Menopause Matters Forum
Menopause Discussion => Personal Experiences => Topic started by: TNM45689 on March 01, 2020, 08:03:53 PM
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Hi
I have been on HRT for 2 years now - I am 48 (3 years post menopausal and have osteporosis). I tried patches for over a year but my estrogen levels never got high enough (up to 150). Been on gel for 6 months - was on 4 pumps (but levels still only 18) so have been increased to 5 pumps and testosterone to add to the mix.
Should I just give up with gel/patches as it really seems I have an absorption problem and go for oral.
My main HRT sympton is low mood, libido, terrible insomnia but I need HRT for my osteporosis more than anything else.
Any personal experience/guidance would be much appreciated.
xx
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Love your response StellaJane.
I will be a good girl and take for a couple more weeks and then ask for tablet. Are there different options for tablets (just oestrogen)?
Tx
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Hi
Just wanted to make sure you're not using moisturising shower cremes, or bath oils or body lotions? These all leave a film behind on the skin which hinders absorption. Even a spray tan can stop transdermal HRT from working properly.
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Thanks GypsyLeeRose - no I make sure I do not cream in those areas. Sooo bizarre but also weird that Chelsea and Westminster just keep upping the number of pumps rather than prescribing oral tablets.
Thanks
x
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I don't absorb either. Have tried 6-7 pumps gel per day plus patches. Nothing works and no doctor can explain why!
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I'm a poor absorber too! On 100 Estradot my oestrogen levels were 100, on 2x100 patches my oestrogen levels were 257. I have extremely high SHBG and testosterone proved to be the key. As soon as that was introduced my oestrogen levels (still on 2x100 patches) rose to the 700s and my latest blood tests put them in the 800s (even 'though I have slightly reduced the testosterone).
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TNM and ladies.
Another poor absorber here.
I stuck 2 x 100 patches on for 9 months and my E reached the dizzy heights of 149 pmol. !! Zero symptom control. 6 pumps eastrogel was no better. I tried every variation of application and gave everything a decent time.
I couldnt understand it. Docs couldnt understand it. It was frustrating to say the least and at times it felt soul destroying so I realy realy sympathise.
After 18 months of blood tests (and I had one every 3 months) consistently showing poor absorption c and w meno clinic considered me for the implant pellet as all else had failed. But...
In the meantime I was switched by them to sandrena gel. 3mg (an off license dose) and my level went up to 358pmol after 3 months. It more than doubled. It was the only thing I absorbed.
Maybe given more time it would have even increased more but i felt my symptoms were still not controlled ( im in surgical meno ) so I went ahead with the pellet implant 4 weeks ago. Too early to say whether it's a good decision or not.
And . I personally viewed it as a last resort as it has drawbacks the other methods dont.
Hiya saffy. We have shared our non absorption woes before so I'm pleased as punch you are finally getting results. Interesting that T made the difference for you. Ive been on daily testogel since more or less the beginning and It didnt seem to have any effect on E for me. But it clearly has for you. The thing is I've never felt any benefits from T whatsoever. Even now. So Maybe I'm not absorbing it.
Dont give up ladies. If saffy and I can get our levels up after such a struggle then there is hope for others.
Xxx
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Thanks so much adies. Just about to introduce testerosterone so fingers crossed....
AlphabettiSpaghetti - what are you going to do next.
I think I will try 5 pumps and test for a few weeks and check things again and if not prob opt for oral route..
xx
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Hi stella. My skin tends on the dry side but isnt thin. I'm also quite well padded shall we say so dont know if that hindered absorption.
X
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Mine isn't thin but I am quite petite - it takes for ever for gel to dry but I keep rubbing it in as I was told this is the best way to asborb.
x
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TNM. I was told that too. I rubbed in well to a smallish area about palm size on a different patch of skin for each dose. I did exactly the same for eastrogel and sandrena. The eastrogel I didnt absorb the sandrena I did.
Xx
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I have dryish skin but not sure if that's why I don't absorb.
