Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: Meeka on January 13, 2017, 04:56:21 PM
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I have been using 3 pumps of oestrogel for over 12 months and recently had a blood test to measure my serum oestradiol level. The normal range states 93.00 -1400.00 pmol/L on the result sheet. My result was 128 pmol/L . I was quite surprised as I expected this result to be higher. I am nearly 54 so probably post meno . I have been using HRT since I was 49 and initially when I started using 3 pumps my serum oestradiol level result was around 1000.00 pmol/L. Do you think the level is lower because I am now making much less oestrogen myself? I guess so....nothing else has changed. Prof Studd likes to keep my levels high as my bones need it.
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hi. don't have an answer but very interested in any info as I am on four pumps for 7 months and my reading was 544! Gp didnt comment if it was good or not and I had no idea! still dont lol
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Hi Meeka - I'm having blood test next week as I suspect I'm in exactly the same position. Prof Studd prescribed me 3 pumps in Aug 2015. It worked well until around summer 2016 so he said to up to 4 pumps. Even with 4, small sweats day and night, insomnia, low mood/energy and terrible joint pains made me move to patches which were worse. I ended up on 2 x 75 patch to get symptom removal but got scared I was using too much so asked doc for tablets. I now use a combo of tablets and gel as I know that I'm absorbing tablets but not sure exactly what I'm getting transdermally. I'm only using a combo in order to use less tablets as they're not the safest option but if I find they're the best option, I'll just continue with them. I've used E for many years now so I know when I'm absorbing/not. Gel is really variable for me and patches are almost negligible. I believe this is unusual regarding transdermal but it does happen. If I find the tablets are best, I'm going to ask for implants as I don't want tablets for too long and I'm certainly not ready to give up HRT.
Mx
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Gosh that is low Meeka! Just goes to show that one particular HRT type may not be the answer to your prayers. I have never used estrogel but I think it is subject to more variation because of the way it is applied. if you get it right and absorb it it's brilliant. Some women ( short and slim) have got levels of 600 on 2 pumps!! Yes you will be making less of your own oestrogen - so you might have been ovulating at the time you attained levels that high - but even so that is still a very low level on 3 pumps! It could be a one-off though - difficult to say just from one measurement. I would want to have another at a different time of day before increasing - has Studd suggested this? However if you're not absorbing .....
When mine were last measured several years ago they were 220 or something on a 50 mcg patch - and that is sufficient to eliminate symptoms for me.
Murphydurf - yes unusual to get better absorption with tablets as so much is usually lost to digestion - but perhaps not in your case.
What a trial it all is for some of you!
Hurdity x
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Mine were 218 this week and I'm on 2 pumps, I'm 42 and this was with Studd too. They were around 600/700 last July so I'm miffed too especially as my own cycle has been suppressed now...but I feel fine no symptoms so im undecided whether to increase to 3 or just leave at 2.
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Just noted your comment Hurdity I would fit the short and slim type as I'm a size 8 and about 5,3 I think I feel like I absorb it well, very confusing which is why Studd doesn't go on the results he just goes on symptoms but you can't help worry!
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Murphydurf, I've had EXACTLY the same issues as you with transdemal methods. My Consultant has been monitoring me closely. For some ladies, absorbtion via transdermal methods can be very problematic despite very careful application (and I was VERY careful)!
Another issue that was mentioned to me was whether you are able to absorb and CIRCULATE the hormones sufficiently. It has been observed that some women absorb and hold the hormones in their tissues locally but they don't then circulate to give good systemic levels. Now this is interesting! Transdermal methods can be every bit as variable as oral methods, it seems! Thank goodness we have some good Consultants out there who are monitoring and noting all these variables - it will help I'm sure in developing more effective HRT delivery methods in the future. My Consultant uses implants when all else fails - and has seen a number of ladies who can't tolerate/absorb either transdermally or orally, so I think implants should be more widely available so that these ladies can be helped.
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Hi Tempest - interesting about the circulation thing, that would explain what happens with me. I'd started manny years ago on combo tablet HRT and only had probs with the prog element so I knew I was absorbing the E. I've gone through the wringer on transdermal with some really quick and extreme low E symptoms. I'm doubted myself s lot because so many women seem to do so well on low dose transdermal. Since starting the E tabs it's very obvious, very quickly that I'm absorbing more. I do absorb some gel but it's really inconsistent and seems much better on arms than lower body which again is apparently less safe. I'm going to do a couple of months on tabs and gel and if it's defo ok on tabs I'm going to ask for implants for long term. I don't like being difficult but have only run into E probs with transdermal. Thank you for your post, it puts my mind at ease somewhat.
