Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: Kelrob12 on August 13, 2022, 03:43:38 PM
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Hi,
I know most of opyu guys will go off symptoms not levels but does anyone know wither levels estrogen that make them feel good?
Im 43 surgical menopause. initially was on 50mg patch but levels were low 200pmol. Went to Newson health(who I didn't rate) who upped to 100mg initially. she said I would probably need more. Levels on 100mg were about 400pmol. I still didn't feel 'right" so Newson wanted to up it. Now Im on 150patch. No longer with Newson. seeing an Nhs endocrinologist - who if you see my other posts isn't necessailry great - won't prescribe testosterone. Tested my levels which came back 800pmol and now says its too high and to reduce.
But aren't the symptoms of high estrogen similar to low (anxiety to be one).Newson health give big patch doses and this specialist says lower is better. Take away the obvious signs of low estrogen - hot sweats, vaginal dryness. The rest could be either too high or too low?
thanks Kelly
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These are my issues with Newson as well. They assume you will need a high dose and it can lead to a total mess for some women.
The best advice I can give you, is to start low, to remain at each dosage for 8-12wks minimum and only to increase if they have remaining symptoms. If they increase and their symptoms don't go or improve, then they should reduce back to the previous dose. That is the advice from BMS.
Forget about blood levels and focus on your symptoms. That is also BMS advice.
You went from 50 to 100, without trialling 75 at all. So when you didn't feel right at 100, was that because it was too high a dose? We don't know... but then you were told to go higher.
As for blood levels, it really varies a lot. Some women feel great at 250, some need 400, some do need to be 800 or more to feel okay. That's why it makes no sense to focus on your blood estrogen and instead to focus on your symptoms...
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Hi
Yeah it was one of reason I stopped seeing them I was paying £200 or whatever it was each time to just up my estrogen.
Yeah 50 to 100 . It’s so confusing as some symptoms could be lack or testosterone or could it be the lack of progesterone ratio to testosterone (I know the nhs say progesterone is just for the lining but I don’t agree with this line of thinking).
I just don’t feel like I used to but maybe I’m fighting a losing battle given I have non of my own hormones 🤷♀️.
Hot flushes have gone, same as vaginal dryness. I’m tired a lot, have reduced sex drive(not gone totally), joints ache(but bone scan clear). I get headaches a bit and am slightly lightheaded. My skin has aged dramatically in the last two years, saggy face and more cellulite. Definitely get anxiety. Some were worse on 100 some I don’t think I had , which is why it’s confusing for me to go off symptoms I’ve no idea if it’s because of too much or too little estrogen 🤦♀️😂. I suppose the only option is to lower for 3 months and see.
X
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Are you on progesterone? You can ask to go on progesterone even if you don't need it. It is very good for skin and hair... (allegedly!).
Lack of libido - are you on testosterone? That would make a good difference there.
Estrogen - well, maybe try the other changes above and if that doesn't help, you could try reducing a bit?
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You're on a dose that would be too high for most people so that, together with the high blood level, would make me think you're on too much. They will usually give you testosterone after surgical menopause so it's unfortunate yours won't. Will they test your levels? I have definitely benefited from it but my libido was zero. I believe there are some women who feel better on progesterone but for many (including me) it makes them feel worse.
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Yeah I’m on cyclical progesterone. I do have a feeling I need a small amount daily tho and have thought about compounding for that reason but that’s a whole other discussion 🤣.
Not on testosterone, the specialist won’t do it on the nhs because of the dangers, having had tumours in the past. So I’m hesitant 🤔. And I was wrong before I’m in 125 not 150 🤦♀️😂x
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You're on a dose that would be too high for most people so that, together with the high blood level, would make me think you're on too much. They will usually give you testosterone after surgical menopause so it's unfortunate yours won't. Will they test your levels? I have definitely benefited from it but my libido was zero. I believe there are some women who feel better on progesterone but for many (including me) it makes them feel worse.
Yes it was newson who said that most surgical women at my age need high doses. They even wanted it higher. One of the reasons I stopped going.(there were others) . I feel better on a smaller amount of progesterone to balance out estrogen but not the high amounts. I think we spoke in my thread about he testosterone and my specialist . I do also worry about the long term effects of testosterone too .
