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[domski71]

Since November 2021 I’ve been in surgical menopause following a bilateral salpingo-oophorectomy due to an inherited gene mutation. Since then I have been struggling to find an oestrogen preparation that is effectively absorbed and provides me with adequate oestradiol levels without being completely unmanageable. (I had a Mirena coil fitted during the surgery.). Over 16 months I have been spending a fortune on private specialist appointments and blood tests to monitor my levels as I am on above licensed doses.   Getting pretty fed up now and considering implant/tablets.

My saga:

After 3 months on 50mcg Estradot patch post surgery my levels were non existent.
Then tried Lenzetto for 3 months - starting with 3 sprays and increasing to 6 which eventually brought me up to levels around 190. At the time this wasn’t available on my local NHS formulary so I didn’t want to continue with it on an expensive private prescription long term nor did I like the plastic waste I was creating, getting through one bottle every 10 days….
So I went back to much higher 200mcg Estradot dose for 3 months and my levels plummeted to 85.   
Specialist ruled out patches going forward as absorption clearly a problem. Then we tried Oestrogel at 4 pumps, increasing to 6 pumps which got me to levels of around 250 after 6 months. But 6 pumps is a lot of gel to be administering (3 morning, 3 evening) and simply not manageable in the long term
I’m now trying Sandrena 3mcg (1 morning, 2 evening) to try and make application more manageable but I’m still having to split the dose between morning and evening and the gel takes longer to dry than Oestrogel so I’m not sure it’s any more manageable.

Was seriously considering a tablet but my very fit husband has just had a DVT and PE out of the blue, so I am more paranoid about the clot risks of oral oestrogen and so would rather avoid.

So what’s left? Implant?  Not sure I can get this locally on the NHS but I’d be prepared to pay and give it a try privately. Does anyone have experience of an implant following similar absorption issues?  How well has it worked?

(My symptoms:
Troubled sleep
Feeling hot at night
Hair loss
Getting fat despite exercise and healthy diet
Dry eyes
Tinnitus
Low libido
Lack of oomph
I also use Androfeme as my testosterone levels were non existent. I do seem to absorb but again I am now on an increased dose of 0.75ml and still at the lower end of the permissible lab range.  Not really noticing a massive difference on it to be honest.)

Thanks for any info on implants!

[CLKD]

Hi!  Who is overseeing your HRT?  It can take a while for the body to absorb replacement therapies.  It can take 3-6 months B4 there is any feeling of improvement.

You don't say when you last had a full blood count to include thyroid function and VitD tests.

Let us know how you get on.

[domski71]

Thanks CLKD.  Being overseen by a private menopause specialist. We’re using 3 monthly blood tests (thyroid function, oestradiol, SHBG and testosterone) to gauge absorption levels, as well as looking at symptom control. Aiming for oestradiol of 250/300 minimum which has been a struggle to date on above licensed (and frankly unmanageable long term!) doses. 
Thyroid function always within range. Vit D last checked in December (131). I take daily Vit D 3000iu.
I’m sure I’ll get there in the end but nearly 18 months after my surgery I wish I had it sorted!