Hiya
Day 3 of 100 Evorel, doing OK! Makes me realise how very much in the doldrums I've been for months, it's like a creeping cheerfulness coming back and a bit of va va voom!
Re gel, I dunno whether this will help. My sis in law had a total hysterectomy in her early 40s (lots of kids, botched caesarians and adhesions) - had a torrid time. After total mismanagement by NHS of HRT post surgery, she went to see Nick Pannay. At first he was totally up for just upping the gel til she felt better as she was a poor absorber (this is before they changed it, obviously) - she got to 8 pumps but her blood levels were still not up in the range and she was still hugely symptomatic. He said, at a certain point with gel, you get to a dose where your body just can't absorb any more, your cell receptors are just saturated. He switched her to estradot 100, and she's finally settled on 2 x 100 estradot changed a day early and is doing great.
I don't know enough science, but does seem to make sense with gel spread over a massive area, that it just gets to a point where you can't uptake any more? I also notice that the BMS have rebuked Newsom (indirectly) with this statement - not saying it applies to our situation, but interesting that more isn't always better
https://thebms.org.uk/2023/09/tachyphylaxis-with-hrt/ I shared your fears about instability, but all told it's been about a month of faffing, I feel significantly better, not ideal but the contrast in how I feel now, I realise it's been a slow slide with oestrogel without even really noticing. Biggest change according to my fit bit is deep sleep, and my skin looks loads and loads better, and weirdly my histamine response is better (I have oestrogen mediated mast cell activation, loads of fun!) - which I'm assuming might be the 24 hr steady dose.
Reb
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