Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: Tc on February 01, 2020, 12:45:44 AM
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Hiya, ladies. I had the estradiol implant inserted yesterday.at C and W Panay clinic. I seem to be one of only a few here who've tried it so I thought I might share my experience.
Bit of background and quick update I'm 54 and 18 months post surgical menopause uterus retained.
Despite trying eastrogel 6 pumps and various high dose patches my E blood level remained low. And symptoms not controlled at all.
I switched from 2x 100 .estradot patch to 3mg sandrena in late October and my blood was around 130pmol . Yesterday it was 358pmol.!!!! I've never absorbed anything that well but was stunned by that . as guess what? .. I havent felt one tiny bit better for it.. I would never have thought it possible it could more than double and I wouldnt feel the difference, , that with a decent level like that the would be zero improvement.
The doctor said "some women just need more" so we went ahead as planned. With..
The implant
lasts 6 .months .aims for between 300- 600pmol She said most women get into the upper range. but it can go much higher, maybe even.too high in which case they dont put a new one in until levels decrease.
It cant be removed so if you have to reduce eastrogen quickly, for health reasons then some form of inhibitor would be needed. . .
Blood levels can remain elevated after its reached the end of its life and may possibly stay that way for some time.during which if you have a womb you must remain on progesterone until your bloods are in post meno range.. it doesnt just drop like it would with other methods
I've been so desperate to feel better for so long I would try anything but Im aware of these risks. all the other risks are much the same as transdermal.
You must be on continous progesterone and as I cant tolerate utrogestan conti the doc wasnt happy for me to have the implant unless I had a mirena fitted. . So..
.yesterday. I had the coil fitted then the implant it's a pellet not much bigger than a grain of rice . local anaesthetic into my lower tummy. Small incision and its inserted under the skin into the fat. One dissolvable stitch and dressing. It's not painful. (Wish I could say the same about the mirena!!)
It will take between 2 and 3 weeks to fully kick in. So I've got to still use the sandrena, tapering down, and see how I feel after 2 weeks.
I can have the testosterone implant too. But I said I want to research it further so meantime I'm still on the testogel.
I feel apprehensive like I've just got on a ride I know I cant get off til the end and I'm waiting for it to start, but it's a bit exciting too. I just hope it doesnt crash.
I Will post updates if and when theres anything to report. Xxx
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Oh Tc - so pleased that at last there is a plan and someone is listening and actually doing something!
Sounds interesting and yes I suppose it is a bit scary as it is an implant but I too have everything crossed that it just makes you feel better xx What is the follow up? Will they do regular testing or want you to report how you are feeling?
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Do hope everything works out for you Tc good luck.
Please keep us updated
Lanzalover x
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Finally something has been done after you struggled for so long.. I'll keep everything crossed for you! 🌷
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Thank yo so much ladies.
Ladybt I've got a,follow up appointment in may. I will need to get blood tests for that.
Xxx
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Great news - love it when a plan comes together :)
Hope all goes well.
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Do discuss at the next appt. how the inhibitor will be administered if it becomes necessary. Do you keep a diary of progress which might be useful?
HORMONES >:( ::) - at last you have been listened to!
:foryou:
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Hi Tc
Good luck with your journey, really hope this is the beginning of you feeling good, after all this time..
Jeepers xx
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I hope you feel better soon. I've had a testosterone implant but now on Tostran. I would advise transdermal unless you don't absorb that either. Mine took 3 weeks to work then stopped at four months, and there's the worry of what happens if you can't tolerate it. Two implants every 6 months will add up to an awful lot of scars.
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Thanks ladies. Sheila.
I have heard about women feeling that the implants run our after 4 months.its called tachyphylaxis. It's a diminishingg response despite eastrogen levels being high. Some doctors then replace the pellet too early and it exacerbates the problem. I've been told it's not uncommon to have to "top up" with gel or patch in the last few weeks of the pellets life.
I'm not worried about the scars if it works . But with the T I am nore hesitant. Theres so little information from research about the long term effects of T replacement. At this point in time. Plus. Having more E might leave more unconverted T to do its job and I might then need to use less testogel than I have been. I use a sachet a week at present.
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Thanks for all the good wishes ladies.
I'm feeling a bit rough.from the mirena cramps and it seems to have upset my bladder. I hope I can get on with it as I had awful problems with utrogestan and would hate to have to switch back.
Xxx
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Tc, what do you mean when you say "Having more E might leave more unconverted T to do its job and I might then need to use less testogel??
To my understanding oestrogen raises SHBG which binds testosterone. So with higher E you will have less T available?
Did C&W gave you recommendations on your use of Testogel?
Levonorgestrel orally ( progestin in Mirena) can lower SHBG but I don't know if if does the same when it's inserted as a coil.
