Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: GeordieGirl on March 29, 2015, 12:54:57 PM
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Has anyone's GP or clinic actually tested your hormone levels before / during treatment - or is it always down to trial and error and (educated) guess work? What happens when your HRT causes you problems?
I found out I was menopausal due to a blood test (checking only FSH) and after that a box of pills was offered without any great understanding of what my hormone levels were or which were deficient / and by how much. I'd like to put it down to the greater knowledge of the doctor but she later admitted she was out of her depth in this area ???
GG x
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Blood test are reliably unreliable ! The only way they could be 100% reliable would be to take bloods every day through a whole cycle,our hospital for instance won't even do them if you are 50 or over ! My nephew who works in lab of another hospital tells me the same thing as he says they fluctuate all the time so they would only give you a snap shot on any given day. Most specialist/gynecologist prescribe on symptoms for this reason.
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Nope. MY gynae doesn't do hormone blood testing, preferring take a thorough medical history and 'go' by symptoms. Same with my GP, initially he did the 'usual' ones to check thyroid function, liver function, platelets etc. which were all OK.
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The other thing is you can't say at what level any particular woman will experience symptoms. There is a huge range of normal estradiol levels at all the stages in the menstrual cycle. Also research has shown that absolute levels are not a good predictor of symptoms - except in the very broadest sense - so in addition to their inaccuracy, there is little point in measuring them!
It is far better as the other two have said (and as Dr Currie on this site says) to go by symptoms, and especially once periods have started to become irregular.
Hurdity x
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Adrenaline is the hormone which is giving me the most difficulty currently, in the form of intense anxiety.
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Yes I HATE adrenaline :(
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Adrenaline is the hormone which is giving me the most difficulty currently, in the form of intense anxiety.
Have you been given any other hormone to counteract that at all CLKD? A friend was (eventually) prescribed DHEA which she swears by.
GG x
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The other thing is you can't say at what level any particular woman will experience symptoms. There is a huge range of normal estradiol levels at all the stages in the menstrual cycle. Also research has shown that absolute levels are not a good predictor of symptoms - except in the very broadest sense - so in addition to their inaccuracy, there is little point in measuring them!
It is far better as the other two have said (and as Dr Currie on this site says) to go by symptoms, and especially once periods have started to become irregular.
Hurdity x
The post was inspired by another thread where the posterwas feeling grotty and her consultant spotted her E levels were low and is aiming to get them to what he considers an appropriate level for her age.
Going by symptoms is a good start if the GP knows their stuff, but what happens if the GP doesn't have a clue about the menopause and /or muddles symptoms with other hormones? Or isn't sure whether someone isn't feeling quite themselves due to progesterone or the oestrogen part of their treatment? There seems to be an awful lot of women on here struggling to feel well again despite taking HRT for a fair while. Is trial and error the best / only way?
GG x
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Please explain more about DHEA ……..
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DHEA has been mentioned a few times before CLKD - maybe if you carry out a search it will bring up some posts?
Taz x
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I've only ever had one lot of hormone blood tests done, and that was more than 4 years ago. Doctors are generally not interested in hormonal blood tests because, as the others have said, the levels fluctuated so much. Salivia tests are even more unreliable than blood tests. Treatment is generally going to be symptom based, and trial and error, which is why those who say hormone treatments can be "tailor made" are just whistling dixie. ;D
I am fully post-meno now, and a little while ago I asked my doctor if it was worth having a blood test done, just out of interest, and she said "What's the point. It's not going to tell us anything we don't already know".
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I'd assume the reason they have tested me twice in 3 years is because I don't have periods because of hysterectomy and I don't get hot flushes, I just seem to get everything else and the minute you research menopause they're the 2 symptoms that come first xx
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Hormone testing would maybe have some usefulness if it were done more frequently and with a general 'picture' in mind. If your levels are way way low consistently for example and other tests to try determining your 'stage' in hormonal decline. Anything that gives a picture of an individuals health is useful I think, along with mindful interpretation.
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Do our hormone levels fluctuate as widely in post menopause?
I'd read that blood tests only take your hormone level at one point in time (though as Bright Light and Annie mention, some consultants obviously do find this useful), what about 24 hour urine tests? I suspect it's something that's only done in private health rather than the good old NHS.
Perhaps in the absence of any testing our GPs should have a big tick list of symptoms that are oestrogen / progestrone/ testosterone/ and everything else-one related so they have a better idea of what's going on in our bodies. (Can I finish this post like most of my others - "Mine are clueless" ) :-\
GG x
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It is far better as the other two have said (and as Dr Currie on this site says) to go by symptoms, and especially once periods have started to become irregular.
Hurdity x
Thinking about this, this actually would empower us. We're just as able as our GPs to spot our symptoms, in fact in many cases more so? If we know we have 8 out of 10 symptoms of oestrogen deficiency or 3/10 for progesterone, it's probably a good start?
We just need to educate our GPs on those symptoms and then we're off ...
GG X
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Yep. I would like to get all the GPs into one chilly barn and keep them there until they LISTEN :beat:
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Do our hormone levels fluctuate as widely in post menopause?
Perhaps in the absence of any testing our GPs should have a big tick list of symptoms that are oestrogen / progestrone/ testosterone/ and everything else-one related so they have a better idea of what's going on in our bodies. (Can I finish this post like most of my others - "Mine are clueless" ) :-\
GG x
After menopause I understand hormones level off and presume some ladies are fine with lower levels and some aren't.
I agree about relating symptoms to certain hormones but there isn't mainstream reference to this and some overlap. Within the limited time with a GP it's my understanding that hot flashes, vaginal dryness and mood swings are the main symptoms they attribute and treat for and all are said to be low estrogen. I presume this is because the drugs are trialled and researched on this basis and not because other symptoms aren't relevant and give clues to which hormone imbalance a woman is particularly bothered by. I honestly think premenopause it's hard to treat specifically with current thinking.