Mx
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Yes Tempest - the inter-individual variation is enormous in how much women absorb estradiol from the different methods! In fact have just checked my go to source paper for all of this and this is the same for patches and tablets ie lack of consistency between individual women - and also depends on other external factors.
I hadn't come across the info about estradiol being “held†in the skin so that's interesting. This source paper I usually quote from about absorption and which I have posted about before, suggests up to a 10 fold (!) difference in serum levels between some individual women!! Re gel absorption – this also depends on skin area and down to individual technique too because this same paper says that about 10 % of the dose is absorbed by the skin during the 2 min until it dries. I have the quotes and the paper ref if anyone wants them.
"Owing to the large individual differences in the resorption and metabolism, there are considerable interindividual variations in the course and height of the serum concentrations of sex steroids in women treated with the same preparation. The coefficients of variation are usually in the range between 30 and 60%. The interindividual variations are mainly due to genetic or acquired differences in the intestinal and hepatic metabolism,while the intraindividual variations from day to day may be caused by external factors like diet, alcohol or drug consumption, smoking, physical activity, stress, etc., which may cause rapid and transitory changes in peripheral or splanchnic blood flow, absorption or metabolism. Certain diseases, e.g. disorders of the thyroid gland, may also affect estrogen metabolism."
"Using patch or gel, there are large interindividual variations in the estradiol levels, which may differ by up to a factor of 10, and, in as much as 30% of the patients treated with a 50 mg patch, the estradiol concentrations are low. There are also considerable short-term intraindividual changes in the estradiol levels"
"The application of a hydro-alcoholic gel containing estradiol results in a rapid penetration of the estrogens into the stratum corneum; this stops after drying of the gel on the skin. As the absorption is proportional to the surface of application, deviations from the instructions may cause variations in the estrogen level and clinical efficacy. About 10% of the dose is absorbed by the skin during the 2 min until drying. The estradiol is stored in the stratum corneum and permeates through the epidermis into the dermal capillaries according to the concentration gradient between the stratum corneum and blood. This diffusion lasts for 2–14 h."
If you do not experience symptoms on the dose you are taking but these return when stopping or reducing then the oestrogen level is likely to be adequate for protection against osteoporosis I presume - without measuring levels. However if you are post-menopausal and symptoms do not return when you reduce oestrogen or stop, and you need to maintain oestrogen levels for osteoporosis protection - then this surely can only be ascertained through measuring blood serum levels when you take oestrogen - so that you know they adequate. Interesting Meeka because I would have assumed from the amount you are using that your levels would be much higher!
Don't forget girls that there is Sandrena gel if you are using oestrogel and not getting good levels. Sandrena is more concentrated so more likely to get more oestrogen into your system from a given amount of gel! I think oestrogel is more popularly prescribed?
Hurdity x
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Yes Tempest - the inter-individual variation is enormous in how much women absorb estradiol from the different methods! In fact have just checked my go to source paper for all of this and this is the same for patches and tablets ie lack of consistency between individual women - and also depends on other external factors.
I hadn't come across the info about estradiol being “held†in the skin so that's interesting. This source paper I usually quote from about absorption and which I have posted about before, suggests up to a 10 fold (!) difference in serum levels between some individual women!! Re gel absorption – this also depends on skin area and down to individual technique too because this same paper says that about 10 % of the dose is absorbed by the skin during the 2 min until it dries. I have the quotes and the paper ref if anyone wants them.
"Owing to the large individual differences in the resorption and metabolism, there are considerable interindividual variations in the course and height of the serum concentrations of sex steroids in women treated with the same preparation. The coefficients of variation are usually in the range between 30 and 60%. The interindividual variations are mainly due to genetic or acquired differences in the intestinal and hepatic metabolism,while the intraindividual variations from day to day may be caused by external factors like diet, alcohol or drug consumption, smoking, physical activity, stress, etc., which may cause rapid and transitory changes in peripheral or splanchnic blood flow, absorption or metabolism. Certain diseases, e.g. disorders of the thyroid gland, may also affect estrogen metabolism."
"Using patch or gel, there are large interindividual variations in the estradiol levels, which may differ by up to a factor of 10, and, in as much as 30% of the patients treated with a 50 mg patch, the estradiol concentrations are low. There are also considerable short-term intraindividual changes in the estradiol levels"
"The application of a hydro-alcoholic gel containing estradiol results in a rapid penetration of the estrogens into the stratum corneum; this stops after drying of the gel on the skin. As the absorption is proportional to the surface of application, deviations from the instructions may cause variations in the estrogen level and clinical efficacy. About 10% of the dose is absorbed by the skin during the 2 min until drying. The estradiol is stored in the stratum corneum and permeates through the epidermis into the dermal capillaries according to the concentration gradient between the stratum corneum and blood. This diffusion lasts for 2–14 h."
