Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: Spangle1512 on September 10, 2021, 09:43:58 AM
-
Hi everyone
I posted recently about changing from oestrogel to Lenzetto, as I was confused about what dose to take. I am now wondering if I am on too much, because I have started to gain weight. The symptoms for too little and too much oestrogen seem to be the same, so it is very confusing. My main symptom prior to starting HRT was feeling really angry most of the time and night sweats. I don't have the anger back, and I am not sure about the night sweats because it has been so warm at night it is hard to tell.
Is there an easy way to tell if you are on too much? My bloods on the gel fluctuated from bottom of range to over range. So I was never sure if I was on the right dose of that either. I still have quite bad fatigue but I don't sleep very well, and the MS thinks that might be habit now rather than a symptom.
Many thanks
-
Hi Spangle,
I can't provide any insight unfortunately but just wanted to say I empathise - I had huge, rapid weight gain after starting Lenzetto (2 sprays) of a stone in the space of 4 weeks (sometimes 5- pounds a day) without any change to diet or exercise. It is definitely the Lenzetto (or just HRT in general) that caused it as I've done a experiment.
Like you, I am also totally unsure whether this means I'm on too much, because as you say weight gain is generally thought to be too little estrogen, though from all the reading I have done it seems like quite severe estrogen dominance can also cause it. However when I try to reduce my Lenzetto, even just slightly, I get terrible side effects and have to go back up.
Have you had any blood tests recently to measure both your Estrogen and Progesterone?
Would love to know how you get on x
-
Hi Spangle,
I can't provide any insight unfortunately but just wanted to say I empathise - I had huge, rapid weight gain after starting Lenzetto (2 sprays) of a stone in the space of 4 weeks (sometimes 5- pounds a day) without any change to diet or exercise. It is definitely the Lenzetto (or just HRT in general) that caused it as I've done a experiment.
Like you, I am also totally unsure whether this means I'm on too much, because as you say weight gain is generally thought to be too little estrogen, though from all the reading I have done it seems like quite severe estrogen dominance can also cause it. However when I try to reduce my Lenzetto, even just slightly, I get terrible side effects and have to go back up.
Have you had any blood tests recently to measure both your Estrogen and Progesterone?
Would love to know how you get on x
Hi Spangle,
I can't provide any insight unfortunately but just wanted to say I empathise - I had huge, rapid weight gain after starting Lenzetto (2 sprays) of a stone in the space of 4 weeks (sometimes 5- pounds a day) without any change to diet or exercise. It is definitely the Lenzetto (or just HRT in general) that caused it as I've done a experiment.
Like you, I am also totally unsure whether this means I'm on too much, because as you say weight gain is generally thought to be too little estrogen, though from all the reading I have done it seems like quite severe estrogen dominance can also cause it. However when I try to reduce my Lenzetto, even just slightly, I get terrible side effects and have to go back up.
Have you had any blood tests recently to measure both your Estrogen and Progesterone?
Would love to know how you get on x
Hi Gilla999
Have you been on any other type of HRT prior to Lenzetto out of interest?
I’m sorry you’re experiencing this too. It’s so hard to know what’s causing what.
I am due bloods in about a month.
-
Hi Spangle,
I can't provide any insight unfortunately but just wanted to say I empathise - I had huge, rapid weight gain after starting Lenzetto (2 sprays) of a stone in the space of 4 weeks (sometimes 5- pounds a day) without any change to diet or exercise. It is definitely the Lenzetto (or just HRT in general) that caused it as I've done a experiment.
Like you, I am also totally unsure whether this means I'm on too much, because as you say weight gain is generally thought to be too little estrogen, though from all the reading I have done it seems like quite severe estrogen dominance can also cause it. However when I try to reduce my Lenzetto, even just slightly, I get terrible side effects and have to go back up.
Have you had any blood tests recently to measure both your Estrogen and Progesterone?
Would love to know how you get on x
Gilla sorry to hear about the weight gain on Lenzetto - is this in addition to the weight gain you experienced on Mirtazapine?
-
It is indeed Gnatty. I gained between 1.5-2 stone from Mirtazapine but that stabilised for a couple of years and I would lose weight with every drop of Mirtazapine I did in my taper.
