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[LuLuLu72]

Hello - I would be grateful for any advice please.

I have been on a fairly stable regime of 3 pumps of Oestrogel, Utrogestan daily for some time now, it has never controlled my anxiety or low mood but has always helped other physical symptoms. About a month ago I started getting hot flushes mostly at night, worse headaches than usual, joint pain.

I am 52.5 and have been getting regular periods but have not had my last one. I am hoping that they are going to stop and I guess my oestrogen is low. My GP won't do blood tests as in the past they have been very erratic.

Given the low oestrogen symptoms is it likely my HRT is no longer working?

Many thanks

[bombsh3ll]

I agree with your GP there is limited value in testing blood estradiol levels in perimenopause, and on gel.

However clinically you may well now be under treated given the return of symptoms.

As your own estrogen falls, it often requires an increase in initial dose to compensate for this.

The only way you will know is by trying an increased dose - making sure your endometrial protection is still adequate. 

[LuLuLu72]

Thank you for your reply. I am going to look at increasing the Estrogen dose with the Progesterone too. Seems a common problem with HRT, it seems to stop working or be less effective as time goes by :-)

[joziel]

You should easily be able to increase to 4 pumps of Oestrogel because that is within the licensed dose. If you need to go over that, you might need to go to a private clinic.

Personally, I had my normal physical symptoms controlled from just 2 pumps or 50mcg patch. The anxiety, the insomnia, the inner tremors and heart beating hard and fast through the night - all that only got better when I increased my estrogen a LOT.

I'm now on 200mcg patches and 4 pumps of gel at night. Things are not perfect but they are the way way way better, the best they have been since this all began about 3 years ago. No way I'd get that dose of estrogen on the NHS though...