If you do not experience symptoms on the dose you are taking but these return when stopping or reducing then the oestrogen level is likely to be adequate for protection against osteoporosis I presume - without measuring levels. However if you are post-menopausal and symptoms do not return when you reduce oestrogen or stop, and you need to maintain oestrogen levels for osteoporosis protection - then this surely can only be ascertained through measuring blood serum levels when you take oestrogen - so that you know they adequate. Interesting Meeka because I would have assumed from the amount you are using that your levels would be much higher!
Don't forget girls that there is Sandrena gel if you are using oestrogel and not getting good levels. Sandrena is more concentrated so more likely to get more oestrogen into your system from a given amount of gel! I think oestrogel is more popularly prescribed?
Hurdity x
Hi Hurdity
Do you know much about the effect of progesterone on ostrogen levels? I ask as my blood tests were 668 in July when I saw Studd last and that's on 2 pumps but I was in a nice long stretch of ostrogen only as he'd let me skip a month owing to the severity of my progesterone intolerance. When I saw him last week I read 228 but I was 3 days post stopping my utro phase and feeling pretty grim. Nothing else has changed so do you think the progesterone was impacting my results?
Thanks
Niamh
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This makes for interesting reading.
Murphy, you mention absoprtion is 'better on arms than lower body which again is apparently less safe'
Is this the case? I put it on shoulders, upper arms. I think the consultant i saw visually showed me this when talking about the gel.
Is it less safe long term?
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Niamh - the progesterone won't be having an effect - my understanding is that although in some parts of the body it can interfere with oestrogen (via receptors) - eg in the uterus, and also the nervous system and brain (so I've been reading recently), I don't think it has any effect on serum levels. If your cycle is now suppressed then those readings of nearly 700 on two pumps suggest that your cycle was not then suppressed but as you say, it is now. Although 218 is not very high it is adequate and if you are feeling fine then why increase? One reading is also not sufficient to say definitively that you remain at this level! If Studd has suggested an increase then maybe try a little extra? You don't want to experience a resurgence of symptoms which can sometimes happen with a sudden increase - tho' this could be temporary.
Hurdity x
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Niamh - the progesterone won't be having an effect - my understanding is that although in some parts of the body it can interfere with oestrogen (via receptors) - eg in the uterus, and also the nervous system and brain (so I've been reading recently), I don't think it has any effect on serum levels. If your cycle is now suppressed then those readings of nearly 700 on two pumps suggest that your cycle was not then suppressed but as you say, it is now. Although 218 is not very high it is adequate and if you are feeling fine then why increase? One reading is also not sufficient to say definitively that you remain at this level! If Studd has suggested an increase then maybe try a little extra? You don't want to experience a resurgence of symptoms which can sometimes happen with a sudden increase - tho' this could be temporary.
Hurdity x
Thank you that's very helpful. I have emailed Studd too. He asked me to increase to 3 pumps not because of the blood tests (didn't have the results then) just because I think that's what he likes to prescribe! I have no symptoms and my cycle is suppressed so no fluctuations so I don't want to increase really. When I've tried 3 before I've felt anxious and jittery, not slept well etc I'm a bit flat at the mo but I'm certain it's still the dreaded utro leaving my system X
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Noheroicsplease - prof studd and my meno consultant at meno clinic told me I could apply the gel anywhere but I've read comments from ladies on this site who suggest that it's less safe on arms, shoulders etc. I'm more inclined to trust the professional opinion i.e. Studd and meno consultant but once you read these things it does make you wonder. If your consultant said it's ok with that application then keep going as prescribed.
