Print

Please login or register.
1 Hour 1 Day 1 Week 1 Month Forever
Login with username, password and session length

[Tulip]

Hi everyone, I'm still here, still nowhere with HRT, and I can't work this out - a few weeks ago I increased my oestrogen to 125 and progesterone to 150mg a night, and my night sweats stopped immediately, so my gynae agreed to that, and increased my progesterone to 200mg to compensate. I've also now got some testosterone, which apparently has nowt to do with night sweats and flushes(?), and increased progesterone is meant to curb them.
Since then the night sweats are off the scale again and flushes are coming back. I've cut back the oestrogen to 112.5 and nothing has changed.
I'm absolutely at my wits end and would love to have your opinions please.

[CLKD]

Morning.  How much knowledge does the Gynaecologist have about peri-menopauses and the effects of different HRT regimes?

It may be that you need to trial a system to find out what works, then tell the Consultant.

Many do not do well on progesterone, what was the thinking behind the increase?

[bombsh3ll]

Sounds like not enough estrogen, I don't know if you are still in perimenopause but the original dose could have been enough with some of your own estrogen, but if this falls you are solely reliant on the HRT and may need more.

It sounds like you have quite a progressive gynaecologist if you are already on more than 100mcg plus testosterone so they may be amenable to you titrating the dose according to symptoms.

A blood test to check absorption might be worthwhile however this is more useful if you are postmenopausal, otherwise your own fluctuations can make it difficult to interpret.

[CLKD]

   bombsh3II - U should sit in every Surgery Consulting room ;-)

[Tulip]

I have no idea about their treatment of the perimenopausal side of things, I've been past that 4 years. I go to the menopause clinic at the hospital.
The prog was increased because my oest is now higher than 100mcg, apparently I'm now off license on 125,  so that has to be balanced. I had a couple of minor bleeds after increasing the oest, and it stopped when I added more progesterone. My GP told me to stop HRT for 6 weeks, but she's not well versed on menopause and has to look up the BMS guidelines, which in this case had been updated to say increase prog for breakthrough bleeds, but my GP didn't know. I didn't stop my HRT.
So that's exactly what I have been doing for 3 years, working it out and then discussing it with the consultant - nothing works for very long though.
I think I have just about every feckin symptom it's possible to get, and it's honestly driving me to despair, I haven't been able to work for almost a year because of bloody menopause. I've never cried so much in my life as I have done this past couple of years.

[Tulip]

Sounds like not enough estrogen, I don't know if you are still in perimenopause but the original dose could have been enough with some of your own estrogen, but if this falls you are solely reliant on the HRT and may need more.

It sounds like you have quite a progressive gynaecologist if you are already on more than 100mcg plus testosterone so they may be amenable to you titrating the dose according to symptoms.

A blood test to check absorption might be worthwhile however this is more useful if you are postmenopausal, otherwise your own fluctuations can make it difficult to interpret.

Not enough oestrogen, at 125mcg??
They won't do bloods, only for testosterone levels. I've been asking for two years.

[CLKD]

Sometimes even in a Menopause Clinic, gynaes don't know enough about the different HRT regimes 

Let us know how you get on.

[Tulip]

Sometimes even in a Menopause Clinic, gynaes don't know enough about the different HRT regimes 

Yeah that became apparent.. I've had 4 different consultants now. It seems like I educate myself as much as possible, use trial and error, and they just ok what I do. But nothing changes for long. I honestly am lost now, I can't just keep increasing the doses and never know what my levels are.

[CLKD]

Why worry about levels  replacement therapy should be used in order to feel better.  Surely that will depend where you R in the 'journey'?

[Tulip]

Because I have no idea how much I'm absorbing. I might get 75mcg worth of oestrogen with 125mcg patch for instance, who knows?
I just want some help. :_((

[CLKD]

MayB get a regime going and increase after i.e. 3 weeks 2 C how you feel?  Rather than over whelming your body all at once?   Blood tests are notoriously un-reliable .

Give the replacement time to work as well as noting down how much different/not you feel.  Then increase\decrease slowly?  Sometimes it takes the body time to uptake any new medication.

U could put your regime into the search box: individually: to read any appropriate threads, make notes ;-)

[Tulip]

That's what I have done really.
As far as I'm aware, blood tests are only unreliable for peri, not post meno.

[bombsh3ll]

If you are postmenopausal that makes a blood test more useful.

If someone is on a reasonable dose via a patch and still symptomatic then checking this is a good idea as some people are just not good absorbers through the skin.

Another reason to test is if you are on hormone therapy for osteoporosis prevention - you need to make sure you are above the minimum threshold shown to protect bones - cited on NHS material as 250pmol/L however prof Studd cites 300pmol/l.

I really struggled to keep patches on for more than half a day unless I used adhesive surgical dressings over the top.

If you can't get it done on the NHS and can afford it then getting a private blood test is another option.

[Tulip]

Thanks bombsh3ll. Yes, the bone density thing isn't something I like to dwell on, I still like the odd adventure you see, but I agree it's very important.

I keep patches on but I have to cover them in medical cling film,  or I scrub my skin raw trying to get the glue outline off.

[Joaniepat]

I keep patches on but I have to cover them in medical cling film,  or I scrub my skin raw trying to get the glue outline off.

The glue outline can be removed with baby oil on a cotton wool pad. Use small, circular motions and it comes off. Nail varnish remover will also work.
JP x