Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: Blue Kingfisher on August 04, 2016, 02:41:49 PM
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Hello all,
This might be why I can't stay awake!
I've just collected my blood test results & they might explain why I am exetermely fatigued & having to sleep as much as possible. My oestradiol is < 19 (less than 19) & the 'normal' range next to the result is 98 - 571. My FSH is 23.8 & normal range is 3.50 - 12.50. My thyroid function is also not normal & explains the extreme fatigue...my TSH is 6.16 & normal range is 0.27 - 4.20. I'm on Levothyroxine (75mcg) but looks like it might need increasing. I presume my thyroid has gone haywire due to my sex hormones being off balance. My progesterone is 1.1 & there's no range next to that so I presume this is ok. My testosterone is 0.3 with a normal range of 0.10 - 1.80.
I'm waiting to speak to my GP on the phone. I've got an appointment at the Prof. Studd clinic on 19th of this month but I feel so bad I'm not sure I can wait before trying to help my symptoms.
Is it worth me asking for the oestrogen gel or patch & just making a start with it now? I will also probably be on more thyroid medication.
Not sure what to do!
Thanks everyone X
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Your GP should be able to sort you out with all the right hormones and treatments. I do hope you get the right help - things seem really off balance - you poor thing. Keep us posted DG xxx
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Thanks Dancing Girl. I've spoken to my GP now & he will won't prescribe me Oestrogel on its own, he has to also prescribe a progesterone to protect my womb. I don't want to have a combination patch as the synthetic progesterone they use in these things makes me feel dreadful & I know the Prof. Studd clinic will say I only need progesterone for some days of the month (not every day).
So I have to decide on either having a combination treatment prescribed by my GP in the interim period before my Prof Studd appointment (19/8) or doing nothing until then.
I have a six year old daughter so things are very hard as I can't stay awake & we have no family near us to help out. The thing is though, if I did try an interim solution prescribed by my GP such as a combination patch, surely it takes about 2 weeks to get into your system anyway so I may as well wait for my Prof Studd appointment anyway??
At least I will be starting the treatment regime from scratch rather than having to phase something out & possibly experiencing unwelcome side effects as a result.
My appointment on the 19th can't come soon enough I can tell you!
Any words of wisdom on this dilemma from anyone will be greatly appreciated! :o
X
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At least you have got an idea of why you are feeling so tired Blue Kingfisher. The normal FSH range you quote is for a fertile woman and I can't remember how old you are - sorry. Mine was 124 and I was still having periods every three months or so.
I'm sure your appointment will set you on the road to feeling much better.
Taz x
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Thanks Taz, & yes, you are right, at least I KNOW why I'm so tired! Better this way than for the bloods to have come back 'normal' :o
I'm 47 years old, still having periods but they are irregular X
I wonder how long after being prescribed the gel etc from Prof Studd's clinic it will take to start to feel a bit more human......I'm hoping it won't take more than a few weeks else I might have to consider employing some kind of home help!
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I've never had my oestrogen level checked - it's never been offered and my fatigue was always put down to being part of the M.E./Fibro which I had also been diagnosed with. I wonder now whether low oestrogen was the cause.
Taz x
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Blue Kingfisher, I'm not sure if these are words of wisdom but I can give you my own personal experience and that is, once oestrogen levels drop, a whole host of things can go wrong. For a start, although I don't have a thyroid problem as such, my reading are getting decidedly borderline when my oestrogen is low and that goes for cholesterol and blood pressure readings too.
You say you have spoken to your doctor, will he/she prescribe Oestrogel now? If so, grap it with both hands and start using it immediately. You can let them prescribe the progesterone part but you don't have to take it straightaway. Also, make sure they prescribe gel and not patches or anything else.
If I were you, I would take the Oestrogel, use it immediately and then explain the situation at your appointment on the 19th. I imagine you will be prescribed Oestrogel (again) and Utrogestan to be taken cylically. There is no way that Studd would prescribe a combination HRT for you if you are progesterone intolerant. I think you might also need testosterone.
The gel kicks in very quickly and you will definitely be feeling an marked improvement by the time your appointment comes around. Under the circumstances, I would start with 3 pumps everyday and go on from there but again, explain what you are taking at the appointment.
Hope that helps.
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Hi,
Your tiredness and sleepiness are also related to the thyroid - perhaps your GP can adjust your current medication while you wait for your 19/8 appointment?
Milamam
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Hi Mary G - my GP unfortunately won't prescribe the oestrogel for me. He will only prescribe either a combination patch or the gel BUT I'd have to have a Mirena Coil fitted so there was progesterone to protect my womb. My GP is very nice but he isn't actually allowed to prescribe anything else. I spoke with Studd's secretary & she agreed that this was really only what my GP could offer. E.g. He can't just prescribe oestrogel on its own.
I will just have to wait for my 19th Aug appointment!
Milamam, my GP has increased my thyroid meds but he thinks I won't feel well until I'm on HRT. My GP wants me to start HRT immediately but I'm holding off! :-\
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Blue Kingfisher, I thought your GP might prescribe the Oestrogel as an emergency now on the understanding that you would (very) obviously introduce some progesterone later on and after your appointment on the 19th.
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Mary G, you'd think so wouldn't you & this was the tactic I was aiming for but even Prof Studd's secretary said my GP was just following protocol. The only thing she could suggest was a telephone consultation with Prof Studd to see is he can then write to my GP to prescribe the gel for the next two weeks but unfortunately Prof Studd is on holiday until 10th August so I would think by the time he can fit me in, write to my GP, my GP read the letter & write me the prescription.....it will be almost the 19th August anyway.
