps. I don't even know anymore, I need to reboot my brain me thinks!


Thank you thank you! Great advice once again.

I'll keep things as is and not sweat it.


TD

[racjen]

It's confusing though TD, because BC can be estrogen-driven, progesterone-driven, something else called HER2-driven (think this is some kind of human protein but not sure), and the type you have determines what sort of treatment you have. I think most people are under the mistaken impression that everyone takes tamoxifen after BC, but that's only if it's estrogen-driven. There are numerous other drugs like Herceptin that are used to follow up PR+/HER2+ cancers. Or if, like me, you have triple negative BC, it's not driven by any of these and there are no drug treatments available to keep it at bay once you've had the initial treatment.

So given that, of all these, BC is most commonly estrogen-driven, I don't really understand the finding that it's the progesterone in HRT that's the danger, not the estrogen. Maybe someone else knows?

[Hurdity]

Hi there - not sure about osteoarthritis but there are licensed doses of oestrogen to help protect against osteoporosis - or rather to give better protection ( as even small doses will help to some extent).

There are the ones listed here with asterisk https://www.menopausematters.co.uk/treatafter.php so  normally 2 mg oral oestrogen, 50 mcg patch (= 0.05 mg per day), 2 pumps oestrogel (containing 1.5 mg estradiol). These doses are not comparable between the different methods because of the way they are absorbed and the way the amounts are presented.

The causal relationship between hormones and breast cancer has not been established directly. However some cancers are oestrogen receptive so if they are present they will grow rapidly in the presence of oestrogen. This is different from saying that oestrogen causes BC. I really know very little about BC and hormones but that's one explanation in a nutshell. The WHI studies ( discredited) did show increased risk of BC in women using HRT containing progestogen when compared to oestrogen only (although as I understand, still a small absolute risk) so there is clearly some interaction. I'm just recounting what I've gleaned and really don't have a deep understanding of this issue.

Hurdity x

[Turkish delight]

Hi again racjen!

It sure is confusing, just when I get my head wrapped around one aspect of it, I find it so difficult to retain what I've learnt.
I'm both shocked and saddened to hear that you have triple negative breast cancer, and here you are reaching out to help me 

Hia Hurdity,

I'm always happy to hear from you even if you feel you don't have the best grasp on a subject, it's usually still very insightful.
Osteoarthritis lol, truthfully I don't even know which corner of my brain that came out of, osteoporosis is what I was thinking of as you cleverly deduced.

Thank you for clearing up the dose question, the chart is helpful. It's tricky having had my mum have BC not least bcz I don't know if my mums BC was estrogen receptive/driven or not. I would like to reap the health benefits of taking an increased dose of Oestrogel(2 pumps). For some protection against heart attacks for example specially since I heard a scary statistic, that one in two women starting at the average age of meno(51)die of a heart attack vs 1 in 29 that die of BC.


TD