Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: Flan747 on October 06, 2020, 03:34:04 PM
-
I have been on Sandrena 4mg for 6 weeks now and symptoms practically remain the same! I am a poor absorber and was wondering whether to increase to 5! I’m day 22 of my cycle ( although I had Mirena coil fitted 2 weeks ago) I can feel mood anxiety and palpitations increasing! As I’ve posted many times before getting fed up of feeling rough everyday!
Any suggestions welcomed !
I am under a specialist who I emailed Friday but no response as yet?
-
Hi again, Flan747. Two things could be happening, you might be a poor absorber, and in that case you should change to a patch instead of increasing to 5 sachets, and Mirena could be opposing the action of estradiol, in that case you need to wait until your body adjusts to levonorgestrel.
Doctors are very busy people ::)
-
Thank you Uptick I don’t feel like the coil has changed anything i feel the same as before having it fitted! I have tried Everol and it sent me manic for whatever reason I’m not sure! Although I did go on 50 for a week then up to a 100!
Yes doctors are very busy i work with them haha :)
-
Hi Flan747, I guess it's too early to know what could be wrong, if there's anything wrong. It usually takes 12 weeks for HRT to settle. I would wait a bit longer. Have you got that email from the specialist?
-
That’s true! This is my 4th 12 week wait :( so will keep going ! No haven’t heard back yet! To be honest I get more help on here so not going to stress about it !
Thank you for your replies they really help
-
I see that you have decided to increase the gel. You're a poor absorber. It won't make a huge difference and you can be intoxicating yourself with so much alcohol from 5 sachets. Why are you not keen on trying a patch? Have you tried them before?
-
Hi Uptick. Yes I increased to 5 as symptoms were bad and need to be doing something but I really do know what you mean maybe it’s just not going to make much difference. I tried Everol 50 for 2 weeks then went up to 100 for about a week and had to rip it off as symptoms went through the roof! Do the patches absorb differently to the gel?
-
Yes, patches and gels have completely different pharmacokinetics. And different patches can also differ in fillers and matrix design that affect absorption rates. You can try 75 mcg Estradot or 80 mcg Estraderm. The important thing is to wait for them to achieve constant levels (3 months) before despairing and changing regime again. It's not easy, but that's how it is.
-
Ok thank you for that! Your knowledge is mind blowing and I feel more than the specialists :) I do feel at this time the patch would now be a better route but again nervous of change even though this isn’t working if that makes sense! I will wait for the specialist to get back to me and see what she says! I know one thing I can’t go any higher with the Sandrena!! May I ask in your opinion if my levels are higher now than when I last tried the Everol would that help should that help with the change over to patches ?
-
I understand you don't want to change before 3 months, but 5 sachets is just too much. Even if you feel better after this time you might need a future tweak which is often the case with HRT and you would probably end up having to change regimes, because 6 sachets... Let us know what the specialist says.
I'm not sure I have understood what you're asking. Have you had your estradiol blood levels tested when you were on Evorel 50 and 100? Your levels could have fluctuated during the transition from one regime to another and maybe that's the cause of your symptoms (manic, anxious, having palpitations). To achieve steady levels is the ultimate challenge, imho.
-
Totally get what your saying about the Sandrena and yes will definitely let you know what the specialist says!
Sorry what I meant was when I tried the latch my levels were a lot lower so if they are now higher would the transition be a little easier if I were to absorb the patches better than the gel!
Thank you again for your replies
-
I've just read some of your posts, you're in perimenopause. Maybe your ovaries are producing estradiol (albeit erratically) and that's what's causing the symptoms. HRT sometimes is not enough to override these fluctuations.
Are you still taking melatonin? It can stimulate aromatase expression and estradiol production in the ovaries.
It depends on the patch, they're not the same. Trial and error, I'm afraid.
-
Yes I am peri normal regular periods! No I stopped the Melatonin a while back as it didn’t make any difference to my poor sleeping habits! Will keep you posted on what I decide and how it all goes
-
Maybe discuss a BCP instead of HRT? Have you ever taken them?
-
That has never been mentioned? Does that effect your estrogen levels? Would that help with symtoms? Sorry I don’t know anything about BCP! Stopped taking them when I was 21!
-
It depends on the type of pill. The combined pill may control menopause symptoms such as hot flushes and night sweats. I'm sorry I have no time to read your previous posts now, how old are you and what symptoms do you want to control? Do you smoke, have any cardiovascular or blood clotting issues? These are usually the contraindications for BCPs and age over 50.
