Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: Tc on February 02, 2019, 05:12:22 PM
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Hiya ladies. Im absolutely certain that I'm either not absorbing any E or the dose is way too small.
3 months on patch and my E was 100 even doc said it's like you have been taking nothing at all.
2 weeks on eastrogel 3 pumps and my symptoms are actually getting worse. I wasn't expecting to see any positive changes so soon and know it takes time to build up but I certainly didn't expect things to get worse. Hot flushes are back, VA is getting worse by the day and my skin is so dry and itchy and don't even start me on anxiety and insomnia..even new symptoms caused by lack of E are emerging.
I have said this on another thread but I think because I wasn't in meno before my operation I might have needed a higher dose to start with.
It seriously feels as though I have been 5 months without any E at all i might as well have been taking nothing, it couldn't be any worse and, at least I wouldn't have had the side effects of the progesterone!!!
I've upped the gel to 4 pumps today but felt like jumping to 6 to see if it actually has an effect. This might sound over the top but I actually feel like My body is screaming for eastrogen.
Has anyone else had this issue. Any experience advice would be so appreciated.
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Hi Tc,
What dose of the patch are you using? I had trouble absorbing the patches and gel so Chelsea and Westminster suggested the pellet.
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Hi sj.
I was on femseven sequi 50 now I'm on eastrogel and utrogestan.i have just been reading about the pellet today funilly enough.
How many pumps of the gel were you on?
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I actually used both. I would put on a patch and add about 2 sachets of Sandrena gel to that. I was too scared to have the pellet so I tried 1mg Ellest solo tablet instead. This seemed to help most symptoms apart from VA.
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It's tricky because if I'm not absorbing then it doesn't matter how many pumps I use I would've thought .
To me it would stand to reason that 50mg properly absorbed is better than 100mg not absorbed i might be wrong.
That's why I think if I up the dose to the maximum now and am still getting these worsened symptoms I will know that its an absorption problem. And may have to try something else.
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Hello Tc,
Physiological amounts of oestrogen are the best to improve symptoms and they vary amongst women. Increasing the dose doesn't necessarily improve symptoms. They may get worse, actually. https://www.nature.com/articles/1300708
I have a theory that women who went through surgical or chemical menopause don't respond the same way as women who went through natural menopause. Maybe estradiol receptors have been downregulated and no matter how much estradiol you are taking, your levels won't be high enough. If this theory is correct (even if it's not the whole picture) there's no absorption problem at all.
Conolly X
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Oh god. How do the receptors get effected?
I also think hrt after surmeno or chemical meno is different especially if you were not in meno before the op/treatment but then...
I was reading the other day that the only difference between surmeno and natural post meno levels are in the testosterone.
I hope and pray the receptors haven't switched off for good
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Hello Tc,
Have you heard of the critical period hypothesis, a 'window' of opportunity to replace oestrogen around perimenopause and early menopause, and if that window is lost, oestrogen doesn't have the same beneficial effects on bone and heart? Well, I think that this critical period works completely different for surgical and chemical menopause, the dowregulation of receptors could be 'accelerated' by the sudden drop of hormones. I have this theory that prior to oophorectomy the doctors should schedule the op in order to synch it with the patient's menstrual cycle, when both oestrogen and progesterone are low (around period), and immediately post op begin HRT, with oestrogen, progesterone and testosterone, trying to simulate the patient's levels pre op. After that the regimen should be adjusted depending on each patient's age, to simulate perimenopause and finally menopause when the lowest dose needed to control symptoms should be the rule.
This recent article suggests something like that could be happening https://www.spandidos-publications.com/10.3892/mmr.2018.8618'text=abstract
Conolly X
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Conolly it makes perfect sense. Thank you.
I only started hrt 4 weeks after op and thats why I crashed. I realy shouldve woken up with a patch on as they do with younger wonen but they were reluctant until the pathology of my tumour and results of the wash cane back.
I hope the fact that it seems i haven't been getting E for the last 5 months hasn't done permanent damage
It's such a worry.
Thanks for the link. You have addressed something I've been trying to find out for months.
I will read it tommorow when I can take it in better. Xxx
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Hey Tc,
Up the pumps to 4 (I can't manage on less than 4). FYI I have been told on the forum that although the widely authorised max dose is 4, you can actually go up to 6 quite safely. There are ladies on the forum who use 6 pumps. Again you do need to let it settle, ;) ;) ;D ::) and up them gently.
Your body has had a shock, it has been without E for a while at all. It will take a while to build its level and you have not yet done a month!!(I wish you could see me smiling when I am posting this ;D) It has taken me 7 MONTHS!! and I am not in surgical menopause, but I was obviously very low in oestrogen given the severity of my list of symptoms as you well know!! because you commented on my story:)
Try 4 pumps every day for the next two weeks and see if the flushes come under control because that is usually the first symptom to go. XXX
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Thanks lady. I see you smiling :)
I guess I'm worrying a bit about not getting any E in almost 4 months on the patches especially as the doc said it was as though id been on nothing.
