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[LadyCC]

Hi all

I'm struggling to find supplementation to help get me through perimenopause.

Some of my symptoms are the usual - hot flushes, night sweats, memory issues, weight (inability to lose), irritability.  But I also had major PMS style cramping daily too.  When I was initially prescribed HRT it was 2 pumps oestrogel and utrogestan.  The cramping increased tenfold to the point I was told to stop taking the oestrogel and continue utrogestan which I did for a while and my the cramping improved and all but stopped.  I was then told to re-introduce oestrogen, slowly, 1 pump and once again the cramping started.  So, I was told to do half a pump - same issue, cramping.  I then stopped oestrogel and tried an over the counter phytoestrogen supplement and had no cramping but I havent found it helped my symptoms either. 


My practitioner advised me to instead try tailored Biest compound as she said that sometimes people dont tolerate the active ingredient estradiol that is in oestrogel.  This Biest compound is 0.1% estradiol and 0.4% estriol, using estriol is supposed to be weaker than estradiol and thereby make taking oestrogen more tolerable for me.  Unfortunately very quickly I had the same issues with PMS style cramping symptoms so once again I have been told to stop taking this but to continue with the utrogestan.

I recently had a blood test and my oestrodiol levels are 354.  At the highest when I was using oestrogel they were 800> at the lowest with no oestrogel or supplementation, they were <18.  As my oestrodiol levels are optimum the pharmacist at specialist pharmacy was confused as to why I had been prescribed biest in the first place but when he heard how low my levels were previously he understood.   However, hormones fluctate so much during the menopause that it probably isnt that surprising and I guess maybe the over the counter phytoestrogen product has helped to keep my oestrogen levels in the 'normal range??' But it is unlikely they will stay at this 'normal' level unless I am supplementing in some way. 

Meanwhile now I have stopped the use of the biest, the cramps are receding but my other symptoms continue - I think that perhaps an over the counter supplement is going to be my next port of call.  I wondered whether:-

Anyone has also had issues tolerating oestrogen

What over the counter remedies people with my symptoms use (minus the cramping which isnt a factor when I am not taking oestrogen supplementation)

Thanks in advance

[EllaAurora]

Hi LadyCC,
I was wondering, have you tried any other form of estrogen than the gel? If you feel meno symptoms are getting worse and you'd need to go back to HRT, perhaps discuss with gynae to try another transdermal (patch or spray), and then there's also the oral option of course. Even tho in all the active ingredient is the same, often ladies feel well on one but not the other, so it could be worth a try.

I haven't had exactly similar situation as yours, but I'm also struggling to find a good balance with HRT. My issue has been that I absorb too fast and get steep highs and lows, which cause side effects and overall make me feel really bad. So far tried gel, then patch, and now back to gel as patch didn't work for me at all. I've also learned along the way that my body does not seem like high estradiol levels, so I'm keeping doses currently quite low (1.5 to 2 pumps).

Unfortunately cannot comment on the over the counter remedies as I've only tried HRT, but hopefully other ladies can add to this.

Take care and let us know how you get on! xxx

[sheila99]

You have many hrt options to try yet so it may be a little premature to rule it out. Although most people are fine on the first one they try it isn't at all unusual to have to change. I have an allergic reaction to evorel patches but am fine on gel (and fine on the prog in evorel but get fatigue on utrogeston. Sorry I can't answer you question but if it was me I'd try a patch before giving up on hrt.

[LadyCC]

You have many hrt options to try yet so it may be a little premature to rule it out. Although most people are fine on the first one they try it isn't at all unusual to have to change. I have an allergic reaction to evorel patches but am fine on gel (and fine on the prog in evorel but get fatigue on utrogeston. Sorry I can't answer you question but if it was me I'd try a patch before giving up on hrt.

I have now tried 2 types - Biest and Oestrogel.  Perhaps im missing something but I dont understand how utilising a different method of estrogen would have any better effect as no matter what amount I use of these creams or gels it ends up with me having these awful cramps.  Therefore I think its clear to deduce that it is not the method of administering the estrogen but the actual estrogen itself my body doesnt tolerate.  Im guessing because my oestrodiol levels are 'normal' for the average woman in being 354 (high for perimenopause perhaps particularly as I have been at <18 in recent months) that adding more is actually causing oestrogen dominance. 

I would love to be proved wrong but to be honest I am scared of trying more oestrogen related hrt again at this stage because the cramping is intolerable and is not even managed by taking painkillers as it used to be when I experienced them when I was having regular periods so the pain is incredibly strong and consistent now in my experience supplementing with oestrogen as part of hrt.