Mx
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Hi Niamh,
I'm jumping in here as I picked up on certain similarities between your HRT regime and mine and also your physical stature :) Like you, I'm short and slim, also 42, and have my cycle suppressed as well as issues with progesterone. I just wanted to say that although I can't explain it, like you, when ever I have been taking progesterone or my own cycle has "broken through" to some extent (so I've produced a bit of my own progesterone), my estradiol levels read low (180-210 pmol ish). I've asked my endo about it and she has said the presence of progesterone per se should not affect our estrogen levels - but I wonder (just speculation really) that given our issues with not tolerating progesterone (and I still don't understand fully how this arises), when it enters our system it places a "stress" on our system (I know it, because my sympathetic nervous system goes into overdrive, heart palps, stomach knots etc) - and as we know, any prolonged experience of stress can deplete estradiol levels. Just a theory, but perhaps plausible. I always feel better if I have an explanation for things, so this is my working hypothesis :)
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Oooh thank you interesting yes! I'm really still feeling the impact of my 7 day dose of progesterone even though I'm 6 days post stopping, I also feel quite stressed so maybe it's all had an impact?!! Who knows I wasn't worried until I saw the result so it's mad I'm now a bit obsessed with a number on a piece of paper! Thank you for your reply :) X
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This makes for interesting reading.
Murphy, you mention absoprtion is 'better on arms than lower body which again is apparently less safe'
Is this the case? I put it on shoulders, upper arms. I think the consultant i saw visually showed me this when talking about the gel.
Is it less safe long term?
Hi there - I have mentioned this in the past when women have asked about application - I posted about it here:
All the other transdermal oestrogens - ie all the patches and Sandrena gel - say to apply it to the lower half of the abdomen whereas estrogel is alone in saying the upper half of the body can also be used.
As Maryjane says I would not use any oestrogen product on my arms or shoulders due to proximity to the breast and concentration gradient from the arms - especially from shoulder and inner arm. - and surely this is borne out by the caveats re blood tests? If application of gel to the arm is likely to give a falsely high serum reading from blood samples in proximity - surely this also might apply to other tissues close by eg the breast - ie levels could also be higher than in other parts of the body?
Hurdity x
Basically that's it - the question was posed and I expressed how I saw it - puzzled really - that the one type most commonly used and prescribed by gynaes (Estrogel) is alone amongst the transdermal HRT types in saying upper body is OK (but not on or near breasts). I am just perhaps over-cautious - but in my book shoulders are quite near the breasts - and as there is no long term information as far as I know personally I would go for lower trunk - as I do with my patches and testosterone gel. Not wishing to worry anyone and yes go with what your consultant says - but I still do not understand why this one (estrogel) should be different from the others. Maybe one of you private gals could ask your consultant next time you see him/her!!! You will see Maryjane was also advised this too (lower body).
Hurdity x
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Thanks for such an informative reply.
I'll put the estrogel on inner thighs now...Is that better?
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Noheroicsplease - it is not up to me to say where you should put it - the instructions say it is OK on upper body - as this is a discussion forum I raised the question as to why - which has not been answered. All I am saying is what I would do - but some of the leading consultants say upper body therefore it should be fine! Others apparently say not - and this is what is says for Sandrena gel - as an example:
The Sandrena dose is applied once daily on the skin of the lower trunk of the right or left thigh, on alternate days. The application surface should be 1-2 times the size of a hand. Sandrena should not be applied on the breasts, on the face or irritated skin. After application the gel should be allowed to dry for a few minutes and the application site should not be washed within 1 hour. Contact of the gel with eyes should be avoided. Hands should be washed after application.
This is what is says re Estrogel:
The correct dose of gel should be dispensed and applied to clean, dry, intact areas of skin e.g. on the arms and shoulders, or inner thighs. The area of application should be at least 750 cm2. One measure from the dispenser, or half the prescribed dose, should be applied to each arm/shoulder (or thigh). Oestrogel should NOT be applied on or near the breasts or on the vulval region.
Sandrena does not say you can't apply to shoulders and arms but it doesn't suggest it either. I don't want to alarm anybody at all but this is a genuine question!!
Sorry Meeka I think this is going a bit off your original topic!!!
Hurdity x
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Sorry, Hurdity. I didn't mean to imply that I relied on your information only. Nor did I mean to take this off topic. Sorry. :( :(
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Hey it's OK Noheroicsplease!! It was me that was taking it off topic by taking the question further! No problem! I often say that when I've gone off topic.....I just didn't want to sound as though I was saying you should or shouldn't apply it wherever - but just pointing out that the instructions are inconsistent and expressing my view! No offence meant nor taken :)
Hurdity xx
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I really don't want to take away from the OP or thread jack either, but I just wanted to add as a point of interest that this: https://evamist.com is a new development that I've heard rumours may be making its way to the UK at some point (only rumours)!
