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[MinnieMoocher]

Hi,

I had a look through the posts but couldn't find anything that matched what I was going through.

I've been perimenopausal since 2021.  Honestly,  it's been hell.

I went from very fit (six pack fit) to overweight and don't fit into anything except tracksuits.   

I've been hospitalised for things from panic attacks to blood pressure readings that were so high I had to be admitted.  I had PTSD for a few years because of that experience

I'm experiencing migraine issues and had to have a brain scan.

I'm anxious all the time!

After a bit research I think the common denominator is cortisol. 

I am wondering what are people to keep this in check and a level where they can feel like their old self again. 

I miss who I was and I want her back.

Any input, suggestions, supplements, treatments, recommendations would be greatly appreciated.   I'm open to anything.

speak soon 

[joziel]

Are you on HRT? I had all those symptoms (including high cortisol) and the right dose of HRT completely resolved them all.

Excess cortisol is produced because your sex hormones are crashing. Your body overproduces cortisol and adrenaline to try to compensate and give you something to run on...

If you'd really like to feel like your old self, you need your old hormones back...

[Mary G]

Basically you need to be on HRT and probably a calcium channel blocker for migraine prevention and high blood pressure.

Lack of oestrogen wreaks havoc with so many things because it acts like a control centre so without it, all sorts of things will go wrong.  I had migraines (auras without headache) at the onset of the menopause and they are caused by low oestrogen, pure and simple.  I found it quite scary reading about what low oestrogen does to the brain ie migraines, depression, memory loss, panic attacks, extreme anxiety.  There is nowhere near enough awareness re menopause and the life changing effects of it.

If you are not already using HRT you need to start and if you are already on HRT, you need to change the dose and/or type.  Finding the right HRT regime is vital but it can also be difficult at first. 

Can you afford to see a private menopause specialist?

What type of migraines do you get?

[MinnieMoocher]

Thank you both for the response

Basically you need to be on HRT and probably a calcium channel blocker for migraine prevention and high blood pressure.


I am currently on HRT. I've been on it since April 2022.  Oestrogel pumpack 750 micrograms/ actuation gel Estradiol and Utrogestan 100mg caps.

I will speak to my Dr about the 'calcium blocker' as well.

If you are not already using HRT you need to start and if you are already on HRT, you need to change the dose and/or type.  Finding the right HRT regime is vital but it can also be difficult at first.

Can you afford to see a private menopause specialist?

I may have revise my current prescription.  I can afford to see a menopause specialist.   So I think I will have a chat with her.  However, I'm always open to any recommendations.    This is my health I will  through whatever cash I need to to fix this once and for all.

[Mary G]

How many pumps of Oestrogel are you using daily? 

Another thought, your ratio of Oestrogel to Utrogestan might be out. If you are using a low dose of Oestrogel and/or not absorbing it well, the Utrogestan will cancel out the benefits of the oestrogen.

[bombsh3ll]

Additionally have you thought about testosterone? It is often forgotten about and can play a big role especially with mood and psychological symptoms as well as body composition and helping to maintain lean mass.

I too have chronic high cortisol and PTSD, in my case resulting from a life altering brain injury at the age of 34. I have healthy, stable levels of estrogen and testosterone from birth control and DHEA but there's no way I could cope with the challenges I face if I didn't, so I believe optimising all the factors you can to be really important.

As well as the DHEA I also take phosphatidylserine which has some evidence for lowering high cortisol.

[AKatieD]

Check cortisol levels with a saliva cortisol test. I take DHEA to help adrenals regulate cortisol levels.

[joziel]

MinnieMoocher, I suspect you are really not on enough estrogen. Are you taking the max licensed dose of gel, which is 4 pumps a day? (Even that is a very low dose.)

If you are not, you are totally within your rights to increase to that and your GP will approve it. If you are already on 4 pumps and still have these symptoms, you need more estrogen. The problem is that your GP will 'computer says no' at that and if you can't afford a private menopause specialist to get it prescribed, you will end up waiting literally years to go to a menopause clinic on the NHS.

One other thing you can try, is switching to patches. The max licensed dose of patches is 100mcg. If you order these monthly one week ahead, you can usually use 125mcg even though prescribed 100. (By chopping up a patch into quarters.)

[MinnieMoocher]

Additionally have you thought about testosterone? It is often forgotten about and can play a big role especially with mood and psychological symptoms as well as body composition and helping to maintain lean mass.

I too have chronic high cortisol and PTSD, in my case resulting from a life altering brain injury at the age of 34. I have healthy, stable levels of estrogen and testosterone from birth control and DHEA but there's no way I could cope with the challenges I face if I didn't, so I believe optimising all the factors you can to be really important.

As well as the DHEA I also take phosphatidylserine which has some evidence for lowering high cortisol.

The thought just occured to me today.  It's something I need to take a look at seriously.    So thank you for the suggestion. 

[MinnieMoocher]

How many pumps of Oestrogel are you using daily? 

Another thought, your ratio of Oestrogel to Utrogestan might be out. If you are using a low dose of Oestrogel and/or not absorbing it well, the Utrogestan will cancel out the benefits of the oestrogen.

I'm doing a 2 pumps once a day.   

[MinnieMoocher]

MinnieMoocher, I suspect you are really not on enough estrogen. Are you taking the max licensed dose of gel, which is 4 pumps a day? (Even that is a very low dose.)

If you are not, you are totally within your rights to increase to that and your GP will approve it. If you are already on 4 pumps and still have these symptoms, you need more estrogen. The problem is that your GP will 'computer says no' at that and if you can't afford a private menopause specialist to get it prescribed, you will end up waiting literally years to go to a menopause clinic on the NHS.

One other thing you can try, is switching to patches. The max licensed dose of patches is 100mcg. If you order these monthly one week ahead, you can usually use 125mcg even though prescribed 100. (By chopping up a patch into quarters.)

I am only doing 2 pumps a day.    I am happy to pay for a private health specialist if necessary.  Any suggestions?

[Mary G]

How many pumps of Oestrogel are you using daily? 

Another thought, your ratio of Oestrogel to Utrogestan might be out. If you are using a low dose of Oestrogel and/or not absorbing it well, the Utrogestan will cancel out the benefits of the oestrogen.

I think you need to have your oestrogen levels checked and increase the dose if necessary.  It could be you are not absorbing the Oestrogel properly.

A consultation with a private menopause specialist would definitely be very worthwhile.  I think you need some proper advice even if it's only a one off.

Have you tried splitting the gel dose by 12 hours?  That might help.

I'm doing a 2 pumps once a day.

[joziel]

MinnieMoocher, you can increase to 4 pumps under your GP. All you need to say is that you still have symptoms and you'd like to increase your estrogen. You may also need to increase the progesterone to balance that.

If you get to 4 pumps and you still have symptoms, then you probably need to go private to get prescribed a higher dose. I recommend Newson Health - I see Dr Jane Robertson there and she's very good.