Thanks for your thoughts anyway

[LadyCC]

Hi LadyCC,
I was wondering, have you tried any other form of estrogen than the gel? If you feel meno symptoms are getting worse and you'd need to go back to HRT, perhaps discuss with gynae to try another transdermal (patch or spray), and then there's also the oral option of course. Even tho in all the active ingredient is the same, often ladies feel well on one but not the other, so it could be worth a try.

I haven't had exactly similar situation as yours, but I'm also struggling to find a good balance with HRT. My issue has been that I absorb too fast and get steep highs and lows, which cause side effects and overall make me feel really bad. So far tried gel, then patch, and now back to gel as patch didn't work for me at all. I've also learned along the way that my body does not seem like high estradiol levels, so I'm keeping doses currently quite low (1.5 to 2 pumps).

Hi Ella

Yes, in addition to oestrogel I have just used the Biest compounded cream.  When you say that some feel 'well' on one but not on another, what symptoms are you referring to here as my issue is that I havent come across anyone who suffers from the PMS cramping that I am experiencing when I use HRT oestrogen.  You mention that you 'feel bad' can I ask what issues you were having?  Even on half a pump of oestogel I was experiencing the cramping.  This only stops when I stop using oestrogen based HRT so there is no coincidence there. 

I had a Dutch test this year and my oestrogen goes down the wrong pathways and I was taking DIM for a while - maybe this is what is happening to me and it is not 'fixed' 

Unfortunately cannot comment on the over the counter remedies as I've only tried HRT, but hopefully other ladies can add to this.

Take care and let us know how you get on! xxx

[Shannonplussed]

I’ve been taking DIM for several months and I quite like it. It’s helped my belly bloat and helps me poop better. I think it helps my moods too!
I’m not sure if it’s related, but it seems like I need less estrogel now that I take DIM; maybe it’s more effective because of the DIM. 

[Scampidoodle]

I was thinking about taking this. How much do you take etc? I think I have too much oestrogen And don’t detox it well so at certain times of the month I feel awful!

[Shannonplussed]

I take 200mg (one capsule) every day of the SMNutrition brand, the most popular one on Amazon (where I am, Canada).

[CLKD]

As suggested keep trying various methods of delivering HRT, if over the counter supplements don't help.  Ladies forget the 'replacement' word in HRT.  Some supplements have nowt to do with replacing what the body naturally loses as we age.  It may take 3-4 months B4 the body feels 'better' with HRT - it doesn't usually get where it is suddenly even with hysterectomy. 

Did U experience cramping during your menstruating years?  I had dreadful, painful periods .........  so went on The Pill which eased that.  Didn't stop the heavy bleeds though 

Some find that keeping a mood/food/symptom diary of use to chart progress.  It's so easy to become lost as our feelings alter 

Which blood tests have you had, as hormone blood tests are reliably unreliable  .  What's a 'Dutch test'?  Are you able to explain "oestrogen goes down the wrong pathways"?  I had no idea how my body worked other than having a 32 day cycle, I was never pregnant so didn't know which hormone appeared at which time of the month.  Every day is a learning curve here 

Also: your own hormones may play a role in how your body reacts to replacement ......... peri menopause can begin 10+ years prior to the ending of the periods.

[Scampidoodle]

Thanks for info on Dim.

I have similar issues with oestrogen Ladycc.

Maybe dim would help? It helps to detoxify oestrogen if you have too much in your system.

Sounds to me like you need a lower dose or maybe more progesterone to balance things out?

[monicap]

QUOTE:

I have now tried 2 types - Biest and Oestrogel.  Perhaps im missing something but I dont understand how utilising a different method of estrogen would have any better effect as no matter what amount I use of these creams or gels it ends up with me having these awful cramps.  Therefore I think its clear to deduce that it is not the method of administering the estrogen but the actual estrogen itself my body doesnt tolerate.

You may be right, but one thing to bear in mind is that the level of oestrogen with patches is much steadier, without the peaks and troughs caused by gels/creams/sprays. So an alternate explanation could be that it's the fluctuations in oestrogen that are causing your symptoms.

"During perimenopause, a woman may experience heavier, longer periods of bleeding and more severe cramping during menstruation. The reasons for these changes are fluctuations in estrogen and lowering progesterone levels."

https://www.medicalnewstoday.com/articles/322040#causes-of-ovary-pain-during-perimenopause

[LadyCC]

As suggested keep trying various methods of delivering HRT, if over the counter supplements don't help.  Ladies forget the 'replacement' word in HRT.  Some supplements have nowt to do with replacing what the body naturally loses as we age.  It may take 3-4 months B4 the body feels 'better' with HRT - it doesn't usually get where it is suddenly even with hysterectomy. 

