Menopause Matters Forum
Menopause Discussion => Personal Experiences => Topic started by: Mindfulmoomins on June 24, 2021, 08:31:37 PM
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Hi everyone,
I would really love some help with whether my Estrogen levels are causing my symptoms to return (anxiety, racing heart, felling low).
For context I am 47 and started peri I think around 41-43. I have been on HRT since 2017 and currently have 4 pumps of estrogel, utrogestan 100-200 mg vaginally 7 days a month (I am very progesterone intolerant so find this hard) and a pea sized blob of testogel.
Back in 2018 my Estrogen levels were 616, last week they were 304. I know that symptoms rather than levels are a better indicator of what’s going on but it seems strange they are half what they were now. Surely no coincidence I am anxious? Meditating, sharing with family and friends and exercising and basically inhaling Bach rescue remedy to try and help ::)
If anyone can offer some advice I’d be really grateful.
Xx
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You’re right that going from symptom control is better than levels, but levels can be a good indicator of how well your HRT is working.
Definitely worth having a review with the doctor. Maybe consider swapping from gel to patch to see if there is a difference.
I went from 4-6 pumps of gel to a 75 mcg patch when I swapped, but more importantly, I felt an improvement.
Good luck :)
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Thank you so much Salad, that’s really good to know. Yes, I will speak to the clinic. Really appreciate you replying :) xx
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Hi Mindfulmoomins,
It sounds like your own hormones may have decreased in the background and the 300ish what you had now is coming mostly from the gel, while in 2018 you probably had your own endogenous oestrogen as well. As said already, considering higher dose with the gynae makes sense.
As far as I understand, the 300 reading per se is not very low, but this doesn't mean it makes you feel good. Alternative could be to wait and see a bit if your body would adjust to the new lower level, but this of course depends on how bad you feel.
As written elsewhere, I'm trying to work out this maze myself and searching for the right dose ??? Strangely, before I started HRT I had very low oestrogen reading, and symptoms were insomnia and hot flushes, but no anxiety. Adding 1 pump fixed these symptoms and I was feeling great for a while. Until I felt my own hormones (or what was left of them) dropped in the background and then I got a new set of symptoms including anxiety, to which I haven't found a solution yet. My 'gut feeling' is that my body somehow does not react exactly the same way to oestrogen replacement as it would to endogenous oestrogen, though Oestrogel is body identical. It seems that even lower level of endogenous oestrogen was enough to keep the mind stable, but now that its almost all coming from replacement, it does take longer time to find a new balance. This is of course just my speculation as in the end I have no idea what's going on ::) Hopefully day by day it will become easier.
Let us know how you get on and what your doctor advises to do! xx
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hello, sorry to hear about the fluctuations you're experiencing Mindful.
Do you mind me asking how you got your estrogen levels tested? I had an appointment with my meno consultant today (in the UK) but was seen by the registrar instead. I had POI by my late thirties with a definitive FSH of 88, have been on HRT for the last 7 years or so (oestrogel 4 pumps daily plus mirena coil, allergic to patch adhesive) but have never really felt any great benefit. Have recently had a resurgence of low estrogen symptoms and so I asked whether my levels could be tested, but was told that they go by symptoms instead.
I don't know why my symptoms have returned but am getting all the night sweats, insomnia, anxiety, low mood etc.
Should I push to get my blood levels tested? Have you found it a helpful marker to discuss/monitor in your consultations? If my GP won't offer it either then I wonder if I can get them done privately...
Thanks for reading and apologies for jumping on your thread :-\
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Thank you Char and Ella,
No apologies needed.
I got my bloods done by asking my GP if I could (explaining I have a reoccurrence of symtpoms). I kind of wanted a marker even though symptoms are more important. The GP said they could do bloods but wouldn’t know what to do with the results. I just said ‘don’t worry, I can take them to the menopause clinic who will’!
The meno clinic thought 300 might be reasonable but for me, I think it’s too low to keep me feeling ok.