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Alice. Thank you. I'm thinking that because I was told by my previous gynae that when E levels dont meet the bodies needs we convert Androgens to eastrogens. Leaving less available to address the testosterone needs. Or as I clumsily put it "do its job" 😀 She said thats why ideally E should be replete before starting T therapy. And that does seem contradictory or confusing to the effects of E on SHBG binding T.
Have I got it wrong? I am a bit confused over it still. It's one of the things in HRT that I've never completely wrapped my head around.
The doc said I can continue using a sachet testogel a week. She didnt test. Maybe because I've got no ovaries there is less chance of Overdoing it. Dont know if it works like that I've been on it since about last April. The doc who originally prescribed it said if you've had oopherectomy you will definitely need T replacement. But I must admit I havent felt any of the expected benefits of it in all this time.
I've just looked it up and you are correct. Levenogestrel has been shown to decrease SHBG in all its forms.
Xxx
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Hi Tc
Just wanted to say I really hope this works for you. I've followed your story and know how you've struggled.
Re the SHBG thing I've never got my head around it either, but I do know the mirena kaiboshed my libido/response, and that it returned to normal (with a vengeance) within 48 hours of having it removed. Like you say though the T implant is always an option if you so choose.
Please keep us posted re your progress. Wishing you well xx
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Thank you perin. My libido did a,disappearing act along with my ovaries!! I so I probably wont notice any difference. I wonder why the mirena has that effect. Xx
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It's confusing, isn't it! Our own testosterone ( endogenous) can convert to oestrogen, yes. That's where we get part of our oestrogen from; the conversion from testosterone to oestrogen ( aromatase)
If exogenous testosterone, Testogel and others, will convert to oestrogen in women is not clear yet. It does in men though.
Oestrogen raises SHBG, SHBG binds to testosterone and to a lesser extend to oestrogen. More testosterone can lower SHBG.
Levonorgestrel has more androgenic properties then other progestins so maybe that's why it can lower SHBG
I think of SHBG as a kind of gatekeeper, trying to keep the balance.
I feel it depends on a indiviual's needs and responses if one needs higher oestrogen levels before introducing testosterone. It's so complex and so much is still unknown.
I would go with your doc's advice. If you change anything else right now it will be very difficult to know what's causing what. You've had so many changes allready.
I really hope you will start to feel the benefits soon!
Alicess XX
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Interesting Alicess. Yes give the implant chance to work before you add anything else in Tc. Just to say though that it's not only levonorgestrel that flattened libido/response in my case, every progesterone I've tried has had the exact same effect x
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I was thinking about you the other day Tc as had not seen any posts. I'm glad you've finally got the implant and will be keeping everything crossed that it all works well for you. Please do keep us posted.
Rosie63 x
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Thank you for that Alice. Interesting . And thank you perin. I think you're both right about not changing everything in one go. It's why I refused the T implant this time. So I will keep to my usual T dose.
It's a bit unknown waters as to what will happen as I taper down the sandrena,, whether I will feel the implant kick in.
Hiya rosie. Thank you. I will of course keep you all posted.
Xxx
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hi tc
i don't understand it all as some who have had ovaries removed are perscribed E and T together and also P all at the same time yet other menopause specialist like mine have advised that you need a good level of estrogen other wise tesosterone will convert to estrogen and will not work as testerone in the body the problem once ovaries are removed is without replacing all the hormones in my opinion at the same then creates imbalances in the body as your hormones after ovaries are removed are depleted but i guess we can only work with what we are advised by our specialist x
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Yes sammie. There does seem to be some difference in the approach to this in surgical menopause. I was told by my gynae that because I was in surgical menopause I was definitely going to need T so she wanted me to start it even though E level was low. . We only have our adrenals to rely on. And tbh I think mine are knackered!!
Progesterone. i have read some ladies post hysterectomy add P to their regime because they feel unbalanced without it.
I suppose you have to weigh up the increased risk of adding progesterone to HRT if you dont need it to protect the endometrium.
I get what you say about balance. Progesterone is supposed to have benefits in it's own right like aiding sleep.t I've had an awful time with the progesterone part of HRT. And would happily take it out of the equation, but maybe that's because iit wasnt well enough balanced with E .
Xx
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hi tc
can i ask if the tesosterone has caused you hairloss if your estrogen is low ?
also do u still have your uterus ?
i?m going to try adding progesterone as i don't feel great on estrogen alone i have mood swings i'd rather feel low ! plus i've had hairloss on estrogen only so hoping adding in P will help in unsure whether to add T aswell at the same time cause i have zero energy no get up and go x
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I do have my uterus sammie. I had hair loss before I went on HRT and it's got no better and no worse. Xx
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Hi Tc - I was also thinking about you as hadn't "seen" you for a while - hope it all goes well for you now you have an impant! Fingers crossed....
Hurdity x
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Thank you hurdity.. xx
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Hiya ladies. It's been 3 weeks now.
first couple weeks o.k. but I dont think the implant has kicked in yet as I'm realy feeling the tapering of sandrena gel.this last week. It might take more time.
