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[Winter]

Three weeks ago I had a blood test as I started Androfemme 3 months ago. Also taking gel and utro. They took oestrogen level at same time. Before I started Andro - my oestrogen was a nice steady 700. After the reading, testosterone had risen a little, but oestrogen was at 3,300 - far too high. I've had an internal and am having a scan next week, and i've had a blood test today just to see what levels are. So obviously I'll find out soon, but in the meantime, I've reduced Andro to every other day and gel by half a pump - but I just feel awful. Far more anxious, jittery, tired etc since I decreased dose a week or so ago.

I'm hoping soooo much that the high oestrogen reading was a rogue one, or contaminated (I hadn't put gel on that day however).

I've a nasty feeling that my body is metabalising the testosterone properly and it's pushing my O up, even though my O was at a good level beforehand.

I just want to go back to using both as normal, I felt fine.

[joziel]

I really wouldn't reduce your estrogen or you will get symptoms back. It is incredible and almost impossible to have those estrogen levels without contamination. I mean, it's almost physiologically impossible.

If you are using gel it is very easy to contaminate where the blood is taken. Once a patch of skin is contaminated it takes ***4 weeks*** before it can be considered okay again. So not using the gel that day makes no difference. Washing it makes no difference. If the blood for the repeat test was taken from the same arm, it is very likely also contaminated so you will need to get another draw done using the other arm.

That is why I really recommend you don't put gel anywhere near where blood is drawn from and you use use a silicone spatula to apply it so you're not getting it on your hands. Same goes for testosterone gel.

[Floo36]

If you are peri then that reading will be a fluctuation and not what your levels are all of the time.  I get really high spikes also.  Bloods should not be used for us peri ladies, symptoms should guide treatment.

[joziel]

Even with a spike, you're not going to naturally spike up to 3,300pmol:

Reference ranges
Children: Less than 130 pmol/L
Males: Less than 146 pmol/L
Females:
Follicular: 72 – 529 pmol/L
Ovulatory: 235 – 1309 pmol/L
Luteal: 205 – 786pmol/L
Post-menopause: Less than 118 pmol/L

https://www.southtees.nhs.uk/services/pathology/tests/oestradiol/

Unless you're pregnant....

[Floo36]

In peri we can have very high spikes higher than ever, this is my experience.  My meno doctor also said in peri especially towards the end Estrogen spikes can be massive, but they are just fluctuations. 

[joziel]

It's true we can fluctuate - but not by that much and that high. The fluctuations would be within what they outline there as the reference ranges.

[Floo36]

Not the case as I have proved it.  I would never have believed it either until I experienced it, I didn’t think it was possible but it is as our ovaries are trying to keep going. The spikes can go much higher than that my highest was over 5000.  Late peri can be chaotic for some of us hence the massive spikes and dips.

[joziel]

You got an estrogen level of 5000 from your own ovaries? Not taking any HRT?

The thing is: Women are getting their estrogen levels measured all the time. You see the results on this forum and on Facebook and just about everywhere. Many of us are in peri. If fluctuations up to 3000-5000 were normal, produced by peri-menopausal ovaries, we would be seeing that all the time. We don't see it all the time.

So until we start to see a lot more of these kind of results routinely from peri ovaries, I'll continue to believe they come from contamination or absorbing HRT estrogen 'too' well....

[Tora]

These reference ranges differ between NHS trusts.

I’ve had oestradiol readings at over 3000 before starting HRT!

[Winter]

Well, my more recent test result is back - and it's 220. So from 3,330 three weeks ago, to now plummeting to 220. My  mood is awful. I've been feeling jittery, worried, paranoid and so so tearful. I'd dropped the oestrogel from 4 pumps to just over three. And reduced androfemme to every other day. Think I'll just go back to normal.

[joziel]

As said Winter, your 3000+ result was very likely caused by contamination. Stick with your regular doses. If you get any weirdly high results again, don't change anything until you've retested to confirm the result... 

[Floo36]

Thankfully you proved by getting that low reading that it was your own spike and not the gel.  It is common to have very high readings at this time.  Doctors that are experienced in treating peri meno ladies will know that we can fluctuate extremely high levels.  Some ladies that have had one off bloods done are wrongly taken off their HRT or have the dose reduced and left to suffer debilitating symptoms,  which is why in peri symptoms not blood levels are key.

We all absorb differently and yes the over 5000 level was on no HRT as I kept getting wildly different levels on blood tests and needed to prove that it wasn’t from the HRT.  It was very stressful and expensive having to do that and we shouldn’t have to to be believed.

[Bungo]

I really wouldn't reduce your estrogen or you will get symptoms back. It is incredible and almost impossible to have those estrogen levels without contamination. I mean, it's almost physiologically impossible.

If you are using gel it is very easy to contaminate where the blood is taken. Once a patch of skin is contaminated it takes ***4 weeks*** before it can be considered okay again. So not using the gel that day makes no difference. Washing it makes no difference. If the blood for the repeat test was taken from the same arm, it is very likely also contaminated so you will need to get another draw done using the other arm.

That is why I really recommend you don't put gel anywhere near where blood is drawn from and you use use a silicone spatula to apply it so you're not getting it on your hands. Same goes for testosterone gel.

Very interested in this. If getting bloods taken to check for absorption, and running on back of arm, is it sufficient to not use gel the morning bloods are due to be taken? The blood test needle is  usually at the crook of the elbow so should'nt be contaminated? I wish there was more clarity and medical knowledge about this