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Menopause Matters magazine ISSUE 81 out now. (Autumn issue, September 2025)

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Author Topic: New HRT user, a bit of advice please?  (Read 1073 times)

caitlinH

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New HRT user, a bit of advice please?
« on: November 22, 2024, 03:31:37 PM »

I started taking Micronised Progesterone orally (1 x 100mg tablet as recommend by my doctor) and 1 pump of Estrodial (750 milligrams) 9 days ago and ticking along nicely. I haven't woke up with a really bad night sweat for years but last night I did, is this normal? It kind of feels like a step backwards. should I monitor and if they carry on does this mean some kind of imbalance between the progesterone and the Estrodial, should I adjust? if so is it more Estrodial I need?

TIA
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CLKD

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Re: New HRT user, a bit of advice please?
« Reply #1 on: November 22, 2024, 04:09:23 PM »

 :welcomemm:

Some find that keeping a mood/food/symptom diary of use, you are in early days.  Hopefully some1 will be along with advice about HRT in general.

Browse round.  Make notes. Ask away.
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bombsh3ll

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Re: New HRT user, a bit of advice please?
« Reply #2 on: November 22, 2024, 04:57:55 PM »

1 pump of gel is a low dose and there is certainly scope to increase, however the general advice is to give a new hormone therapy regime 3 months to settle in before making adjustments, unless there are intolerable side effects.

I wouldn't think about it in terms of balancing the estrogen against the progesterone, it is more a case of finding the dose of estrogen that meets your needs and then making sure the progestogen is sufficient to prevent bleeding and endometrial hyperplasia.

100mg of micronised progesterone daily is adequate for 1 pump of gel, but if you plan to increase the estrogen don't do this alone without speaking to your prescriber.
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caitlinH

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Re: New HRT user, a bit of advice please?
« Reply #3 on: November 23, 2024, 12:03:54 PM »

1 pump of gel is a low dose and there is certainly scope to increase, however the general advice is to give a new hormone therapy regime 3 months to settle in before making adjustments, unless there are intolerable side effects.

I wouldn't think about it in terms of balancing the estrogen against the progesterone, it is more a case of finding the dose of estrogen that meets your needs and then making sure the progestogen is sufficient to prevent bleeding and endometrial hyperplasia.

100mg of micronised progesterone daily is adequate for 1 pump of gel, but if you plan to increase the estrogen don't do this alone without speaking to your prescriber.

great advice, thank you!
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CrispyChick

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Re: New HRT user, a bit of advice please?
« Reply #4 on: November 23, 2024, 01:37:40 PM »

Hi

I don't have any real advice as I'm going through the same. But thought that was maybe useful.

I'm two weeks into my HRT dose and I too felt my flushes increased. I'm seeing no improvement in my low E symptoms and I have a ton of start up side affects on top.

I'm quite an extreme case and I'm also in chemical menopause. So my E is now zero underneath.

And what I will say is I used to get night sweats a lot. But since being in chemical menopause, with no estrogen, I only get flushes. No sweat at all.

So I think sweat must be fluctuations - for me. Rather than low E. And by adding in HRT you're creating a fluctuation 💁

Also my specialist said, whilst it's 3 months to fully settle, it's 4-6 weeks to gauge if it's the right dose.  ;)

Hope that's helpful. X
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caitlinH

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Re: New HRT user, a bit of advice please?
« Reply #5 on: November 24, 2024, 03:04:11 PM »

Hi

I don't have any real advice as I'm going through the same. But thought that was maybe useful.

I'm two weeks into my HRT dose and I too felt my flushes increased. I'm seeing no improvement in my low E symptoms and I have a ton of start up side affects on top.

I'm quite an extreme case and I'm also in chemical menopause. So my E is now zero underneath.

And what I will say is I used to get night sweats a lot. But since being in chemical menopause, with no estrogen, I only get flushes. No sweat at all.

So I think sweat must be fluctuations - for me. Rather than low E. And by adding in HRT you're creating a fluctuation 💁

Also my specialist said, whilst it's 3 months to fully settle, it's 4-6 weeks to gauge if it's the right dose.  ;)

Hope that's helpful. X

I'd never heard of chemical menopause until you mentioned it, I did a quick search but don't really understand what it is?
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bombsh3ll

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Re: New HRT user, a bit of advice please?
« Reply #6 on: November 24, 2024, 03:49:07 PM »

Chemical menopause = when medication is given to put the ovaries to sleep temporarily.

It is reversible.

Estrogen levels never get as low as if the ovaries have either been removed or menopause has occurred naturally, however menopausal symptoms can be experienced.
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CLKD

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Re: New HRT user, a bit of advice please?
« Reply #7 on: November 24, 2024, 03:56:42 PM »

If the stump of the ovary is left behind at surgery, it may generate a hormone burst occasionally.
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CrispyChick

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Re: New HRT user, a bit of advice please?
« Reply #8 on: November 24, 2024, 04:04:05 PM »

Yes. As bombshell says a medication to put the ovaries to sleep.

It works very very very quickly. So whereas natural menopause sees a decline of hormones gradually, chemical menopause acts within 4 weeks.

Sorry bombshell, but it does indeed take hormones exceptionally low, just like surgical menopause. It doesn't leave them higher. On my bloods at only 4 weeks in my estrogen was less than 18. And menopausal symptoms are in full impact. Most add hrt back in. The aim is to stop fluctuatuons for things like pmdd. Or to reduce estrogen for endo pain.

It's brutal. It's often tried before surgery. As, yes, it's reversible.
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