Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: Amberc on July 27, 2023, 08:20:51 PM
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Hi everyone, I was prescribed gel (one pump per day) and progesterone a couple of years ago. In the last year I’ve had loads of weight gain, tiredness and loss of libido. I had a private blood test at Marion Gluck. The test is done before you’ve done your hrt regimen for the day, so you are ‘au natrel’. My oestrogen showed up as a normal pre menopausal woman. The doctor told me I didn’t need oestrogen at all and it was probably oestrogen dominance that caused the weight gain etc. Has anyone else encountered this? She told me to stop the gel immediately. Now she’s told me to have the progesterone lozenges. I’m a bit worried about what to believe but I’ve seen the test. Just wondered how long the hrt gel stays in your body - does it accumulate to get used up every 24 hours?
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Why would. you need HRT at all? Can U remember why you began to use it? Was there a specific symptom that you needed to ease?
:welcomemm: Browse round. Hopefully some1 will be along. Is she selling HRT?
Some find that keeping a mood/food/symptom diary of use to chart progress. Apart from treatment for vaginal atrophy, I haven't required any other HRT. My last period was in the early 2000s.
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I had major anxiety, and I was really angry - like pmt on crack! The symptoms definitely subsided once I started hrt, but I seem to have developed new ones. I’ve never heard of oestrogen dominance before and I think the Marion Gluck clinic is fairly well regarded…
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She is mentioned on the Forum.
I had rages B4 a bleed began even if a period wasn't due :o
I don't know how long HRT remains in the blood stream, nor whether you require progesterone which many find difficult to tolerate. Hopefully some1 will be along talking more sense ::)
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I have estrogen dominance.
It is hell. I have never supplemented estrogen. I'm in peri and my own estrogen spikes are hellish. Plus anything I touch seems to help my body to make more estrogen - like vitex.
I've also been to the Marion Gluck clinic. I was prescribed just prog. Unfortunately I get a lot of side affects from it. But. I can categorically say it can help with certain things like pms and migraines.
There is a progesterone, cyclogest, licenced in the UK for pms. Look it up.
It's all very quiet in the UK about progesterone only therapy. The NHS deny estrogen dominance exists. They just want to give you more estrogen. For me, estrogen poisons me - at the moment. I've had to turn my back on the NHS due to this.
Do you take utrogestan as part of your hrt??? Or are you on a progestin?
A progestin will not help estrogen dominance. Natural Prog will. Marion Gluck will compound for you - but if you take utrogestan already, happily, you can use that. You don't need to spend the money on compounded.
If u do take utro...drop the E and see what happens ...
There is lots out there on estrogen dominance once you start looking. In the US and Europe - prog only therapy is common. We are miles behind.
X
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I'm beginning to think I'm also suffering oestrogen dominance. Would that cause loss of libido, poor sleep, anxiety and histamine related sinus issues? Also itchy inside ears, mouth ulcers, cold sores. They were some of my original symptoms. Now on HRT I have a whole load of other symptoms 🤦♀️ including constant bleeding, IBS, tingly feet, thoracic outlet syndrome has returned, which I had while pregnant.
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I wouldn't like to say, but certainly histamine is very closely linked to estrogen. One fuels the other.
Defo something to look into.
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I’ve been given progesterone lozenges by Marion Gluck - let’s see how this works out! Very expensive 5hough but it’ll be worth every penny if I start to feel alive again!
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Amberc. What dose lozenge?
We're ubon utrogestan?? Cause it's just the same, but only in 100mg.
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It’s 25mg twice a day
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For low libido, you might need some testosterone. Usually they don't want to prescribe that unless you're also on estrogen (which doesn't make sense, since surely it's about the levels of estrogen you have being sufficient - whether you make it or take it??). You might be able to get T only (or with just progesterone) from Marion Gluck though....
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You defo will. MG gave it and dhea to me. I'm guessing your levels were fine though or they would've offered it...to make more money ;D
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I agree with Crispy, oestrogen dominance does exist, particularly when you first go into menopause and your oestrogen levels are often very high and your progesterone levels are extremely low. That is why women are susceptible to breast cysts and womb lining build up plus anxiety and panic attacks.
Progesterone flattens oestrogen spikes and in my particular case, it was protecting me from developing migraine auras during periods of spiking and wildly fluctuating oestrogen levels. In some women, progesterone protects them from anxiety, insomnia, mood swings and panic attacks.
