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[alltheleaves]

Are they all the same ? can you get different side effects form for instance evorel 50 versus another type of 50 patch.
was using half patch sequi version for nearly 3 months, my mental health has deteriorated since then , but I was going out still as of last week.
Had a break for one week because I thought I would see what it was like , slept a bit better to start with had a couple of good days , felt pretty normal, but still low sometimes was going out still it was a distraction then had a really bad night with racing heart and anxiety.
So I put on a full 50 just estridiol evorel on and thought i will try it , I felt spaced out and like my brain has been switched off , like I couldn’t think so I just been riding it out in bed .I have 24 hour anxiety and the two times I have tried to leave the house i had to come home , so I halve lost desire to go out . My anxiety is keeping me awake most night , Is this my head playing tricks , or could the evorel not suit me.
I want to see a specialist but don’t know who to turn to , I just paid for a private zoom call from a specialist and am no further forward , just recommendations they said blood tests don’t matter .
Gp is stressful, they keep not calling , they not experienced enough, anyone give me a name of someone i can book with .
I am definitely meno from blood test , azz as previously posts radiation has killed my ovaries .

[alltheleaves]

I feel jittery seems internal like vibrations, and I am needing toilet all night .

[joziel]

You probably need a lot more estrogen, not just removing patches and then putting them back on again - that's just going to create more fluctuations.

I don't know if you've read past posts by me, but internal tremors through the night, heart beating hard and fast at night and that kind of thing are all my low estrogen symptoms and I need a lot of estrogen to fix it. (I tried increasing to 12 pumps of gel a day but I wasn't absorbing more than 6 pumps and so I've now added in 100mcg patch as well as the 12 pumps of gel, and will be increasing patches and decreasing gel.)

50mcg patch is just nothing if you don't absorb well. You can increase to 75 and 100mcg patches without seeing a specialist though. Those are all licensed doses and your GP should be happy to increase to 100....

[bombsh3ll]

Yes the different patch brands all contain the same active ingredient at the strength it says. This is tightly regulated.

There may be variation in size and how well they stick, also some people itch with the adhesive in one but not another.

I would stick to one consistent dose continuously whilst you sort out an appointment with someone who is able to manage your care.

You are in iatrogenic menopause due to radiation- this warrants being referred to an NHS menopause clinic.

Chopping and changing all the time is likely to make things worse.

Half a 50mcg patch is unlikely to help anyone beyond a placebo effect, you may as well buy a box of plasters from Tesco.

50mcg is also sub therapeutic for most but is at least giving you something until you get sorted.

You can get a blood test from Medichecks, you don't need anyone's permission!

However unless you are on a consistent dose there's no point testing, it would be meaningless.

[Nas]

You have received sound advice.
Consistency is key; chopping and changing is a recipe for disaster I’m afraid!

You mention you want to see a specialist, but also had a zoom appointment with a specialist? What was the outcome of that? NHS waiting lists can be lengthy. Can you afford to put £250-300 on a credit card and see a MS face to face? If so, I  recommend Dr Paula Briggs. Accredited MS can be found on the BMS website.

Once post meno ( or induced menopause due to cancer treatment etc) bloods are irrelevant. It’s what you are actually absorbing which is key and you will have an idea of this, from how you are feeling day to day.

You need to decide on a regime and stick with it for a period of time.

As joziel said, GP’s can prescribe patches up to 100 or 4 pumps of gel, but menopause specialists can prescribe more and instruct GPs accordingly.

[alltheleaves]

You have received sound advice.
Consistency is key; chopping and changing is a recipe for disaster I’m afraid!

You mention you want to see a specialist, but also had a zoom appointment with a specialist? What was the outcome of that? NHS waiting lists can be lengthy. Can you afford to put £250-300 on a credit card and see a MS face to face? If so, I  recommend Dr Paula Briggs. Accredited MS can be found on the BMS website.

Once post meno ( or induced menopause due to cancer treatment etc) bloods are irrelevant. It’s what you are actually absorbing which is key and you will have an idea of this, from how you are feeling day to day.

You need to decide on a regime and stick with it for a period of time.

As joziel said, GP’s can prescribe patches up to 100 or 4 pumps of gel, but menopause specialists can prescribe more and instruct GPs accordingly.

Thank you , I do realise I need to stick with it , I think because I feel worse than when I started I was convinced it was the patch , when it’s probably my hormones dropping off a cliff , I have been referred to a specialist , but yeah nhs waiting is bad .
The zoom call didnt really address my specific needs , they just went through a list of symptoms and basically told me what I already know that I am going mental with symptoms, they said I could try another type but didn’t recommend which one , and sent me a letter for gp and some links , it would have been good for someone who is having trouble getting hrt prescribed.
They talked about libido and stuff which  I couldn’t care less about to be honest last thing on my mind when I am having nightmares and panic attacks in the night .

[Hurdity]

Sorry to hear about your difficult health experiences alltheleaves.

Although estradiol patches all contain the same active ingredient and a given dose eg 50 mcg from one brand should be identical to another, as they are different sizes and contain different total amounts of estradiol, then you could get a different amount from different brands depending how you absorb them. However as already stated, provided you stick with one brand you can eventually work out which dose suits you best, rather than changing.