I'm just in. The process of sorting out my endometrial biopsy as I have thickened lining (hyperplasia) but the meno clinic said (in November) they were going to see if they could get me an implant (oestrogen).
It sounds like the implant is almost impossible to get on nhs and that also it might not be well tolerated by a lot of women
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I don't know if I'm a poor absorber of just need extremely high doses of estrogen. I've been on birth control from the age of 14 till age 48. Had to as it controles my cluster headache Then a gynaecologist prescribed 75 mg patche and Urtrogestan and I almost immediatly had all menopause symptoms and my skin aged in only three weeks Since then birth control only keeps CH a bit at bay but doesn't control my symptoms of cycle.
I' ve tried 400 mg patches, 8 pumps Estrogel, Premarin and Tibolone . They alle made my symptoms much worse including more and more hot flashes and skin aging almost overnight.
Like you Saffy, my SHBG is over 200 , testosterone made it worse too, maybe because my estrogen isn't high enough.
I've tried oral BCP; 1,5 mg Estradiol with normegestrel, and besides ( again) a worsening of symptoms I grew a real beard on my chin.
According to the BMS 2 mg oestradiol tablets ( oral) is equivalent to a 50 mg patch.
My skin is very thin, dry and like yours, Stellajane, super fragile and easily brused.
Maybe some of us need a higher estrogen dose or absorb better orally or SHBG is too high and binds too much estrogen?
I wish I knew the answer, I'm at a loss.
Alicess.
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Alice. Did the doc take you off the birth control pill and put you on 75mcg patch instead. ? If so that .mustve been a significant drop in E. The pill may well have been controlling peri symptoms and once you were changed to a patch although 75mcg isnt low it's a lot lower than the pill. Then all your symptoms came at once.
Like having an instant menopause.
I know what that feels like. I could feel and see the effects of the drop within weeks. So I understand exactly what you mean.
You havent tried sandrena? Might be worth a shot. It worked for me when I thought nothing ever would in terms of absorption. The level it gave me is considered a decent level post meno but it still wasnt high enough for me or I wouldve stayed on it.
What level our body needs to feel well is individual and can be related to age too. But you are right. Some of us just need more than others.
Alphabetti. I got the implant on NHS.
X
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Stella 👍
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Yes Tc, I think it was way to low for me as it was in your case too. I really hope you will feel better with the implant!
I don't think we can rely on estrogen levels in bloodtest only as it's just a moment in time. I feel control of symptoms is more important. Did Sandrena made you feel better?
I don't want to hijack this post but I don't think any doctor would prescribe a higher dose, especially in Holland. And I'm afraid to try again because if it
it gets worse again there's no return.
I also think you are right, Tc, we are all different. That's why DNA testing ( for cytogenetics /cytochrome) becomes more and more available for certain mediation like AD's. Some people are ultra- metabolizers and need a higher dose of medication while others are slow metabolizers and need less or have more side-effects. Steriod hormones like estrogen are metobolized by the same enzyms ( cytochroom P450) as other medication like AD's . So it stands to reason the same principal applies.
Alicess X
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That is,such a good point Alice. About metabolisation.
I didnt feel better on the sandrena. I had to increase from 2mg to 3mg. To get that blood result. And it's off license at 2mg so you might well have trouble getting it. I was shocked when my bloods had doubled as I didnt notice any difference!!!
It still wasnt enough. But it did absorb and get into my system better than anything else .
I tend to rely on blood tests to back me up in what I'm saying to doc. No doc would ever have believed me that 2 x 100 patches didnt do a thing for me if they hadnt seen the consistently low blood tests.
I must admit I put SHBG and what is happening to the T I'm slathering on that I dont feel any benecfit from to back of my mind recently. I've had mirena fitted and the P in that is supposed to lower shbg. But the implant makes it high and then it binds E and it binds T. I dont know about you but it Seriously does my head in. 😬 Ive got blood tests in 2 months so picture will be clear then what the implant has done to all my levels.