As Crispy said, you need body identical progesterone that mimics your own progesterone, not the synthetic variety which is really only for womb protection.
I found the progesterone lozenges very good and took 50mg every day for a few years. I've since switched to progesterone gel but that's a different story!
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As Crispy said, you need body identical progesterone that mimics your own progesterone, not the synthetic variety which is really only for womb protection.
I had oestrogen dominance in peri, my symptoms were very severe, simple Mirena coil, which is synthetic progesterone and supposed to be only for womb protection, successfully treated all oestrogen dominance symptoms in my body. For some reasons Mirena didn’t work only locally in my womb, it worked generally for the whole body. Why? GP didn’t have an answer, it just worked for me.
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Angela h that's amazing.
I'm actually trialling the mini pill, cerazette, for the second time during this peri estrogen dom hell.
It absolutely takes away some of my worst E symptoms - my poison, motionsickness, dizziness, ear pressure and nausea. I guess that's because cerazette keeps E at low follicular levels. I just tested, and indeed my E is much lower than it has been.
However, progestin stops you producing your own progesterone, so I end up swapping my high E symptoms for other Symptoms - mostly migraines and very severe pms. Both things natural Prog helps me with.
But. Your story shows how diff we all are. Don't change it if it's working 8)
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As Crispy said, you need body identical progesterone that mimics your own progesterone, not the synthetic variety which is really only for womb protection.
I had oestrogen dominance in peri, my symptoms were very severe, simple Mirena coil, which is synthetic progesterone and supposed to be only for womb protection, successfully treated all oestrogen dominance symptoms in my body. For some reasons Mirena didn’t work only locally in my womb, it worked generally for the whole body. Why? GP didn’t have an answer, it just worked for me.
That is brilliant and long may your success continue. If it works, don't be tempted to change it.
I had my very first Mirena coil back in 1998 for contraception and I didn't have any problems with it. My silent migraines started in 2004 (the very beginnings of the menopause) and my coil was up for renewal in 2005(ish) so I went ahead with it but unfortunately the migraine auras continued so I finally had it removed in 2010. I also had breast pain. Migraines are very difficult to treat but I can well imagine the Mirena coil would dampen down the effects of oestrogen.
I have never been pregnant (through choice) so having the coil fitted was the worst pain of my life, it really was agony and I broke into a shaky sweat afterwards. After I had my first coil fitted I was in such a state, the doctor had to drive me home and I almost fell out of his car - luckily I was his last appointment.
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But. Your story shows how diff we all are.
Yes, you are right, in my case Mirena couldn’t stop me producing my own progesterone simply because my body already could hardly produced it at that time, but only high level of oestrogen. Actually, as I remember, I didn’t have migraines when oestrogen was dominating, I had depression, panic attacks, non stop heavy bleedings with big clots. I started experiencing migraines only now, 4 years later, when my oestrogen level eventually dropped to the bottom.
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That is brilliant and long may your success continue. If it works, don't be tempted to change it.
It’s time for me to have another one, because I have it now for 4 years and it should be changed soon, but this time my body stopped producing oestrogen and now I have symptoms of low oestrogen, I will keep Mirena for progesterone part of HRT because natural prog makes me feel sick, my body doesn’t tolerate it at all.
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But. Your story shows how diff we all are.
Yes, you are right, in my case Mirena couldn’t stop me producing my own progesterone simply because my body already could hardly produced it at that time, but only high level of oestrogen. Actually, as I remember, I didn’t have migraines when oestrogen was dominating, I had depression, panic attacks, non stop heavy bleedings with big clots. I started experiencing migraines only now, 4 years later, when my oestrogen level eventually dropped to the bottom.
It's a difficult balancing act getting your oestrogen dose right if you suffer with hormonal migraines.
Do you have migraines with or without aura? From what you have said, it sounds like your trigger is low oestrogen.
I started having silent migraines (aura without headache) in early menopause and I have to keep my oestrogen levels at no less than 300ish. I also have to avoid oestrogen spikes, high doses of progesterone and bleeds are completely out. I also take amitriptyline (an AD) as a preventative and it's very effective.
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This is a general post, not aimed at any poster or post in particular.
