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[Mumandgp]

Hi, I’m a GP recently joined forum, 1st time posting. Trying to navigate HRT for myself and my patients best I can but my own GP is difficult to access and I cannot find an answer online as to what I should do? I have an IUS and been using 1 pump daily oestrogen long time but was curious about my oestradiol levels so had b/t last week and result was >3000! Might have ovulated afterwards? Still I think is very high? Should I stop the gel? I thought I could repeat b/t in 1-2 weeks but do I continue hrt meantime? Advice welcome 🙏🏻

[Winter]

Feels odd to 'advise' a GP, but i had a similar experience recently. I'm on 4 pumps. I had a blood test for testosterone and we checked Oestrodial at same time, like you well over 3000. They all panicked. Sent me for urgent scan and i reduced to 3 pumps. Had a repeat test 3 weeks later and it was through the floor at 200. I still feel like crap now. Personally I wouldn't reduce, but that has to be up to you and your medical team. I've been recommended the implant but that sounds v scary.

[Joaniepat]

Welcome to the Forum, Mumandgp.

As a healthcare professional, there is free training on menopause available to you which is CPD accredited. One is "Confidence in the Menopause" on the Fourteen Fish platform. This was devised by Dr Louise Newson, a well known menopause specialist GP with a large private practice. It has proved very popular. There may be other free courses too, perhaps try the British Menopause Society (BMS).

I agree with Winter, don't get too hung up on the estradiol blood test result. It is best to apply your daily dose of gel after the blood draw, could that have been a factor? You are on a very low dose of gel, so I would not try to reduce it.

JP x

[Mumandgp]

Thank you both xx

[Floo36]

Your level was most likely just a spike and not what your Oestradiol is most of the time.  I have massive spikes and have done many Oestradiol bloods and they have not helped because in peri especially the closer we get to meno it becomes a chaotic time and our ovaries can throw our massive fluctuations in their quest to keep going. 

I did almost daily bloods over a 3 week period to prove it, on that particular experiment the lowest was 457 and the highest over 5000pmol.  My meno specialist has said that further tests are pointless whilst I’m in this chaotic stage.

Too many women in peri are told that they are on too much Estrogen based on bloods, symptoms are key not bloods.

Also the amount of gel you are on is not capable of delivering those levels.