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[Hollyboll]

Hi

First post so be gentle ... also very fragile so will keep long story/intro for anon ...

After horrible few years of overlooked peri symps, totally inappropriately overdrugged with antideps, sleeping pills, etc etc, I started HRT and felt immediately and increasingly better for first year.  Then I didn't, and patches were increased - way above licensed dose, by a pvt GP I now know generally does this (to a lot of criticism) - she said my E2 levels were crazy fluctuating and putting more in would make them more undulating.  Things have not improved and last year terrible again. 

My oestr levels are still all over the place.  Finally finally into NHS meno clinic.  They wondered about tachyphyl but say it can't only be that because sometimes they plummet too - they go from so high consultant wonders about tachyphylaxis to so low they repeat the tests, then back up and down and up and down etc etc.   They are now talking about E implants.  And possibly GnRH injections, although I'm not clear whether they'd do with implants or try implants alone first. 

I realise I'm very lucky to have this referral, and possible opportunity - having done lots of googling, I now know E implants are not easy to come by in NHS.  But that also means there's not a lot of stories, even on here, of people who have had them.  To be clear, these are the 'E' only implants that used to be much more widely used but no longer generally available in UK ... not pvt compounded things.

I still have all my bits; I know they are often used for people who don't.  I was initially reluctant to have anything remotely invasive or not easy to stop if needed, but I'm desperate.  I've lost the last year again, after a good year on HRT, after 3-4 years of terrible symps that GP and I missed completely - hard to believe with all I know now, but hey ho.

So qn is ... does anyone have experience of E implants (possibly and GnRH?) to stabilise E levels?

This is definitely one of the more experienced mno clinics, but I can't find anything anywhere about this use of implants.  I've every reason to trust no medic ever again after the last several years - couldn't make it up - would be entertaining if it wasn't true etc! 

I think I'm probably at the stage of doing whatever they tell me they recommend, but I'd love to hear from anyone else who's had similar. 

x

[Arya Underfoot]

Hi Hollyboll.

Welcome to the forum and thank you for sharing your story, you really have had some bad luck with doctors there. I can understand that desperate feeling, a few years in to my HRT while in peri, everything went downhill and I'm still struggling to get the balance right. Like a lot of people I use Estrogel but am curious about the implants. I've looked them up and see that they've been discontinued where I live (Australia), but not sure why, it seems to work for some people, just be wary of side side effects. Hopefully someone more knowledgeable can provide more info.

[Hollyboll]

Thanks. Sorry to hear you too are struggling. 🤗

Yes they’ve basically been discontinued in Uk. Only a couple of specialist clinics use them. As far as I can work out, this was a cost thing because patches and gels work for most people. It does mean that finding info about them is not easy!

[Nas]

Hi Hollyboll and welcome 

Goodness what carry on for you!
Peri can be hideous, largely because as you say, your hormones are raging up and down.

Do you mean oestrogen implants ? I think lasla who posts on this forum from time to time, has implants; she is possibly under Chelsea and Westminster clinic
 ( don’t quote me on that). 

Maybe do a search on here to see what you can find out?

I’m sure there are ladies on here who have them. Hopefully they will be along shortly to help.

[Hollyboll]

Thanks Nas!

Yes, sorry - oestrogen implants.
I’m under what I think used to be chelwest team - I gather Nick panay left and it was reduced.

I’ve searched this forum and everywhere forever - there’s very little and even less recent - very keen to hear from lasla or anyone else

X

[laszla]

Nas you're exactly right, I am under Chelsea and W NHS where they do still use implants (praying they don't discontinue the service).

I had a testosterone one inserted in October and it will be replaced in February, it's been helpful but Holly I haven't had the E implant yet - they wanted to give it to me together with the T one but I wanted T on its own first to establish what effects if any it had independently of oestrogen.
 
We agreed that I'd have the E one implanted together with repeat T in February.
So obviously I can't report back yet but will be happy to do so later - perhaps in late Feb when I'll have had it in for about 4 weeks.