The whole concept of “oestrogen dominance” is based on the premise that there is a magic ratio of oestrogen to progesterone needed for well-being and when this gets out of balance, as it does in peri-menopause, then what is needed is extra progesterone, for therapeutic reasons.
We first discussed this may years ago on the forum and I think all the earlier posts were archived, but from what I recall this term and this theory was invented by John Lee to sell natural progesterone cream. That was from memory. Since then there have been numerous proponents and equally many practitioners and products all making money of the back of it notably in US where there is no NHS and all sorts of people set up to promulgate all sorts of treatments and products in an unregulated fashion.
Having just googled it again for the first time for years I found this:
https://www.medichecks.com/blogs/news/oestrogen-dominance-too-much-of-a-good-thing
“The term was originally coined by Dr John Lee in the 1990s [1] and was based on his experiences of treating women with natural hormone therapy. His theories have been criticised because they are based on anecdote rather than scientific evidence [2]. There are still very few published scientific papers on oestrogen dominance and no widely accepted criteria that doctors can use to diagnose the condition.”
So what is actually meant by oestrogen dominance? To me the most obvious time when oestrogen predominates is during part of our natural menstrual cycle during our fertile years. For the first part of the menstrual cycle oestrogen rises and reaches a peak around the time of ovulation. At this time, oestrogen dominance ie the ratio of oestrogen to progesterone, is at its highest. Once a woman has finished the main part of the bleed then this is the time when most women feel at their best – obviously, otherwise we would never reproduce! Post ovulation, oestrogen crashes and progesterone start to rise, and later oestrogen rises again and then both fall and then the period starts when oestrogen and progesterone are at their lowest. Women usually feel at t heir worst during the last part of the menstrual cycle – either when progesterone is high relative to oestrogen or oestrogen has fallen or because of the progesterone withdrawal. During the whole of the second part of the cycle the ratio of oestrogen to progesterone will be lower than the first half and around ovulation.
If oestrogen dominance was a thing, the reverse would be true, surely ie we woud feel at our worst during the first part of the cycle and around ovulation?
It’s important to distinguish between “oestrogen dominance” (high oestrogen relative to progesterone), and very high oestrogen per se, both of which occur during peri-menopause.
The lack of ovulation during some peri-menopause cycles means that the ratio of oestrogen to progesterone remains high for some time and progesterone is needed here to regulate the cycle and protect the endometrium, but not because the progesterone is needed for well-being.
The very high spikes of oestrogen which undoubtedly occur during the peri-menopausal hormone fluctuations are a different matter altogether. As I understand, the side effects/symptoms of very high oestrogen at this time, have nothing to do with oestrogen dominance but purely because of the oestrogen itself – sudden high levels ( as we notice during pregnancy) can cause amongst other things very tender breasts – but adding progesterone won’t prevent this. Only suppressing or controlling the cycle can dampen these fluctuations eg through the pill, some types of mini pill, or the Mirena coil (which doesn’t always suppress the cycle) or very high consistent doses of oestrogen. Of course eventually the oestrogen levels continue on their downward trajectory, no longer spike very high, and that’s when HRT comes in. A progestogen is always needed to protect the womb.
Also progesterone has been used in pharmaceutical quantities (rather than physiologically for “balance”) – but this is not because of its role in alleviating “oestrogen dominance”, but due to its sedative effects - though I don't think it is indicated for this?
That being said if anyone feels they want to take progesterone for whatever reason, in the doses used for HRT or less, then why not, though as far as I know there is only anecdotal evidence for its efficacy? However no need to go to an expensive private clinic to get it prescribed.
As always wishing everyone the best, but trying to see the wood for the trees….
Hurdity x
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Hi amberc
:welcomemm:
Sorry to hear about your menopausal woes. Also that you felt you needed to pay for a private and expensive clinic to get treated.
If you read my previous post, it is not surprising that you haven't heard of oestrogen dominance - at least as a condition that needs treating in the way that it can be.
Firstly about the blood test. You are right in that any blood tests taken while you are on an HRT regime will not be a reflection of your natural state. A better indication of where you are in menopause would be what your periods were doing in the months leading up to your starting the HRT? Was this regime on the NHS? What was the dose and regime of the progesterone?
It is not possible to know if you need oestrogen or not from this blood test, but really a better guide is what your cycle might be doing, (what periods you eventually have) or if your menopausal symptoms return when you stop oestrogen (assuming you had irregular periods and flushes/sweats and other symptoms before you started HRT?).
