. Again im unsure if the dose im on is too high or too low for me at 37? I do suffer with joint pain, etc now also...i feel 90 not 37.
Shell. Younger ladies especially under 45 in surgical meno sometimes need higher levels of eastrogen than their older counterparts.
But i have found higher doses might not necessarily mean higher levels. . if you are not absorbing the patch well you may not be getting much from it even though it's considered a high dose. You may find you absorb more on another method at a similar dose.
Have you had a blood test. It might help in assessing if you are absorbing enough from the patch ?
It seems getting E levels right for the individual to control symptoms is key to any HRT regime
You mention tibolone. It may not be enough eastrogen for you but i know of some ladies with no uterus who choose to take progesterone alongside eastrogen to counter the effects or "balance" hormones. Obviously a careful consideration as progestins have their own side effects.
Certainly testosterone is an important factor, particularly in surgical meno. Half of our T production has been lost. T decreases with age So at your age without surgery your T would naturally be higher than say myself at 54 so it's probably a good idea to explore this.
Even at my age (suremeno at 53) I was offered T because it's widely accepted that there is a significant drop after ovary removal.
I feel for you. I know how intolerable migraine is.
I hope the specialist is able to help. Xxxx