I'm interested to hear you say that you were put into menopause by your radiation treatment, and wonder how this was confirmed? It's just that I read that radiation will damage the ovaries but that ovarian function sometimes resumes, and wondered if enough time has elapsed for the medics to know this in your case?

Be that as it may, the fact that they are not functioning now means you do need to replace oestrogen to a decent level, and as you say, your symptoms may well be related to the sudden fall in oestrogen ( and testosterone to a certain extent) following your treatment.

Although blood tests are not normally needed to determine oestrogen doses, it is recognised that they may be helpful in some cases such as yours where your ovaries have been damaged and you have no idea whether and how much you are absorbing, though perhaps more than one test would be good?

What was your cycle doing before before you had your treatment? Had you started skipping periods etc?

Hurdity x

[alltheleaves]

Sorry to hear about your difficult health experiences alltheleaves.

Although estradiol patches all contain the same active ingredient and a given dose eg 50 mcg from one brand should be identical to another, as they are different sizes and contain different total amounts of estradiol, then you could get a different amount from different brands depending how you absorb them. However as already stated, provided you stick with one brand you can eventually work out which dose suits you best, rather than changing.

I'm interested to hear you say that you were put into menopause by your radiation treatment, and wonder how this was confirmed? It's just that I read that radiation will damage the ovaries but that ovarian function sometimes resumes, and wondered if enough time has elapsed for the medics to know this in your case?

Be that as it may, the fact that they are not functioning now means you do need to replace oestrogen to a decent level, and as you say, your symptoms may well be related to the sudden fall in oestrogen ( and testosterone to a certain extent) following your treatment.

Although blood tests are not normally needed to determine oestrogen doses, it is recognised that they may be helpful in some cases such as yours where your ovaries have been damaged and you have no idea whether and how much you are absorbing, though perhaps more than one test would be good?

What was your cycle doing before before you had your treatment? Had you started skipping periods etc?

Hurdity x

My cycle was irregular but still there i had no other symptoms of menopause, i haven’t had a period since treatment.
I am desperate at the moment, I am confused and feeling hopeless, a week gone sunday I put a full evorel 50 on and since then my head went very spaced out feeling like my brain had been scooped out , i couldn’t go out and haven’t been out much since , I have bad ringing in my ears and my anxiety is constant, my insomnia seems to have got worse to point I have been in a and e with shakes and racing heart . They said take two 5mg diazepam to get some sleep and I am still struggling to relax it’s like my body won’t switch off , I am at doctors today and I don’t want to leave the house.
I don’t know if this is menopause or side affects or what , i was getting out the house a couple weeks ago it’s all so confusing and I feel like I can’t find any help anywhere, it seems everything causing me side effects, i am seriously sleep deprived for over two months.
I was sleeping better before the hrt but that was only 6 weeks after the radiotherapy, he said the level I got is going to cause a full menopause , I am wondering why J wasn’t put on hrt when I started so when I felt good on the morphine probably wouldn’t have thought anything of it .
A lady having same treatment as me was already on hrt she hasn’t the problems , I have at the moment.
I need advice how to get through the next few weeks as I know her isn’t a quick fix , my anxiety is constant and I can’t nap , can’t sleep , can’t eat very well . Have had 3 x5mg diazepam since yesterday and I still woke up in night anxious and shaky .

[joziel]

I think you need more estrogen. I have been where you are, when I first stopped desogestrel POP and went on HRT. What was interesting is that, at first, it seemed to get worse or more intense with each estrogen increase. I ended up in A&E after an entire night with zero sleep, just shaking through the night with heart beating fast. I was really wired.

I then thought I needed less estrogen, not more. That led to stopping the HRT, but the symptoms remained. Then I re-started it but was very very gradual about increasing - and this time, it seemed to do nothing at all. This was where I finally realised that I wasn't absorbing it very well and needed A LOT more.

When something sudden changes (for me, stopping desogestrel after 10 years on it, and starting all 3 hormones at once - for you, the radiotherapy) it throws everything into turmoil. It leads to huge fluctuations which in turn causes these symptoms. And no, it doesn't affect everyone the same. Otherwise there would be many more of us. But there are enough of us to know this is hormones...

Are you taking progesterone? How much and is it continuous? I would see if you can increase progesterone. It didn't help me, but it is the calming hormone and it has a sedative effect so it might help you.

Only increasing estrogen has helped me. But I know where you are, where it feels like it might be making things worse. The fact is that you are only on a 50mcg patch, which is the standard tiny dose they want to give women to have the bare minimum for symptom relief post-menopausally. But you have been thrown into sudden menopause and you highly likely need a high dose, because that is typical for women with sudden onset menopause. That's not even considering any issues absorbing it transdermally. Have you had estradiol blood tests, to see if you are able to absorb any of this 50 patch?

Estrogen functions like a neurotransmitter in the brain. When it cuts out, your adrenals try to compensate for it by making more adrenaline and cortisol. This leads to you not being able to sleep and lying awake with your heart pumping hard.

I would get some supplements which reduce cortisol and take them in the evening around 7-8pm. Ashwaganda, Alpha GPC and zinc are all good cortisol reducers and can be taken together.

I would really recommend you having a private consult online with the Newson Clinic so you can get access to the higher doses you likely need and increase very gradually. But be warned that it also takes time....