Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: Vicky81 on September 10, 2024, 12:32:20 PM
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Can I ask how could I know if I'm not longer absorbing from the patch?
Im doing alot of crying on my antidepressant so they are reducing it from tomorrow,.
But I guess it was just a thought.
My blood tests have come back in the 400's .
And identity get night sweats (which I have done I the past when low)
Just looking for reassurance really ladies if that's OK? Xxxx
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Sorry meant to say "I don't get night sweats"
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Hi if your symptoms are reducing or staying the same then that’s a sign that you are absorbing. If your symptoms are coming back then that’s a sign that you might need a higher dose.
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Thanks Dotty- yeah you just wouldn't stop absorbing from the patch if you've been on it a few years and it's always done yiu good?
My recent oestrogen results were 497
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Are you peri? Or post?
If peri, when in your cycle was the blood test done?
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Hi Joziel I hope you are well?
So I don't have periods as Im on combined pill (yasmin)
Reason I'm asking really is I've been on duloxetine for 10 weeks and had my patch the same mg throughout. I've had 6 goid daysnext to each other, 11 goid days next to each other, mood great. Then the crying starts again
The crying was there before in May when my oestrogen dipped but I was on 65 patch. I've since upped this weeks ago. So I thought "it can't be my patch making me cry otherwise I wouldn't be having the 6 days, then the 11 good days....then the odd 2 days here 2days there.
I just panicked a bit I guess but my work colleagues have said its the duloxetine causing the crying spells. Now we've come to the conclusion that it could be too high gp agrees that the crying has gone on too long.
Plus- to add I'm not getting any night sweats which years ago I would get when low....that was always my sign
So I'm just asking you ladies really you don't think it's my patch ? Xxx
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I'm peri
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Sorry to add- when I say we think its too high we mean the duloxetine not patch
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Whether you're getting night sweats or not doesn't really mean anything. There are many low estrogen symptoms besides night sweats, it's not really a reliable measure.
I would think it is your own hormones fluctuating underneath whatever the HRT is doing, which is causing it. That much is shown in your blood results varying from 200-something to 400-something. Although if you are on Yasmin, that's going to affect your blood tests and make them not reliable in terms of the estrogen results.
The best way to fix it is to actually take higher estrogen, not lower. That fixes fluctuations by buffering any lows. If you take less you might have greater fluctuations and when it cuts out, it will go lower.
I think it's more likely that you are progressing through peri, your own estrogen is fluctuating more and cutting out lower when it does, causing these symptoms.
Am I right you are on both Yasmin and also on HRT?? That's a bit unusual. I would think getting off Yasmin and fully onto HRT would be best and if you do need contraception, to take a POP or use the Mirena....
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Thanks Joziel - so you reckon this intense crying is from low Oestrogen?
Yes ive had 3 blood tests in 3 weeks - something like 497 then 291, then 492 (I think - i am at work so cannot look)
Does this suggest my patch is too low? I am currently on 80 (100 cut down) as i was a little afraid to go too high - silly i know. Maybe i now need the 100 after the way you have explained this to me (so grateful)
The yasmin i have been on since 2022 and has always kept me steady along with the patch, then every 3 months i add extra Provera for a week, then bleed.
I have a scan every 5 months to check - everything always been fine.
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What is the reason you're on the Yasmin as well??
I wonder if you could switch Yasmin to Zoely which has body identical estrogen. That way your body could actually use that estrogen. Synthetic estradiol is not body identical.
You can't even measure your estradiol levels accurately if you are taking Yasmin: https://www.sciencedirect.com/topics/agricultural-and-biological-sciences/ethinyl-estradiol
You are taking something which adversely affects hormones, is an endocrine disruptor and makes it impossible to accurately measure whether you have enough estrogen or not. Your blood results may come back very decent yet your body is unable to use the estrogen because it is synthetic ethinyl estradiol and not body identical estradiol.
You need to get off the combined pill with synthetic estrogen. If for some reason you really want to take a combined pill, switch to Zoely which has body identical estrogen - or just use HRT with a progestin only pill if needed for contraception. There is zero reason to use Yasmin and it is messing up your results.
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Oh ok Joziel i did not realise.
The reason i started taking it is because on read on this forum oh gosh maybe 2022 - a lady called Gypsy Rose Lee and Briony i think were saying the combined pill suppresses the ovaries and is good for peri - that was my only reason xx
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So Zoely is a very low dose pill oestrogen wise - is it strong enough to suppress the ovaries? I remember trying this in the early days and i still felt rubbish hun x
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I'd be careful switching Vicky. You are looking for stability and have had that with Yasmin for a while now. You're nearly there. You are having a run of good days. You weren't getting that months ago.
