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[pepperminty]

Hi Ladies,

I am on currently on 1.5 mg to 2 mg of oral estrogen a day. I will be changing my HRT type. I have been advised to start on a 25mg patch. They suggested cutting a 50 in half and waiting at least 6 weeks before I increased. This dose seem to be a bit low? I was told that being late 50's I shouldn't need so much any way? I will be taking Utro for 14 days per cycle.

 I wanted cyclical to ensure I got the right dose of estrogen before I even consider a conti regime, for obvious reasons.
My concern is that on 25 mg only I will be on the floor!
(I intend to get my estrogen levels tested regularly via medichecks to see where I am . I test now and my last level was 500 ish and I have always been consistent around the 300 mark before I increased my oral dose. )
Is 25mg too low?

PMxx

[bombsh3ll]

Dose finding studies suggest 2mg oral estradiol produces similar blood levels to 100mcg patch.

Popular equivalence charts eg on the BMS website put 2mg oral as approximately similar to 50mcg.

I would start with at least a 50mcg patch (you could show them the BMS chart) and have a low threshold for increasing based on symptoms.

I would also ask them what evidence they have that older women need less estrogen. This belief is frequently stated but there are no published studies that I am aware of looking at outcomes in women who have their dose arbitrarily slashed at a given age.

[pepperminty]

Dose finding studies suggest 2mg oral estradiol produces similar blood levels to 100mcg patch.

Popular equivalence charts eg on the BMS website put 2mg oral as approximately similar to 50mcg.

I would start with at least a 50mcg patch (you could show them the BMS chart) and have a low threshold for increasing based on symptoms.

I would also ask them what evidence they have that older women need less estrogen. This belief is frequently stated but there are no published studies that I am aware of looking at outcomes in women who have their dose arbitrarily slashed at a given age.

Thank you for confirming this. I have looked at charts and there dose as you say appear to be discrepancy about dose equivalents between charts . I thought 50 mcg patch was about right.  The advice regarding a lower dose for older women was from the specialist and the reasoning was that older women don't have any estrogen  anyway when they are menopausal. You can't argue with that 

PMxx

[bombsh3ll]

That's the most ridiculous and unscientific argument for undertreating a condition that I have ever heard!

I'm just glad he (and I am almost positive it was a he) isn't treating amputees "sorry that's your whole leg gone, but here's a prosthetic toe".

It sounds like that clinician is one of those types who really begrudges anything more that a sniff of estrogen and would rather we all just ****ed off and took antidepressants instead.