But my biggest issue is possibly the mirena,.. . I'm now getting all the side effects I got from utro. Including depression, nausea, shakiness and I've had a migraine too which I hadnt had since last time I used utro.
. It started after about 2 weeks which was also when I dropped the sandrena to 2mg. So whether it has taken 2 weeks for the P effects to build and be noticeable or whether the implant hasnt kicked in enough to balance it when I dropped the gel dose I dont know.
I wonder if these things settle in time .with mirena . If maybe I'm reacting to the initial dose and body will become accustomed. But the depression is the most worrying thing. . I m scared of going back down that road.!! At least on a cycle I learned my limit from bad experience and was eventually able to prevent it getting bad for too long by stopping the utro.
So, I'm panicking a bit. Thinking if this is how it's going to be with the coil depression wise it's a deal breaker.
Incidentally , Has anyone with mirena experienced leg pains? like when you've got flu. (I havent got flu) . . Worse at night. Might be unrelated but started at same time so I thought I'd ask.
Xxx
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hi tc
it will take a while to kick in i guess like any hrt x fingers crossed for you though
i started my journey 13 days ago on combined gel and utrogestan and so far so good
my hair shedding stopped when i came off hrt from using gel on its own and so far hasn't got worse what has got a little worse is vagina dryness and aniexty and i?m experiencing a few more flushes adding in progesterone so see how it goes may need to increase estrogen for that with regard to aniexty i had this before in estrogen alone so isn't the P effects and the more estrogen i took the worse it got i have found though i need to take utro same time every night x the dryness i?ll have to monitor x applying gel to my arms and feeling a little top heavy as boobs a slightly tender now to be expected with adding in hormones so i?m confident it will settle and isn't as bad as estrogen on its own i had it so bad couldn't touch my breasts or where a bra was awful x
so i've got my finger and toes crossed for both u and I that it works . if not then i will have to change from the gel to patch or tablet x i?m guess i?m worried that i?ll obsorb even less with a patch x
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Hiya,sammie. Thank you.
I found I absorbed sandrena gel far better than patches. I apply to top of legs rubbed in well a hand sized area. Per dose/sachet. I was on 3 sachets so although I applied all 3 at same time to the same leg I did each dose one at a time.. So I rubbed in 1 sachet then the next slightly higher up and not over the same patch of skin. Changed leg next day. I found that system seemed to give me good absorption.
Good to hear your hair loss hasnt worsened.
You may need to increase E but it needs more time before you will realy know that for sure. Meantime get some ovestin cream for the dryness. I wish I had a quid for every doc who has told me "systemic eastrogen should sort that out". Plenty of us know different and have to use local too.
Good luck and give it a bit more time to settle on your new regime. X
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hi tc
well at least i can rule out progesterone having any effect on my hair cause if it sheds again i?ll know it makes no difference so will stop it and change estrogen unless of course i feel fantastic and loose the weight i've gained etc
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Hi Tc
Re the mirena side effects for me kicked in after exactly 2 weeks (thought I'd got away with it up to then) and never got better throughout the whole 6 months I had it in. Apparently, levels do eventually drop off, but I just couldn't wait that long as I thought 6 months was long enough and so I had it removed. I also got the leg pains, which went once it was removed. Really hoping it's better for you than it was for me as I know how you've struggled.
Sending you a hug x
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Thanks perin. Sounds very similar.
I wont be able to do 6 months that's for sure.
I wonder what it is about it that causes the leg pain. It's one thing I didnt have on utrogestan.
Iyou would think lower doses would equal less severe side effects but it doesnt seem to work that way for me .. I was just as bad on utro 100 as I was on 200. Mirena,is far lower still but I feel just the same as if I'd had a whacking dose of utrogestan. Is that what progesterone intolerance is?
Maybe I'm prog intolerant after all.
X
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Hi Tc, I don't have any experience with the Mirena so I can't give advice about that but I did have a birthcontrol containing Levonorgestrel and at first it made me depressed too. After about six weeks those feelings and other side-effects subsided and I felt fine. If these side-effects started when you decreased the Sandrena it could be the pellet hasn't kicked in yet as you say, as the estrogen counteracts the progesterone. Did they give you any indication how long it would take for the pellet to work fully?
I do have leg pains but no Mirena,. For me it feels like my trousers are way too tight , even if I don't wear any, and something is oppressing the veins in my legs. Restless legs too.
Alicess X
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Hiya,Alice's thank you for that. I was told 3to4 weeks for the implant to kick in.
I have always suffered restless legs but not the pain. Closest thing I liken it to is "growing pains". I think the tightness you describe in your legs might be part of restless leg syndrome. It can make you feel like even having covers over your legs in bed is uncomfortable .
Good to know the side effects of levenogestrel subsided for you. Makes me not panic quite so much. Xx