I will just have to grin & bear it for the next few weeks but very encouraging that I can expect to feel better on the gel after a couple of weeks or so.
This gives me hope! I'm sooooo glad I made that appointment now as the whatyoumacallit has really hit the fan in.my body! :o
X
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Well at least you have tried! It's lack of flexibility and knowledge of HRT that has forced you to seek help privately in the first place - well it was with me anyway. Your GP could easily have prescribed the widely recognised Professor Studd regime of Oestrogel and cyclical Utrogestan (which obviously and by definition you do not take everyday anyway) safe in the knowledge that your appointment is on the 19th and Professor Studd will be writing to him anyway with his recommended prescription. Some joined up thinking is needed here.
Anyway good luck for the 19th, you will be in very good hands.
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Mary G - I might try one more time tomorrow & ask specifically to be prescribed Utrogestan as well as the oestrogel. Is the Utrogestan a cream? I apply it internally is that right?
Perhaps if I'm a bit more specific with my GP he might be able to help me. He is basically saying he can't just prescribe oestrogen......might be worth one more shot!
If anyone can clarify what I need to ask for in terms of Utrogestan that would be really helpful.
X
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Yes, that would be well worth a try at least. Utrogestan is a micronised progesterone capsule that your either take orally or vaginally. For some reason that nobody has ever been able to explain, the NHS do not licence it to be used vaginally (not that I care because I do anyway and most other countries prescribe it to be used vaginally) so he will tell you to take it orally but don't worry, many women use it vaginally which is better anyway because it has fewer side effects and works better when used in this way.
I don't think he can reasonably refuse your request for Oestrogel and Utrogestan and you could explain that Professor Studd will probably be prescribing this anyway and will be writing to him with his recommended prescription.
So ask for Oestrogel and Utrogestan which is a micronised progesterone and hopefully he will agree but only take the Oestrogel (3 pumps everyday) until you have seen Professor Studd and he will tell you when to start the Utrogestan.
Anyone would think we were suggesting something illegal and asking for a controlled substance. It's ridiculous.
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Thanks Mary G. My GP is booked up today but I'm seeing another GP at 10am & hopefully I will come away with the prescription.
Will let you know how I get on! :-*
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Success!!! ;D I have the prescription! I need to go back to the chemist at 4pm to collect it as its been ordered.
So I just need to make sure I know what I'm doing the the gel now! ...So, do I apply it twice daily, one & a half pumps each time, roughly 12 hours apart each application? Not sure where to apply it though? Is it inner thigh or outer upper arm? Do I alternate where I apply it or doesn't it matter to keep applying on the same skin area?
Thanks so much Mary G for giving me the confidence to go back & try again, I'm so desperate & extremely grateful for your help X
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Just use 2 pumps per day either night or morning - the instructions will tell you what to do. As Mary suggests you may need to increase to 3 pumps if flushes are not under control. Further blood tests after 4 weeks might be necessary to see if your hormone levels have built up to see if you need to increase to 3 or even 4 pumps per day. I always apply to inner thighs - just apply it to clean dry skin & don't use moisturiser on that area. Your oestrogen level is so low you need to build this up to start to feel better. You can add in some progesterone after 2-4 weeks to induce a withdrawal bleed but Studd should guide you through all this when he sees you. Do take you blood test results and a list of your symptoms and questions when you see Studd so you get the most form you appointment.
Well done - hope you fell better soon. Dg x
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Thanks Dancing Girl, I didn't realise you just applied it once daily. I think I will apply the gel at night as that way it doesn't interfere with shower routine etc & I can start sooner!
I just hope that this gel isn't one of those "you need to feel worse before you get better" type things! :'( I've had too many of those experiences & in my experience they NEVER get better :-\
Thank you so much for your support X
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Great news and well done! It is so helpful for you to start the gel before you see Professor Studd on the 19th because you can then discuss any points you wish to raise about doses etc.
Professor Studd usually starts you off on 3 pumps of gel everyday but as I said before, don't touch the Utrogestan until you have seen him and he will tell you when to take it. Because your oestrogel levels are so low, he will probably want to give you a good long run on oestrogen only to give you the feelgood factor.
You can use the gel whenever you like and you can take it all in one go. I have reduced my dose to 2 pumps everyday and do a split dose of 1 pump every 12 hours to get an even dose.
Great stuff, you will be feeling better very soon!
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Thanks Mary G! It's Dr Savvas I think he's called that I'm seeing at the clinic but he is Studd trained. I can't wait until Oct to see Prof Studd himself but I'm sure it will be fine.
I will experiment with dosing. Instinct tells me split dosing makes sense in terms of trying to establish some hormonal stability but I'll have to 'suck it n' see' because im also on thyroid meds which I currently take either at night or early hours of the morning if I've eaten late the night before.
Very interesting that low oestrogen affects your thyroid function......I think I need to be careful now I'm on an increased of thyroid medication. I have a suspicion that when some oestrogen builds up in my system that I'll be able to better utilise the thyroid medication....I'd better keep an eye on things as I don't want to end up all hyped up on too much thyroid hormone!
Looking forward to starting the gel tonight! :)
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Sorry, I got a bit confused because you mentioned your phone call to Professor Studd's office but of course your are seeing Dr. Savvas on the 19th and I hadn't realised you are also seeing Professor Studd later on!
At least you have something to work with now and you can discuss this on the 19th. It will be trial and error getting the dose to suit you and you may or may not wish to split the dose. Some women feel better using the gel at night and some in the morning but you will only know once you start using it.
Please keep us posted on your progress.