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[Gilla999]

Hi Joziel - yes it was Zoely I tried previously. According to the studies I've read the average steady state of Estrogen while on it is circa 130 pmol, which is relatively low. When I went onto it previously I was already suffering from cyclical terrible low Estrogen (in my luteal phase only) so it's not totally surprising to think reducing my overall average Estrogen levels would have caused me to still be symptomatic! Though why it was only every 3-4 weeks I'm unsure and does indicate maybe I was still having my own hormonal fluctuations, but it's possible 3 months just isn't enough time for it to fully steady your own hormones. I think knowing now that I can top up with HRT (whether permanently or when needed as you say) I hope to stand a better chance of it helping. The fact I'm now starting it from a place of not having suffered from low Estrogen issues for ages is also a positive thing.

I think the trickiest bit is going to be getting on it in the first place, as any hormonal increase or decrease of either Estrogen or Progesterone causes terribly allergy symptoms in me since Covid (might just be a coincidence) which is a big part of my overall issues. Hopefully I'll be able to bear the initial hump!

[bombsh3ll]

Gilla were you taking the 4 yellow placebo pills in the pack of Zoely?

That would certainly explain feelings of low estrogen every 3-4 weeks.

I pop them out and bin them at the start so that I don't accidentally take them.

I went straight from 2*cerazette daily onto Zoely so I can't speak to how long it would have taken to shut me down.

I had lost access to my previous combined pill during the pandemic and could only get cerazette for a while. One of those daily did nothing for me, I continued to bleed monthly and developed a hormonally active cyst on it with estradiol of 7000 pmol/L. I then went onto a double dose daily for a couple of months which completely stopped my periods and allowed the cyst to resolve.

My estradiol level right before switching to Zoely was around 100pmol/L and my ovaries were really quiet on ultrasound, no follicular activity.

I was actually comfortable physically and psychologically on double desogestrel and not suffering in any way from the low estrogen, however I chose to go back on a combined pill as I was not happy to live long term with low estrogen for health reasons.

[Gilla999]

Thanks for confirming Bombshell - I guess we were / are in quite different states going into it then as my Estrogen levels are consistently high, but I'm still hopeful that I'll be able to top up with HRT and not have problems from the drop. No, I never took the placebo pills, I went straight through on active pills. The bouts of terrible night sweats and 3am insomnia that I got every 3-4 weeks (my classic low Estrogen issues) were always accompanied by cramps too, so it really did feel like my body was periodically trying to do something. Maybe if I would have taken the placebo pills it would have got more into a rhythm and avoided that, or maybe 3 months just wasn't long enough to shut down my own ovarian function entirely. Time will tell - I can only give it a try and hope for the best! Thanks very much for all the advice xx

[joziel]

Wise bombshell... I was on desogestrel for about 8 years after my laparoscopy for endo, with the goal of suppressing the endo. It worked. I did bleed slow brown sludge for what felt like ages but then it stopped finally and I hardly ever bled at all and when I did it was incredibly light. I did several times worry about the low estrogen levels on it but I never got my levels checked. I was on just the one dose of 75mcg, not double dose.

Before desogestrel I had tried to go back to the levonorgestrel POP which is what I'd been on for another 10 years earlier in my life without any problems. But on that one I just bled and bled and bled constantly for months and it really didn't stop. I preferred that one because I thought it shut down my own ovaries less and would leave me with more estrogen as a result. But I couldn't use it. No idea why it worked so well earlier in my life but then I couldn't stop bleeding on it when I went back to it. I really did give it ages, like 8 months or something!!

Gilla, I think I'm not sure why you want to try Zoely rather than oral HRT? (If that's the way you want to go.) I mean, the estrogen in the Zoely isn't high dose and you suspect you will need to take more. Is it just to get access to the progestin? Is that not available as a separate progestin for HRT purposes by itself?

And if you get allergy symptoms, have you investigated histamine intolerance and the work of Dr Tina Peers? Sorry if I've mentioned that to you before...

[Gilla999]

Yes that's why Joziel - the progestin in Zoely is the newest generation which was virtually side effect free when I tried it before, where as I've never been able to tolerate any other synthetic contraceptive pills. I tried the whole range when needing contraception in my 20s and early 30s and couldn't tolerate any - Zoely was very different. I would also prefer to take the bio identical form of Estrogen contained in Zoely rather than Ethinyl Estradiol contained in all other birth control pills (except for Qlaira). It is safer and again has less side effects.

I'm very familiar with Tina Peers but haven't actually ever seen her - I was under the came of Immunology at Guys & St Thomas's for about a year before being discharged. I don't have a lot of the markers of Histamine Intolerance (did quite a lot of reading up) it does just seem to be some kind of allergy connected to / triggered by hormone changes. I was fine for the first year on HRT but it all started two days after the Covid booster and worsened after Covid. It has now improved to a point where it's mostly manageable, so I'm just hoping Zoely doesn't trigger a flare up 

[joziel]

Well good luck and let us know how it goes. It sounds like a good plan if you need that progestin, even if you also need a couple ultrasounds because you want to add extra estrogen in. Hope you've found the answer for you...

[bombsh3ll]

My estradiol on Zoely is 390pmol/L.

Bearing in mind I was producing 100pmol/L endogenously despite a suppressive dose of desogestrel.

Assuming a similar level of endogenous production with the suppression achieved by the progestin in Zoely, this gives me 290pmol/L from the 1.5mg of oral estradiol it contains.

Obviously this can vary between peaks and troughs over 24,hours but I've had a few tests with very consistent results.

Data on thrombosis risk is also very reassuring.

[Gilla999]

That's interesting and actually reassuring Bombshell - that kind of level would mean I'd need to top up much less. As you say I realise every lady is individual though.

[joziel]

Pretty good. More than I was getting from 12 pumps of gel. 3x the max licensed dose. SHOCK HORROR.

It's such bollocks.

[bombsh3ll]

I believe there is far more individual variability in absorption and metabolism of most drugs tbh than the manufacturers admit or even know about, and certainly more than prescribers assume.

[Gilla999]

1000% agree with that statement Bombshell. I've scoured many reports on medications and the trials relating to various medications (I always like to do thorough research before starting anything) but they only ever provide an average blood level, they don't detail how much variation there is from that average. Joziel I have the opposite problem from you in that transdermally I absorb so much more than the average person, and it annoys me when people mock me for my 1/4 of a 25 patch. I know from many experiments that I get about 200pmol from that, which is way way more than the average given. I also absorb much more Progesterone transdermally than normal - I read in a couple of studies that that's normal - if you're a high or low absorber it's of everything, not just one thing