Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: Baldrick11 on March 26, 2024, 07:41:09 AM
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Hi All,
I am on Lenzetto as about a year ago I stopped absorbing the patch.
I was on 2 pumps a day with every third day 3 pumps and my oestrogen blood test result was 741 pmol/l but I started to experience serve night sweats so upped the Lenzetto to 2 pumps / 3 pumps alternate days about 6 weeks ago.
My night sweats have subsided but now my blood result is 1743 pmol/l, which I understand is extremely high, not sure how it can jump up so much.....
Should I reduce the Lenzetto again? as I want to stay in a safe level being that my sister has estrogen positive breast cancer and don't want to put myself at any risk.
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Hi. Sorry you’ve had sweats again recently.
If you’re still peri, levels jump around a lot. But yes that’s a high level so worth repeating.
Also fwiw, I’ve learned the hard way and finally lucky enough to see a leading meno specialist… changes in levels/fluctuations are at least as much of cause of symptoms as absolute levels. So personally I’d not alternate doses as it means imposing fluctuations (by 50% of dose) on top of peri.
Hth x
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Thanks Hollyboll,
That's very interesting about not alternating my dose and makes sense.
I think I am past the peri stage as I am now 57 years old.
I will have another chat with the doctor, if you don't mind me asking who was your meno specialist and where are they based please, I feel seeing a specialist maybe a better options as the general GP do not have in depth knowledge of the menopause.
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Hi.
Age is really no indicator of where we are, despite outdated GP suggestions it is 🙄.
Also thinking about your alternating, if you do blood test on a 3-pump day that wd likely show a higher level than a 2-pump day if that makes sense…
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Hi
You can also have a skewed test if you've got it on your skin, so the test is contaminated. My gynae tells me not to apply before testing, and defo not to the blood draw arm, some women don't apply to the blood draw arm for a week or more before the test. Also if you're peri, will depend on which day of your cycle.
x
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Yep that’s a good point. I had this with testosterone- never used spray so didn’t think of it but if you apply on arm cd definitely contaminate test. X
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Morning all,
Many thanks for your comments and thoughts.
I spoke with my GP yesterday and they advised the oestrogen level was far to high and that I need to reduce my Lenzetto sprays immediately, as this blood range puts me at risk of breast cancer.
She asked me to reduce to 2 pumps a day (fyi I administer them on my inner thigh), which should bring my levels down to the normal or higher end of the normal range.
Basically she said if my symptoms come back but my oestrogen levels remain the higher end of normal, I will have to live with it as they would not increase the Oestrogen further as this would put me at risk of breast cancer. I could try the gel or patch again but the reason I changed to Lenzetto from the patch was that I was no longer absorbing the patch.
I will have another blood test in 12 weeks and see what it shows them and revisit the type of HRT I am using then.
Fingers crossed my nights sweats and mood improve.
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Do you have any choice when in your cycle they do it? It's best when your own levels are lowest when you start to bleed and before you apply the spray.
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Baldrick, I think it's extremely extremely unlikely that you are getting a valid estrogen result there. What often happens with Lenzetto, is it gets onto the skin of your inner arm where the blood draw is taken from.
This contaminates the blood draw and it ends up being artificially high. Even the 700ish result I think is contaminated and too high if you are still getting night sweats.
Could you apply the spray to one arm only and take the blood from the other? Do you have to use both arms? You would need to do this for several weeks after the arm has been contaminated. You might want to ask to switch to gel or patches if you haven't tried them already, just to avoid this. I very very very much doubt you are getting those results from Lenzetto. It's a very low dose of estrogen and you are getting night sweats and classic low estrogen symptoms. I wouldn't want to see you reduce further when that could be the opposite of what you need.
Try to discuss the idea of contamination with your doctor. Perhaps ask for a different type of estrogen which isn't applied to your inner arms.
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Hi Shelia,
Thanks for your comment.
I don't have a cycle anymore as I have a merina coil and and I spray at night, the blood test I took was the morning after.
I will make sure the next blood test is later in the day to help with the reading.
Thanks
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Baldrick, did you see my post above?
https://pubmed.ncbi.nlm.nih.gov/15283926/
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Hi Joziel,
Many thanks.
I will have a read and think I will ask for my bloods to be taken again and go from there.
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Hi again Joziel,
Thanks for your comments and link.
I spay the Lenzetto on my inner thigh not my arms, so not sure this would cause a false reading, but you never know.
I too thought Lenzetto was a lower strength than advertised or compared to a patch and I was on a 50 patch in the past. It's my understanding that 3 pumps of Lenzetto is equivalent to a 50 patch so if I now use 2 pumps that quite a reduction.
