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[Gilla999]

Is there a blood level of Estrogen that is generally spoken about as being a number to roughly aim for? (I realise it's very individual and you should go on symptoms etc). I think I remember 300 pmol being spoken about before as a general guide, but might have got that wrong.

It's looking more and more likely that I'm going to have to go down the chemical menopause (Zoladex) route, as my mast cell / histamine problems (which are very severe) appear to be triggered by the act of my Estrogen rising, regardless of what level it's at (and was the same even when I stopped HRT).

I'm just wondering as a post meno lady if there is a general level that is spoken about. I have tended to need a higher blood level than most people and although if I'm not ovulating that will drop, my fear is that I will need more than I can actually get, even from a 100mg patch.

[CLKD]

How were you during your menstruating years?  How do you know that there is a problem with mast cell/histamine levels?  This is science above my understanding, you can probably tell.   

Blood tests are reliably un-reliable as hormones rise and fall all the while.  I never knew when I ovulated so that bit of my cycle went by me 

[Gilla999]

It's a big long-winded CLKD, but I've had a bunch of severe issues that appeared to be initially triggered by the covid booster, but are now definitely being aggravted by my Estrogen fluctuations (which is a known cause of these issues). Initially it was severe chronic spontaneous urticaria for 5 months last summer, now it's a whole mixture of severe allergy / borderline anaphylaxis type symptoms - eczema all over my body, papitations, flushing all over, wheezing, coughing, tightness of the throat, problems swallowing, stimulated/adrenaline feelings and insomnia as a result... I could go on and on. The only time it dies down is when my period arrives for a few days (as my Estrogen drops) and then as soon as it starts to rise again for ovulation it all flares up. I've been put on all sorts of meds and immunosuppressants by my specialist but nothing works when it's constantly battling my perimenopausal fluctuating Estrogen level. Even coming off HRT entirely didn't get rid of the issues (and just sent me loopy in the other direction). I have been hugely reluctant to go down the chemical menopause route, purely because although it will get rid of the flucutations causing the problem, historically I have needed a relatively high Estrogen level to feel well on the flip side (night sweats and 3am insomnia being the main two). But it's getting to the stage where I have little other options left - I'm signed off work long term sick and can't pay the mortgage etc.

My understanding is that blood tests post meno would be much more stable and reliable, hence the question  I'm sure I recall a 300 pmol number being spoken about but wasn't sure!

[Kathleen]

Hello Gilla999

The only personal experience I have is that when my oestrogen was measured at 600 pmol my meno clinic doctor told me that I should have felt good at that level. I am a long way post meno and I was using three 1mg sachets of Sandrena gel at the time. I think other ladies have quoted the Studd clinic  who advocate 800pmol to treat menopausal anxiety and depression.

There are many ladies who are knowledgeable on the subject and I am sure that they will be along soon.

I have been learning about vitamin D lately and I wonder if you have had that tested? As you probably know it is a hormone that regulates the immune system so optimal levels would be of benefit to you.

Wishing you well and take care.

K.

[Gilla999]

Thank you Kathleen for your reply - that's much higher than I thought it would be for post meno! And also curious, because according to all the scientific studies I've researched online even a 100mg patch doesn't give more than about 400pmol on average. Do you have any idea what 3mg of Sandrena equates to in a patch? To be honest that gives me a bit of hope, because my fear is (after having seen the average pmol given by either patches or lenzetto in the studies) that I wouldn't be able to get my Estrogen high enough with HRT, if I've had my own Estrogen production totally switched off by Zoladex (chemical meno).

I've been taking 1,000 Vitamin D for a while but this week have just started taking a high dose of 5,000 plus vitamin K to go with it as I had also read those studies 

[Pippa52]

Gilla 999 I am post meno and on oestrogen only HRT.  Meno consultant told me to aim for 150 - 240 pmol but nearer the 240 mark.  I was scarily low a few months back at 53 but last blood test showed I am on the way up at 144 so am slowly increasing my patches up to a 75 patch and then will be re-tested xx

[Gilla999]

Thank you Pippa, this is super helpful! So glad to hear you've slowly managed to get your levels up. Do you feel you absorb better on patches than anything else? Interesting that you've needed to slowly increase rather than go straight in for a 75 patch... xx

[Bungo]

Gilla 999 I am post meno and on oestrogen only HRT.  Meno consultant told me to aim for 150 - 240 pmol but nearer the 240 mark.  I was scarily low a few months back at 53 but last blood test showed I am on the way up at 144 so am slowly increasing my patches up to a 75 patch and then will be re-tested xx

Hi Pippa, am always curious about bloods. Did your meno specialist tell you to wear the patch while bloods being taken , was it the last day the patch was due to be removed or the first day? I came across some study that was saying there's no guidance/ consistency as to when bloods should be taken to give accurate average oestrodial levels.