If you were taking progesterone continuously then this could have been the cause of your fatigue but obviously other causes such as underactive thyroid or vitamin/mineral deficiencies also need to be ruled out so hopefully you had tests with the doc for these?
Continuous progesterone can also have the effect of reducing libido ( as well as some anti-depressants) and testosterone itself also reduces with age - you haven't said how old you are. Similarly weight gain is not a function of HRT (though progesterone can cause fluid retention and bloating) and is sadly a feature of our slowing metabolism as we age - and it is hard work to prevent this - mainly through diet and exercise, especially strength training to minimise muscle wasting ( and this is where testosterone can help, along with the exercise).
If you find after a few months that the lozenges are not working and as you say, very expensive to keep buying, then do come back to us and ask for further advice that doesn't involve parting with lots of money - there will be something out there that works for you!
All the best
Hurdity x
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I'm so glad you never had to live through the hell that is estrogen dominance hurdity.
Estrogen dominance, estrogen spikes, just high friggin Estrogen. Who cares what it's called. I'm still living through it. Awful.
And, my follicular part of my cycle is my worst.
And, as ive said many a time in this forum, if left to the NHS...I'd just be poisoning myself even more in this peri with added estrogen. I agree, we shouldn't have to look to the private sector either. But that's the reality.
Cyclogest is bhrt progesterone and is licenced to treat severe pms. This doesn't fit with your theories, I'm afraid.
I'm trying cerazette just now to suppress my system. It does. But unfortunately because it stops my prog production, I have horrific pms and migraines. So I'll be going back to bhrt progesterone - as we know is licenced for pms.
I'd love to just take utrogestan. But 100mg hit orally knocks me sideways.
Good luck Amberc. Leg is know how u get on with the lozenges. Xx
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Yes good luck amberc, the lozenges may work really well for you. I hope so!
I’m glad this discussion is ongoing on the main forum as it’s had to be buried within alternative therapies previously. But it’s a common problem and better recognised in the US and Australia.
There is no magic ratio that will work for all but everyone’s has a balance that works well for them and it’s so tough to find for many. Oestrogen just isn’t sadly the answer for a lot of women. In fact it can make them very ill.
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I'm so glad you never had to live through the hell that is estrogen dominance hurdity.
Estrogen dominance, estrogen spikes, just high friggin Estrogen. Who cares what it's called. I'm still living through it. Awful.
And, my follicular part of my cycle is my worst.
And, as ive said many a time in this forum, if left to the NHS...I'd just be poisoning myself even more in this peri with added estrogen. I agree, we shouldn't have to look to the private sector either. But that's the reality.
Cyclogest is bhrt progesterone and is licenced to treat severe pms. This doesn't fit with your theories, I'm afraid.
I'm trying cerazette just now to suppress my system. It does. But unfortunately because it stops my prog production, I have horrific pms and migraines. So I'll be going back to bhrt progesterone - as we know is licenced for pms.
I'd love to just take utrogestan. But 100mg hit orally knocks me sideways.
Good luck Amberc. Leg is know how u get on with the lozenges. Xx
I agree with all of that, it's not as simple as ABC,123. You should not feel like you are being judged because you have an "inconvenient" condition that apparently doesn't even exist!
Equally nobody on here should feel judged if they seek help privately. If you choose to spend your money on fast tracking to better health care that is your business. People spend their money on all sorts of different things like holidays etc so they are allowed to choose to spend it on their health if they wish. If someone is ideologically opposed to private health care, nobody is forcing them to use it.
As I've said on numerous occasions, no wonder so many women have horrendous problems with Utrogestan, the 100mg dose is too much in one hit. That is why the Newson clinic prescribe 100mg , every other day.
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I’m another one that wishes amberc good luck.
Oestrogen dominance/excess/whatever you want to call it genuinely exists. We are all too familiar with symptoms of low oestrogen, but high oestrogen levels can make you very ill indeed. I have it. My GP says I have it. My menopause specialist diagnosed it. My gynaecologist grudgingly admits it too (and he’s only dealing with the fibroids and cysts……thanks oestrogen) It’s hellish to manage. Other countries recognise the condition and treat it. Why is the UK so backwards on this?