X
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You're on a dose that would be too high for most people so that, together with the high blood level, would make me think you're on too much. They will usually give you testosterone after surgical menopause so it's unfortunate yours won't. Will they test your levels? I have definitely benefited from it but my libido was zero. I believe there are some women who feel better on progesterone but for many (including me) it makes them feel worse.
Sorry forgot to add yes my testosterone has been tested and is 0.6 nmol/l x
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You're on a dose that would be too high for most people so that, together with the high blood level, would make me think you're on too much. They will usually give you testosterone after surgical menopause so it's unfortunate yours won't. Will they test your levels? I have definitely benefited from it but my libido was zero. I believe there are some women who feel better on progesterone but for many (including me) it makes them feel worse.
I’m also struggling to understand what it it’s about 800 pmol that is too high, as this level is a normal level for mid cycle in a premenopausal woman. I can’t figure what symptoms I have indicate it’s too high? If the nhs goes off symptoms? Say I went to newson without having bloods and said I had itchy skin and sore joints would t they up my patch? X
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800 isn’t too high if you need that amount to feel better. There are women online and on FB who only feed good when their serum levels are 800.
But if you don’t need that amount to feel better and if you’ve increased and it hasn’t stopped your symptoms then you don’t really want to be taking a high dose which also isn’t doing anything for you….
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It’s a minefield to be honest.
Just start low as joziel suggested and stay at that dose for a 3 months ( if you can). If symptoms persist, increase again until you are at the maximum licensed dose.
Then, if you are still feeling rubbish, it would be appropriate to have a blood test to check absorption. If low absorption, it’s probably time to change product and start again.
It can be a slow old process, but I can’t stress enough about maintaining a stable oestrogen dose for a decent length of time. In the last two weeks, I’ve increased, decreased and gone without oestrogen. Fatal mistake!! The repercussions were brutal. Now back on my stable 75 patch and all is okay ( for now). Blood levels are subjective. Mine are 300. libido is through the roof, some anxiety, no irritability, no flushes, don’t sleep well.. just a real weird mix right now.
There’s no way I would introduce testosterone, nothing would ever get done !! 😊 ( libido issue!)
Definitely forget blood levels
( unless you’ve reached the end of the line with a product) and go on symptoms. Keep stable. More is not always best.
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It’s a minefield to be honest.
Just start low as joziel suggested and stay at that dose for a 3 months ( if you can). If symptoms persist, increase again until you are at the maximum licensed dose.
Then, if you are still feeling rubbish, it would be appropriate to have a blood test to check absorption. If low absorption, it’s probably time to change product and start again.
It can be a slow old process, but I can’t stress enough about maintaining a stable oestrogen dose for a decent length of time. In the last two weeks, I’ve increased, decreased and gone without oestrogen. Fatal mistake!! The repercussions were brutal. Now back on my stable 75 patch and all is okay ( for now). Blood levels are subjective. Mine are 300. libido is through the roof, some anxiety, no irritability, no flushes, don’t sleep well.. just a real weird mix right now.
There’s no way I would introduce testosterone, nothing would ever get done !! 😊 ( libido issue!)
Definitely forget blood levels
( unless you’ve reached the end of the line with a product) and go on symptoms. Keep stable. More is not always best.
😂 with the testosterone. Sometimes i feel like starting again . Ive been at it for 3 years since my operation and agree went thru a period of swapping too quickly. Ive been on 125 mg for the past year and its onlye last week the endocrinologist asked for bloods and it came back at 800 she said it Was too high. The only symptom I said I had was tingly/pins and needs skin at night. So she's not suggesting to lower based on symptoms she's saying it based on levels. im not totally sure what symptoms I have or if they are related to oestrogen or progesterone or testosterone. So like you say its a minefield. I could be low estrogen based on say joint pain when actually the estrogen is at the correct level and I just need testosterone. Or the estrogen is fine I just have symptoms of estrogen dominance due to lack of progesterone. Its not simple to just change oestrogen when its a balance. I have times I want to try to get it right and other I just think bugger it feel like this till im 50 then reassess. Im also struggling to remember what I was like on the 100mg patch 😂 in order to decide if to lower 😩
xx
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I’m also struggling to understand what it it’s about 800 pmol that is too high, as this level is a normal level for mid cycle in a premenopausal woman. I can’t figure what symptoms I have indicate it’s too high? If the nhs goes off symptoms? Say I went to newson without having bloods and said I had itchy skin and sore joints would t they up my patch? X
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800 pmol would definitely not be too high for some women; generally women with more strictly physical symptoms might be fine or better with less but for hormonal depression levels of 800 pmol or more are often necessary.
