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[lillith112]

I'm on Estradot 50 now. (Was on 62.5 but have taken that extra bit off now.)

Have you thought about using some local estrogen to help with the bladder urgency? If you want to hold off using systemic estrogen longer, you might find some local Vagifem helps there.

My estrogen was 233nmol on the 50 patch. I think this is pretty normal. What a desirable level is really depends on who you ask. Some people say it should all be guided by symptoms only and there is no minimum blood results. Other doctors want to see specific levels for optimal bone protection. I tried to do some research into this and there is actually a lot of variability in terms of what the desirable amount is, with some doctors saying that even tiny low doses are effective and others saying 400nmol is needed. The best I could find was this:

"The lowest dosage of patch (0.025mg/day) produced a mean oestradiol level of 140 pmol/L and was associated with substantial bone loss. With a mid- dosage patch (0.05 mg/day) the mean oestradiol level observed was 227 pmol/L and bone loss was prevented at this dose. Optimal results were achieved with the patch delivering 0.1mg oestradiol/day. Accretion of bone was observed at this highest dose when mean oestradiol levels of 400pmol/L were observed (see Table 5)." https://journals.sagepub.com/doi/pdf/10.1258/0004563021902107

So if you can be around 230nmol, you will maintain bone density - not gain it, not lose it. If you can get higher up to 400nmol, you will actually gain bone density.

I'm hoping that just maintaining it is enough for me, seeing I've started HRT pretty early in peri-menopause. Because I don't think I can get up to the dizzying heights of 400 without being taken to A&E on a stretcher at the rate I'm going    I really hope I don't need to reduce further and can now stabilise at 50 patch....

Joziel, yes I have plenty of the vagifem pessaries and another make. I might start using them. I have cut my usual 75 patch in half today, so 37.5 and see how I go on that, I'm going to increase gradually after suffering all these migraines.

That's very interesting reading about the bone density and strength of patch, so 50 and 100 is ideal. The size of Estraderm patches I cannot imagine what 100 would be like, it would cover a whole butt cheek ! 😆

I hope you stabilize on your 50 patch now. It certainly is a rollercoaster ladies isn't it !

[joziel]

I think it's more about the serum estrogen levels - those are just the average patches needed to get to those levels. Some women might need more or less patches to achieve those amounts, depends on how they absorb it.

Are you feeling better yet with the patch reduction? Half is quite a lot to reduce by. I've only been on 50 for a couple of days but already I'm thinking I want to reduce further to 37.5. I feel like I just need to find a level where I'm not getting these symptoms and stabilise there for a while. I can try to increase very gradually again in future but ultimately if I really can't increase, some estrogen has to be better than none.... I seem to think I was okay at 25mcg - I didn't try 37.5 on the way up.

[Pippa52]

lillith - completely agree re the heat.  I hate it when it's this hot especially when it gets really humid too.  Dreading next week.  I bought s small cool box to put my Lenzetto in as it is supposed to be stored no higher temperature than 25 and certainly don't want it degrading or whatever as it is still really hard to get hold of at the moment. There was another post on the site about the heat too.  I had a hysterectomy plus ovaries out many years ago so it was ok for me to have the blood test at any point. I'm afraid I don't know the answer about when in your cycle it would need to be done but I am sure some of the other lovely ladies on here will know.  I hope so much you start to really pick up now you are back on your proper patches. Lets hope the heat is not as bad as the weatherman are predicting!!  xxx

[lillith112]

How are you feeling today ladies ? I got up with another bad head, not as severe as they have been. I still can't believe they are still continuing. Anyway by around 5pm it eased off after taking some paracetamol. Surely they will stop soon as Evorel and Estradot can't add till be in my system, maybe it's the drop in estrogen. 😐

I felt really exhausted today as well, literally found it hard to move. The heat doesn't help either !

[joziel]

I used to get migraines till I started HRT. I think due to low estrogen. I didn’t have them from the 25 patch upwards though.

I doubled my utrogestan last night and had an especially bad night. Throbbing and pulsing with high blood pressure, fluttery heart… I don’t think the utrogestan caused it that was just a coincidence. But there was part of me secretly hoping that doubling it was going to solve everything immediately.

But instead it looks like I need to reduce estrogen down to 37.5 and try again. I don’t really have words for how exhausted I am as I haven’t slept properly due to this since I started hrt in march.