Whilst I get joziel's comments on bio identical versus synthetic, I think when we are having a hellish peri, it's about finding stability. You will have a more stable cycle on the pill.
I've tried all the pills going and could no longer get on with any of them. If you are getting cycle suppression, I'd stay put. You've said yourself you tried zoley before.
And. I also disagree about swapping your pill to only hrt. Hrt does not suppress the system. We can have huge swings in peri...and that extra E simply swings with us. I felt dire on extra E.
Just be careful in your choices. You've been through a lot. You are being told it is the antidepressant causing the crying. I'd consider looking at that first.
Is there a cyclical nature to the crying?
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Thankyou Crispy - and i am grateful for all responses and yes i have been through hell since May, from severe anxiety, to ending up in hospital through self harming because of Sertraline.
When i was on here a while ago i got criticized quite alot for the upping and downing of my patch and not listening to people on here (i know thats how it seemed), at that time i didnt know if i was me or not, my mental health had took a dive and i didnt know if i wanted to live the anxiety was that bad.
So thank you for understanding and listening to my story/journey - its been so hard on me and my partner to try get everything right and i am learning slowly not to mess too much and to give things time.
Today i started 40mg Duloxetine from 60mg after 10 whole weeks of suffering terrible crying/fatigue/headaches/anxiety. I joined a duloxetine forum whereby i was told by a few to reduce as it seems too high for me., so GP agreed. xxxx
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sorry Crispy - No cyclical nature to the crying
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I'd be careful switching Vicky. You are looking for stability and have had that with Yasmin for a while now. You're nearly there. You are having a run of good days. You weren't getting that months ago.
Whilst I get joziel's comments on bio identical versus synthetic, I think when we are having a hellish peri, it's about finding stability. You will have a more stable cycle on the pill.
I've tried all the pills going and could no longer get on with any of them. If you are getting cycle suppression, I'd stay put. You've said yourself you tried zoley before.
And. I also disagree about swapping your pill to only hrt. Hrt does not suppress the system. We can have huge swings in peri...and that extra E simply swings with us. I felt dire on extra E.
Just be careful in your choices. You've been through a lot. You are being told it is the antidepressant causing the crying. I'd consider looking at that first.
Is there a cyclical nature to the crying?
When you say Dire on extra Oestrogen - what do you mean? Where you on patch? What mg? and what bad effects did it give you?
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Sorry Crispy - i probably did this wrong - but i asked on the quoting you - what bad effects did you get from too much Oestrogen? Was it the patch? What mg made you ill?
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I've only tried E once through my horrific peri. And basically, all the symptoms I was having were made 10x worse within days.
I think you're doing the right thing taking advice on the AD and adjusting the dose as recommended. They are powerful drugs and can absolutely cause issues like u describe.
Messing with the pill or hrt at the same time should be a no no. :). You're on high dose E and the pill. your bloods are in good range. I can't see how you could be low E. especially if there is no cyclical nature to your crying spells.
However, I'm just yet another person on a forum. So I'm glad you're getting expert advice.
That's why I've responded as I don't feel it will do you any good to swap your pill right now or go all over to HRT. Everyone has an opinion, bug we also all respond differently.
I hope the reduction in AD is the right move. Hold on in there. Xxx
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It's not about suppression of the cycle, that's too simplistic. I tried taking desogestrel whilst on HRT to suppress my ovaries and cycle - and it did nothing to my symptoms. High dose HRT finally is helping overcome the fluctuations which were causing those symptoms. Shutting my ovaries down to try to stop fluctuations didn't help, because our brains also manufacture estrogen and get deficient in it...
You can't dose HRT using blood tests at all if you are also taking Yasmin (or any combined pill with synthetic estrogen in it). How are you going to know if you are on too much, too little estrogen and how much you are absorbing etc etc...
You can't compare bio-identical estrogen with synthetic estrogen in terms of the quantity, they are not comparable. They are 2 completely different drugs. You are not taking estradiol with synthetic estrogen.
You are going to be taken off the combined pill when you hit 52 anyway, because that's best practice advice. It increases the risk of blood clots. You are going to be forced to go in search of 'stability' via HRT anyway. What you are doing now isn't tenable for the long term so you may as well use this situation as an opportunity to sort things out. How much worse is it going to be if you reach nirvana and are symptom-free and then are forced to come off the combined pill anyway....??
To be honest I'm really surprised a doctor has approved you being on both HRT and the combined pill.... I've never heard of anyone else doing this. There are some women who prefer to stay on the combined pill as long as possible, but not alongside HRT. It would be very unusual anyway.