My meno clinic has advised me to get my plasma estradiol up to 800pmol for this reason and although I'm not sure I'll ever get that high as I have difficulty absorbing, a significant increase in levels this year after more than doubling my estrogel has definitely helped my acute mental distress.
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There is this fear of Estrogen amongst professionals, I wonder if they would fear it if they didn’t absorb it well and needed high doses too. It’s not about the dose but about how much we take in which cannot be established by blood tests in peri. I absorb barely anything whether oral or transdermal so it’s really upsetting when doctors concentrate on dose rather than symptom control. As I am peri I know what my low, fluctuating and high symptoms are which are very different, it has taken me a long time to work out though.
Hi Nas, how you doing? Remind me I’ve not been on for a while, are you peri?
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Hey Floo,
I’m post menopause now.
I think you are right in that many professionals do seem to fear oestrogen in high doses. But even the highest Hrt doses, are nothing like what we produced in our younger years!
They definitely need to focus on symptom control and not worry about a level which is in the upper hundreds for example. If that’s what you need, so be it I say.
As you correctly say, you could be on a high dose and absorb only a third of the hormone. There are many ladies who require a couple of hrt types even,to feel well.
It’s not an exact science and there lies the issue amongst the medics i think.
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I don’t agree that if by increasing the dose a bit there is no improvement then to reduce down again, symptoms don’t improve at all unless a certain level is reached then it’s about tweaking to improve further. Think about when we first have symptoms then as levels drop further more symptoms appear. We only start getting any symptoms when our Estrogen drops to a certain level which is vastly different between us. If we are not on the right type and dose nothing will change that’s why we have to increase until we notice a change. I don’t absorb anything at all on some Estrogen types so by increasing we sort of prove it when nothing changes so then move on to another type. Blood tests do not prove how much we absorb, I know I’ve done loads to prove it. Symptoms are what we should go by not dose.
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I agree Floo36, symptoms are what I gauge my dose on. I’ve had a lot of tests but the only number I care about is not being under 800. My body tells me when levels lower, symptoms start to slowly return if I decrease dose and I don’t want to live with symptoms. Everybody will feel different about their symptoms, what they find acceptable or what they can work around or treat with other meds is a highly personal choice.
I didn’t have palpitations/flutters before HRT yet it is the first symptom that returns when I reduce dose. I think some of us will have to adjust estrogen for the rest of our life as needs will change with age etc.
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Yes I agree absorption makes a difference. I have been put on a list for a meno clinic through my GP. I don't want to change anything until I see them. I do struggle with knowing which symptoms are related to the oestrogen though. Im worried about lowering and getting more symptoms! Most people who haven't gone thru peri just think of hot flushes as a symptom. So once they go - your on the right dose - even the endocrinologist asked - any hot flushes ? no good your dose is fine. When actually there are so many more symptoms of low estrogen. Then you have the symptoms of unbalanced hormones or low testosterone! Total minefield!
x
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Yes I agree absorption makes a difference. I have been put on a list for a meno clinic through my GP. I don't want to change anything until I see them. I do struggle with knowing which symptoms are related to the oestrogen though. Im worried about lowering and getting more symptoms! Most people who haven't gone thru peri just think of hot flushes as a symptom. So once they go - your on the right dose - even the endocrinologist asked - any hot flushes ? no good your dose is fine. When actually there are so many more symptoms of low estrogen. Then you have the symptoms of unbalanced hormones or low testosterone! Total minefield!