When you say you're scared to try again do you mean the effects of the T?
TNM . Good luck with the 5 pumps and T. Please let us know how you get on.
Xx
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I haven't thought of bloodtests as a back-up for doctors but you're right, they wouldn't have believed you without them. Then it's a wise decision. It's already a struggle but you also have to battle just to be taken serious. It's upsetting.
If your levels went up but you didn't feel any better then It strenghtens my feeling it isn't a accurate way to know if estrogen levels are sufficient for you or for most women. Even when there is enough estrogen in bloodcirculation it doesn't mean it will reach it's destination. So many processes in our body can interfere. Most research on hormones rely on bloodtest ( of estrogen for example) and I'm starting to feel increasingly sceptical about their reliabillty. I'm afraid I'm becoming an old cynic :-)
Pff, I can imagine it does your head in, mine too. But if you didn't feel any better with testosterone then it cannot be SHBG alone that"s keeping your estrogen low, could it? Otherwise you would have felt a bit better at least. Like Saffy. Do you know what your SHBG level was before the implant?
.It's possible the implant needs more time as you have been deprived of estrogen for so long..And if not C&W will have to take another course of action. Do you have a follow- up app?
I'm scared of trying HRT (estrogen that is) again, in any form. Every time I've tried it it made me worse and worse with even more symptoms. It lowers my estrogen levels and when I stop it stays that way. And it ages me so quickly I look old and sick now. It's not just vanity about my apperance but it imakes me vulnerable, I can't pretend anymore, if that makes sense. And I'm worried about my health; my hands and feet are reddish blue, I' m so nauseous I have throw up almost every day etc. A very long list besides the 'usual' like hot flashes, insomnia, anxiety....
If I had enough money I would buy loads of (oral) Estradiol online and just take as much tablets as I need to get some relief.
Alicess Xx
Sorry, didn't mean to take so much space. I don' t know what happened...?
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TN have you tried different patches? I was on Estrodot 100 x2 and they gave me average 900 pmo/l.
When I no longer could get them a friend got me some from Spain. As the name was different I checked with my meno dr and she said they should be.
Within a week I was panicking, flushing which I have never suffered from, couldn't sleep, losing weight. It turned out my oestrogen levels had shot up to 4000pmo/l. The only explanation offered was the fillers could be different so I was holding onto more of them.
The reason I was feeling awful was at that level it was the same as having no oestrogen as my receptors would have shut down hence the meno symptoms.
Maybe if you tried a different patch you might absorb more.
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Hi
I tried Estradot and Evorel - I got to 75mg patches but my levels still 150ish - trouble is it caused excessive bloating/tightness so I could not tolerate going any higher.
x
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Hi TNM,
Sorry, I hijacked your post a bit. Bloating and tightness are symptoms of low estrogen for me I never had any digestieve problems like that when I was on BCP. It"s difficult to tell if you are not absorbing enough or the estrogen dose is just not high enough for you. The only way to tell is either trying a higher dose patch or gel or try oral. 2 mg oral is approx. equivalent to 50 mg patch or 2 pumps gel according to BMS.
Alicess x
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Just wanted to update this old thread from March. My oestrogen levels were 85 even on 6 pumps oestrogel and estraderm 100 patches changed daily. I switched to sandrena and a mirena and my levels are now 550. Still not feeling quite like my levels are high enough but after years of trying to get my levels up, it's an improvement!
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Thanks for the update alphebetti. I'm.so glad you finally found something you absorb. May I ask how much sandrena you are using?
As i said, the only thing I absorbed was sandrena but I was on 3mg (3 sachets) it gave me a level of 378pmol. Which was more than double my previous levels. I stopped it when I had the implant. Unfortunately my levels have fallen on the implant. It's not supposed to happen and They dont realy understand why. But it hasnt worked for me. :(
How are you TNM?
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Thank you for letting us know, Alphabetti. I hope you also feel some improvement in how you are feeling.