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Author Topic: HRT not working  (Read 16151 times)

Fizwhizz

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Re: HRT not working
« Reply #15 on: February 27, 2025, 10:35:16 AM »

My mood has definitely slipped. Last time my bloods were taken they were 230 ppmol for oestrogen and they’ve dropped to 180 ppmol on 50mg patches. I just seem to be poor at absorbing everything, including my thyroid meds. I’m also on testosterone now and my free testosterone is above the range but my other level is low end of within range. I’m going to stick another patch on as I just can’t be bothered with anything currently and feel flat, negative and low. I was definitely feeling better with slightly higher oestrogen. It’s helpful reading everyone’s different experiences.
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joziel

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Re: HRT not working
« Reply #16 on: February 27, 2025, 04:49:10 PM »

Fizwhizz, you should easily be able to increase up to 100mcg patches via any GP. 180pmol is really low, not enough for even bone protection or the health benefits of HRT. 280pmol is the bare minimum really... 
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Fizwhizz

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Re: HRT not working
« Reply #17 on: February 27, 2025, 04:58:41 PM »

Fizwhizz, you should easily be able to increase up to 100mcg patches via any GP. 180pmol is really low, not enough for even bone protection or the health benefits of HRT. 280pmol is the bare minimum really...

Thanks, I’ve stuck another patch on. I was a bit worried about the progesterone but I think one tablet of 100 mcg per day is still ok especially as I’m not absorbing well. I’ve definitely felt my mood drop so I wasn’t surprised to see my oestrogen levels have dropped. I’ll arrange a review and see what’s suggested. I really do feel very low and absolutely lacking in any interest in anything whatsoever and clearly am not getting any other benefits at these levels either. 
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joziel

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Re: HRT not working
« Reply #18 on: February 27, 2025, 11:15:36 PM »

Yes, at that low level your P should be fine where it is. If you manage to get to the dizzying range of 400pmol you might need to consider an increase.

You might need some testosterone as well, if you are finding you have no interest in anything. For me, that is very T related... Libido is not just about sex, it's about creativity and investment in life etc.
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Fizwhizz

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Re: HRT not working
« Reply #19 on: February 28, 2025, 07:51:26 AM »

Yes, at that low level your P should be fine where it is. If you manage to get to the dizzying range of 400pmol you might need to consider an increase.

You might need some testosterone as well, if you are finding you have no interest in anything. For me, that is very T related... Libido is not just about sex, it's about creativity and investment in life etc.

Thanks, somehow I doubt I’ll be getting to 400 pmol, based on previous experience but we’ll see! I’m already on testosterone and my free testosterone is out of range but my systemic levels are just in the low end of the range. I seem to be generally poor at absorbing/converting everything. Testosterone definitely makes a difference but obvs I need my oestrogen levels up as well to feel better and get rid of this horrible feeling of apathy.
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Turtle45

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Re: HRT not working
« Reply #20 on: February 28, 2025, 06:06:17 PM »

I’ve had a blood test which shows estrogen is high, progesterone is low and LH and FSH are really low. Does anyone know if this means anything? Thanks x
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joziel

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Re: HRT not working
« Reply #21 on: February 28, 2025, 07:04:48 PM »

You need to post the actual numbers. Otherwise that's pretty subjective and meaningless. You have a legal right to the actual results.
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Fizwhizz

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Re: HRT not working
« Reply #22 on: February 28, 2025, 08:22:28 PM »

I’ve had a blood test which shows estrogen is high, progesterone is low and LH and FSH are really low. Does anyone know if this means anything? Thanks x

I’m assuming you’re peri menopause Starfish? So trying to balance hormones when they’re shifting around isn’t easy either. Sometimes adding extra oestrogen in can actually cause symptoms. As Joziel says you need your test results to try and understand what’s happening.
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Turtle45

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Re: HRT not working
« Reply #23 on: February 28, 2025, 10:48:46 PM »

Estrogen was over 1000. Progesterone 0.9 and FSH and LH both around 0.4
If that means anything to anyone!
I’ve had lots of peri symptoms so I believe so.
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joziel

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Re: HRT not working
« Reply #24 on: February 28, 2025, 11:34:56 PM »

What day of your cycle was that test taken on? It could well be your own estrogen spiking and contributing. This is one of the problems with doing tests during peri. I tend to do at least 2-3 tests and see what the average is and if results are consistent, before I adjust any dosages - otherwise it's just a moving target. I test myself, because I don't think my doctor would agree to test that often.

