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[YellowSunflower]

Hello,this is my first post and I truly hope someone can help solve this riddle of mine.
One hour after applying my oestrogel I feel extreme exhaustion,it happens every single time and I do not know why.
Progesterone does not make me feel tired,it does not make any difference to the way I feel,but I decided to take x2 tablets instead of one at night and that made me feel happier,not hyper ,not tired just happier.
I will tell you a little about me and my journey.
I am 48,post menopause (well I was only having x2 periods per year).I have been prescribed oestrogel and utrogestan continuous(I take 2 pumps and 100mg utrogestan per day-had to change my oestrogel application to nighttime because it simply causes me extreme fatigue.Im currently into my 4th month of this routine.
More or less the same time as starting the hormones I was diagnosed with hypothyroidism so I now take 100mg of levothyroxine.
I've only been able to find a couple of people on line that have this reaction to the oestrogel and both were trans people who had had there testosterone suppressed,so that didn't feel like it related to me,but it was strange that they had exactly the same issues as myself.
I am really hoping that someone understands what is going on with me and can help me please.

[bombsh3ll]

I cannot explain it, but the human body is a peculiar thing that we don't understand nearly as well as we like to think we do.

Certainly with gel though the pharmacodynamics are different than with patches or tablets with a very sharp initial spike, and your symptoms certainly fit time wise with when you would be expected to peak after applying gel, so you may find you do better on another formulation.

Patches give the most stable levels with no initial spikes. Tablets do create a peak and trough but nowhere near as dramatically as gel.

[YellowSunflower]

Thank you so much for your reply.It did not even cross my mind to think it could be a spike,I just assumed I was odd-as in everyone is saying estrogen gives you energy and progesterone makes you tired but I'm the opposite.So I should try a patch as it's slow release,that's a good idea.Ive ordered a hormones test to see if I'm lacking in testosterone and I've also ordered a full thyroid panel test.Can I ask do you have any idea why adding an extra utrogestan made me feel happier?I was thinking maybe I have none or an extremely low reserve and even though I'm only taking two pumps of oestrogel it's not balancing -its so confusing.I was also thinking that maybe the estrogen is making my thyroid function weaker and maybe the extra progesterone is helping my thyroid,that why I feel better on more progesterone.Its so frustrating trying to figure it all out and I know of I asked the doctor (in the 5 minutes you get with them)he would tell me he doesn't know and can't do any tests .

[dangermouse]

I also feel exhausted if I try exogenous oestrogen, like someone has just given me a sedative. Progesterone makes me feel energised so, as I sometimes take prog cream only, I take it on the morning because of the energising effect.

I have a feeling it’s all linked to cortisol metabolism as I have had similar lethargy, anxiety and nausea from having steroid eye drops the last few weeks, that I also get from oestrogen. I also had the same in peri when my own oestrogen would spike through the roof.

[YellowSunflower]

Thank you for your reply.So it could be an issue with cortisol -so the estrogen would always make you feel this way ,even using a different form like a patch?do you take your estrogen at night like I am having to do?have you ever had your hormone levels checked?I just don't really know where to go from here-i mean should I just stick with the gel or should I try patches?can I combat the tiredness if I introduced testosterone or does testosterone effect cortisol?Sorry about all the questions,you see I was lacking energy/motivation before I started hrt and I just expected to get a boost from the estrogen,not for it to make me feel extreme exhaustion.

[bombsh3ll]

If you are taking the progesterone orally it is largely metabolised to allopregnanolone, which acts at GABA receptors.

This is similar to taking diazepam, which some people could easily experience as a happy feeling. Others report feeling sleepy or groggy

[YellowSunflower]

I take it vaginally,but I definitely find taking 200mg rather than 100mg better in the way it makes me feel,it's not a tired feeling at all,just relaxed and happier(hard to explain).

[SundayGirl]

It's common that ladies need to tweak their thyroid meds when adding in HRT. Some need an increase, some need a decrease.

Things can get confusing as this time of life as menopause symptoms can overlap with thyroid symptoms.

As you've started more than one thing at once you can't know for definite what is causing any issues. You'll probably get more clarification when you've got the blood results back. 

[dangermouse]

Thank you for your reply.So it could be an issue with cortisol -so the estrogen would always make you feel this way ,even using a different form like a patch?do you take your estrogen at night like I am having to do?have you ever had your hormone levels checked?I just don't really know where to go from here-i mean should I just stick with the gel or should I try patches?can I combat the tiredness if I introduced testosterone or does testosterone effect cortisol?Sorry about all the questions,you see I was lacking energy/motivation before I started hrt and I just expected to get a boost from the estrogen,not for it to make me feel extreme exhaustion.

Yes I react badly to all oestrogen so I do not take it. My levels of both P and O are low but my ratio of progesterone to oestrogen is more the issue where P is much too low, even though post menopausal. I suspect that testosterone may also affect cortisol, it would only be a guess though given it’s stimulant nature.

If you feel better with more P then you may need more of that and less O for better balance.