Then when my hormones kicked off and I needed HRT, the Lenzetto made me gain an extra stone. I'm now on a lower dose of Mirt than I was previously but am a stone higher, purely because of the HRT. Between the two things I am 3 stone over my natural weight I've been my entire life. And just to point out... the only reason I was put on Mirt was because of what I now know to be perimenopausal insomnia! My hormones have a lot to answer for :'(
I actually feel like the weight gain from the HRT is much worse than the Mirtazapine weight gain. With the HRT weight increase it has changed how my whole body feels - I'm very constipated too, and I don't even feel hungry ever really, it really has affected my sense of well being in that way quite a lot. No matter what I eat or how little, the weight will not move - where as with Mirtazapine weight I could see a shift on the scales if I made good changes. Yet the Lenzetto has been a miracle product in getting rid of my night sweats and insomnia (until the last 3 weeks when I had a relapse).
@Spangle, I did try Estradot last year but only for one week, so I can't really comment. In my situation I feel the weight gain from the HRT isn't specific to Lenzetto. I still haven't worked out why it is - whether it's because my dose is too high (but then don't understand why I would be symptomatic if I drop it) or if I don't have enough Prog to balance it out. It's very difficult to tell isn't it? I am awaiting the results of bloods so will keep you posted if I get any insights! xx
-
It is indeed Gnatty. I gained between 1.5-2 stone from Mirtazapine but that stabilised for a couple of years and I would lose weight with every drop of Mirtazapine I did in my taper.
Then when my hormones kicked off and I needed HRT, the Lenzetto made me gain an extra stone. I'm now on a lower dose of Mirt than I was previously but am a stone higher, purely because of the HRT. Between the two things I am 3 stone over my natural weight I've been my entire life. And just to point out... the only reason I was put on Mirt was because of what I now know to be perimenopausal insomnia! My hormones have a lot to answer for :'(
I actually feel like the weight gain from the HRT is much worse than the Mirtazapine weight gain. With the HRT weight increase it has changed how my whole body feels - I'm very constipated too, and I don't even feel hungry ever really, it really has affected my sense of well being in that way quite a lot. No matter what I eat or how little, the weight will not move - where as with Mirtazapine weight I could see a shift on the scales if I made good changes. Yet the Lenzetto has been a miracle product in getting rid of my night sweats and insomnia (until the last 3 weeks when I had a relapse).
@Spangle, I did try Estradot last year but only for one week, so I can't really comment. In my situation I feel the weight gain from the HRT isn't specific to Lenzetto. I still haven't worked out why it is - whether it's because my dose is too high (but then don't understand why I would be symptomatic if I drop it) or if I don't have enough Prog to balance it out. It's very difficult to tell isn't it? I am awaiting the results of bloods so will keep you posted if I get any insights! xx
Yes please do. I’ve always been slim and I’m struggling with the weight gain and how it effects my sense of identity.
-
Spangle that statement could literally have come from my own mouth, I've said it so many times over the last year. I too feel like I've been robbed of my whole identity because of it. It's difficult to be a certain way your whole life and then have it taken away from you when you're doing nothing different. When you're eating so well and exercising and nothing makes a difference and there's literally nothing you can do about it, it's very disheartening. And even aside from the aesthetic point of view I don't "feel" very well because of it.
Have you noticed any changes with your digestion or appetite as well?
-
Spangle that statement could literally have come from my own mouth, I've said it so many times over the last year. I too feel like I've been robbed of my whole identity because of it. It's difficult to be a certain way your whole life and then have it taken away from you when you're doing nothing different. When you're eating so well and exercising and nothing makes a difference and there's literally nothing you can do about it, it's very disheartening. And even aside from the aesthetic point of view I don't "feel" very well because of it.
Have you noticed any changes with your digestion or appetite as well?
The same here, healthy diet, lots of exercise. More than ever in fact and still the weight is going on.
I have yes, my bowel habits have changed, they’ve increased and I tend to get full quite easily.
-
Interesting... I'm similar with the appetite. My appetite has really reduced with it - in my natural state I would need to eat every few hours and get ravenously hungry. Now I can go all day without really feeling hungry. It feels like my metabolism has just ground to a halt since starting HRT.
I've had tests done that show since starting HRT my cortisol is consistently higher than normal, which is notorious for weight gain and I think also impacts things like appetite and metabolism.
I read that raised cortisol is a side effect of elevated estrogen levels. It just makes no sense to me why I would get side effects of too high estrogen but then suffer from unbearable side effects when I try to reduce it even by a small amount.