[CLKD]

Tnx for the information. 

[Pippa52]

Bungo - re blood tests yes I had to arrange the blood test 48 hours after putting on a new patch as apparently that is when it would reach  optimum levels and yes I was wearing the patch when the blood was taken.

[Pippa52]

Gilla999 - yes the patches have been better for me absorption wise.. Lenzetto started out well but then for some reason my levels dropped right off despite dose increase and I just felt pretty awful all the time  but I won't pretend it's been an easy journey increasing as I am ridiculously sensitive to oestrogen changes be they up or down so much as I would have loved to slap a 75 patch straight on I've had to do it slowly.  I am now on 68 as of last night so nearly there but feeling pretty rubbish today.  I so hope you start to feel better soon ....hang on in there I can see you are having a really rough journey but I so hope you will soon start to come out the other side.  Do you have a nice and understanding Dr or Consultant helping and supporting you? Health worries are bad enough but when they impinge so much on your life in general being signed off sick etc that is awful.  I also re-acted really bad to the Covid vaccines which really put me back big time too and ended up in A&E after both first jabs with cardiac problems which took months to resolve. I honestly know of several people who were made very poorly by the jabs. Sending love and hugs xx

[Hurdity]

I'm not a lady but I am post meno!  . There doesn't seem to be standard recommendation about oestrogen levels per se. Different levels for different reasons. Some years ago I read a paper about minimum level for (good)  bone protection (and have not been able to find the paper again) which mentioned something like 165 pmol/l if I recall correctly - as I was surprised it was so low, though any oestrogen will improve bone health.

Have also read a paper about HRT - again some years ago - suggesting the amount to aim for was the average level over the menstrual cycle - but as we're all different, that itself would be a range - but was something like 300-350. Then again as Kathleen said - treating reproductive depression - a clinical condition - there is recommended a  level of 800 pmol/l or so - but I think that may well be in peri-women?

Clearly for women in their 60s 70s 80s it is probably not a good thing to continue to artificially maintain very high oestrogen levels indefinitely - mainly because there is insufficient research.

Many doctors in any case go by symptoms - as you say - for many women are happily unaware of their oestrogen levels - only those who go to private consultants, or particular reasons on NHS, will know their oestrogen levels through blood tests.

So how long is a piece of string?!!

I cant remember how old you are but have you tried any of the contraceptive pills like Zoely which gives a constant oestrogen level that is not high, but will prevent ovulation? Maybe you are too old or tablet don't suit you but might be worth a try before going down the chemical menopause route?

I do hope you manage to find a solution to those unpleasant symptoms.

All the best
Hurdity x

[Gilla999]

Thanks for taking the time to reply Hurdity, I appreciate it and realise it is such a difficult one to answer. Yes I think 300-350 is what I'd seen somewhere,.

My main concern is that (still being perimenopausal) my Estrogen level has been relatively high particularly in the luteal phase. I've generally needed it to be anywhere between 600-800 on day 21 to feel well (in the sense of no night sweats, 3am insomnia or depression/fatigue.) However as I've gone into in my post above, I am now experiencing really debilitating and quite serious allergy/anaphylaxis type symptoms whenever in my cycle my Estrogen is in a state of rising (seemingly irrespective of the level to/from). I have come off HRT altogether for a while and it made no difference - it's as though my body has somehow become "allergic" to the physical state of my Estrogen rising. I don't understand it at all and I've seen a wide range of specialists, but none of the antihistamine/mast cell drugs they've prescribed have worked. My urticaria doctor did say that hormone "fluctuations" are a known cause of these issues and was supportive/positive about the idea of Zoladex to switch off my hormones entirely, thereby only relying on HRT and having a "steady state" ie. post menopause, so no triggering of the issues.

However my worry is that having had such a relatively high average amount of Estrogen over my cycle that I'm not going to be able to get enough HRT into my body to make it be happy/compensate by being put into post meno suddenly, and I'll be left in hell on earth! This is because I read that even a 100mg patch only gives approx 360 pmol, which I'm worried won't be enough for me?

It's such a huge decision to take and one I wouldn't be considering if I wasn't absolutely at my wit's end, so I'm trying to understand and prepare as much as possilbe. Very scared and nervous!

[Floo36]

Your symptoms are almost the same as mine. If nothing changed when you stopped it may be because you weren’t absorbing the HRT.  Because of out fluctuating Estrogen it’s impossible to get an accurate blood test as you don’t know what’s your own Estrogen and what if any I’s from the HRT.

[pepperminty]

Hi,

sorry you are feeling so unwell.

perhaps look at gut health? There are loads of functional medicine nutritionists who treat the whole person. Magnesium ( not oxide) is good for sleep and absorption of Vit D . Liz Earle had bad eczema and it improved when she started eating probiotic foods. Also try mindfulness and meditation which can improve health as stress makes things so much worse.

PMxx