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The hot flush Q! 🤬 Totally agree with you, I’ve not had one since day 1 of HRT yet many doc’s treated me as ‘cured’! Flushes we’re my easiest symtom, the rest was far harder!
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Exactly my hot flushes went super quickly on quite a low dose. But I certainly didn't feel great in any other way 😂
x
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Floo36 and tora,
It sounds like you guys have done up and down tweaking. Can you tell me what symptoms you used as a guide? Have you both used too much estrogen and what symptoms did you get?
One thing that I have just thought about this week is that I have far more cellulite than I did before having my ovaries removed and looking online this can be high oestrogen? Anxiety is another one that is confusing as can be both high and low estrogen? Dizziess? headaches?
Wouldn't it be so much easier if there was definitive list!
x
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I think it would be impossible for me to have too much via HRT as I dont absorb much. I do however know what it feels like when I have high spikes of estogen (my own estrogen), I get a sudden libido which I dont like but all my other low estrogen symptoms go like dry everything, palps, hot flushes, anxiety, jitters, panic, dizziness, heavy head, tinnitus to name a few, it never lasts long though. I would love to get the relief but without the crazy libido. I never had cellulite until the start of peri 10 years ago.
Nas, that's why I asked if you were peri because you mentioned a libido that would come and go, it happens to me when I'm fluctuating high estrogen. It baffled me for a while because I was told i was menopause but turns out Im not, Im very peri.
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Oh crickey Floo,maybe I am peri then. I hadn’t thought of that at all!
I went 27 months without a period and bloods seem to have confirmed post menopause.
The only thing I can say is, that for well over a year ( whilst on HRT) my Oestrogen levels have been consistent at between 300 and 400. I’ve tested every 3 months.
Prior to that ( peri so I thought) they plummeted from 700 to 100 in a short space of time.
When I’ve had no HRT, zero Oestrogen has been detected.
No idea at all, except this libido is crazy and conducive to my pregnancy libido. I just put it down to the HRT working.
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Hi Keirob,
I don’t think I’ve ever had symptoms of too much estrogen. From what I’ve read on here painful/swollen boobs is a symptom and I’ve never had that.
I don’t think I’ve got an absorption problem, I just need a high level to stop symptoms. I’ve reduced several times and felt great until day 6/7 when palps/fuzzy chest start, wake up feeling sad, wake up in the night for a pee, anxiety starts etc. I’ve not tried to reduce this month and feel good so tweaking is on hold for now!
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It’s mad isn’t it. Bloods can show you menopausal one minute and not the next so not much use to determine status because of how erratic this time can be, mine are anyway. I think a lot of us are led to believe that high Estrogen symptoms are the same as low because of one off Estrogen bloods that come back high when in fact they were fluctuations and not what they are most of the time, in my experience anyway.
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Two high FSH readings are pretty conclusive that you are menopausal.
It's only during peri that we can't tell what is happening because your estrogen could be all over the place whilst your FSH is still low.
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Ive had FSH done probably 5 times and 2 x menopausal, 3 x not.
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It's 2 consecutive high readings. So if high, low etc, it's not...
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Hi Keirob,
I don’t think I’ve ever had symptoms of too much estrogen. From what I’ve read on here painful/swollen boobs is a symptom and I’ve never had that.
I don’t think I’ve got an absorption problem, I just need a high level to stop symptoms. I’ve reduced several times and felt great until day 6/7 when palps/fuzzy chest start, wake up feeling sad, wake up in the night for a pee, anxiety starts etc. I’ve not tried to reduce this month and feel good so tweaking is on hold for now!
Yeah my boobs don't hurt. They grew a size when I started HRT but have stayed the same even when I increase dose. I are fibroids after starting HRT again its hasn't grow with increasing my patch. I remember having to pee overnight a lot and feeling more sad on a lower dose and I think my joints hurt more- but cant remember it that was 50mg or 10mg. I still have brain fog and tiredness. I think my endocrinologist isn't great tbh. I said my joints hurt she says take chondritn, I say im anxious she says that's life. Same with sex drive. I think its time to get a new one. 😂
x
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No clue if I am menopausal or peri now.
