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[Madge79]

Hi everyone
Has anyone else found HRT only works temporarily?
A brief history - I’ve been on HRT for many years, tried basically all the formulations and it’s obvious I’m a very poor absorber.
I’ve finally found the best of the bad bunch to be lenzetto at double the licensed dose. For the first couple of months after changing dose I felt better then low and behold all the symptoms come crashing back.
Has anyone else found that it works for a bit then stops working? At last blood test I was told my levels were good at 390 pmol/l, but I was also told levels take on lenzetto are not always reliable so I’m not sure where to go with it from here. Also the bloods were taken the first month of increasing my dose which is when I tend to feel ok.  My specialist mentioned the implant but I’m also very worried this will trigger my migraines, and so is she.
So today I’ve woken up again aching, hot flushes, migraines, dry eyeballs, tinnitus all on 6 sprays of lenzetto! This is mad 😩

[MrsMitch]

Hello Madge, I'm like you. I seem to be a poot absorber - 4 pumps of oestrogel and I need more now. Every single type of HRT I've been on only works for a short time. I started on herbal remedies which to begin with were great, but the effects gradually tailed off. Same now I'm on HRT.  They all work for a while and them my symptoms start to come back. That's where I'm at now. But I do have an appointment Tuesday with a meno specialist,  finally.  So I hope to discuss that with them.
It's frustrating isn't it because once you can feel better, you dread the symptoms coming back. (I'm post meno BTW). I'll let you know what happens Tuesday in case it helps you.

[AngelaH]

I seem to be a poot absorber - 4 pumps of oestrogel and I need more now. Every single type of HRT I've been on only works for a short time.

MrsMitch, you ask about bio identical hormones in another topic, I answer you here, probably it’s a better topic to talk about it.

You didn’t mention the name of product.
But probably because you are poor absorber this type of product it’s not suitable for you. Bio identical product is normally weaker than body identical, which is available from NHS.

I had the same experience with estrogen gel, good effect lasted no more than 2 days and then I felt ill. No luck with patches and Lenzetto spray. But in my case it happened not because I was poor absorber, but the opposite because I was too good absorber. My body absorbs fast, everything and from everywhere in my body. So estrogen gel, patches and spray were too strong for me. I needed something weaker and in smaller dose, some product I found in NHS and some  had to buy online.

[sheila99]

Have you tried oral? If you're a poor transdermal absorber you may find it's more effective for you.

[MrsMitch]

Thank you ladies. I guess I don't know what the issue is until I've seen the specialist. It's all my own speculation at the moment.  But I do appreciate your input. It gives me more understanding and so more to talk through at my appointment. I'm hoping to get some info that might help Madge as she seems to have similar issues to me.
I was on oral originally. Loved it for the convenience but I only had it for one month and then there was a shortage so I was changed to patches, when they stopped working, gel plus progest. I was warned by 2 GPs that oral HRT is very dangerous and they were glad in the end they had to change it. But I'll bet you'll tell me they were wrong ( unsurprisingly).

[sheila99]

Transdermal is safer than oral but if you don't absorb it it's useless. The newer oral hrt is much safer than the old horse urine ones that weren't so safe.

[imgeha]

I was told - after my oestrogen levels were found to be sky high - that too high oestrogen causes the same symptoms as too low oestrogen. So it may not be that the effect is temporary, but the dose is too high and you may get some relief if you reduce it.

I went down to 2 pumps of Estrogel and lived with it a bit to see if symptoms were any better. I am now back on a higher dose with symptoms, and believe there are some people who just have symptoms regardless, but if you're bad on HRT, imagine how you would be without it. You will at least have the long-term protective benefits of HRT, even if you are symptomatic in the short term.

Trying to get HRT levels right when hormones are shifting on an hourly or daily basis is like trying to score when the goalposts are moving!

[joziel]

Hmmm, there's a lot of questionable doctor stuff going on in this thread(!).

Madge79, Lenzetto is quite a 'weak' form of HRT, dosage wise - you need a lot of it. And I've also heard that bloods are not reliable because of the way it is stored in the skin which can affect blood tests somehow. So you might need to switch to another product but just a lot more of it, or to try the oral HRT (only problem there is the estrogen is a fixed dose so if you do need more you can't increase unless you add some transdermal in).

And merrygoround, I'm not sure what you mean by the highest dose you were 'allowed' to try was 3 pumps of gel... 4 pumps all GPs should be quite happy for you to use, and the NICE guidelines say you should be allowed to increase to that if symptoms need it - which it sounds like they did for you. Many women need more than that and your option then is either wait ages for an NHS menopause clinic or go to a private clinic like Newson.

I am on TEN pumps of Oestrogel at the moment, 5 pumps in the AM and 5 pumps in the PM and my serum estradiol is around 430pmol. I probably need to go higher still, as I get night time symptoms.

My Newson doctor says most women need to be between 400-600pmol for symptom control, especially during peri-menopause. My NHS GP has been happy to prescribe me this dosage with the letter from my Newson doctor to say that I need it.

Don't forget that most HRT was designed to get women around 250pmol in post-menopause, so if you need to get much higher than this for symptom control in peri you may well need quite high dosages - even aside from the 'poor absorber' issues. ALL GPs should prescribe up to the max licensed dose which is 4 pumps of gel or 100mcg patch. If your GP is reluctant to prescribe more than this, IMO the best route is with a letter from a private menopause clinic to the GP to tell them to prescribe higher. You still get the meds on the NHS.

[joziel]

Hmm, provera isn't body identical (like utrogestan)- it's a synthetic progestin.

When I was on the POP (desogestrel, another synthetic progestin) I had horrible melasma on my face - for like TEN YEARS that I was taking it. I didn't realise it was the desogestrel causing this until I came off the POP and started HRT - and it went away. I don't have it now on utrogestan.

Have you tried utrogestan?

[Kathleen]

Hello ladies.

I have also found that either HRT only works for a short time or isn't particularly effective with my range of symptoms.

The highest dose I took was three one mg sachets of Sandrena gel and my Oestradiol blood levels were 600. I felt fine some of the time but other times I would feel tearful etc.
At 67 I am now using one sachet of Sandrena and Utrogestan orally, with the exception of some vaginal dryness my physical symptoms have resolved but my emotions are all over the place as usual! 
 I have been told by medics and my consultant that HRT doesn't help with the emotional symptoms and I would certainly agree with that! 
I am aware of other women for whom mood changes have been a troublesome symptom and it is so frustrating that HRT can't resolve everything.

Take care ladies.

K.