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[Shannonplussed]

I use just one pump Estrogel now, and as I felt like sometimes that was too much, I’m experimenting with following the actual directions of using it in cycles, so days 1-21 of a 28 day cycle, or days 1-25 of the calendar month. I do get a withdrawal bleed/spotting. I don’t think I get periods, but it feels like there is some background cycle at times, something in flux anyway. Because I’ve been on HRT over 2 years, I can’t “officially” say where I am in terms of peri vs post, and I’m unwilling to go without hormones for a full year just to satisfy criteria. Dr says my cervix shows signs of menopausal changes and that I need to be on at least one pump of estrogel. I played with all kinds of scenarios, hoping to get me back to my old self. I feel pretty close now, and generally quite well, but I think most of this weight is here to stay (and they say that’s a good thing, it’s protective in the long run; it’s the very slight ladies that suffer most with falls etc as they age).

[LadyCC]

Hi Gilla999, sorry to hear that you are struggling. 
You mention that perhaps your circulating oestrogen may be too high and I can certainly attest to the fact that if your oestrogen levels are too high (or too low) this can affect your ability to manage your weight effectively. 

My weight gain is no doubt related to the change in hormones that happened as a result of being perimenopausal.

In my mid teens I went on the pill to help combat PMS inc cramping and quite heavy periods.  I spent 20 odd years on the combined pill only to be told in my mid 30s that I couldnt have it any more.  Within months of stopping it , i gained half a stone and bearing in mind I had not changed anything with the way I ate or my lifestyle.  My skin also broke out too and I had what probably is termed adult acne.  I tried various Progesterone only Pills (PoP) and products (the coil was the worst and I had gross amount of postulating spots and again weight was not manageable either).  I stopped any form of contraceptive but spent about 5 years in the wilderness where I could not lose the weight gained and I would have breakouts in my skin. 


FFWD to my early 40s and I was fed up.  I had gone back on a low dose combined pill as I had given up smoking and my GP prescribed it as a way for me to manage my by then troublesome skin issue.  That part worked and my skin was in control but other aspects of my self just werent right still - I just didnt believe I had to accept feeling and looking so bad.  I decided to have one last ditch attempt at getting my body back.  I approached a nutritionist who utilised a  health nutrition and weight loss programme tailored specific to the individual and it worked.  It was brilliant - I lost all of the weight, my skin was healthy and vibrant and I had sooooo much energy.  This lasted for just over 2 years but then suddenly, I started noticing changes to my periods - I would get cramping for 2 weeks before having an actual period for 7 days (usually 4) which meant I had 3 weeks in a month of period related issues.  I was having trouble managing the weight too and then in early 2020 the weight started to increase weekly - nothing I could do would stop it, even going back to basics with the tailored programme and, I just had relentless period like cramping.  I then had confirmation that I was in perimenopause.  I was desperate for help with this cramping which painkillers just did not touch.  I approached a Dr at the surgery and he said that I would 'just have to get used to it and take painkillers daily'  even though I told him they were not helping.  I also started to notice many of the other symptoms like memory loss, irritability, anxiousness etc and this was all coupled with me taking on a more senior role and managing a team of employees.

Since then, I have been on a journey to find the right support for me - I cant tolerate oestrogen related hrt at the moment as not only do I appear to at times produce a lot, it goes down the wrong pathways (according to my dutch test) and manifest itself in oestrogen dominant like symptoms.   A the moment I take only Utrogestan and I feel ok with that.  I recently tried tailored Biest and boy did I have issues and felt awful with PMS like crazy and I thought I was going to have a period (not yet so far) so my body just cant seem to cope with it yet. 

My weight just isnt shifting and I am the heaviest I have ever been in my life and as I am petite it is very obvious.  I have had to buy new clothes as my job means I have to go on site at times and they are 2 sizes above my average clothes size.   

My practitioner says that my oestrogen levels are going down in a zig zag fashion as in the last year alone I have had readings of over 800 (when I was using 1 pump of oestrogel) and as low as <18 (when I paused oestrogel). 

The crux of this all is that my practitioner said that as the combined pill puts hormones to sleep, that once I stopped taking them my body needed time to adjust and it seems that essentially the default of my body was imbalanced hormonally anyway and would always have needed some kind of supplementation to balance it.  But when peri hit it was the 'perfect storm' with the added stress of jobs, pandemic, coming off the pill in early forties and then shortly after going into peri menopause.   

So at the moment, I am trying to get balance of oestrogen vs progesterone and ensure oestrogen levels are sufficient so that I can lose weight.  I have had a battery of tests done to try and understand my body more and from this, I should have clarity on how best to approach weight loss. 

According to the practitioner I am working with Premenopausal transition is the hardest as hormones vary over time and what suits at one stage may be different to what is needed 6 months down the line which means probably some kind of regular hormone/blood test can be useful to gauge where individual levels are.  She also said that the weight issue in menopause is the hardest to manage and least understood by our research to date. But there are people who do manage to lose and maintain weight in this stage of life - I just think keeping abreast of fluctuating individual levels and understanding them is probably key here 

[Gilla999]

Thank you LadyCC and Shannon for sharing your stories. I guess it goes to show the length that hormones can affect our weight - it's just so frustrating to not be able to pin down the exact cause. It seems like you both have similar stories about the Pill and weight gain when you came off it!