As you know im impatient but i think thats because i keep seeing it as another week going by without E . And t that might be doing damage to my body just dont want things to deteriorate even more and I think my VA has.
. But when I calm down and think it through My Hot flushes did stop on patches (Although it was the only thing) so I must've been getting something just far too little.
I will iup the gel dose gradually. I Promise.
Although today I did feel like just covering my whole body in it lol.
Incidentally I've been putting it on my thighs and rubbing in very vigorously and today I had two big matching bruises on each leg!!!
Keep well lady xx
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bruises - oh for flips sake!! Tc ::) x
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Oh god. How do the receptors get effected?
I also think hrt after surmeno or chemical meno is different especially if you were not in meno before the op/treatment but then...
I was reading the other day that the only difference between surmeno and natural post meno levels are in the testosterone.
I hope and pray the receptors haven't switched off for good
Hi there Tc - where did you read that about oestrogen levels? In fact I was reading a paper which said quite the opposite! The post-menopausal ovary has been shown to continue to secrete androgens which are converted into oestrogen and testsoterone. There is also production of androgens from the adrenals and oestrogen from fat cells but the ovary does continue to be a source of oestrogen in the body.
Also when would one define menopause? According to the stages of reproductive ageing - the ovaries continue to be active in terms of follicular activity for up to 7 years post-menopause so this would be a direct source of oestrogen - even if nowhere near as much as when ovulating, of course.
Whatever the reason, then surgical menopause does put the body into sudden menopause which is worse when you have not yet reached natural menopause because of the sudden withdrawal of a major source of oestrogen and androgens.
It's a tough one trying to replace hormones at the right level!
Hurdity x
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I can't remember where I read it hurdity. There's a lot of mis information out there as you know.
My gynae did say though that "you would've gone through meno naturally soon anyway and so it's the same but I felt I t might have taken years to transition but No meno to post meno overnight. No time to adjust.its too much all at once.
I have found It hard to get accross thst its different If your not meno when it's performed so thank you for your reply and to conolly for hers. I think if your not in meno when it's done you should probably start on a higher dose. Which can eventually be slowly lowered. It would be so much kinder to the body and it makes perfect sense. Instead the opposite has been done and it's too much of an initial drop resulting in a following uphill battle of increase. Anyway that's all too late for me now.
I so regret that i didnt go through natural meno supplementing what is decreasing if I needed to and I might or might not have chosen to instead of having to replace a total loss which I feel.i now have to do .And now seems I can never do anyway.
the ovaries continue to make some androgens but I dont know which ones because the only one that seems to be supplemented is T. Do you know what the others are and if they can be replaced
I would imagine that from whst you and others are saying an oopherised woman taking hrt could get her levels up to the same as a natural post meno lady but might need higher doses to do it?
Or is it that the natural meno is getting at least some from ovaries and that is superior or works differently in the body.
Does it mean whatever I try to replace wont work the same or as well for me and that I can't replace everything a natural post meno has and so will be disadvantaged whatever I do.
And the receptors If they have shut down then surely nothing is going to work for me.
I've already gone ifrom having not a single problem vaginally to 6 weeks later having VA bad enough for doc to diagnose it on examination. It feels so unfair that it got so bad without me even having a chance to try to prevent or treat it.
I realy feel this urgent unending need to replace what I have lost and that in no small part could be my body craving what is missing.chemically. and it makes me impatient and anxious for things to not keep on deteriorating.
I feel that I will always be inferior somehow because ive had my ovaries removed even amongst other women who are post meno but intact. I dont mean thst to offend anyone on here who have all been so supportive. It is my feeling and none of you have ever made me feel that way I wish I could say the same for a particular site I first looked at which I think actually planted that seed by telling me that. The effects of which have been realy damaging to me and others.i wish with all my heart I'd never looked at it.
The idea that the rest of my life will be so much harder in so many ways because I have no ovaries it's so hard to bare.
Thank you so much for your reply. Sorry for spilling out so many questions I do have so many I feel I need to answer and feelings to resolve which I'm sure you don't need to hear. Sorry. I just have no one I can say it to.
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Very helpful indeed petricher.
I think you may be right. The last week I was on the patch before I had to change over was the best week so far.
But that patch is out of production now.
I'm going to try splitting dose because night time And early morning seem to be the worst
Thank you and I will check out the link.
Hope you are keeping well. Best wishes
TC
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I can't remember where I read it hurdity. There's a lot of mis information out there as you know.
My gynae did say though that "you would've gone through meno naturally soon anyway and so it's the same but I felt I t might have taken years to transition but No meno to post meno overnight. No time to adjust.its too much all at once.
