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[Mary G]

Denise Didi, a FIT test is a faecal immunochemical test which has (mostly) replaced the older type faecal occult blood test because it is more accurate for detecting polyps in the intestine.   The FOBt used to pick up a lot of false positives.

The specialist I saw has spent most of his career in Germany where everyone is offered a colonoscopy aged 50.  It costs their public health system a lot of money but apparently it has paid off because they have very low rates of bowel cancer.   He thinks bowel screening should start aged 50 and I think the NHS are going to start sending out FIT test earlier now in some regions.

[Mary G]

Wrensong and polywollydoodle, I read somewhere (sorry, I can't remember where but I will try to find it) that IBS is more prevalent in postmenopausal women using HRT.   This would probably include both IBS-C and D.

The Menostar is a US product but apparently women who use this patch only have to take progesterone every six months.   They do have the support of a gynaecologist.   It's an interesting idea though and it does seem to prevent osteoporosis.   The dose is very low, about 14mcg I think, but it's not available in Europe.   I suppose it's possible to either cut a 25mcg patch or use half a pump of Oestogel/Lenzetto spray.

[pollywollydoodle]

Many thanks Wrensong, I'll have a look for that thread, but tbh, since I stopped/drastically lowered oestrogen I've not had any problems, although I'm also self-treating what I think is a thyroid problem so that may also have had an impact. But my IBS was hellish on high dose oestrogen so that would make some sense.

MaryG - yes, I'd read about the menostar on various US blogs, and some women seem to do really well on it, however, over the last couple of days, I've had an 'experiment' with a 1/4 oestrogen patch so around the same level as menostar, and even at that very low dose I get hypothyroid symptoms, so it's a no-no right now until I get this sorted. It's filed for future use though!

[pepperminty]

Just wanted to add , very interesting thread with lots of very good points.

 Yes -We do need to think about the other things that can play in the mix that can effect us too. Thyroid etc

and that higher estrogen is not always the answer - some Docs do seem to push this  more now.

PMXX

[Gnatty]

I thought that they pushed for more for those women who are poor absorbers of oestrogen to get their readings up to par, rather than wanting high oestrogen per se.

[Postmeno3]

Yes, but how is poor absorption determined? 🤔

[Gnatty]

I imagine through blood tests. Once post Meno these are probably more useful as less likely to be subject to peaks and troughs.

[Mary G]

I think the very high oestrogen doses are mostly aimed at younger women with reproductive depression, very severe menopause symptoms and in my case, migraines.

The thinking behind my high oestrogen dose was to lessen the effects of hormonal instability which was causing my migraines.  I also had very severe sweating which needed to be treated with a high dose of oestrogen.   The idea was to keep the levels artificially high all the time and I found it worked very well for a number of years but this type of regime has a shelf life because, as discussed above, the body changes over time.

[Hurdity]

Just to add to the discussion and the point about low oestrogen doses and osteoporosis

The Menostar is a US product but apparently women who use this patch only have to take progesterone every six months.     It's an interesting idea though and it does seem to prevent osteoporosis.   The dose is very low, about 14mcg I think,

The extent to which osteoporosis is prevented by oestrogen is dependent on the dose of oestrogen. so a low dose will reduce bone loss but not as much as medium does which in turn not as much as highr doses - though I don't have a study reference for that. There has been work done though.

If you look at this website you will see that the minimum doses licensed to prevent osteoporosis are mostly the medium and higher doses (those marked with an asterisk). https://www.menopausematters.co.uk/treatafter.php

Hurdity x

[pollywollydoodle]

Unfortunately, for reasons I still don't fully understand, I'm no longer able to supplement oestradiol, even in ultra low doses. I was concerned re. the implications for osteoporosis and spoke to my endo about this. She explained that there are encouraging studies using DHEA and progesterone, progesterone in particular is thought to have an osteoporosis reversal mechanism, which is great news for those women who can't/don't wish to supplement oestrogen, but have an open mind and may be interested in using either/both of these hormones. The addition of oestrogen in small doses apparently further enhances the action of DHEA and progesterone in bone protection and this may be where this type of patch is valuable.

[Mary G]

Can this thread be moved to the post menopause section please?

[Postmeno3]

MaryG...Good plan! Just request it of Emma via a PM. 👍

[Jaylow]

It’s so much more complex than just taking estrogen and progesterone isn’t it.
I’ve spent the last 2-3 years chasing estrogen to recently realise that I don’t need as much as I thought I did.

[laszla]

Important thread that illustrates the complexity of HRT. I'm currently at a stage where I've just discovered to my horror that I have the opposite problem, ie. I barely absorb estrogen despite daily estrogel.

As mentioned in this thread, it's not just the amount of the hormone in your body, it's how much is being absorbed and my understanding is that one of the markers that indicates this bioavailability is the Sex Hormone Binding Globulin (SHBG).

My estrogen is very low for someone on HRT while my SHGB is very high, meaning poor absoprtion of what hormones are in my body.

I'm currently trying to get to the bottom of this, with zero support from GP or Chelsea meno clinic but my sense is that very little is still known about the complex network of hormone receptors and their interaction with other systems, eg digestion as discussed here.

And as many of you say, a regime that might work for some time might eventually stop working or need significant modification.
The unfortunate reality is that treatments are far too standardised

[Mary G]

MaryG...Good plan! Just request it of Emma via a PM. 👍

Done!