What dose of the gel were you on and what dose of Lenzetto? Xx
-
Hi,
ElkWarning has a lot of professional knowledge on cortisol. It might be worth asking in a PM if she has any suggestions? She's very knowledgeable about how hormones convert and "trade". Was your cortisol tested cumulatively or at least across a day? A one-off test falls short on accuracy according to the time of day done? I was like a matchstick on raised cortisol. It's a complex cascade.Good luck.
-
Postmeno thank you this is super helpful! I will definitely drop her a PM.
I had in depth cortisol tests done throughout the day and night as part of a package (I think it was 8 samples across the day). Prior to starting HRT they were normal but since starting they are all high and out of range for all times of day. But no one has really been able to tell me why or what that means. I'll drop her a message! xx
-
Glad to have helped. Hope you get some more info. Might also be worth considering if anything else was going on in tandem with starting HRT to cause the raised levels? I imagine any testing worth its salt would give an interpretation of your results? I hope ElkWarning gets back to you to offer knowledgeable support. 💚
-
Interesting... I'm similar with the appetite. My appetite has really reduced with it - in my natural state I would need to eat every few hours and get ravenously hungry. Now I can go all day without really feeling hungry. It feels like my metabolism has just ground to a halt since starting HRT.
I've had tests done that show since starting HRT my cortisol is consistently higher than normal, which is notorious for weight gain and I think also impacts things like appetite and metabolism.
I read that raised cortisol is a side effect of elevated estrogen levels. It just makes no sense to me why I would get side effects of too high estrogen but then suffer from unbearable side effects when I try to reduce it even by a small amount.
What dose of the gel were you on and what dose of Lenzetto? Xx
Interesting about the cortisol, I’ve not had mine done recently. They were a bit low previously. But yes I’ve heard the connection to cortisol and weight gain.
I was on 3.5 pumps of gel and I’m now on 3 pumps of Lenzetto. But no one seems able to confirm how much gel is in spray equivalent, Something I read said I’m now effectively on 6 pumps of gel by taking 3 sprays! It’s all very confusing.
-
Yes that is the official line: 3 sprays of Lenzetto = 6 pumps gel. But there is a lot of debate here about absorption - some people seem to absorb one better than the other. I know that blood tests aren't the be-all-and-end-all but I do think it's worth testing your levels to see where you're at. Aside from the weight gain have you had any other symptoms to indicate your levels might be off one way or another, or are you feeling good weight aside?
Another suggestion would be to do a Rhythm Plus hormone profile from Genova Diagnostics. It's not cheap at £235 and there is debate about the reliability of saliva testing over blood, but all I can say is that for me the two times I have done them they have accurately portrayed my hormone levels. They are tests that you do every other day to chart your hormone levels across a whole cycle. They also track the ratio of Prog and Estrogen to each other which is I think a reallt critical thing a lot of spot blood tests leave out.
I have my estrogen blood test result coming back on Monday and I'll be doing another Rhythm profile across next cycle, so I'll definitely let you know if I get any insights. Xx
-
Yes that is the official line: 3 sprays of Lenzetto = 6 pumps gel. But there is a lot of debate here about absorption - some people seem to absorb one better than the other. I know that blood tests aren't the be-all-and-end-all but I do think it's worth testing your levels to see where you're at. Aside from the weight gain have you had any other symptoms to indicate your levels might be off one way or another, or are you feeling good weight aside?
Another suggestion would be to do a Rhythm Plus hormone profile from Genova Diagnostics. It's not cheap at £235 and there is debate about the reliability of saliva testing over blood, but all I can say is that for me the two times I have done them they have accurately portrayed my hormone levels. They are tests that you do every other day to chart your hormone levels across a whole cycle. They also track the ratio of Prog and Estrogen to each other which is I think a reallt critical thing a lot of spot blood tests leave out.
I have my estrogen blood test result coming back on Monday and I'll be doing another Rhythm profile across next cycle, so I'll definitely let you know if I get any insights. Xx
Thank you.
I’m not sure if I have other symptoms because I have insomnia, I have fatigue and I’m also not sure if I’m getting night sweats or if it’s just the temperature.
Did you get your blood results?
-
I just got them back Spangle and thought I'd update...
