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[Postmeno3]

Hi. Has anyone who is postmenopausal, preferably very postmenopausal, had hormone level blood tests done on the NHS? Is it an expensive test, hence the avoidance? I can understand other stages fluctuating too much for testing to be accurate enough. I also appreciate that blood tests can sometimes not be terribly useful, but I'd be interested to have my very oestrogen deficienct status informed by something less time consuming and hit-and-miss than trial and error now?

[Pippa52]

Hi ...yes I had an oestradiol blood test done on the NHS 5 weeks ago.  I am 68 so most definitely post menopausal!! x

[CLKD]

Hormonal blood tests are reliably unreliable.  MayB get a referral to an endocrinologist ?

[KarineT]

I wouldn't say it's unreliable in postmenopause.because hormones don't fluctuate that much.  I had one done back in January this yearr.  It was a home one so I had to pay for it.  I wanted to know how low my oestrogen was.  I will do another one to see if the level has gone even lower but chances are that it will and at some point it will remain at a very low level. I spoke to an endocrinologist because I thought that 103 pmol was the norm in postmeno.  He told me that every woman is different and the level of oestrogen is unique for each woman so it may never reach 103 pmol.

[Joaniepat]

For those who are postmenopausal and/or in surgical menopause, and using transdermal oestrogen, the occasional blood test for beta estradiol is advisable. It checks whether you are absorbing enough from the product, and whether you should increase or change the delivery method. The same might be said for testosterone if using. ("Note to self" 😉). Also, one might feel OK, but not be absorbing enough to protect bones if that is of concern.

I had blood tests at the NHS menopause clinic where my regime was prescribed, but none since. If I asked at the GP surgery I suspect the answer would be "we don't do that". I sometimes wonder what they DO do.

JP x

[applejack]

Karine, you say you tested at home?  did you get the kit via your doctor?

[Pippa52]

Hi.. I had a telephone appt with a Menopause consultant recently.  I have been on transdermal Oestrogen only HRT since my surgical menopause over 20 years ago.  The Consultant was very shocked to hear in all those years I had never had a blood test for hormone levels and has requested my GP to undertake one every 6 months from now on which she will review. I recently moved house and our new GP surgery is fantastic so I feel very lucky as my last one was not so great.  The Consultant also advised a DEXA scan every 3 years and my GP has put me on the waiting list for one. xx

[Wrensong]

Yes, I'm 9 years postmenopause now & had my first oestradiol test on the NHS before starting HRT 3 yrs postmeno, but only after it had been requested in a clinic letter from a Menopause specialist at a private hospital.  The level was too low to be measurable - merely came back as below bottom ref range.  Then had nearly 2 years on HRT with poorly controlled symptoms partly because when I asked, my then GP declined to retest because she said she wouldn't know what constituted a good level.  I asked for referral to an NHS menopause clinic where oestradiol was retested & confirmed the poor absorption that explained the continuing symptoms.  Was advised to avoid that brand of HRT in future as specialist thought it likely I'd get poor absorption of oestradiol from other products in the range.

Since then, to save time & the stress of pushing the very stretched NHS to provide services they don't seem to be set up for at GP level (at least here), it's been easier to have HRT overseen privately.  So I've arranged private testing of oestradiol, usually together with testosterone & TFTs given the need for T3 - atypical hypothyroidism being another condition that's less stressful to manage privately for anyone lucky enough to have the means.  Having the whole lot done together means I get a "package price", which works out quite a bit cheaper than the sum of the individual tests.  Thankfully, given we're not that comfortably off & choose to do without other things to make this possible.

I do think it's a good idea to have oestradiol & testosterone checked now & again when on replacement, to clarify the clinical picture if symptoms are not adequately improved, so that we don't waste time on an unsuitable regimen/dose.  Also seems sensible when on testosterone preparations designed for men, where there's not a measured dose dispensed for women - e.g. Testogel, where we have to estimate the size of a suitable blob according to our mental image of what garden vegetables/pulses look like!  Petit pois, lentil anyone  ?!
Wx

[CLKD]

 

Men always think it's bigger than it is ;-)

[Postmeno3]

Gosh, what a range of differing experience. How lovely the day will be when this requirement is standardised and performed routinely to inform and spare us all going round the houses, self-medicating, spending a fortune etc etc etc to get us to a point of rough proximity to accurate treatment. I shall ask the specialist if she will make the request of my gp. Watch and wait, ladies. Watch and wait!

[KarineT]

Karine, you say you tested at home?  did you get the kit via your doctor?

No.  I bought it from a company online. 

[KarineT]

Applejack, I forgot to mention that I'm not on HRT and I have been postmenopausal for 17 months now.  The reason I've had my oestradiol tested is simply because I wannt to know how much lower this hormone can go and thus if my mild to moderate symptoms will get worse.  Not because I have HRT absorption issues.
Testing in postmeno should be fairly accurate since there should be hardly any fluctuation.  I was always thought that fluctuating hormones are the culprit of menopaual symptoms but it seems that it's not really the case, as the symptoms are caused by a low level of oestrogen. 

[Hurdity]

Karine T - menopausal symptoms can be caused either by fluctuating hornones or low levels of oestrogen or both!

I have had oestrogen tests done at request of my NHS GP (gynae specialist) - I can't remember why but it did turn out that I wasn't absorbing so well by the third day so my dose was increased - and this was in mid 60's. Also I've had testosterone/SHBG measured several times (on NHS) though not recently - maybe a couple of years ago. It is particuarly important to get T tested after replacement starts - as Wrensong points out. I am I suppose, late 60's now...

Hurdity x

[CLKD]

...... and well, Hurdity?  Feeling OK?

[Hurdity]

Yes thanks CLKD - feeling well generally - apart from the usual ageing aches and pains 

Hurdity x