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[Sprat_Jax]

Disclaimer first: I have an appointment with my GP in a couple of days, and with Menodoctor in 4 weeks. I just want to see if anyone else has experienced this.
I started HRT a year ago. Started at 25mcg estrogen (and 100mg progesterone) and all symptoms abated until about a couple of months later, when I was then put up to 50mcg estrogen. This worked for 2-3 months and then again I had breakthrough symptoms. I saw Zoe at Menodoctor - she put me up to 75mcg estrogen and 200mg progesterone). She also did a blood test for my estrogen levels.
This worked nicely until about 3 months later I started getting breakthrough symptoms again - irrational anger, anxiety and bladder pain. Zoe sent me for a blood test, and despite going up to 75mcg of estrogen, my estrogen blood levels had halved. (gone from 190 down to 90). This explains why I've been feeling like crap and getting menopausal symptoms.
Has anyone had HRT stop working for them at a variety of increasing doses and what did you do? I don't understand why this keeps happening.

[Dramy3]

Hi
This happened to me. Pretty much the same scenario. I just wasn’t absorbing the patches consistently at any level. Switched to oestrogel and all sorted (for now at least!).

[chopsuey]

Sprat-Jax  - were you definitely post menopausal when you started HRT or do you think there may have been some of your own residual oestradiol, which is now tailing off? That said, 90 does seem a low level for a 75mcg patch, so there does seem to be an issue with absorbency. Agree with Dramy3 it might be worth switching to gel, which does seem to work better for some people.   

[joziel]

Sprat, even at 190 you weren't getting anywhere near enough estrogen. You need at least 250-270 just for bone protection and the benefits of HRT.

You will need much more than the max licensed dose, even with gel (I reckon). You are a poor absorber. Hopefully your private dr is happy to prescribe above the licensed dose....

My advice would be to increase the patches really, they are much easier to use high doses with than the gel. I have gone up to 12 pumps of gel/day and it's a nightmare applying 6 every morning and evening, takes ages to dry.

I'm now on 2x 100mcg patches plus 4 pumps of gel in the evenings. This is working pretty well although I might try switching to 3x 100mcg patches instead, the patches are just so much easier. You could try a different brand of patch, in case you absorb that better....

[Sprat_Jax]

Sprat-Jax  - were you definitely post menopausal when you started HRT or do you think there may have been some of your own residual oestradiol, which is now tailing off? That said, 90 does seem a low level for a 75mcg patch, so there does seem to be an issue with absorbency. Agree with Dramy3 it might be worth switching to gel, which does seem to work better for some people.

Hi - I'm not completely sure because I was on the birth control pill until I was 51 and I was stringing the pill packets together with no bleed. (As per instructions from my doc). At 51 my GP said I needed to come off the pill as it was the average age of menopause and they didn't know if it was safe to take the pill once you were in menopause. Within a couple of weeks of stopping I started having bladder pain (that's my worst symptom) and went onto HRT. I haven't had a period since.

[chopsuey]

Have you tried taking any vaginal oestrogen for your bladder pain?