I now have a big question mark over whether I’m going to be able to take it at all and the alternative isn’t worth thinking about so I’m feeling a bit desperate 😞

[Nas]

Aww joziel, sorry to hear you are feeling rubbish.
If it’s any consolation, my sleep has fallen of a cliff recently, down below feels a bit like sandpaper and just generally feeling a bit “ meh”.

What dose patch are you currently on?

I would love to come off HRT and sail through this frankly shite time of life, but sadly, the alternative is not worth contemplating.

Sleep is priority, but how?

[Pippa52]

I used to get migraines till I started HRT. I think due to low estrogen. I didn’t have them from the 25 patch upwards though.

I doubled my utrogestan last night and had an especially bad night. Throbbing and pulsing with high blood pressure, fluttery heart… I don’t think the utrogestan caused it that was just a coincidence. But there was part of me secretly hoping that doubling it was going to solve everything immediately.

But instead it looks like I need to reduce estrogen down to 37.5 and try again. I don’t really have words for how exhausted I am as I haven’t slept properly due to this since I started hrt in march.

I now have a big question mark over whether I’m going to be able to take it at all and the alternative isn’t worth thinking about so I’m feeling a bit desperate 😞

joziel so so sorry to hear your latest post I so feel for you, as you know we are in a similar type of boat.  I see you are thinking of cutting down to 37.5 for your oestrogen.  My meno consultant has put me on a lower dose since I came off the patches (2 sprays of Lenzetto).  She told me I need to level out properly for at least 4 - 6 weeks at this lower dose.  I had a blood test last week as you know and the level was really low at 91 so at least I know for sure now that in a few weeks time I need to up the dose to 3 sprays unless I start to feel perfectly ok in the meantime.  I am then going to have another blood test at 8 weeks when more than likely I will have upped the dose to 3 sprays a few weeks before and then another consult with her.  Since stopping patches I am feeling far less anxious, have only had one episode of fast heartbeat, am sleeping a bit better BUT I feel absolutely exhausted and it's a struggle to do anything much although obvs the heat does not help either.  I do feel I am on the right medication for me personally and now it is a matter of time and getting the dose right.  I did find the patches were too strong for me - even though I started on the 25 ones but it is such a personal thing as to which way of delivering the oestrogen suits each person.  I think for me it was the high oestrogen in the patches that affected my sleep or rather lack of it.  Don't get me wrong \i am far from right but my sleep is improving and I don't have such brain fog anymore either. I honestly think you will be able to take HRT its finding the right one that suits you.  Sending hugs xx

[Pippa52]

Aww joziel, sorry to hear you are feeling rubbish.
If it’s any consolation, my sleep has fallen of a cliff recently, down below feels a bit like sandpaper and just generally feeling a bit “ meh”.

What dose patch are you currently on?

I would love to come off HRT and sail through this frankly shite time of life, but sadly, the alternative is not worth contemplating.

Sleep is priority, but how?

Nas so sorry to hear you are suffering too.  This lack of sleep is just awful and not helped by the heat at the moment either.  Sending love and empathy xxx

[Pippa52]

How are you feeling today ladies ? I got up with another bad head, not as severe as they have been. I still can't believe they are still continuing. Anyway by around 5pm it eased off after taking some paracetamol. Surely they will stop soon as Evorel and Estradot can't add till be in my system, maybe it's the drop in estrogen. 😐

I felt really exhausted today as well, literally found it hard to move. The heat doesn't help either !

lillith ... how are you feeling today?  Like you I feel totally and completely exhausted. If somebody told me there was a £50 note at the end of the road I'd say fine you have it I just don't have the energy. The Evorel should have gone from your system within 24 hours apparently but  the meno consultant said to me it will take several weeks for things to even out and has put me on a low dose of Lenzetto as she wants me to level out for 4 - 6 weeks and if I don't feel much much better then to up the dose to 3 sprays and then have a blood test at 8 weeks and  another consult. As you know my blood test was very low at 91 which was to be expected as I had only been back on low dose Lenzetto for 3 days and she wanted a base line level.  She told me that this is not an instant fix and it takes time for the oestrogen to build up and to level out.  It just seems totally endless but now you are back on your proper patches hopefully you will start to begin to feel better. Sending love and hugs and empathy xx

[Nas]

Thanks Pippa x
I feel I’m heading back to square one again. So so tired and brain won’t switch off. Hyper sensitive to sounds too, is that a symptom?