My estrogen was 797pmol two days before I ovulated. The range given for follicular period is 45-84 and for ovulation 151-1461, so from what I can see I don't think I am on too much (2.5 sprays), which is really reassuring to know.
I'm doing another E & P test tomorrow which is day 21 of my cycle and will be the real test of potential estrogen dominance which always seems to be measured on the luteal phase.
A couple of additional interesting things from the rest results:
- My testosterone has dropped from just over the top of the range to just under the bottom of the range. I have no idea why this would be (does HRT affect it?) or whether it could be responsible for the weight gain
- My Free Androgen range is also just below the bottom of the range. Again I have no idea what this means!
I'm going to follow up on both of those points and will let you know if I get any answers!
-
I imagine as you head into menopause just as oestrogen levels drop so too do testosterone. Both produced in ovaries. So maybe some testosterone would be helpful for you. GPs can prescribe it but you have to say it's for low libido rather than say brain fog or tiredness or depression - all of which are helped by testosterone but NHS don't recognize as such, but private clinics do. Bit like if you want a PCR test you have to say you have a fever or cough whereas these days neither are in the list of top five symptoms....
-
Gnatty thank you that is SO helpful, I wouldn't have known to say that. I had a look at the BMS website and it does say women with a level of less than 1 would benefit from testosterone replacement therapy so I think at least I'm on the right track.
Fingers crossed :)
-
There seem conflicting issues amongst the medics about oestrogen needing to be "at a certain level" and/or "consistent" before testosterone should be prescribed. I think it is eventually produced in the adrenal glands as the ovaries start to fail (and especially after hysterectomy and postmenopausally) which certainly joins the dots for me in terms of libido, energy, mood etc. Just wish the medics could be on the same page for such an important hormone!
-
Just thought I would give an update on this thread Spangle. My testosterone prescription arrived today so will be starting that, however I also had the blood tests results this morning from day 21 in my cycle, which is the classic/standard day to test hormones. As I intuitively felt was going to happen, my Estrogen is too high. I think I made a mistake in increasing to 2.5 sprays of Lenzetto in a panic after having some sleepless nights. However I actually feel that even when I was on 2 sprays it was too much and I think it has played a big part for me in the weight gain and constipation.
The problem is that I seem to get "addicted" to Estrogen and even when I have tried to lower to 2 and 2/3 spray, I get "withdrawal" from it in much the same way as I do with antidepressants. I have absolutely no idea if this is a known medical thing or just a problem with me...
All I can think to do is gradually taper over a number of months my Estrogen by taping over the dispenser and increasing the tape by a tiny bit each month. Pretty gutting to be stuck on another medication like I am with the antidepressants that I don't need anymore, but I have no other idea of what to do :-\
Of course this may not be the case for you, but thought it might help to share my experience.
My results are - day 21:
estrogen: 1846 pmol (range 82-1251)
progesterone: 53.3 nmol (range 5.82-75.9)
-
It's great you have a testosterone prescription! That will help with your anxiety too plus any brain fog, lack of energy etc. Let me know which prescription you get. I have testim which is in little tubes. Just spoke to my Meno doc at Newson Health. I am going to get blood tests done hopefully from GP and then see whether there is room for more testosterone. She is thinking moving forwards in a few months to come off the mirtazapine and therefore be good to have optimum testosterone levels first. Have to say am in no rush to come off mirtazapine until maybe next Spring or Summer.
-
Forgot to add, I think testosterone helps with curving weight gain too. Win, win!!
-
Also....Louise Newson has just made another podcast about testosterone. It's on her website menopause doctor. Under resources - podcasts.
-
Ooh thanks so much Gnatty! I will check it out.
I got a compounded testosterone prescription - I know there is lots of debate and controversy about compounded hormones but I've always got on well with the progesterone I was given and more importantly I'm quite happy under the care of the meno specialist (trained by Marian Gluck) I'm with at the moment (which is something of a miracle as we all know!) so I didn't really feel I wanted to go elsewhere to get it. But if for any reason I can't get on with what she's given me, I will try to switch to a normal one.
One pump of the cream I have = 1g (?) of Testosterone - I'm not sure if that's high or low but she said to start there for now.
In general I find it's best to taper from antidepressants over a period of time, so at whatever time you do decide is right for you, give yourself a bit of space. I'm so glad you've got on so well with it and as you say, there is no rush!