I was taking the pill back to back but only for 5 months before I gave up, but I know from hormone tests I had done while on the Pill that my own hormones weren't put to sleep - my own hormones were actually fluctuating like mad underneath and caused me to be very symptomatic with my night sweats and insomnia, which is why I ended up giving up on it and moving to Lenzetto, which has quite literally saved my life. I know I am ovulating as normal now, as I test every month. My sense (right or wrong) is that I have too much circulating estrogen not necessarily as a level in itself (because reducing it brings back my symptoms) but compared to the amount of Prog I am getting from 100mg Utro vaginally 12 days a month. I know the two are a delicate balance and that in a normal cycle Prog should be higher than Estrogen in the last part of your cycle and I wonder if that's just not happening with the amount I'm getting vaginally. The trouble is, taking more than 100mg, or taking it orally, makes me comatose - it's not liveable with!

Wrensong if you're still following - I posted on a thyroid forum about my test results and asked if you could still be symptomatic when in the low end of normal range, and the moderator replied yes and said he is extremely symptomatic when at the low (T4) end of the range and that the aim is always half the range as a minimum. So I definitely think it's worth me giving the 25mcg another shot to at least see how it goes. I do somewhat worry about how I'll be with it when it comes to the Utro stage, but we'll see. I wish there was some other natural alternative to Utro - but I bet I'm not alone in that wish!

[Wrensong]

Gilla, yes that's right, hypothyroid patients reliant on prescription thyroid hormones often need to be in the upper half of the T4 ref range to feel well & I certainly did when younger & on thyroxine alone.  But as you're making some thyroid hormone for yourself, converting what T4 you are making into the active form (your T3 is OK-ish) & your TSH is not raised, it gives a confusing picture in someone who's not yet on replacement.   That's the dilemma for clinicians, whether to start treating a patient in your situation or not.  Often they will wait until TSH is considerably raised before prescribing replacement.  But your T4 is really quite low & at that level most people already on replacement (i.e whose thyroids have failed or been surgically removed) would probably have symptoms.  The thing is, your thyroid may be producing more T4 than that sporadically - a test in someone not on replacement is only a snapshot.

But your Endocrinologist wouldn't have prescribed the thyroxine if he didn't think it a reasonable course of action, so if you feel you'd like to give it another go, that does make sense to me.  I hope what I've written in this thread isn't confusing the issue for you - it's just that it's not straightforward & I think the more we understand, the more confident we can be in decisions about treatment.  Would be irresponsible of me to point you one way or the other in a situation that's not black & white.  But I'm very happy to thrash it out with you.

Absolutely agreed on the desirability of another natural alternative to Utro!  I'd be elbowing you out of the way in the queue
Wx

P.S. please don't worry about what I said earlier about my own reaction to Utro - I'm on T3 as well as T4 & the combination complicates management somewhat, meaning that my situation isn't typical.  I can remember a former member on here who was on thyroxine with transdermal oestrogen & Utro with no problems.   I was looking for an explanation for the hyper way you reported feeling on thyroxine so that's why I asked if the trial was when you were on the Utro phase.  If you are at all anxious about taking new meds (as most of us are) that alone may explain your jitters on starting thyroxine.  It's a low dose though - I was started on 25mcg nearly 3 decades ago before thyroid surgery & felt no difference whatsoever!  Even when they put me straight on 100mcg after surgery I had no adverse effects.

[Gilla999]

Thank you Wrensong, this is so helpful to know - I am sensitive to meds but I did think 2 days was quite quick to have a reaction on a low dose of 25mcg, and I wouldn't be surprised if my anxiousness compounds the sleep issue because I become hyper aware. I've decided to start taking it today and see how I go. Fingers crossed xxx

[Wrensong]

OK Gilla.  Glad you've been able to decide & really hope the thyroxine helps  .  Please let us know how you get on

[Gilla999]

Wrensong, I wondered if I could ask you in your experience how long it takes for thyroxine to work for your symptoms? Is it something that you notice straight away or is it a matter of weeks rather than days? I'm on day 6 today - I'm super glad I'm not having any negative side effects from it at least. Because that's what the Endo prescribed I may up it to 50mcg after a few weeks but will see how it goes!

[Wrensong]

Hi Gilla - glad you've posted  .  Sent you a PM a couple of days ago, asking how you were, but perhaps you never saw it.  I often go quite a while without looking at the forum so if you ever have any worries it might help to chat about, please send me a PM as those come through to email so I'll know you're trying to get in touch.
Great that you're not having any side effects this time & well done for taking the plunge  .  I know how scary it can be starting new meds.  I wouldn't be surprised if you don't notice any difference in the short term as 25mcg is a pretty low dose & it will take time to reverse any systemic changes you may have had from possibly being mildly hypo for a while.  I was on 25mcg for 5 months awaiting thyroid surgery & don't remember feeling any changes from that small dose, but it's possible I just wasn't that tuned in to my body & of course like yours, my thyroid was also still making some hormones at that stage. 

These days I can usually feel a difference from a dose adjustment in 7-8 days, but that's probably because I'm wholly reliant on replacement to run my metabolism & after all this time, very attuned to symptoms.  It takes 6-8 weeks before it's worthwhile repeating a TFT after any change of thyroid meds.  Though my Endocrinologist likes to test after a month, I prefer to wait as levels are not stable with me in just 4 weeks.

Please don't worry if you don't feel any changes in the short term - it will be working quietly behind the scenes as it were!  You will probably notice some difference after a while on 50mcg, I think.  Can I ask how soon your Endo appt is?
Wx