I have found It hard to get accross thst its different If your not meno when it's performed so thank you for your reply and to conolly for hers. I think if your not in meno when it's done you should probably start on a higher dose. Which can eventually be slowly lowered. It would be so much kinder to the body and it makes perfect sense. Instead the opposite has been done and it's too much of an initial drop resulting in a following uphill battle of increase. Anyway that's all too late for me now.
I so regret that i didnt go through natural meno supplementing what is decreasing if I needed to and I might or might not have chosen to instead of having to replace a total loss which I feel.i now have to do .And now seems I can never do anyway.
the ovaries continue to make some androgens but I dont know which ones because the only one that seems to be supplemented is T. Do you know what the others are and if they can be replaced
I would imagine that from whst you and others are saying an oopherised woman taking hrt could get her levels up to the same as a natural post meno lady but might need higher doses to do it?
Or is it that the natural meno is getting at least some from ovaries and that is superior or works differently in the body.
Does it mean whatever I try to replace wont work the same or as well for me and that I can't replace everything a natural post meno has and so will be disadvantaged whatever I do.
And the receptors If they have shut down then surely nothing is going to work for me.
I've already gone ifrom having not a single problem vaginally to 6 weeks later having VA bad enough for doc to diagnose it on examination. It feels so unfair that it got so bad without me even having a chance to try to prevent or treat it.
I realy feel this urgent unending need to replace what I have lost and that in no small part could be my body craving what is missing.chemically. and it makes me impatient and anxious for things to not keep on deteriorating.
I feel that I will always be inferior somehow because ive had my ovaries removed even amongst other women who are post meno but intact. I dont mean thst to offend anyone on here who have all been so supportive. It is my feeling and none of you have ever made me feel that way I wish I could say the same for a particular site I first looked at which I think actually planted that seed by telling me that. The effects of which have been realy damaging to me and others.i wish with all my heart I'd never looked at it.
The idea that the rest of my life will be so much harder in so many ways because I have no ovaries it's so hard to bare.
Thank you so much for your reply. Sorry for spilling out so many questions I do have so many I feel I need to answer and feelings to resolve which I'm sure you don't need to hear. Sorry. I just have no one I can say it to.
The endocrine production and synthesis is complex but ultimately the two hormones that can be depleted and that we want to replace are as you say - testosterone and estradiol. I don't want to burden you with links to too many studies but there is plenty of information, and detailed studies out there which show that the post-menopausal ovary continues to be a source of estradiol (and as far as I understand it both directly, and indirectly through conversion to androgens) for some years post-menopause, and androgens - ie testosterone via DHEA for many years.
You are right in saying that replacing these hormones exogenously (outside the body) is different from their endogenous production when everything is working and bio-feedback mechanisms operate etc - but we have to make the best of our declining hormones and replace how we can. Although I still have my ovaries - nevertheless I am still replacing oestrogen as well as testosterone because of the symptoms I experience without them - so I am similarly making use of external, exogenous hormones, however imperfect that may be.
Your receptors won't have shut down - as far as I understand it they remain responsive to oestrogen (although possibly not in the endometrium which can become atrophic in the absence of oestrogenic stimulation I did read?) - otherwise HRT treatments wouldn't work nor would VA treatments!
By the way I can't remember if you are currently taking a VA treatment as well as systemic oestrogen?
In terms of patches v gel - it seems that different women absorb these products differently and it will be different too for women without ovaries. I have only ever used patches and I find them a very stable medium of delivery - but then I am not on a high dose. It seems some women are more affected by the "hit" of oestrogen from application either by gel or by patch and you have to arrive at the method that works best for you.
I can see you may be to some extent mourning the loss of your ovaries, as well as other losses in your life, but try not to worry Tc and regret what could have been and concentrate on moving forward little by little to make the best of what you have and your situation now - and I know this is difficult.
Take care
Hurdity x :bighug:
PS re your last post - you can get the same progestogen as was in the femseven patch from a Mirena coil ( I might have already suggested this?) and then use a different oestrogen only patch with it - if you found the Femseven patches were helping?
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Hi hurdity and pettichor. I don't feel bombarded at all. It's all very helpful. I always read them but wait till I'm in the right frame of mind. Thank you petrichor for sharing your own experience.and to both of you for your words of comfort.
Hurdity. You asked me a couple of questions thank you and..
VA: I am using estriol 0.01 I internal and external. After the loading dose of 3 weeks I have found I can't bring it down from every other day and even that isn't controlling it.
You mentioned uterus.:
my uterus feels as if it is asleep if that makes sense.
It was perforated during my op which they said was caused because I have a retroverted uterus. Its something I have been told before and i think it's quite common. I didnt have a bleed on the patch.
're the coil. The doc mentioned it but I'm not sure. My sister uses it for contraception. She also has a retroverted uterus and has had problems removing it each time. the last two times they couldn't find it which resulted in her having procedure to remove it.
Also with me the injury to womb during surgery was repaired inside and out and might well be scar tissue
I've got trans vag scan on Saturday .
All the best hurdity and petrichor xxx