I have been criticised on here before, (not by Hurdity for clarification) for suggesting oestrogen dominance /excess exists. It’s real. It’s difficult. It makes you very ill. The follicular phase is hell.
Let us know how you get on with the lozenges. I take utrogestan. It’s not perfect but it’s the best the NHS can offer me.
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But. Your story shows how diff we all are.
Yes, you are right, in my case Mirena couldn’t stop me producing my own progesterone simply because my body already could hardly produced it at that time, but only high level of oestrogen. Actually, as I remember, I didn’t have migraines when oestrogen was dominating, I had depression, panic attacks, non stop heavy bleedings with big clots. I started experiencing migraines only now, 4 years later, when my oestrogen level eventually dropped to the bottom.
It's a difficult balancing act getting your oestrogen dose right if you suffer with hormonal migraines.
Do you have migraines with or without aura? From what you have said, it sounds like your trigger is low oestrogen.
I started having silent migraines (aura without headache) in early menopause and I have to keep my oestrogen levels at no less than 300ish. I also have to avoid oestrogen spikes, high doses of progesterone and bleeds are completely out. I also take amitriptyline (an AD) as a preventative and it's very effective.
I never had aura, and now, probably because I am on low dose of oestrogen spray, I have stopped having headaches at all. But in general it’s more difficult for me to manage the right oestrogen dose, it’s a complicated hormone to deal with.
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Hi AngelaH
I have followed this post with great interest.
I am 4 years post meno and never needed hrt until last year, I lost loads of weight ( which I have since put all back and then some) and maybe my hormones took a nosedive, I don't know but I went on hrt last August.
I am now on 3 pumps of gel and 100mg cyclogest. Over the past few weeks, I have had really sore, swollen and tender boobs and I'm wondering if my gel is too high. Is that all estrogen dominance is, just when your estrogen is higher than your progesterone. I had my estrogen blood levels checked last week and they were 448 xx
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I think it's not about absolute numbers of estrogen and progesterone, but the ratio between the two. I don't know what sort of ratio indicates estrogen dominance but I do know I was told that it isn't the numbers that matter as such. I was diagnosed with this during my monitoring cycle for ivf, so way before peri reared it's head. They had to manage my estrogen levels really carefully.
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Hi AngelaH
I have followed this post with great interest.
I am 4 years post meno and never needed hrt until last year, I lost loads of weight ( which I have since put all back and then some) and maybe my hormones took a nosedive, I don't know but I went on hrt last August.
I am now on 3 pumps of gel and 100mg cyclogest. Over the past few weeks, I have had really sore, swollen and tender boobs and I'm wondering if my gel is too high. Is that all estrogen dominance is, just when your estrogen is higher than your progesterone. I had my estrogen blood levels checked last week and they were 448 xx
Hi discogirl :)
Estrogen dominance means estrogen and progesterone are out of balance. Personally I can see how it works in reproductive age and during peri, when both hormones play the main role as reproductive hormones. But when it comes to menopause and post I honesty can’t see how imbalance may look like. What sort of balance is needed between estrogen and progesterone if the body doesn’t need progesterone at all? :-\ The main role of progesterone in the body to prepare lining of uterus for pregnancy and maintain early stage of it. In menopause and post we use it just to protect uterus, but not for the natural original use of it. So in this case I would rather talk about overdose of oestrogen than about imbalance between two hormones. But this is just my own thoughts, it is not necessarily true. ::)
I believe sore, swollen and tender boobs can be due to high oestrogen, I have the same symptoms on 2 pumps of gel, 1 pump doesn’t give me those symptoms.
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Thanks for that AngelaH
I believe that my estrogen is too high, however I am loathe to reduce it just yet, and I was wanting to increase my progesterone to see how I got on.
I really appreciate the information xxx
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Hi Angela H - exactly!!! Very well said.
The "oestrogen dominance" lobby - and I explained what I meant that earlier in this thread - so the lobby that wants to sell progesterone cream, lozenges or whatever - will have us all believe that there IS magic ratio for well being - and logically - how can this be true? As I explained and you reiterated - we experience different ratios throughout our reproductive life, depending on what is happening - be it pregnancy, menstrual cycle or menopause.