All i know is, I had no period from Aug 2018-Dec 2020 and then erratic bleeding on patches.
In Oct 2019 my oestrogen was 771.
By December 2019, it was 118.
The highest it has reached with any hrt is 462.
No HRT equals zero oestrogen within a week.
Currently 300 odd, with a 75 patch.
Is that peri or post meno?
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It's hard to say, you need FSH - not estrogen. Estrogen levels can vary even in a pre-menopausal woman from 50 to 800+ over the course of a month. Which is why it's not reliable to look at estrogen levels.
The HRT has to add in a stable amount for you as an individual, if you keep the same level of patch or whatever, I'd have thought. That's what it's designed to do.
Were you always a 75 patch, across all those tests? If not, it's a bit impossible to figure anything out...
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sorry to confuse you Nas but id say its not definite that you are post. When you did those bloods in 2019 were you on HRT and the same dose? Its just the symptoms you mention especially a libido that comes and goes is like me when I have spikes of estrogen, this will happen until meno hits, the ovaries can spurt out massive amounts of estrogen at times, I fluctuate a lot. I wonder how much we can fluctuate in the first year or two of meno.
You can't really go by FSH either in peri as you could be menopausal one minute and not the next, that's my experience anyway. How are we meant to work it all out? All I know is that i have worked most of it out and know that I need estrogen to rid me of my dreadful symptoms and be well again.
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I’m beginning to think you are right Floo, maybe I’m peri after all.
Those bloods in Oct 2019 were after 3 months on 1mg sandrena I think. By December 2019 they had dropped to 118 on the same dose.
To be honest, i don’t know where I am any longer. The libido has vanished, the mood is low and my tummy hurts. Can’t get this coil removed and no clue what oestrogen i need.
A monumental mess comes to mind!!
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Sounds like it Nas, it explains things. If you still have symptoms you probably need more estrogen, dont rely on bloods. It took me a long time to work it out as I was told i was meno or post that was in 2019 and I am not, shouldn't be long but not there yet and still trying to get estrogen into me.
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Oh lord Floo, what am I going to do. Ive had breast cancer and specialist isnt a fan of high doses at the best of times!
What a bigger mess!
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Floo, any clue how to push forward with this? Im having huge fluctuations every few days now. I mean real highs and lows. The libido has literally gone!
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I would say it depends how bad your meno symptoms are and if you can manage or are they really affecting your quality of life. I think its got to be a balance and a joint decision but ultimately your decision.
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Yes, clearly the oestrogen i'm on now, isn't enough.
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There is this fear of Estrogen amongst professionals, I wonder if they would fear it if they didn’t absorb it well and needed high doses too. It’s not about the dose but about how much we take in which cannot be established by blood tests in peri. I absorb barely anything whether oral or transdermal so it’s really upsetting when doctors concentrate on dose rather than symptom control. As I am peri I know what my low, fluctuating and high symptoms are which are very different, it has taken me a long time to work out though.
Floo (Hi!), I know this is an old thread but my searching brought me here and I'm so interested to know how you know whether your estrogen levels are high, low or fluctuating? I have been trying to work out what is going on with mine for a long time. I've been on HRT for 8 months and life is definitely much better but I do still struggle with symptoms in the first half of my cycle. The symptoms being lack of refreshing sleep, fatigue, dry mouth, gurgling guts and churning belly, general lethargy. I've been round and round in my own head about histamine, iron, low estrogen, high estrogen.... I know you are not me and there might not be relevance but I'm so keen to hear your experience. I know for me there is a big iron involvement too. I was anaemic and got very ill a few years ago and I still struggle to keep the levels up despite lots of supplementation. I had lots of investigations at the time and it's thought to just be heavy periods but i know there's a hormonal involvement. Thanks for anything you can share.
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Two high FSH readings are pretty conclusive that you are menopausal.
It's only during peri that we can't tell what is happening because your estrogen could be all over the place whilst your FSH is still low.
When you say menopausal do you mean postmeno or also include perimenopausal?