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Author Topic: Do post menopausal women need less estrogen? Therefore do we lower HRT dose ?  (Read 4469 times)

pepperminty

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Hi Ladies,

Just wondering about everyone's thoughts regarding levels of estrogen and HRT post meno.

Should we be going down to a lower level of estrogen in the late fifties when the peri stage has most likely stopped ?
I wondered what levels of estrogen those of use after the peri stage on average ?
Are we all on medium doses or mostly low doses?
The consensus is that post meno we need less estrogen.
 If so when did you decide to lower the dose post menopause and what were the reasons?
Did it make you feel any better?

PMxx
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Dotty

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Hi I’m post meno, 60 years old and I’ve been on 4 pumps of Oestrogel (high dose) for 7 years. I don’t intend lowering the dose . 😊
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Epona52

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Interesting question 🤔
I'm on the same, four pumps of gel, and a pea sized blob of testosterone, so I have wondered if it should go up or down in dosage, I think our own levels drop every year is that right but also do we have spikes in our own as some times of the day can feel very different as in moods etc..
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chopsuey

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I'm 6 years post meno and it took 4 pumps of Oestrogel to control my symptoms. I have no intentions of reducing that and hope the GP will continue to prescribe at that level. I don't absorb that well and my blood levels when last tested were only just about that needed for bone health. I feel pretty good on my current regime, so see no need to alter it. As far as I am concerned, HRT is for life!
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joziel

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If you are doing well, symptom-free and have no signs of excess estrogen like unwanted bleeding or sore boobs, there's zero reason to change anything.
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Fizwhizz

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I’m mid 50’s and increasing mine as still trying to get suitable absorption and enough oestrogen into my system to feel well and functional.
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pepperminty

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Hi I’m post meno, 60 years old and I’ve been on 4 pumps of Oestrogel (high dose) for 7 years. I don’t intend lowering the dose . 😊

Hi Dotty,

I agree- Why change whilst it works. Do you know your levels of estrogen, or whether you are a poor absorber or not?

PMxx
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pepperminty

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Interesting question 🤔
I'm on the same, four pumps of gel, and a pea sized blob of testosterone, so I have wondered if it should go up or down in dosage, I think our own levels drop every year is that right but also do we have spikes in our own as some times of the day can feel very different as in moods etc..

Hi Epona52,

I keep on reading that older women do not need a high dose - but what constitutes older I wonder? And what constitutes a recommended dose for older women ? Obviously we are all different, but there must be an average ?

PMxx
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pepperminty

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If you are doing well, symptom-free and have no signs of excess estrogen like unwanted bleeding or sore boobs, there's zero reason to change anything.

I agree, but there appears to be a lot of information indicating lower doses for older women. The Newson website states :
Will I need a lower dose of HRT if I’m older?
Older women often need smaller doses of oestrogen than younger women, and there are preparations of lower doses specifically for older women. The safest way to take replacement oestrogen is through the skin in a patch, gel or spray. Even a small amount of oestrogen replacement can often alleviate your symptoms effectively and provide you with the bone and heart protection you need.

It also says about remaining on an effective dose for symptoms.

PMxx



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Fizwhizz

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If you are doing well, symptom-free and have no signs of excess estrogen like unwanted bleeding or sore boobs, there's zero reason to change anything.

I agree, but there appears to be a lot of information indicating lower doses for older women. The Newson website states :
Will I need a lower dose of HRT if I’m older?
Older women often need smaller doses of oestrogen than younger women, and there are preparations of lower doses specifically for older women. The safest way to take replacement oestrogen is through the skin in a patch, gel or spray. Even a small amount of oestrogen replacement can often alleviate your symptoms effectively and provide you with the bone and heart protection you need.

It also says about remaining on an effective dose for symptoms.

PMxx

I find it all so confusing. Presumably by small dose they mean the smallest dose that a particular woman can get away with to alleviate her symptoms?  Which depending on many factors might not be a small dose even if she’s an ‘older’ woman. I’m currently on testosterone too and I know my levels of that for free testosterone are out of range but the testosterone in my body is at the low end of the normal range. I’m assuming my GP isn’t going to reduce my prescription as I’m not absorbing all that I’m taking. Having a similar issue with oestrogen too which is currently low.
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sheila99

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I'm inclined to think it's from the same book of fairy stories as the 'everyone is meno by 54' fable. Every time I've tried to reduce my symptoms return.
  It's possible it's true if you start hrt post meno.
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bombsh3ll

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I will be staying on the dose that enables me to thrive and which has evidence for preventing osteoporosis.

There is absolutely zero evidence supporting the commonly held belief that older women need less estrogen - whilst older women frequently receive less estrogen, this has nothing to do with their need.

It is usually a unilateral decision by the prescriber based on conclusions drawn from the flawed WHI study.
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Epona52

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I wonder how you can tell that you are post menopause when you have had a hysterectomy at 34, 'ovaries were left in'
I'm currently on four pumps of gel and a little testosterone but have in the last month experienced tender breasts and dry around nipples also bladder issues, just wish you could have light at the end of the tunnel  :(
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bombsh3ll

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I just wish you could have light at the end of the tunnel  :(

Menopause isn't a tunnel, it's a hole.

In your case you could get a FSH blood test done. If this is sufficiently elevated you can be considered postmenopausal.

However symptoms can occur long before FSH rises, and should be used to guide treatment.
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Epona52

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Thanks bombsh3ll,
Oh and I like that, definitely a hole that's deep with nasty little surprises in it all waiting to mess your life up :o,
I will ask about blood tests, always been told in the past that blood tests are unreliable and not good at showing what stage you are in menopause, it's more about symptoms being under control,
X
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