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Hi Joziel - I have always gotten on really well with Yasmin, along side the patch - always worked well - stopped my anxiety/crying etc. GP agrees that as long as im ok and getting scans that i can stay on it. So am on HRT and the pill. So once off the pill at whatever age, i will still be on the patch so hopefully it wont be that distressing for me.
What has happened in May is i took a dip in oestrogen - as you say Joziel may i am further along. So now my patch has been upped. Maybe it needs upping again due to the severe crying? who knows? The Pharmacist a while back suggested i just put the 100mg on instead of cutting the patch to 80. Maybe 80 is too low?
Crispy - Thanks for the message, I shall keep on my regime with the hope that this reduced Duloxetine will cease the crying, i guess i have to now give it 4 - 6 weeks? is that right? to see if its going to be for me? xx
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Yes, I think 4 to 6 weeks for stability on an AD.
With all due respect joziel - I know u believe in high dose E. And if it works for you, amazing. But some of us have a harder time finding that sweet spot or indeed getting on it in the first place.
Please bare in mind Vicky has been through a lot of upheaval and the best thing for her right now is stability. No, she can't stay on the pill forever, but at 48, I just had a meno specialist say that's what they would still recommend.
For some it is all about the fluctuations, not solely about low E levels. that can come later.
If the drop in AD doesn't help Vicky, maybe a different AD? I'd expect crying to disappear on an AD. Or try the E increase then. As you say, your specialist has approved pill and patch.
Good luck. Xx
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Indeed - who knows if you should increase or reduce? My point exactly: If you can't use blood tests - and you really can't on synthetic estrogen - then you are just guessing whether to increase or reduce.
Bearing in mind some of us (like yours truly) can need very high doses of HRT estrogen, how would you ever know if you were in that situation if you couldn't rely on bloods?
Yes, when off the pill you will still be on the patch - but what dose? Presumably you will need to increase HRT because you will have stopped the synthetic estrogen. Or you will still have some ovarian function left at 52 (not all women are instantly menopausal at 52.... ) and your own ovaries will contribute varying amounts then, maybe requiring more to overcome those fluctuations.
Point being - it's just delaying the inevitable really. You will need to come off the combined pill at some point. And whilst you might have been stable on it for a while, you clearly aren't now - and it is making it difficult to determine what's really going on.
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But Vicky thinks it's the AD causing the crying. So surely she's better to start there, as she's had expert advice to that affect.
Delaying the inevitable? Not necessarily. For many woman the pill helps mask the fluctuations until post meno. My own sis has stopped the pill at 50, has gone straight into meno and is doing absolutely fine. whereas me, in this peri hell of wild fluctuations, is not.
If I could, and god I've tried, I'd take the pill in a heart beat and take my chances post meno.
We're all very very different. And it is most definitely a course of action still recommended by specialists. That's because it does flatten the hormones, whereas hrt tops up. Pill is stronger.
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Hi Crispy i agree, I would rather stay on Yasmin as every blood test i have had to check LH and FSH have always come back as 0.1 - even the Gynae told me when i asked - she said they are very supressed.
So i guess the dip in May must be what Joziel said earlier - maybe I've come a bit more far along in peri? and that the 65 patch needed upping.
But since the Duloxetine, the crying has been terrible and quite frequent.
i have also heard of women who come off the pill and are fine just carrying on with HRT so thats my plan really.
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It's good to thrash it out on here vicky - to see what is best course of action for you.
For me, you sum it up perfectly here: "since the Duloxetine, the crying has been terrible and quite frequent.". Since the duloxetine. I'd definitely start there. Xx
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Crispy I can't thank you enough for understanding everything I've been through ...thank you so very much xxxx
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Hello Vicky81
I am sorry to hear that you are suffering, especially as you are trying so hard to feel better.
I hope that the reduction in your Duloxetine dose does the trick.
Like many ladies I take an AD along with my HRT and I have often wondered if this is really helping or even making matters worse. Would you mind reporting back on your progress so that we can learn from each other.
Wishing you well and take care.
K.
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Awww Kathleen so nice to hear from you! And yes of course I will report back ..
I hope you are doing ok? Xxx
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I was on the "am I absorbing?" merry-go-round at first with HRT. Turns out I was absorbing, my dose just wasn't high enough. My .05 patch knocked out my night sweats and hot flashes but I had to get to .075 for my mood to improve and the depression to go away.
It's hard to get the dosing right. Don't be afraid to go up a notch. Your body will tell you if it's too high! Good luck!