Interestingly, this is dosed inner forearm, starting near elbows so I assume a good chance of transfer to the breast maybe? Especially in bed at night when laying on one's side. I wonder if there is any in depth published risk data for this? Just a point of interest - sorry again for thread jacking! :)
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Interesting Tempest and very convenient but I'm not sure I like the idea of an estradiol spray though as some will get into the air maybe and into the environment more than other methods I would have thought? :-\
Re the studies. I can't say I have meticulously trawled the net - too busy for that! Would need to do this full time! However now and again I have a Google when the subject comes up but haven't been able to find anything. The only studies I've found relate to application area (ie size of area covered). There was a detailed paper which investigated that - the results of which form the basis for the standard advice on how to apply the gel and the area of skin to cover. I can't remember which part of the body was used but I don't think that was the subject of the investigation. I did find a paper about Intrinsa testosterone patches which compared serum levels from application of patch to front or rear lower abdomen. I think the same thing has been done for some oestrogen patches (with conflicting results I recall!). Not though for serum concentrations at different distances from the application site nor if the oestrogen is transported laterally through the skin as well as directly through it - it definitely is for testosterone as I read this somewhere. Sorry I don't have any refs - sometimes I click on papers, have a quick read and some info goes in (to my head) but then forget where I got it from!! Even if I bookmark it's difficult as I have so many..... if you find anything or if your consultant (or anyone else's for that matter) has any info ( papers!) - that would be fab :)
Hurdity x
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Many thanks for all the replies......I don't mind at all if it goes off topic a little. .....I think its all relevant really and very helpful to know other peoples thoughts and experiences.
I have always applied the gel to my thigh area......I'm quite tall but relatively slim and weigh under 9 stone.
I had the blood test taken in the afternoon and apply the gel in the evening......Maybe the time of the blood test was relevant in the low reading....
I feel fine and didn't expect my reading to be low. I don't have any sweats in the day but recently I have had a light sweat during some nights........felt more like I had got too hot with too many bed clothes than a hormone sweat. I have been quite anxious but I have things to be anxious about at the moment....work issues etc. My breasts are also quite full at the moment which usually indicates my oestrogen levels are adequate........my breasts tend to deflate when my oestrogen is low. Also my hair is not shedding from my head which was one of the reasons I started on HRT......my hair was getting very thin prior to HRT.
I also have a decent bleed when I use progesterone, only lasts around 3 days but everything looks OK. I guess I will have to see Prof Studd........I have the feeling he may advice an implant due to my bones.....didn't really want to do that. I also have concerns that keeping my oestrogen very high may not be too good in other areas. I havnt been able to book an appointment to see Prof Studd yet as I have such a lot going on at work etc. I have discussed it with my GP ......they are very vague about hrt .
I guess I could increase to 4 pumps and see if I feel any less anxious and these slight night sweats improve, I think I will split the dose, morning and night.
Thank you again for all the replies......much appreciated.
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All, I found a useful site which discusses route implications / pros and cons of different application routes in some detail here :
http://surmeno.blogspot.co.uk/2006/03/route-considerations.html (http://surmeno.blogspot.co.uk/2006/03/route-considerations.html)
Its a blog by someone who's had surgical menopause but it covers oral, dermal, vaginal / rectal, gel, cream etc application. I did find another paper (now lost ref unfortunately) which suggested that further away from the uterus the application was the less dose would be delivered to uterus, but that would be primarily relevant for progesterone - for oestrogen depends where the receptors are....and on the other hand that soft / fatty tissue would hold the dose better.....don't be offended!
Hope that's useful - academic knowledge only on my part but I've found others links useful....
KatyB
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What a brilliant site KatyB - I'd come across snippets from there when searching previously but that link is wonderful. Just discovered that I can take my tablets under the tongue which is avoiding first pass effect - yay! Thank you so much for posting the link.
Mx
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Very glad it was useful, maybe I should post it as a topic so people can find it easier?
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A quick note re measuring estrogen levels; variation in levels can probably also be due to the timing of the blood sample taken as relative to the estrogel or patch application (as mentioned by someone on this thread I think and by Surmeno on her blog). I have a book by a US-based reproductive endocrinologist called Elizabeth Vliet (Screaming to Be Heard: Hormone Connections Women Suspect and Doctors Ignore) where she says measuring estrogen levels are important - not all menopause specialists think so - but that its important to standardise the timing of tge sample: 12 hours from estrogel application or the third day of the patch.
The Surmeno entry on this is really interesting (and really confusing, as I've mentioned earlier on this thread) 🙄
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:thankyou: Kkay - I have that book too! I've only read bits of it and the trouble is when I want to refer to it I can never remember which part of the book I found her golden nuggets of information!
Hurdity x
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Hi, Murph! :)
Yes, sublingual dosing is a great idea isn't it? Just note that its 'off licence' here in the UK (boy, do we have a LOT of catching up to do)!