Got a blood test booked for Thursday, so will see what that reveals.

Empathy and support for all who are suffering, plodding on etc etc... no energy today 😔

[Pippa52]

Thanks Pippa x
I feel I’m heading back to square one again. So so tired and brain won’t switch off. Hyper sensitive to sounds too, is that a symptom?

Got a blood test booked for Thursday, so will see what that reveals.

Empathy and support for all who are suffering, plodding on etc etc... no energy today 😔

Bless you I totally relate to what you say.  Ditto so so tired - my husband goes nuts as I keep asking him to turn down the TV!  I think it seems to put all our systems on hyper alert.  That's great you have a blood test booked as at least that will give you some clarity on where your levels are.  xx

[joziel]

Levels don't always help though, in fact sometimes there seems to be a conflict between what would be 'good' for blood results and how we feel, if that is possible?!

Sometimes I wonder if I should go get bloods redone. What if that 233nmol was just some freaky blip result and actually my results are really high... I've got a finger prick test Medichecks test to do, I was going to do it in about a month's time. Although on only a 50 patch I think it's pretty unlikely I have sky high estrogen really 

[Pippa52]

Levels don't always help though, in fact sometimes there seems to be a conflict between what would be 'good' for blood results and how we feel, if that is possible?!

Sometimes I wonder if I should go get bloods redone. What if that 233nmol was just some freaky blip result and actually my results are really high... I've got a finger prick test Medichecks test to do, I was going to do it in about a month's time. Although on only a 50 patch I think it's pretty unlikely I have sky high estrogen really 

Totally agree it's symptom control that is the key not blood levels but I guess they do give a guide.  50 is certainly not a high dose but I just wondered as you are still peri and young that maybe you have quite a lot of circulating oestrogen yourself still so possibly might need less?  Just a thought I am certainly no expert xx

[joziel]

Yes Pippa, I'd wondered that before.

When the bloods were done, I wasn't on the desogestrel POP. The desogestrel POP keeps estrogen levels (from your ovaries) within the early follicular stage. So I'd have thought whatever estrogen I was producing would have reduced when I went back on the desogestrel. So if anything I'd expect my blood result to be worse/lower now, not better.

It's all a bit confusing. Now I am off the desogestrel again - and I'm on double the utrogestan instead. I've no idea what that is going to do in terms of controlling my ovaries... Does double utrogestan prevent ovulation? I've tried googling this and there doesn't seem to be anything about it. For endo prevention, it would ideally stop ovulation and keep the ovaries quiet. If it's not going to do that, it might not work for the endo and I might have to go back on desogestrel until menopause.

And then, when I was 21 and went on the combined pill, I had the same symptoms I have now. What does the combined pill do in terms of the estrogen produced by your ovaries? Do you just get the estrogen in the pill and none from your ovaries or both?! I don't know... it's all very confusing.

[Pippa52]

Yes Pippa, I'd wondered that before.

When the bloods were done, I wasn't on the desogestrel POP. The desogestrel POP keeps estrogen levels (from your ovaries) within the early follicular stage. So I'd have thought whatever estrogen I was producing would have reduced when I went back on the desogestrel. So if anything I'd expect my blood result to be worse/lower now, not better.

It's all a bit confusing. Now I am off the desogestrel again - and I'm on double the utrogestan instead. I've no idea what that is going to do in terms of controlling my ovaries... Does double utrogestan prevent ovulation? I've tried googling this and there doesn't seem to be anything about it. For endo prevention, it would ideally stop ovulation and keep the ovaries quiet. If it's not going to do that, it might not work for the endo and I might have to go back on desogestrel until menopause.

And then, when I was 21 and went on the combined pill, I had the same symptoms I have now. What does the combined pill do in terms of the estrogen produced by your ovaries? Do you just get the estrogen in the pill and none from your ovaries or both?! I don't know... it's all very confusing.

joziel - do I remember right and that you are a patient of Dr Newson's clinic?  Would they be able to guide and advise you as you are having to deal with so many things it must be a minefield for you.  I really feel for you.  I am having enough problems just dealing with one aspect i.e. the oestrogen levels but you have a much more complex issue of things to try and deal with. x