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[Shannonplussed]

I've learned on this forum that HRT works alongside your existing hormones, rather than taking right over like the birth control pill. My OB-GYN does not agree with that, however. She's conservative in that she prescribes only one pump of Estrogel. I use two, and sometimes 3, so I ran that past her, and she agreed that at my age (43) two pumps would be okay. We didn't discuss 3 pumps, but I got the sense she would be against that. She said two pumps would be okay because it's less (or line with?) than the birth control pill. This got me thinking, how much Estrogel would be needed to reach the estrogen dosage in the birth control pill (ignoring the progesterone part)? One pump delivers 0.75mg estradiol, while Marvelon for example delivers 0.030 mg ethinyl estradiol. How do those numbers compare? I get that there are factors like absorption at play. Just curious if it's established that like 6 Estrogel pumps a day (for example) and you might as well take the birth control pill.

[Alicess]

Hi Shannonplussed,

Comparing ethinylestradiol (EE) with estradiol (E2) is like comparing apples to pears. The potency of EE is much higher then estradiol in HRT

EE is measured in microgram while E2 is measured in miilligram. According to Nick Panay you need at least 60mg of estradiol to surpress ovulation.
Two pump Estrogel is approx. 2 mg Estradiol according to BMS

https://en.m.wikipedia.org/wiki/Ethinylestradiol#Differences_from_estradiol

2 pumps Estrogel is low at your age,  I don't think your GP is knowledgeable enough.

Alicess

[CrispyChick]

Hi Shannon plussed.

I have no idea of the answer to your question, but I am the same age as you and trying combined pill for my symptoms. Struggling to find one that works. So many side effects that I never used to get!!!!

Are you finding the hrt working for you?

[Sammiejane]

hi

i was on the understanding that 2 pumps gel is equilvent to 1mg estradiol as my friend takes tablet 2mg and then swapped to patch and had to have 100 patch to be equilavent and 2 pumps gel is equivalent to 50 patch

[Alicess]

Hi Sammiejane,

I"ve copy/ paste this from British Menopause Society:

https://www.menopausematters.co.uk/forum/index.php/topic,46933.msg754991.html#msg754991

Alicess x

[sheila99]

I agree your gp doesn't know enough. If 2 pumps don't control your symptoms and she won't prescribe more ask for a referral to a menopause clinic. I was told by the specialist I could take up to 6, started on 2 and now on 3 in late peri. Absorption varies between people though so you really need to take the minimum amount that controls your symptoms.

[Shannonplussed]

Hi Shannon plussed.

I have no idea of the answer to your question, but I am the same age as you and trying combined pill for my symptoms. Struggling to find one that works. So many side effects that I never used to get!!!!

Are you finding the hrt working for you?

I am finding relief with Estrogel (2 pumps and recently 3 pumps--although in North America the licensed dose is 1 pump, once a day) and oral 100mg Prometrium (same as Utro) continuously. I've tried this sequentially and vaginally as well, but it's just awful for my mental health. Continuous is best for me. Most symptoms are gone, but I feel there's room for improvement yet--sometimes I feel a glimmer of how well I know I can feel, and I want to get that all the time. But right now, this is for sure an improvement and quite tolerable.