I believe the implant is a lower dose than what I take with the gel, 50 as opposed to 100 oestrogel but the idea is that 50 properly absorbed units are going to be much more effective than 100 that.arent being absorbed.

I can say that the insertion itself (same for either hormone) is easy and not painful and there's a lot to be said for not having the faff of daily application of gel.
You're right that there's not much feedback on here re implants but there is some, I also looked on other sites.

[Hollyboll]

Oh amazing lasla - thank you!  I'm at QCh, where I think some of the ChelWest team went. 

Interesting they started with T for you - we've not discussed T yet, but yes I was thinking I'd rather do one at a time to see effects etc.  Tbh I'm not worried about insertion - can't possibly be worse than the shitshow of peri symptoms - or about faff of application - although I use several patches I now change every 2 days so it's more of a faff than it used to be - but not as much as gel (I use testim for T). 

Is it clear to you why implants might help even out fluctuations? 

x

[laszla]

Holly I did have to stick to my guns to get the T implant first but I have been on testogel and oestrogel for years with v poor absorption so it's not that I hadn't exhausted the transdermal options.
My best guess re implants helping with fluctuations is that the pellet emits a slow but completely steady flow of the hormone as opposed to a patch or gel where, I would think, there would be troughs and peaks even over a 24 hr period, eg if you apply the gel in the morning, it would probably peak a few hours later and by the next morning have dipped - which is why we have to apply every day or every couple of days with patches

[Hollyboll]

Thanks Lasla.  I had my appt this afternoon and you're right - like you I've done years of transdermal (patches) and they said that by the nature of changing / reapplying anything it is going to rise and fall a bit (even if you changing patches every other day, as they'd told me to try, hour 1 is a new patch, hour 47 isn't). 

So today they took more bloods than I think I've ever had taken at once (!) and referring me for an urgent scan, and then I'm back in 2 weeks - probably for oestr implant and possibly suppressor at same time.  I'm less keen on the latter, but at this stage I will do what they recommend. 

We didn't really get onto it, but my impression is they won't be pushing me to do T implant until we see how E goes, so well done for sticking to your guns.  And (unless scan shows something untoward) I got the impression that they will be OK to leave me on utrogestan for now (they had talked about mirena), again because it's best only to mess with one variable at a time.  So well done for sticking to your guns!

When are you back at chelwest?  I will see Qch again on 31 Jan - we can perhaps compare notes!

Meantime - anyone else who's had oestrogen implants, very keen to hear

[laszla]

Holly I'm back at Chels on 1 Feb and will report back - but probably after I've had it in for a few weeks! All the very best with your appointment and hopefully someone else might appear in the meantime with some implant experience

[Hollyboll]

How funny Lasla that we are likely to be getting the implants almost round the corner on consecutive days! 
Hope yours go well.  Let's compare notes afterwards - was it your experience last time it took a few weeks?
Any tips for what to do or prep beforehand?

Wonder if there's anyone else here with experience of oestrogen implants?

[sjpercy3]

Hi both,

Were you able to get your implants done? I'm waiting for mine and have been told that the government are currently withholding them.

[laszla]

Hi Sj, yes, I had my E implant on 1 February, I can't yet report back on any change as it's too soon (can't notice any difference so far) but there was no mention at the hospital of there being shortage/witholding etc. In fact they immediately booked me in for my 4 month follow-up. I would think if there were a government policy it would affect all hospitals?

[sjpercy3]

Hi laszla! Thanks for responding. Could you please keep me posted on how you get on as I'm new to implants. The pharmacist who supplies them to the NHS hospitals and private clinics told me the medications authority (I think) has put a hold on them, but they don't currently know why...
I'm currently at breaking point as HRT isn't working for me, and this was my last hope.

[laszla]

I understand completely sj, just to say that although it's a bit early for me to gauge effects of E implant, I can say that my T implant definitely helped me: my body would not absorb the gels at all whereas my blood levels finally went up with the implant and a couple of symptoms improved markedly.
So don't lose hope, for some women implants are the thing that finally tip the balance in their favour.
I will definintey update also on E in a couple of weeks or so when it seems like a sensible amount of time has passed and I'll also do a blood test.