Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: jasper on November 09, 2016, 03:44:37 PM
-
Hi, I know from my previous threads that high dose estrogen patches (75-100) or equivalent oestrogel is not always successful if you're still producing varying estrogen and potentially still having regular periods (like I did on evorel 75).
I'm not doing well on Zoely and have given it as long as I can manage with the extra headaches and muscle pain plus rising bp. Got to work out what to do and so really wondering if anyone with a fairly strong cycle has eventually succeeded in getting relief?
Thanks
-
I was given oestrogen gel when I got my mirena coil fitted 14 months ago. Main peri symptoms at the time were very heavy periods & insomnia. Coil sorted both symptoms but when I added gel into the equation, the insomnia came back. Got hormone levels checked and found that, at that time, my own oestrogen levels were fine so the gel was surplus to requirements!
I'm 50 and still peri.
-
Hi Elsie,
Glad to hear that the mirena worked for you. I started out with the evorel patch only but my cycle was overriding it so improvements were not consistent - there is no doubt though that I was better on it than off it. Zoely was an attempt to stop my cycle taking over but I am not tolerating it well and from what I gather it is more likely that I am reacting to the synthetic progesterone than the estradiol component (though the mode of delivery may also be an issue).
Anyone actually doing well on HRT rather than bcp in peri having had a pretty regular cycle when they started? I know finding the right method and dosage is hard enough for otherwise 'healthy' people, let alone trying to deal with a chronic illness at the same time, which I have. I know the bcp is the more reliable option but it appears I just can't hack it!
thanks
-
Yes, I am doing well Jasper.
I am 49, in peri and was having regular periods when I started HRT and end of July. I started on 25 mcg Estradot patch then waited 6 weeks before going up to 37.5. After another 6 weeks I went up to 50 mcg but felt that was a little too high.
So now I'm sitting on about 44 mcg (I am cutting a sliver off the 50 mcg patch).
My only symptom was insomnia. I'm doing very well now.
I also take 100mg Utrogestan vaginally for 14 days.
Take care
-
Great to hear you are doing well Sonia!
And hope you get sorted as well Jasper.
-
Thank you Matilda - hope you're doing well too :)
-
Good news you are doing well soniad - long may it last :). I am also an inveterate patch snipper ::). Interesting that this is suiting you despite having your own hormonal surges to contend with - or maybe these are still to come as you become properly peri-menopausal and your own cycle goes awry. Maybe though the HRT will continue to work as it is now which would be brilliant - so do keep us posted :)
jasper - sorry to hear the Zoely is not working well for you - how long have you been on it now? I can understand why the high doses of prog can cause problems. Have you spoken to Briony who takes Qlaira? I know it took several months for this to work for her but I don't know if she suffered initial side effects as you are.
Hurdity x
-
Hi SoniaD - did you get prescribed hrt when your only symptom was insomnia?
Dxx
-
Good news you are doing well soniad - long may it last :). I am also an inveterate patch snipper ::). Interesting that this is suiting you despite having your own hormonal surges to contend with - or maybe these are still to come as you become properly peri-menopausal and your own cycle goes awry. Maybe though the HRT will continue to work as it is now which would be brilliant - so do keep us posted :)
Thanks Hurdity! I'm still feeling the hormonal surges, for example I can tell when there's more estrogen as my boobs get really sore. When the estrogen is too low or too high (surges and drops) I will take some time to fall asleep or I'll wake in the early hours for a couple of hours, BUT I still get enough sleep. I can range from 7 hrs to 9 hrs sleep with all this going on, but I am never tired the next day. So I think the extra estrogen is acting as a kind of buffer. As long as I feel refreshed each day, I'm happy:)
Hi SoniaD - did you get prescribed hrt when your only symptom was insomnia?
Hi Dawncam - yes I did! I went to a women's health specialist in my area and she said it is quite common for peri ladies to experience insomnia with few other symptoms. I don't get hot flushes at all but I think that's probably because I've been on citalopram for years.
-
You range from 7-9 hours and you think that's insomnia?!!!!
I haven't had 7 hours sleep in 20 years!
-
Hi I don't know if I'm a high dose but I take 3 pumps of estrogel and usually week before period when on utro I take 3 and a half. I am peri and nearly a year on this regime and I feel great also take a blob of testosterone for the past month. I do not experience high or low surges anymore, the gel seems to work for me. Xx
-
Forgot to say my cycle has always been regular as clockwork even with all the peri symptoms xx
-
You range from 7-9 hours and you think that's insomnia?!!!!
I haven't had 7 hours sleep in 20 years!
Hi Dawncam, sorry for the confusion.
This is what my sleep is like AFTER having been on HRT for 4 months. Before that it was all over the shop.
So yes, it has improved dramatically
-
Thanks Hurdity,
Yes I've read Briony's posts and I am trying to stick it out partly for that reason - though I seem to recall her side effects were more psychological than physical.
So difficult when it's hard to be sure if the issues I am having are side effects or not! I think my energy is marginally better on Zoely than evorel but pain worse! I gather 75 evorel is roughly equivalent to 1.5mg estradiol in the pill?
-
There have been lots of posts recently about equivalence and how it's impossible to say exactly because women vary so much in how they absorb the different doses and preparations. All the different strengths of oestrogen are given here: http://www.menopausematters.co.uk/treatafter.php Just go on whether the dose is low medium or high. From this it looks like 75 mcg counts as high-ish but 2 mg estradiol is medium dose so it's a question of seeing how you feel overall.....Looks like Zoely is not a very high dose oestrogen but gives a consistent dose.
Hurdity x
-
Thanks for the link Hurdity. Is there any rationale as to why progesterone might cause worse muscle / neck / shoulder pain?
-
I stopped the Zoely on Friday as the muscle pain (neck, legs, back) was unbearable. It maybe it isn't the Zoely causing it (wondering if it could be making my borderline hypothyroid worse) but I figure this is the only way to find out? Stuck a 50 evorel on to try to reduce the crash from stopping it.
Anyone know how soon side effects (if this is what it is) would disappear? If it wasn't the Zoely then I'm in real trouble 😪
Thanks
-
Sorry I can't help re the side effects of Zoely but there is definitely the potential for interaction between thyroid meds (for underactive thyroid) and oral oestrogen - the technical aspects of which escape me at the moment, but mean that those taking medication may need to have their medication reviewed after starting oral HRT. It could well be that there is a similar interaction even for those not taking medication for borderline under-active thyroid. I quoted from a study about this recently - just had a search and here is the extract:
"Because of its hepatic first-pass effect, oral estrogen therapy, the most commonly used modality of ET/HT, raises the circulating levels of thyroxine-binding globulin (TBG), thereby increasing the bound fraction and decreasing the free (bioactive) fraction of circulating thyroxine (T(4))"
Here is the thread where I quoted this:
http://www.menopausematters.co.uk/forum/index.php/topic,30662.msg487889.html#msg487889
Muscle pain is a feature of underactive thyroid so it could well be a secondary response to the therapy in view of your hormone levels. Depending on how borderline you are I would see if you can get some low dose treatment for this or at least ask to be referred because you have a better chance of the HRT working if your thyroid function is good. Someone started a thread about this recently (ie thryoid function and HRT) referring to women who have had ovaries removed but the arguments still apply to everyone I think.
I don't think stopping it will tell you if it is the tablet (oral oestrogen) is affecting your thyroid function - as you say it could also be the progestogen not agreeing with you.
Hurdity x