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[Poppy78]

I'm on Evorel 100 (plus Utrogestan continuous and Vagifem every day) and after months and months of no night sweats and day flushes I am suddenly facing up to 15 a day. Went to see my GP and she told me that I can't go any higher than 100 and refused to ask the consultant I saw in June for further advice. She instead offered me anti depressants (WTF??) or suggested I put lavender on my pillow at night and try a bit of mindfulness. The fact I'm on Evorel 100 shows the severity of my symptoms (27/34) and to be fobbed off with inappropriate drugs or alternative remedies that have no conclusive medical basis to stopping night and day sweats made me super angry. Because I haven't now slept properly for two weeks all my other symptoms have returned including a significant ramping up my anxiety.

I am thinking of getting a second opinion - anyone else out there on a high dosage of estradiol and still getting flushes/sweats - what have you done that has worked?

[Bobidy]

Hi, have you had your thyroid checked? X

[Poppy78]

Yes all good - had my full 40 year check in Jan so know that I'm completly healthy other than early menopause

[KiltedCupid]

Yes all good - had my full 40 year check in Jan so know that I'm completly healthy other than early menopause

Poppy - do you mean you're 40?

If so, like some other early meno ladies on here, I'd go on bcp if you've tried it and it works. Utro especially conti can knock down oestrogen levels, something to do with occupying oestrogen receptors. It's happened to me, symptoms returned so I know it's a thing. You could consider a cycle but it's a faff and who wants to bleed if you can avoid it?

There's also bio contraceptive hrt available, Zoely is one, if you still need contraception. Just depends if you prefer transdermals over pills. Mirena is another option and you can add a high oestrogen dose to that.

[Poppy78]

Thanks so much - yes early meno.

I'm taking Utrogestan tablets vaginally daily as I had terrible side effects from taking it orally or vaginally at the 200 dosage for the 12 days. I had a psychotic episode while on Conti so that's how I ended up on Utrogestan. I would definitely want to avoid tablets due to IBS sensitivity.

Is your thinking that moving to the Mirena coil will reduce down the impact of the Utrogestan and allow for the full affect of my 100 to be felt?

[KiltedCupid]

Hi Poppy - yes, is the short answer as the Mirena is SUPPOSED to produce very small amounts of levonorgestrel systemically as it's situated in the womb and therefor most is absorbed there. Some women love it and it gives them a new lease of life, particularly if they have bleeding issues. I tried it twice, and both times had it removed around 8/10 weeks as I was just swamped with the prog. BUT, I'm really prog intolerant so not a good example and I maybe should have waited it out a bit longer as the dose diminishes with time and side effects fade apparently. If you've ever used levonorgestrel and not suited it then it's probably not a go-er for you. But if you can tolerate levo, it's a great way to add prog to your regime as most gynaes will allow you to use as much oestrogen as you need alongside it.

Hope that helps.

[Hurdity]

Poppy78

Just because you are on 100 mcg patch which is theoretically a high dose - does not necessarily mean it is a high dose for you and docs should really understand this. The dosage levels ( low medium or high etc) are arrived at through a series of measurements on individual women which are enormously variable and the dose strength is an average of these. I can't remember if it is patches or gel but in my "go to" paper about absorption of hormones either patch or gel can result in a TEN-FOLD difference in systemic estradiol levels in the body. If you are a "non-absorber" or absorb poorly then 100 mcg is not high for you.

Also yes in some parts of the body, progesterone can interfere with the beneficial effects of oestrogen on the body - it doesn't reduce levels as such as far as I understand but can reduces its impact. Many of us remain with a cycle for that reason even well post-meno and even in our 60's!! Some (stellajane is one) increase oestrogen while taking the progesterone part of the cycle also because of this reason ( not sure if she still does - hopefully will read this!).

There is no way I would want to take any form of progesterone every day anyway as it has a sedating and dulling effect.

I calculated that the amount of absorption from the Mirena is very approx in the same ball park on average as from a Femseven patch - but of course the amount from Mirena is high to start with and declines over the years it is in place - but it depends how sensitive you are to synthetic prog . Have you ever taken the pill?

As for the ADs and lavender - that's appalling!! She wnats to get you hooked on happy pills like many of the nation...

She is out of order not asing the consultant for advice ( if NHS) and if she won't consider any modifcation to your regime despite your return of symptoms I would (in the nicest possible way!) demand a referral to a menopause clinic nearest to you ( there are none near me though).

Good luck and keep us posted

Hurdity x

[Poppy78]

Thank you so much for your replies. I have a consultant appointment booked in for March 2020 and as the waiting list is so long I'm unlikely to get it moved forward (first appointment was a 3.5 month wait and that was urgent!). I think I may have to return to expensive specialist again and get my bloods done to check what my levels are and if am am truly on 'enough'. It makes me so angry as the money will need to come out of my wedding fund but I feel really fobbed off. I wonder if I should complain to the surgery and demand they at least get a second opinion from the consultant - they have done this for me before when they upped my vagifem to daily? Oh why does this have to be so hard.....

It has taken me so long to get used to Utrogestan 100 daily vaginally that I don't want to have to change that unless I really have to (finally no daily bleeding and not feeling sedated during the day)

[KiltedCupid]

Poppy - if you're happy on Utro and feel no side effects, don't change it. It sounds like you just need extra oestrogen. There are some ladies who use higher patches, it's not completely out of the question, especially as you're young for meno. Could you ask a different GP if you can trial a higher patch dose until your consultant appointment? Explain that you feel it's unfair to dip into your wedding fund and that overall you feel well, it's just low e symptoms returning. If you're willing you could suggest that you'll pay for a private endo scan (around £90) to monitor the extra oestrogen.