Did U experience cramping during your menstruating years?  I had dreadful, painful periods .........  so went on The Pill which eased that.  Didn't stop the heavy bleeds though 

Some find that keeping a mood/food/symptom diary of use to chart progress.  It's so easy to become lost as our feelings alter 

Which blood tests have you had, as hormone blood tests are reliably unreliable  .  What's a 'Dutch test'?  Are you able to explain "oestrogen goes down the wrong pathways"?  I had no idea how my body worked other than having a 32 day cycle, I was never pregnant so didn't know which hormone appeared at which time of the month.  Every day is a learning curve here 

Also: your own hormones may play a role in how your body reacts to replacement ......... peri menopause can begin 10+ years prior to the ending of the periods.

Hi CKLD

Yes, I used to have horrible cramps during my menstruating years and like you, they only improved when I started taking the combined pill.  However, I never considered the fact that actually the pill suppresses our own natural estradiol and progesterone (puts the ovaries to sleep). So in a way we only find out what our own hormones are like when we stop the pill. Hence acne spots mood and heavy periods can initially get worse when coming off the pill until the body finds his balance. This is certainly what I experienced when I was told I could no longer take the pill at 35.  I then went on the pill again in my early 40s and came off at 42 and a couple of years later, this started happening so by taking the the pill until peri- menopause it has made it even harder to bear the hormones fluctuations.

I keep a diary of my symptoms. I only experience this cramping when I use oestrogen as part of HRT.  Within days of coming off it I am fine again. 

I have exhausted a number of tests including:
OAT Test
Lifecode Gx Genetics
Fasting Insulin Test
Full female hormone test*

Amongst a few.  I have received response only on the full female panel test.  The others I am waiting for but they are extensive (and incredibly expensive) tests too.   The Dutch test is a Urine test that is pretty comprehensive and looks at profile of sex hormones and their metabolites and melatonin to understand hormone imbalances.  They way my body processes oestrogen means that apparently it goes down the wrong pathway and contributes to some of the side effects that I have had so int he past they have told me to take DIM for small periods which helps to correct this. 

I am speaking to my practitioner tomorrow but her brief response on this so far is that she still thinks my hormones are making their own oestrogen.  It would be good to clarify with her as earlier this year my levels were less than <18 so I didnt think they could ricochet back up to 354 on their own.  Given that result I really shouldnt have been using the Biest as it wasnt necessary so ill see what her explanation is tomorrow!

[LadyCC]

Thanks for info on Dim.

I have similar issues with oestrogen Ladycc.

Maybe dim would help? It helps to detoxify oestrogen if you have too much in your system.

Sounds to me like you need a lower dose or maybe more progesterone to balance things out?

Hey Scampidoodle

How have you managed your symptoms or have you just kept on trying other oestrogen based hrt products?  I tried more progesterone myself also - it didnt take the edge off and I just felt so bad and consumed with pain that painkillers werent touching

[LadyCC]

QUOTE:

I have now tried 2 types - Biest and Oestrogel.  Perhaps im missing something but I dont understand how utilising a different method of estrogen would have any better effect as no matter what amount I use of these creams or gels it ends up with me having these awful cramps.  Therefore I think its clear to deduce that it is not the method of administering the estrogen but the actual estrogen itself my body doesnt tolerate.

You may be right, but one thing to bear in mind is that the level of oestrogen with patches is much steadier, without the peaks and troughs caused by gels/creams/sprays. So an alternate explanation could be that it's the fluctuations in oestrogen that are causing your symptoms.

"During perimenopause, a woman may experience heavier, longer periods of bleeding and more severe cramping during menstruation. The reasons for these changes are fluctuations in estrogen and lowering progesterone levels."

https://www.medicalnewstoday.com/articles/322040#causes-of-ovary-pain-during-perimenopause

Hey Monicap

I think you are right re the fluctuations in oestrogen as going from <18 in February to 354 last week, before even taking Biest has astounded me as I didnt realise that levels could vary so wildly  - but that makes it really difficult to support the varying oestrogen vs declining progesterone.  The problem is also that I just cannnot lose weight with my hormones so out of whack which is so frustrating and hard to cope with for me who cannot afford to be overweight due to short petite stature. 

I feel like crap!  I can cope with one utrogestan capsule a night as it makes me sleepy in a nice way but more makes me groggy so no good.  I hope my practitioner has some practical answers tomorrow pending results of all these numerous and expensive tests I mentioned! 

Thank you for taking the time to reply and for the useful link

[Shannonplussed]

Curious about what your practitioner said about taking DIM; how long was it advised? Did you take monthly breaks? I’ve been on it for a few months now and really like it but I’d love to hear what guidance you got for taking it.