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[CrispyChick]

Thanks for all the advice.

Bomb the reason I wanted to ensure my E level was high enough was to now prove my horrific symptoms are not hormonal levels.

I was just getting iller and iller and iller on the HRT and cm. Just as I did last year on the various pills i tried. No way could I continue for another 3 months. I now want it all out of my body. This is not a case of stabilising at a hormonal level. Unfortunately.

[joziel]

Woah, Crispy... I was like 'hmm, interesting' reading your post... until you came to the conclusion to stop it all 

I mean, surely if you have noticed a huge improvement in your joint pain and then you've tested your E and found you're in the 600s, that actually proves (or at the very least suggests) that getting your E up will help your symptoms? (At least some of them!!?)

It's very true that the increase may not be due to the patch, it might be that your own body has produced some - but wherever it has come from, a high level has correlated with an improvement in your symptoms?

I would really just focus on increasing according to your symptoms and not even thinking about bloods except checking very occasionally to be sure you are not going stratospheric with levels. (Like above 1000pmol.) You are not anywhere near that at 600...

Really the goal is to even out the lows so they are not too low. Because most people reckon that's what causes the symptoms. Which is why there might sometimes be higher results.  For example, I asked ChatGPT if a woman can spike high with estradiol even during her period if she is peri-menopausal. Chat GPT said:

"Yes, it is possible for estradiol levels to spike during a menstrual period in a peri-menopausal woman. Perimenopause is a transitional phase where ovarian function becomes irregular but is not yet completely shut down, leading to fluctuating hormone levels. Here’s why this can happen:

1. Irregular Ovulation

   •   During perimenopause, the ovaries may occasionally release eggs sporadically, even outside the typical ovulation window.
   •   These sporadic ovulations can cause temporary surges in estradiol production, even during what might seem like the menstrual period.

2. Erratic Hormonal Feedback Loops

   •   The hormonal feedback system between the hypothalamus, pituitary gland, and ovaries becomes dysregulated in perimenopause.
   •   This can result in unexpected rises in follicle-stimulating hormone (FSH) or luteinizing hormone (LH), stimulating the ovaries to produce estradiol unpredictably.

3. Residual Follicular Activity

   •   Even if ovulation does not occur, small follicles in the ovaries may still produce estradiol. During perimenopause, these follicles can function erratically, leading to occasional surges in estradiol."

So I really wouldn't think too much about serum levels or adjusting dosages unless and until you are consistently and always getting too high results....

[CrispyChick]

" I mean, surely if you have noticed a huge improvement in your joint pain and then you've tested your E and found you're in the 600s, that actually proves (or at the very least suggests) that getting your E up will help your symptoms? (At least some of them!!?)"

I'm afraid not joziel. I'm probably not being very clear on here.

To cut a very long story short I've been in hell for 7 years. So many tests. Nothing found. I have always believed it is hormonal. I have messed soooo much in this last few years - paid out £££ for help. All fruitless.

The chem menopause is extreme but I was convinced it would work. Alas no. As I hurtled into menopause all my awful ill symptoms came on full force.

I developed new symptoms of classic meno - hot flushes and severe joint pain. It is important to note I had no low E symptoms before. Never had joint pain.

Then I realised I needed to get to sufficient E to ensure I was simply battling low E. Hence the shifting up the patches and this post.

But that conclusion was reached in a matter of days. Defo absorbing. Joints 70% better.

But me...I feel iller and iller. Very very ill. It's not tolerable. Now when I add/remove hormones I get worse and worse - I now know for sure these 'reactive' symptoms are nothing to do with hormone levels. Incredibly hard to explain, but takes me to a point where I feel so vile and ill.

I have been worse on this process than on nothing (and I do now get some wild peri symptoms - obvs they have gone in cm). The same thing now happens when I start or stop a pill. I get very very ill. When I stop it's like a steroid withdrawl. It's not normal. It's not low D or high E. It's taken this awful experience to prove that.

It's not normal and it is most definitely not something I can sit on for another 3 months.

If it was 'just' about hormonal levels I'd have cracked it this week and been sailing. Gutted doesn't come close. I'm broken and traumatised by the whole thing.

Hope that explains. X

[joziel]

It sounds incredibly complex Crispy. I hope you find some answers. Have you had a full thyroid panel run, including T3 and rT3? Those symptoms can be v similar to sex hormone stuff and can also intersect with the sex hormone stuff. I am trying to navigate it all as well with a lot of guesswork...

[CrispyChick]

I have indeed. Yes.

But I'm off to endocrinology next. 

[joziel]

Good luck with that. Is that privately or via NHS?

Because I've been told I should also see an endo but for various reasons it would probably need to be privately and so I am umming and ahhing because I really don't think it's going to go anywhere ultimately but will just be very expensive...

[CrispyChick]

NHS joziel.

I'm not overly optimistic either.

[flo69]

Crispychick, Tibolone, have you tried it?

It's one dose fits all, one pill a day, on the NHS.

It is a progestin which is given to women who are intolerant to other progestins because the form of it is very different and you just feel better.

None of this nonsense of feeling better for two weeks then awful for two weeks.

I've been on it ages and I don't understand why posts suggesting it are shall we say, discouraged? Only on this forum/business platform, I don't know the reason.

I think it is the best thing since sliced bread.

[bombsh3ll]

I agree tibolone is a great option for some, and very underutilised.

I have certainly seen people thrive on tibolone and am interested in it for myself once I no longer need menstrual suppression.

There has been a lot of social media evangelism around bioidentical and transdermal options in recent years, which are great but will never meet everyone's needs as we are all different.

I don't know if tibolone is particularly disapproved of on this forum but I feel the disparaging of oral and/or synthetic options more generally has led to people feeling like they have to struggle on with treatment that is messy, inconvenient, expensive, doesn't stick, poorly absorbed and causing unpleasant side effects.

[CrispyChick]

Right now I need to stop everything.

I asked my consultant about tibolone, as I noticed the majority in a chem meno FB group seem to be given it. Sometimes if doesn't seem strong enough for many though. But that's those in cm, not natural meno.

I was told there's a higher incidence of migraine, which is why I was started on patches.