[YellowSunflower]

Thank you Sundaygirl and dangerous(I used to love dangerous as a child,never missed one).Anyway I diverse -yes I did wonder what is causing what but I definitely know estrogen cuts me down in my track with extreme fatigue,it's only after I apply the gel and it's about an hour after so no denying it.I do also think that the estrogen gel definitely does make me feel weaker overall which is why I think it is also effecting my thyroid (but doctors are always reluctant to increase your medication,even though you have symptoms and you know your own body).
Dangermouse I do think I should either stop the estrogen or try a different type-my main reason for wanting to keep using it is because a month before I went on it I had an X-ray on my hands,wrists and neck and I have the mild osteoarthritis,also was diagnosed with high blood pressure,oh and that another thing the estrogen drops my blood pressure down into normal range,so I've stopped one blood pressure tablet and I'm only on a low dose of another one ,which I want to stop if I can keep on with an estrogen.Its give and take but I hate feeling tired and weak on the estrogen but it seems to be protecting me from my other ailments ,my wrists,hands,neck are also not as stiff/painful.

[YellowSunflower]

I forgot to add-to dangermouse:is it ok to take continuous 200mg of utrogestan?as in health risks?I am obviously going to talk to the menopause nurse,but she is always busy so that won't be for a while but I do have enough utrogestan to carry on with 200mg for now.Also do you know if progesterone has health benefits apart from keeping the lining thin? obviously all the talk is about estrogen but surely progesterone must have a few benefits.Thank you for helping me ,I truly appreciate it.

[Elissa]

I wonder if like me, 2 pumps of estrogel is too much for you?

My GP explained that 2 pumps is the standard starting dose but suggested I start on only 1.  I was very happy on 1 pump but trialled 2 pumps (for a very short period, granted) and I quickly reverted back to 1 pump because of the fatigue it caused.

I saw your post and thought that sounds like me! Of course I could be wrong but with the gel you can easily reduce the dose to see if that is the problem?  Might be worth a try before changing to patches or something else.  Best of luck resolving it 

[joziel]

Instead of trying to guess whether you have too much or too little, why don't you get your bloods tested? Don't apply the gel the morning of the test or you will just be testing the false immediate peak after it. And be sure not to apply it anywhere near where bloods are taken from. (I prefer to put it on my thighs and not arms for that reason.)

If you want to test yourself, Randox offer at home blood testing using a device called the Tasso which goes on your shoulder to take the blood and avoids finger prick contamination issues. (As long as you don't rub gel in your upper arms...)

Really, if you have mild osteoarthritis and high blood pressure, this would suggest you are not getting enough estrogen. If you have started thyroid meds, again, there can be more demand for estrogen now. The human body is weird and sometimes giving it a little bit of something - but not enough - leads to symptoms which you don't have without any of it (if that makes sense).

2 pumps of gel is the basic starter dose and is a pretty small dose really. I would suggest you get tested, ensure your levels are 300pmol +. If they are not, you don't have enough estrogen.

You can try the patches for sure, the more consistent steady release might help. Or you can take the gel AM and PM. (You could try that now, if you wanted - rather than 2 pumps at night, try 1 pump in the AM and 1 pump at night....).

[YellowSunflower]

Thank you ellisa and joziel.
Ellisa- I did revert back to one pump for a while but it still caused me fatigue and my hot sweats came back so I'm trying to deal with two pumps,it's a nightmare.There seem to be very few people online that react this way to estrogen,I mean I've never felt tired in my youth when I had lots of estrogen so why won't my body except this gel and give me more energy?
Joziel- I have just this minute done the randox text and posted it(I loved the ease of the tasso device).I looked all over the net to find a test kit that I didn't have to prick my finger,because I've tried that before and could not get any blood out(I think I'm simply lacking in everything including blood)....I am also waiting for the blue horizon test kit to arrive (it will text all thyroid and vitamins,oh and reverse thyroid although I'm not sure what that is).Should I update my post when I get results or do I do a new post?it's just that I will not know what the results mean-so I could do with some help regarding my next step.I think the randox will take 2/3 days to come back.

[dangermouse]

Ooh like the sound of that device too, I hate finger prick tests!

I have had osteoarthritis for some time, it’s bad in my mum and dad and, conversely, progesterone eases it for me. Yes, progesterone has many health benefits as all hormones are important, it’s all about the balance.

Progesterone is needed to grow new bones, its good for inflammation, anxiety, insomnia, motivation and also controls night sweats and many other things. There are many women who take progesterone only as it tends to drop a lot lower than oestrogen and oestrogen can still be made by the adrenal glands post menopause.

Utrogestan if taken orally can metabolise differently and seems to affect other hormones as well. I did try the 200s and was good for a few days but then had hyper stimulation and my endocrinologist said it can convert to oestrogen for some women, so no luck again for me!

I would say a good rule of knowing when you’ve had too much progesterone is that it can cause depression as it calms the nervous system too much. Also stressful times take from the progesterone bucket so more can be needed at certain times, probably the same for oestrogen.