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[WildOtter]

Hi all.

I went through surgical menopause following a total hysterectomy about18 months ago.  I was put on the patches (Evorel 50) initially and was ok on these for a year or so. In the last few months though I've been suffering from extreme fatigue, depression, detachment and anxiety. I've been transitioning off an SSRI that wasn't agreeing with me so it's hard to say what's caused what but my doctor noted my estogren levels were low during a blood test and suggested I wasn't absording the patches very well so to try a shift to gel.

Is it normal for shifting to a new HRT method to feel like it's thrown you back to square 1 initially? I started oestrogel (2 pumps daily) about a week ago and I have felt high levels of terrible anxiety since, as well as fatigue and flushes.  Is this likely to settle down again once my body gets used to the new delivery method? 

Also, does it matter what time of day I apply the gel? I've been doing AM but I swim a lot so it becomes a pain making sure I leave enough time for it to absorb before swimming.   Does it matter if I do it just before bed?

[Tinkerbell]

I have always used my Estrogel at night.

[Hurdity]

Not sure why the doc didn't suggest an increase in patch dose - that way you would know whether it was low oestrogen or not. Depends how low your oestrogen levels were -  50 mcg is not a high dose. You could for example try 75 mcg and if these are prescribed then increase gradually by cutting a bit off for the first few weeks to give around 62.5 mcg and then gradually increase to full dose.

Did you keep your ovaries? If not then you may benefit from testosterone - depending on libido though best to think about this once you've completely come off the SSRI, but low T can also cause fatigue etc in addition to affecting libido.

Hurdity x

[WildOtter]

She didn't give me a number for the oestrogen, just said it was low. I don't know why her instinct was to move to gel instead of increasing the patches.  I'll see her again in a few weeks so I will ask her.

I don't have any ovaries (ovarian cancer in one, and they remove everything to prevent spread), I would really like to be on testosterone, and I will talk to her about that.  She did talk about a referral to the menopause clinic too but it's a very long wait in my area.  I do wish I could afford private and just get this sorted.