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[Seasidegirl]

Clearly I will talk to my prescriber....

Many of my symptoms resolved on my existing dose of HRT (started May 2024, increasing Aug 2024) so anxiety,  overwhelm, gynae pain,  joint pain, insomnia are much better.

My fatigue was hugely improved initially but came back after 6 or 7 weeks.   I increased from 50 to 75 Estradot at that point which improved the other symptoms but had no impact on the fatigue or elevated heartrate

I'm pretty sure that I've got an underlying issue,  probably thyroid but despite having lots of tests,   no obvious source of the fatigue and heartrate is showing itself. 

I have tried increasing to 100 but only very briefly,  I'm reasonably reluctant to increase progesterone as I've only just managed to tolerate the full lower dose which has put me off going to the higher dose of oestrogen (I take P vaginally already and I'm not keen on the synthetic versions because of the slightly higher breast cancer risk)

I wonder if I am missing an obvious and that whilst the 75 dose is fine for most symptoms,  I need more for the remaining symptoms.   

Has anyone found something similar?  Really good control of most symptoms but not all....

Thanks

[Flipjango]

Can't you switch to a different product so you can increase the oestrogen but not the progesterone? Split them into different products?

[bombsh3ll]

It would not hurt you to have a time limited trial of say 3 months on the dose of estrogen that you feel would really benefit you, whilst keeping the progesterone the same.

After this, you can make a decision whether to drop back down or change the progestogen.

Anecdotally being on an adequate dose of estrogen, and adding testosterone as well if you have access to it, can make it easier to tolerate the necessary progesterone.

Or is a mirena IUS an option?

Alternatively, dydrogesterone doesn't seem to have a higher risk of breast cancer than micronised progesterone, and can be better tolerated as the chemical modification means it is effective at much lower doses.

It is only available in oral combination in the UK however.

[joziel]

If you think thyroid is a cause, then you need to investigate that really.

Have you done a full thyroid panel and can you post results with ranges?

Sometimes starting HRT can put extra demand on your thyroid hormones because the body needs more T3 (fuel) to use those sex hormones and get all functions up and running again.

[Seasidegirl]

If you think thyroid is a cause, then you need to investigate that really.

Have you done a full thyroid panel and can you post results with ranges?

Sometimes starting HRT can put extra demand on your thyroid hormones because the body needs more T3 (fuel) to use those sex hormones and get all functions up and running again.

Thanks,  yes I've had NHS thyroid testing and a full set of private bloods.     Everything is in range so Endo have refused to see me.    I'm waiting for a private Endo appointment. 

[Seasidegirl]

It would not hurt you to have a time limited trial of say 3 months on the dose of estrogen that you feel would really benefit you, whilst keeping the progesterone the same.

After this, you can make a decision whether to drop back down or change the progestogen.

Anecdotally being on an adequate dose of estrogen, and adding testosterone as well if you have access to it, can make it easier to tolerate the necessary progesterone.

Or is a mirena IUS an option?

Alternatively, dydrogesterone doesn't seem to have a higher risk of breast cancer than micronised progesterone, and can be better tolerated as the chemical modification means it is effective at much lower doses.

It is only available in oral combination in the UK however.

Thanks Bomb,  I think that is probably the sensible suggestion to give it ago, otherwise I won't know. 

That's really interesting about adding testosterone helping with tolerance of Progesterone, I moved to vaginal at the same time as starting Testosterone (I know two changes are unhelpful...) and I've tolerated it much better.   

I'm only taking 1 per day for longer a semi continuous regime but want to try to go back to a sequential regime with the higher dose.   Maybe having added T I might do better.

Thanks

[Seasidegirl]

Can't you switch to a different product so you can increase the oestrogen but not the progesterone? Split them into different products?

Thanks,  I have separate oestrogen and progesterone but the BMS suggest that a higher dose of progesterone should be taken with a 100 dude of oestrogen to ensure womb protection.