-
I’m 51 and have never suffered from hot flashes or night sweats. Symptoms were severe anxiety palpitations and insomnia. All of these I would say have decreased since HRT by half at least so I manage say to day but I generally feel rough everyday. Lots of nauseous feelings, palpitations and very disturbed sleep . No other health problems.
-
Just wanted to update to say I have definitely felt better since using 5mg Sandrena! My question is? this is obviously not going to be a long term solution as the dose is so high! Should I change to a patch ASAP is so what dose? Still no word from the specialist so looking for help here
-
50mcg and wait a couple of weeks. It's not exact science, unfortunately.
-
I have been advised to stay on4mg until next review in November which will cost another £200! Have bloods and see how absorption is going? I am seriously considering going to GP well woman clinic!
-
I would go to GP well women clinic.
-
Just wanted to update to say I have definitely felt better since using 5mg Sandrena! My question is? this is obviously not going to be a long term solution as the dose is so high! Should I change to a patch ASAP is so what dose? Still no word from the specialist so looking for help here
I am so glad to hear you are feeling better, so at least you know it can work for you! I didn't realize you hadn't tried the patch before, wouldn't that be a lot more convenient than the gel? What made you chose the gel over the patch?
And wouldn't your dr expect that it would be to stay on the gel if she prescribed it? :-\
-
Thank you not anywhere near where I want to be but will take it at the minute :) I tried Everol patch but only lasted about 2 weeks as I had terrible anxiety and palpitations! Someone suggested trying another one! I thought they would all be the same! I have reduced back to 4mg as specialist said it was way too much! She has advised I stick with this for approx another 4 weeks and have a blood test to see if my levels have risen again which I feel they must have! I would love to use a patch as the gel is a pain to be honest !
How are you feeling now?
-
Thank you not anywhere near where I want to be but will take it at the minute :) I tried Everol patch but only lasted about 2 weeks as I had terrible anxiety and palpitations! Someone suggested trying another one! I thought they would all be the same! I have reduced back to 4mg as specialist said it was way too much! She has advised I stick with this for approx another 4 weeks and have a blood test to see if my levels have risen again which I feel they must have! I would love to use a patch as the gel is a pain to be honest !
How are you feeling now?
Yes, it would be a pain as there's so much liquid to absorb! Well, be the half full person, you have had some improvement and there are other options to try, think positively!
I'm feeling great thanks, can't believe how good. I honestly didn't think it would work so well for me, and it is early days still, but I feel better than I did in my 30's!
-
Lovely to hear a positive story Britt66
Time for you to enjoy life again. Are you still on 1mg Sandrena ?
-
Lovely to hear a positive story Britt66
Time for you to enjoy life again. Are you still on 1mg Sandrena ?
Thanks! Yes, still on that, I worked my way up to it over the first month.
-
So I’ve now been on Sandrena for 11 weeks and Mirena coil in for 6 weeks. I had recent blood test which showed 529. When I was on 6 pumps gel I was at 274 so a massive improvement in absorption . So whilst I am feeling some changes to how I feel I am still living day to day suffering with an anxious stomach and nausea with low energy and no libido! Palpitations have lessoned and sleeping a little better . Would the symptoms change now or is this it? I can’t go any higher with the gel. Would consider trying a patch again but nervous swapping again. Any advice welcomed
-
Hi Flan747 - could some of your symptoms be due to the side effects form the progestogen in the Mirena coil? It gives out a lot initially but gradually decreases so the systemic effects will be more noticeable in the first weeks/months. Nausea also is a symptom of high oestrogen but usually settles. Lack of libido is another issue. Off-hand I can't remember the effect of levonorgestrel ( the progestogen in the Mirena) on free testosterone but I had an idea it may increase it through reduction in SHBG but I might be remembering incorrectly there! Whatever the effect - low libido can be treated with testosterone but of course this is off-licence.
Do you have any strategies for dealing with your anxiety because that alone can cause digestive problems amongst other things?
Hurdity x
-
Thank you for your reply Hurdity
I did start to wonder whether it could be coil related! I couldn’t tolerate Utrogestron and I tried different doses and regimes! Hoping it will all settle soon. I don’t feel anxious at all I just have an anxious stomach and generally feel rubbish. I’m taking a different approach next week I’m booked in to see a hormone balanced specialist who concentrates purely on diet- mine by the way is rubbish - hopefully that will help