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[Pippa52]

Kathleen -thank you so much for posting  that is really interesting to know. xx

[joziel]

Pippa, I read all this just now and immediately after your first post I wanted to say that all those symptoms you describe are symptoms of too *low* estrogen, not too high. SOME of them (jitteriness) can also be high, but it is very unlikely that a 50 patch would be too high for anyone and causing those kind of symptoms. It is much more likely that your absorption has changed for some reason and you're not absorbing your patch as well as previously, causing low symptoms.

The only way you can know if you are too low or too high, is to do a blood test. If your GP won't do it, you can do one for about £45 via Randox Health at home. I recommend their 'premium' device option which takes the blood from your shoulder, it's much easier and more reliable than finger pricks. Your E should be definitely over 270 at a minimum to get the health benefits of HRT and many women need it around 450.

[Pippa52]

joziel... thanks so much for your message.  Have ordered the blood test from Randox.  Excellent way to collect the blood for those of us that are likely to have traces of oestrogen on our fingers using patches and gel etc. 
Last night was horrendous to be honest.  Hardly slept with heart pounding away and feeling really high anxiety, bloating etc plus this heat doesn't help either.  I have a check up appt with the Meno consultant tomorrow which was booked ages ago so will see what she says.  I do wonder if I am absorbing as well as I used to from the Estradots.  I have definitely noticed a difference since I have been on them and that was before the dose dropped. Was trying hard not to have to change type of HRT yet again ... will see what she says and what the blood levels are.  Thanks again for the advice. xx

[joziel]

Yes, those are all low estrogen symptoms for me (heart pounding, anxiety, insomnia etc)... When you do the Randox shoulder test, it takes a short while before the blood starts to come out. Just to warn you, because I put it on and then thought it wasn't working and was on the phone to them with it stuck on my arm, before I saw the blood coming through  so just be patient

[Pippa52]

Kathleen thank you so much for your reply.  We are all so different regarding HRT and I totally hear you and some ladies require only very small amounts of it to achieve relief of symptoms.  Your consultant sounds amazing how lovely you have been able to stay with him over the years too x

[Pippa52]

joziel...thanks so much for the heads up x

[Wrensong]

Hi Pippa,

the bloating and gastric symptoms have improved a lot after the cut down

so glad to hear this as it's a horrible feeling & a relief when it resolves  .  I hope the other symptoms subside sooner rather than later & that your blood test will be helpful.   The heatwave will be an additional source of stress for your body as you adjust to the dose reduction.  Unfortunate timing in terms of helping you get an idea of which way you may need to go to feel well again.  Unexpectedly, my body seems to have coped better with the extreme heat on this lower dose than in previous years on more oestrogen, but one difference between you & I is that it's now 5+ months since I went down to 30mcg so I've had considerably more time to adapt.

As Joziel says, some of the symptoms you & I share can of course be indicative of low oestrogen, but as you stated in your original post

Going higher on dose has ALWAYS made things worse for me

your specialist's advice to reduce makes sense.  Frustratingly, as I said earlier, this also seems to align with my own experience over the last 2 years, in early-mid 60s.  I had not anticipated this scenario & it's been something of a blow, but it is what it is.

Kathleen, thank you for posting your consultant's advice  .  Judging by the varying experiences reported on here by women in their 60s & 70s, I think what dose we do best on in our later years is probably a very individual thing.  Never having been this age before(!) every day is a learning experience  .  I hope you are feeling better.
W x

[Pippa52]

UPDATE. - my HRT journey continues.  Just had a consult with Meno consultant and we have agreed that Estradot are not working for me now.  The new Sandoz patches are causing skin inflammation (never happened with the Novartis version) which she says in turn is more than likely affecting the absorption as the oestrogen does not absorb well through inflamed skin apparently which makes sense.  She is transferring me onto Lenzetto which I have been on before but she looked back and said the dose was not high enough then so we shall see.  I always liked the delivery method of Lenzetto so fingers crossed hopefully the higher dose will do the trick although I am expecting some side effects when swopping to yet another version of HRT.  She also said that Estradot availability seems to be so unreliable that it would be better to swop now.  Its such a shame as the original Estradots were magic for me and really worked.  Ho hum I wish they would stop altering things.

[Wrensong]

Oh no - inflammation?  Yes, imagine that would compromise absorption.

I agree about Lenzetto - it's so easy to apply & leaves no trace.  I do hope this resolves your symptoms Pippa & then you'll have no worry about obtaining Estradot either.  The strength I need was still out of stock when I made enquiries earlier today.   Luckily I have a good few weeks' worth left but that's all.

Everything crossed for you.
Wx

[joziel]

Pippa, glad you have something to try... the only thing to say about Lenzetto is that it is quite low dose. Meaning even the max dose of Lenzetto may not be enough. But if she's happy to prescribe about the max licensed dose (and if you have enough skin to fit it on) then should be ok. Otherwise, Oestrogel or Sandrena could be things to try...

[Pippa52]

Wrensong - thank you for your lovely post. I am aware it is a weaker product than Estradot so some jiggling around with the dose will probably be needed but I will do it slowly as always.  My Meno lady told me if I need to to half a spray to cover the nozzle with a fresh sheet of paper each time and measure on the nozzle with 2 lines.  I am going to try and stay on 2 sprays if I can but 3 seem to be what most people need =time will tell.  I do hope you get the Estradots you need very very soon.  What a nightmare this you would think they would be able to cope with extra demand now they have had several years to gear things up after all.  xx

[Pippa52]

joziel - yes am aware it is a weaker product than Estradots but will start on 2 sprays as suggested then tiltrate upwards.  When I was on it before I was on a low dose and it wasn't realised how much weaker a product it was.  Hopefully 2 - 3 will do the trick but time will tell.  I do remember get good absorption to start with but clearly did not increase the dose enough in the longer term. I still have a few Novartis Estradots to use up as don't want to waste them so will finish them first. xx

[Wrensong]

Pippa, if I remember rightly they are building a new factory  hence shortages likely (again ) until some time next year.  I will probably go back to Evorel but had considered asking for a retrial of Lenzetto.  The latter never did it for me, but I wasn't on it for long as a standalone oestrogen.  The 2nd time it was prescribed to use at bedtime to top up patches from which I was getting astonishingly erratic levels  ,  with the hope of reducing my relentless night time symptoms.

All the best with it anyway & do let us know how you go.
W x

[Pippa52]

Wrensong yes I read they were building a new factory so hopefully the supply issues will sort out once and for all!  I had a blood test today for Oestrogen levels and will see what that says when it comes back as I am having serious cold feet about swopping off Estradot which have been so good.  I am going to research and see if there is any way I can mitigate the skin re-action of the Sandoz patches.  Providing I am still absorbing it ok I would rather have some skin irritation that feeling awful on another product.  x

[Wrensong]

Completely understand that Pippa.  Please let us know what your research throws up.  Not sure what I will ask for when my patches run out    have you tried different sites for patch application to see whether the skin is less sensitive in other areas?  Sorry to ask if you've found you don't absorb well from elsewhere even before this reaction - I forget what we've covered.
Wx