Estrogen dominance means estrogen and progesterone are out of balance. Personally I can see how it works in reproductive age and during peri, when both hormones play the main role as reproductive hormones. But when it comes to menopause and post I honesty can’t see how imbalance may look like. What sort of balance is needed between estrogen and progesterone if the body doesn’t need progesterone at all? :-\ The main role of progesterone in the body to prepare lining of uterus for pregnancy and maintain early stage of it. In menopause and post we use it just to protect uterus, but not for the natural original use of it. So in this case I would rather talk about overdose of oestrogen than about imbalance between two hormones. But this is just my own thoughts, it is not necessarily true. ::)
I believe sore, swollen and tender boobs can be due to high oestrogen, I have the same symptoms on 2 pumps of gel, 1 pump doesn’t give me those symptoms.
Yes it is the high oestrogen spikes in peri-menopause that I was talking about in my post too (I think - I haven't looked back!) - which is a completely different issue from the issue of a ratio. When you say they are just your thoughts - they are my thoughts too - but based on logic and what actually happens in our bodies, ie taking the theory to its logical conclusion and pointing out the flaws. The other idea has no evidence to support it - though if someone can show me that it does, with good evidence, I will change my view.
Hurdity x
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I actually think we're all saying the same things Hurdity. It is my peri estrogen spikes that are horrific for me.
That is 100% my problem. Proven by the fact cerazette has currently stopped all of those symptoms. Bliss - I wish. Cerazette unfortunately makes me a grumpy bear with migraines!
So yes, who cares what we call it. But progesterone alone can help as it can help tame the estrogen spikes. Especially if one has very low progesterone through anovulation.
It is not just a made up theory by those trying to sell progesterone cream, lozenges or whatever. Many UK bhrt clinics recognise it - they also sell estrogen creams and lozenges - if it wasn't a thing, they'd sell everyone estrogen too! Many will also treat you with utrogestan, if you can tolerate it.
As I said earlier, low progesterone is a real thing and a real problem - as cyclogest is licenced for severe pms.
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The issue we have here in the UK is the NHS do not recognise these estrogen spikes ...instead suggesting you take even more estrogen. That can be pure hell for us.
I've lost a lot of time due to this ignorance and I'm so happy us ladies can share our experience of estrogen dominance (or spikes if that's what you want to call it).
Personally, I think the term is quite apt as when I am experiencing the poison, it is because my estrogen is dominating in my body and not balanced with progesterone.
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Hi Angela H - exactly!!! Very well said.
The "oestrogen dominance" lobby - and I explained what I meant that earlier in this thread - so the lobby that wants to sell progesterone cream, lozenges or whatever - will have us all believe that there IS magic ratio for well being - and logically - how can this be true? As I explained and you reiterated - we experience different ratios throughout our reproductive life, depending on what is happening - be it pregnancy, menstrual cycle or menopause.
Hello Hurdity,
There is something else apart from that. If we look at reproductive age we all agree that all sex hormones constantly fluctuate in ours bodies, but in different bodies they are fluctuate differently. This is why some of us always had longer and heavier periods than others, had acne on their faces, probably the level of their estrogen was fine, but the level of progesterone was slightly lower than it should be. So it’s not just about spikes of estrogen, this is about condition, which can be going permanently in the body, it looks like estrogen is always dominant and progesterone always seems to be weaker. I started my periods at the age of 10, it wasn’t even periods it was something like constantly dripping from me, it could take months and months until it stopped. In a couple of years they stabilised, but they were heavy all my reproductive life and never shorter than 7-8 days. I think my progesterone was always to weak to make my periods lighter and shorter. I don’t know what exactly was the reason for that, low level of production by my body? Or there was something in my body, which was killing progesterone? So in this case can we consider me as an estrogen dominated person?
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It is my peri estrogen spikes that are horrific for me.
As far as I know in peri progesterone always drops first, for some women it doesn’t create any problems, but for others it can turn to a horrible nightmare.
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The theory with estrogen fluctuation and more estrogen is that taking more estrogen so you have a higher level from exogenous estrogen is supposed to make your own body's fluctuations a bit irrelevant - they will be minor by comparison... No idea if this theory is true but that's the thinking for giving more estrogen when there are fluctuations in peri (according to my Newson dr).
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This is interesting joziel, so taking oestrogen would help?
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Yes, that's the theory. It might be why relatively high doses of estrogen are often needed in peri, compared to post-meno. So your own fluctuations are like a drop in the ocean...