I have just picked up Estradot (75 mg patch) from the pharmacy so I really hope it helps in the coming weeks. I wish this time was easier for us all.
Thank you for your replies and sharing your thoughts. Much appreciated xxx
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Hi again,
When are you planning to move to patch? Do let us know how you get on!
Fingers crossed it will go well and you'll feel an improvement soon!
xx
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Thank you Ella,
I put in on this afternoon. It came off at the corner so have read a bit more about how to improve adhesiveness.
Really hope I can feel more like me in the coming weeks xx
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Hi Mindfulmoomin,
How're you -any first day experiences from the patch to share? How did you fix the adhesiveness issue?
I'm a bit behind you, I've been prescribed 50 mcg Estradot patch and should start in the coming days, maybe even today. Trying to gather courage to do it! :o I can't even understand why I'm so worried to switch from gel to patch. Intellectually, it doesn't make any sense as I've been feeling so bad with the gel recently that I'm questioning if it can really get any worse. But the pessimist in me tells that one can always get worse :P
I still have couple of hours to go before decision time, as I'd start with the patch at the time I'd otherwise apply Oestrogel in the evening..
Hope all is well there and eager to hear your experiences!! xx
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Hi Ella,
I totally understand the fear of changing things. It’s all so disruptive (this peri/meno stuff) already and at times it can feel like we are just hanging on as it is.
I am glad I switched to the patch. I woke up the morning after putting it on and blitzed the kitchen. Not like me! Then had a lovely day the next day. Then I was due to start the Utrogestan so I did and could only tolerate it for 4 days before feeling awful and stopping it. I bloody hate that stuff and just cannot put it in my body anymore. I have enquired about the Jaydess coil but have been told it’s not licensed for use as HRT. Still, I will persist.
I am starting to feel angry (a good sign rather than just feeling weepy and grateful for any help) with the lack of acknowledgment of how utterly debilitating it can feel when hormones are out of balance.
I spoke to the GP and increased the antidepressant I was on. I didn’t want to do this but have since read some research on the combination of estrogen and an antidepressant being helpful for late peri when there can be huge fluctuations (if that’s where I am).
Anyway, I am feeling better on the patch I think. Hard to tell as it’s only just been over a week but I do feel more like me.
Let us know if you decided to take the plunge. Thinking of you and hoping you are feeling ok whatever you decide.
Xx
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Hi again,
so happy to hear you are feeling better on the patch, though disappointing that utro still causes issues.
Hopefully there will be a solution for that too soon! Good that you're keeping on pushing, that's the thing we just have to do! It shouldn't be that way, but it is. I feel that even female gynaes often don't really take this illness seriously enough, and somehow there's the underlying attitude of this being 'just a normal part of woman's life'...blah blah.. :o
Thanks for asking about me. I'm now 1 week with the patch -started last Saturday with 50 mcg. Very difficult to say as its so early, but I'm relieved that I no longer have the oestrogen 'rushes' and related anxiety peaks, so that's an improvement. But I can't say I'd really be on a stable or good mood either, its still very much a rollercoaster. I guess it takes time to settle in, so I just try to take day by day now, and enjoy every normal hour I can get without symptoms. I just realised that I"ve cried several times over the past days, which I actually think is a good thing. I haven't cried in a very long time, so it feels like some heavy baggage is being unloaded.
Hope you continue feeling good with the patch and thanks again for your kind words!! Take care xxx
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Hi Ella,
That does sound like an improvement. The crying sounds quite healing (and different from feeling weepy). I am taking it day by day too and sometimes hour by hour and trying to relax into the stable hours and trust and breathe through the tougher ones.
I hope things continue in a positive direction for us both xxx
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Hi Ella,
How are you getting on?
I am one week into 100 mcg estrogen patch now. That combined with the increase in the antidepressant I was on I think have helped. I feel less anxious and low.