Imagine if you went to the GP and said 'so is it ok if I take my hrt sublingually'? They'd have an apoplectic.....Half of them don't even know what bioidenticals are and think Estrogel is for VA...... :o ;D
Just wish we had compounding pharmacies and troches too......I'd pay big bucks to have that option!!
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Me too Tempest - we seem soooo far behind. The E cream sounds like a great idea as it sits in fat stores as our own E does, NOT in the outer layers of skin as our own E DOESNT!
How are you doing with Tibolone?
Mx
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Hi ladies,
I'm just dropping by to tell you that my oestradiol level tested Dec 2016 was < 5 pg/ml (< 18.3 pmol/l) which is below test sensitivity. ::)
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Wow Menomale - why is it so low? You must feel wretched!
Mx
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Blinkin' heck, Menomale!!!! Your poor wee soul!!! What if anything are you using for HRT at the moment? Sending you massive hugs! Please know that we''re here to give you any support we can! xxxxxx
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Murph, the creams sound smashing don't they? Also options to have tri-est and bi-est (combination of estrogens), as well as progesterone and testosterone in this medium. Bring on compounding, I say!! Over at Hystersisters, women have HUGE success with these. :)
Re:Tibolone - shhhhh....[[whispers]] ....I don't want to jinx anything...... ;) ;)
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Couldn't agree more Tempest - just sounds like a better fit as we'd be replacing ALL the E's and not just estradiol. Would be interested in cream delivery route too. I'm not at all surprised these ladies are having success. Good for them. Glad you're tibolone is behaving. Maybe this formula/delivery route is your ideal?
Mx
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Hi again dear ladies,
Oh well, I only told you my ultra low oestradiol levels in order to stay on the op's track but if you want to know ALL my steroid hormones were low... Prog 0.17 ng/ml, Testo 16 ng/dl DHEA 0.8 ng/ml.
I'm trying the patches now Tempest. I was on the compounded (NOT recommended/licensed in UK) estradiol, estriol, progesterone cream but I was having local allergic reactions and I'm not very keen on using creams.... Asperger's trait. The patch (Estradot 25 µg) is not having effects so far (but there are other problems going on, so hard to say for sure) and I have not starting the Utro phase, so now just waiting to see what's going to happen. I guess next month will up to 50 µg, all trial and error really.
Isn't it ironic? My former gp is all pro compounded (NOT recommended/licendes in UK) and I'm making her mad right now ;D
Here they have widespread use in all health/beauty areas and the medical boards are not so against it as in the UK but regarding menopause they are not fully recommended as well because hormones are dangerous, right? But testosterone for men is ok! >:(
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Menomale - I would have thought that standard dose hormones which could be way too high/low for any individual would be more dangerous than something which is made to fit your needs?
Maybe your compounded was quite a bit higher in E than the patch which is quite low?
Mx
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In theory, yes, but in practice, the compounded (NOT recommended/licensed in UK) are not the subject of extensive trials and quality of product varies from pharma to pharma, etc, so you cannot be sure of what and how much you are taking, which is potentiallly dangerous.
On the other hand the so called regulated produtcs that are licensed in the UK and elsewhere for that matter (the ones produced and financed by the big pharma companies) are in theory more reliable because they were the subjtec of extensive trials and have been tested for quality, but in practice we all know that this is not a clean business where things are done according to laws and rules.
So in the end, it's all about trial and error, cost/benefit ratio and FREE CHOICE.
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Yes, quite.
Mx
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Answering your other question... I have no idea how to compare my previous regime of Estradiol 1mg, Estriol 2.5mg, Progesterone 50 mg cream (NOT recommended/licensed in UK) to the 25 µg patch 2x/week + Utro (7x /month..12x/month, alternate days, 3x/week... oral, vaginal (NOT licensed in UK)....) ::)
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I get the whole thing about 'textures' with Asperger's, Menomale! I have a female friend with Asperger's who is the same. She can manage one type of hand cream - but all others feel really 'off' to her so I make sure I stock up as little gifts if I visit the Lush store (not sure if Lush has reached you in Brazil)?
Can I just also say that you have 'middle ground' when it comes to the Estradot too. There is a 37.5 patch available, which is good news! All other patches jump straight to 50, so this would be a gentle increase for you. Over at Hystersisters, they recommend that you increase by no more than 25% at a time to allow your body time to adjust - go low and go slow is their mantra for achieving hormonal balance and women over there have good success by following this. It's infuriating, sure - but it's also quite easy to dose into excess by even quite moderate increases.