As I mentioned I will ask for my bloods to be taken again and go from there, maybe I'll try a different delivery method of the Oestrogen like the gel.
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Hi there - Just in case you've somehow accidentally contaminated an arm, maybe ask them to take the blood from your other arm if possible?
Try to get it taken when you are on your period, because that's when the estrogen from your own body will be lowest and will give you the clearest picture of what you're getting from HRT. For eg, maybe you had just ovulated last time, which can cause estrogen to spike up to 1300pmol - that is the normal reference range for ovulation. And then around your period, maybe you are down very low... It's the lows you want to catch so you can buffer them out with HRT.
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Thank you Joziel :)
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Baldrick - that sounds like a very unhelpful GP - if your symptoms return it may well be worth trying a different kind of HRT, not 'just living with it'!!!
I've not used sprays but from my experience with testosterone contaminating and putting everyone into a total panic before they realised it ... if you apply on your inner thigh and wash hands thoroughly afterwards (and for good measure wash your blood arm thoroughly too!) it's not so likely to be contaminating.
If you are applying at night, I was told by leading meno consultant the best time to do test is next morning - I think something to do with that being an average of uptake over c24 hours but I'm not sure.
Also, sometimes there are mistakes. My own tests were so crazy changing that the first couple of times he dismissed as must be a mistake.
So fwiw and if you can manage it I'd have another test you’re a million percent sure not contaminated (washed hands/ arm etc) and then you have a reference. If on 2 sprays consistently you still get symptoms and the advice is then not to go up on sprays, might be worth trying another method.
Just a thought - I've been told I have very unusual absorption issues (on patches) and discussed the different patterns and possibilities a lot while people tried to work out what going on ... but i've not heard of patches 'stopping being absorbed'. Doesn't mean it's not possible, but ... consultant specifically said he wasn't sure why patches helped me for a while and then didn't - but most likely down to they were good when on sensible doses but caused massive problems when pushed a lot higher. Anyway, just a long way of saying is there any chance you hadn't in fact stopped absorbing but were for example taking tests on day 3/4 instead of day 1 / not consistent, or needed a higher dose?
Can you get a referral to a menopause clinic (consultant)? The waiting lists are long but if your GP will co-operate it's worth getting into the system / on the way ...
HTH x
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Hey
My menopause specialist (and my well informed GP) told me lenzetto is incredibly unreliable when it comes to blood tests. It works in a different way to the gel and patches it creates a kind of reservoir of estrogen under the skin when you spray it on. So blood tests don’t always show as stable. Also if you are spraying on your inner arm and it’s close to the blood draw site it’s very possible the blood test is picking up some of the reservoir in the skin and showing a false high.
My specialist said the only way to really get a realistic idea of levels is to use a patch.
Hope you get it sorted x
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Hi All,
I am on Lenzetto as about a year ago I stopped absorbing the patch.
Hi @Baldrick11
Can I ask how you know you stopped absorbing the patch? - I'm wondering if that's what might have happened to me. 3 years ago my oestrogen was tested and it was 866 on Everol patch 100. So I reduced to 75 and my anxiety decreased with it (thank God!) . I recently upped back to Everol 100 as I had started again with the worst night sweats I've ever had as well as hideous anxiety. After a month blood test came back as 566 .... I wasn't expecting this. By the way upping Everol didn't help the night sweats or the anxiety..... it's a long story and this is my first post so I wanted to ask here but am also going to start a new post as I feel my medication is complicated at the moment and also don't want to hijack your thread ;)
TIA x
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Alex this is totally normal, your own body will probably still have been producing more of its own estrogen when your levels were higher. As time goes by this amount drops and then you need to increase your dose to make up for that.
It’s probably not that you stopped absorbing, I don’t absorb well (I never have) and my levels have never been over 300 on 200 patch! If you weren’t absorbing chances are your levels would be much lower.
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Thanks Madge, I didn't know that, that's really helpful x
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No worries it’s very common this happens usual a couple of years after starting HRT. Mine has been a nightmare I just can’t get it up any higher 😩. Hope you feel better soon x
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Made, it's good to hear from another poor absorber... I'm on 9 pumps of gel now, with advice to go to 10 pumps in a couple weeks if symptoms continue. ::) ;D Estrogen is around 430pmol at 9 pumps.
Switching to another product feels like going back to the drawing board in terms of finding the right dosage now I've finally started to see an improvement from 8 pumps upwards(!), but if I need more than 10 pumps I probably will need another product because I'm so fed up of applying gel and waiting for it to dry twice a day.... ::)