It's also worth considering contamination. Was the blood drawn from an arm you apply gel to (if you use gel)? Did you apply gel the morning of the test? (It is best not to, since it peaks a few hours after application.)

It's fine (good) that FSH and LH are both low. That suggests that your body is getting enough estrogen.

However, progesterone being low isn't good. What dosage are you on and how are you taking it? Was this taken whilst you were on progesterone? (In the last 2 weeks if on sequential?) The NHS ignores progesterone results - I think because the test is not reliable if you take progesterone orally (which most women on HRT do). It is only reliable if you take it vaginally and rectally. However, if you take it orally it will instead read metabolites produced by the liver as progesterone proper - which they are not. This means you will get a falsely high reading. Your reading isn't high which means your real levels could be even lower. I'd increase progesterone dosage if I were you and also consider taking it vaginally if you're not already as this leads to better absorption.
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Fizwhizz

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Re: HRT not working
« Reply #25 on: March 01, 2025, 08:40:33 AM »

Estrogen was over 1000. Progesterone 0.9 and FSH and LH both around 0.4
If that means anything to anyone!
I’ve had lots of peri symptoms so I believe so.

Good advice from Joziel. When you say HRT isn’t working anymore what are your specific symptoms? Have you looked at the symptoms of oestrogen dominance? Do they correlate? I had problems on HRT in peri as my own oestrogen spiked hugely and adding in extra sent me loopy. I remember in peri the aim was to try and balance the hormones out more so as Joziel says the low progesterone could be your issue. Alternatively have you had your thyroid checked? This can go out of whack too.
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Turtle45

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Re: HRT not working
« Reply #26 on: March 01, 2025, 08:50:16 AM »

@joizel really appreciate the advice. I’m not having a cycle because I was put on the progesterone pill. How do you do your own testing?
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joziel

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Re: HRT not working
« Reply #27 on: March 01, 2025, 06:38:56 PM »

Yeah my thyroid is messed up in all this too, although that's a long story. But I'm now on both T4 and T3.

I don't understand, Starfish, when you say 'I'm not having a cycle because I was put on the progesterone pill'. Remind me what you are taking? Are you taking utrogestan as well as a synthetic progestin? Or just the synthetic progestin?

If you're taking a synthetic progestin, then it will most likely be suppressing your own ovaries and it's less likely that the estrogen is from you - although the effects vary depending on the pill, with some more suppressive than others. (Desogestrel prevents ovulation and is more suppressive than levonorgestrel for eg.)

But it's really not surprising your progesterone is low if you're on a synthetic progestin. Most of them prevent ovulation, that's how they work. If you don't ovulate, you won't produce any progesterone of your own. Progesterone is made from the corpus luteum at ovulation. There is no corpus luteum without ovulation. There is no ovulation on the majority of synthetic progestins... That's how they are birth control.

Really if you want to balance your hormones and get some body identical progesterone, you need to take utrogestan. You can take that as well as the synthetic progestin if you want although ideally you wouldn't. Why are you on the progestin?

As for the testing, the best option I think is the Tasso Female Hormones test with Randox Health. It costs about £45, you do it at home and because it takes blood from your shoulder/arm, it avoids the issue of finger tip contamination. So as long as you don't put gel on your upper arms, you will avoid a contaminated result.
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Turtle45

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Re: HRT not working
« Reply #28 on: March 01, 2025, 09:30:08 PM »

Thank you so so much for all the information. I really appreciate it. Drs do not tell you enough and I know very little about the pill as when I first went on it in my teens I had lots of side effects.
When I first became anxious I was convinced it was peri because of all the other symptoms. I went to newsome health who put me on utrogestan and Estrogel. At one point they tried me on large amounts of cyclogest (1600!) instead of utrogestan as a number of years ago a study suggested it possibly helped PMDD but i was all over the place.
I truly believe peri kicked off my anxiety but I wonder now if the anxiety is there because everything then fell apart.
Thanks for the info on the testing. I’m thinking I might come off the pill and then try to see what my baseline is.
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joziel

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Re: HRT not working
« Reply #29 on: March 01, 2025, 10:06:03 PM »

So you never came off the pill, even when on the utrogestan and gel from Newson Health? What is the name of the pill you're on?
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