I know Hystersisters is for ladies who have had hysterectomies, but there is a lot of invaluable advice over there as they are much more 'clued up' on using HRT's it seems. A great guide over there is their 'too much, too little' guide which tells you the symptoms of having too much or too little of estrogen, progesterone and testosterone. Of course, you also have the 'wild card' of fluctuating hormones in perimenopause to deal with too! Hormonal balance makes much more sense when you're post menopausal of course, but hopefully you will find a way to ease yourself through with some relief. I'm really hoping so much for you, Menomale - I know that you're really having a tough time juggling so many things and I hope that we can at least be of some support to you. xxxxx
:bighug:
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Oh dear, I'm afraid no Lush nor 37.5 Estradot are available here >:(
I'll have to jump into 50 or cut the patch (not my primary choice, too lazy to do it, and also may spoil the thing?)
I once registered on the Surmeno blog (because I wanted to see any info and pass it on to my sister who has gone into surgical menopause and does not speak English) and was kindly advised by Framboese that I was not allowed to be there... ;D
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Well!!!! How awfully rude!!!!!! I've never really been a fan of the Surmeno site - there was some very obsessive 'advice' over there about transdermals that I thought was just bordering on the hysterical (excuse the unintended pun)! >:(
Damn! I was so hoping you could get the 37.5!!! You CAN cut them according to ladies here, but I know one of our member's recently had her levels drop a lot from doing this. Hurdity has never had a problem with cutting hers, though. Now, you DO know that you can get slightly more from your patch by wearing it on your behind? I'm not sure if you're actually doing this already? It can be up to 25% more, so if you are currently using it on your tummy as advised in the leaflet, it's fine to switch to your bottom to see if you get better dosage there. If we can help with any tips, we are always more than happy to! :) xxxxx
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That's fine, really, I found the episode hilarious...
I am wearing it on my bottom ::) how 8) is that?
I'll try the 50 (already got them), but if I feel too bad, I'll cut 1/4.
I really appreciate all the info, advice and tips! It's a relief to talk to humans that actually know and feel what you are experiencing! Otherwise I'd rather just socialize with animals, so much easier to feel good without saying anything!
:hug:
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You've already got it then, Menomale! ;) :)
I'm glad you've got the 50's - see how you go, and yes - trim a bit if you don't feel comfortable.
I TOTALLY get where you're coming from with animals! They really are the most loveable and unjudgemental of companions! 🐰🐹🐀🐭🐥🐱🐈🐑🐎 xxxxx
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Hi ladies,
I'm just dropping by to tell you that my oestradiol level tested Dec 2016 was < 5 pg/ml (< 18.3 pmol/l) which is below test sensitivity. ::)
Hi Menomale - not sure why you are getting your oestrogen levels tested - but I wouldn't take much notice of these as it sounds like an error to me - or if you are wanting a true reading I would suggest you get them re-done and try another lab! This level would be extremely unlikely I would have thought - especially if you are not yet 2 years post-menopause and are also taking oestrogen - because oestrogen levels will not have declined that far yet. Do not worry and concentrate on treating your menopausal symptoms without worrying about levels!
Hurdity x
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Oh dear, I'm afraid no Lush nor 37.5 Estradot are available here >:(
I'll have to jump into 50 or cut the patch (not my primary choice, too lazy to do it, and also may spoil the thing?)
I once registered on the Surmeno blog (because I wanted to see any info and pass it on to my sister who has gone into surgical menopause and does not speak English) and was kindly advised by Framboese that I was not allowed to be there... ;D
Yes cutting is absolutely fine - but there might be a problem with uncurling more at the cut edges but as long as you have a quick feel every now and again ::) to make sure it's stuck down you should be fine :)
Hurdity x
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Hurdity - in light of a post which stated that many professionals did not agree with trimming matrix patches as it could lead to 'leakage' along the cut edge, how can you advise cutting with such certainty?
Murphydurf
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I ran out of my usual 50mcg EVOREL patches and by mistake was given 100mcgs patches with my new prescription.
I didn't worry too much and just decided to cut them in half. BIG MISTAKE!!!
Over the last 4 weeks my estradiol levels have plummeted to 90 pmols ! My mood isn't too bad but I am sooo dizzy!
I'm now wearing a 50mcg patch and waiting for my levels to be restored back to there usual 275 pmols.
My endo once told me not to cut patches in half. He said it mucks about with the matrix. Others may be able to but it won't be something I'll be doing again.
[/quote
This was the thread discussing cutting.