Thing is I am so convinced this is largely hormonal that I would love to see someone who can take an in depth look at my history (PND, progesterone intolerance etc) and advise on a way forward taking that into account.
The NHS meno clinic have been good but they just keep telling me to take more progesterone or have the Mirena coil. My latest (private as the Anaya’s wouldn’t do one) scan said the womb lining was 4.2 which is ok I gather but the specialist said I am putting myself at risk of cancer in a few years by only taking 7 days utrogestan 100 mg per month :-\
She also wasn’t sure I would find a Dr who would prescribe a trial of the Jaydess coil or consider a hysterectomy although she mentioned Dr Panay might.
So, more digging around and research for me to find a (probably private) specialist in progesterone intolerance and mood issues in peri/meno.
I think my symptoms started in early 2017 so 4.5 years ago. There must be an end in sight!
I hope you and anyone else following this are doing ok.
Xxx
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Hi Mindfulmoomin,
great to hear from you and thanks for asking about me.
Have you upped your patch -I recall you started with 75 mcg, right? How did you get there, did you feel 75 was not helping enough or had a blood test to check absorption issues?
All in all, super to hear you are feeling better!!! Aside from the remaining progesterone question of course, but sounds like you are making progress there too in terms of understanding the options better.
I'm still on the 50 mcg, feeling somewhat better than couple of weeks ago with the gel, but absolutely still not great. Continue to suffer from daily anxiety, which is only better very early in the morning and later in the evening. I suspect it somehow relates to cortisol production because I start feeling worse ca an hour or so after waking up, but don't know what can be done to it, other than trying to relax and of course getting the HRT dosage right.
I just visited gynae and we discussed upping the dose to 75 mcg as my symptoms continue. Haven't started yet and frankly am a bit second guessing now as I just received my blood tests which showed estradiol at 480 pmol/l, which is high for me. So now I"m wondering if its actually the right thing to go even higher, or perhaps I should keep the current strength or even try a lower strength to see what happens. The problem is that I simply can't figure if the symptoms are due to low or high oestrogen (or the fluctuations).
Hope you'll continue feeling well and keep us posted on your experience with the 100 patch as you go on!! xxx
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Hi Ella,
It’s so tricky isn’t it trying to work out what our body needs and what is causing issues.
I think my issue has been low estrogen causing anxiety and also fluctuations causing issues (my own hormones in the background). My sense is the 100 mcg patch is a good fit for me as it keeps things level and steady which I think my body maybe needs.
I was ok ish on 75 but it was a daily struggle and the anxiety was still present.
It’s all a bit confusing as I increased the antidepressant very slowly at the same time.
I had an estrogen reading of 600 3 years ago and 300 a month or so ago. Definitely loads more symptoms with 300. I just seem to need more than 300/400 to feel ok.
Good luck Ella, keep us posted xxxx
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Hi again,
great to hear you are doing well with 100 patch!
Do you feel you get an even dose from it all through the 3.5 days? I'm asking as I'm wondering if my dose is too low, or if its more of an issue of uneven absorption (if such thing is even possible with patch). My recent bloods were taken the day after new patch, and at least at that moment I had a high reading, however often on day 3 it feels the dose is already wearing off and I feel closer to what I felt when my oestrogen was really low. So I'm wondering if its possible that I get too much from it at the beginning and too little towards the end.
In any case, trying to gather courage now to increase the patch dose :)
Enjoy the weekend and hope you continue feeling well!
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Thanks Ella,
I think I get a stable dose but my own hormones are fluctuating in the background I believe. By day 3 I have, on occasion, felt like it might be wearing out and have changed it but I felt this more on the 75mcg (which I don’t think was enough for me personally). I am. To sure if I was imagining it though! I was more anxious then so changed it more frequently due to feeling so worried and keen to feel better.
I know we are all different but my understanding is that lower levels mean things are a bit less balanced as your own peaks and troughs in the background aren’t balanced out. Let us know if you try increasing the patch. Best of luck xxx