Mx
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Hi ladies,
I'm just dropping by to tell you that my oestradiol level tested Dec 2016 was < 5 pg/ml (< 18.3 pmol/l) which is below test sensitivity. ::)
Hi Menomale - not sure why you are getting your oestrogen levels tested - but I wouldn't take much notice of these as it sounds like an error to me - or if you are wanting a true reading I would suggest you get them re-done and try another lab! This level would be extremely unlikely I would have thought - especially if you are not yet 2 years post-menopause and are also taking oestrogen - because oestrogen levels will not have declined that far yet. Do not worry and concentrate on treating your menopausal symptoms without worrying about levels!
Hurdity x
It's unlikely to be an error, I've done 3 tests last year (different labs, I was living in another city) and just had another done this year, similar levels. I won't post them here but if you want I can pm you part of the files. Anyway, all labs in Brazil have to confirm unusual readings before releasing the results.
On a side note, my DHEA levels have increased to normal after starting taking it as a supplement.
I'm not worried about levels, my gp and gynae are. My symptoms haven't subsided so they think there might be something else going on apart from emotional issues and perimenopause.
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Hurdity - in light of a post which stated that many professionals did not agree with trimming matrix patches as it could lead to 'leakage' along the cut edge, how can you advise cutting with such certainty?
Murphydurf
Hi there - since you ask, I can advise with such certainty because Dr Currie said so - I've been around a long time and this was discussed 5 years ago - including on this forum. Dr Currie also posted an answer in the magazine to a question about it (in 2012 I think). She was referring to cutting Evorel conti - and that includes progestogen - but that cutting a combi patch was off licence - although gynaes are fine with it. There is nothing in the structure of a matrix patch which could lead to much of the hormone leaking out of the side!
Hurdity x
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Hi All,
I have also been advised by my meno specialist, who is a colleague of Dr Currie that it is absolutely fine to cut (certainly Oestrodot) patches. Good luck Menomale with the patches. Just for info, I ensured that I got the dose right for oestrogen before starting on the prog and this took 8 weeks until I felt fully settled.
Rhiner x
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It would seem that some consultants say yes, and others, no. Like so many other things discussed on this site, there are no definitive answers. As I remember, Dr Currie also sanctioned arm application of gel but that was questioned by some on here. Unless you are a medic, you are NOT qualified to prescribe how, when or why women use what they do.
Mx
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Hello Hurdity ! I actually went to see her many moons ago after reading her book, when I first developed premature ovarian failure. It was she who put me on Estrogel, which had just been licenced in the US that same month I think. It eventually worked for me, but took many many months and playing around with the dosage and location of application.
I wish I hadn't been persuaded to switch to Tibolone two years ago - it's a great drug for many women, don't get me wrong, but in hindsight I should have been given local estrogen with it; struggling with VA now and I suspect, vulvodynia as a result. 😞
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Does anyone know what the oestrogen levels should be whilst on HRT, or what is considered normal? I had a test in my 40s when on the gel and the circulating level was if I remember correctly over 600 and then when I had it retested a few yrs bk it was down to 200 not sure if there is a guide line as to what is considered too high or too low.... :-\
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Hi Cassie
My GP has said 'normal' is anywhere between 100-1000. But everyone is different.
My last test was 253 and I was tested as I was having low symptoms: feeling unwell, sinus tachycardia,
joint pains, extreme tiredness, foggy head whilst using Femseven 100 patch.
I was switched to Estradot 100 and my symptoms have now settled.
My highest level was 2300 when I wasn't absorbing Oestrogel correctly so was changed to patches.
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Wow Salad 2300 that is high, when you say you were not absorbing it correctly, you were clearly absorbing it in huge amounts? Interesting how we are all so different and how we absorb the meds so differently....
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Hi Cassie
Yes. That rather impressive level was done three hours after my morning application! My GP suspects I was absorbing it all in one hit rather than throughout a 24 hour period, as between 3-5pm I had all my low symptoms back.
I swapped to patches and my level dropped back to 'normal'.
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Hi Menomale
Did you ever get this sorted ? Was it on Estrogel or switch to patches ??
As i have just had my saliva test results back and i one pump of estrogel recorded 3.9 pg/ml which is around 18 nmol
Big hugs
Yx
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Hi Menomale
Did you ever get this sorted ? Was it on Estrogel or switch to patches ??
As i have just had my saliva test results back and i one pump of estrogel recorded 3.9 pg/ml which is around 18 nmol
Big hugs
Yx
Hi yriches65 - just to let you know that when a name is in black with the word 'Guest', as Menomale's is, it means they are no longer a member of the forum.