Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: CrispyChick on October 04, 2024, 02:09:42 PM
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Hi all
Lots of chat on the LN thread about how we're all different and need different levels of E to feel good. And chat about suggested levels for bone health etc.
I'm just wondering if any of you post meno have been able to pinpoint an E level (through serum testing) where you 'feel good' (or bad), either naturally, or with added hrt.
I think in peri our levels fluctuate far too wildly to be meaningful.
Be interesting to see variations.
Many thanks.
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I’m interested in this. My oestrogen is currently 18 as the patches been sliding around and dropping off. The GP said it’s practically non existent. Just doubled to 50mcg patch to see if that improves things. It’s possible I’m a poor absorber as I’ve never found the sweet spot with HRT but I also have hypothyroidism which I was trying to tackle first and I have no testosterone either as confirmed by the same blood test. Even though my thyroid’s improved now I still feel flat, can’t be bothered with things and no appetite which GP said was linked to no testosterone.
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Hello ladies.
A blood test in August this year showed my post meno Oestradiol to be 139 pmol/L which was an increase from 78 pmol/L six months earlier. My practice nurse says she wants to get me up to 200 pmol/L and I will try and get a follow up appointment with her soon.
These levels come from using a 1 mg sachet of Sandrena gel and 100 mg of Utrogestan daily and I still have some meno symptoms.
On the My Chart app it gave an Oestradiol level of up to 118pmol/L as the expected level for post meno women not on HRT.
I hope this is of some help.
Take care ladies.
K.
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Thanks Kathleen. No wonder I feel so bad!! I was on 25mcg patches now on 50mcg but I don’t think you can compare patches to gel. I’m hoping the 50mcg patch helps boost things if not maybe trying a different product.
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Hello ladies.
A blood test in August this year showed my post meno Oestradiol to be 139 pmol/L which was an increase from 78 pmol/L six months earlier. My practice nurse says she wants to get me up to 200 pmol/L and I will try and get a follow up appointment with her soon.
These levels come from using a 1 mg sachet of Sandrena gel and 100 mg of Utrogestan daily and I still have some meno symptoms.
On the My Chart app it gave an Oestradiol level of up to 118pmol/L as the expected level for post meno women not on HRT.
I hope this is of some help.
Take care ladies.
K.
That’s helpful. Thanks. I want to cry about my levels. I knew 18 ppmol was low but when the GP said Oestodial ‘practically non existent’ I wasn’t expecting it. I’ve been on and off HRT as it’s been a ‘journey’ and obvs I’m still not in a good place. I’m worried about my bones now 🙈 x
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Post meno by 6 years; not a scrap of oestrogen in my body. I feel horrific from lack of hormones.
My bones are the least of my worries! :(
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I'm not postmenopausal (that I know of) as I'm a long term pill taker for menstrual suppression.
I take Zoely which has body identical estradiol, and my plasma level is consistently around 390pmol/L.
I am happy with this, I feel good and do not plan to go below this level ever.
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I’m interested in this. My oestrogen is currently 18 as the patches been sliding around and dropping off. The GP said it’s practically non existent. Just doubled to 50mcg patch to see if that improves things. It’s possible I’m a poor absorber as I’ve never found the sweet spot with HRT but I also have hypothyroidism which I was trying to tackle first and I have no testosterone either as confirmed by the same blood test. Even though my thyroid’s improved now I still feel flat, can’t be bothered with things and no appetite which GP said was linked to no testosterone.
It might be beneficial to change to a different type of patch or gel/spray. I couldn't get evorel to stick but estradot are fine (others find the opposite so I think it's trial and error time). I think on 25mcg patch your levels are unexpectedly low.
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I’m interested in this. My oestrogen is currently 18 as the patches been sliding around and dropping off. The GP said it’s practically non existent. Just doubled to 50mcg patch to see if that improves things. It’s possible I’m a poor absorber as I’ve never found the sweet spot with HRT but I also have hypothyroidism which I was trying to tackle first and I have no testosterone either as confirmed by the same blood test. Even though my thyroid’s improved now I still feel flat, can’t be bothered with things and no appetite which GP said was linked to no testosterone.
It might be beneficial to change to a different type of patch or gel/spray. I couldn't get evorel to stick but estradot are fine (others find the opposite so I think it's trial and error time). I think on 25mcg patch your levels are unexpectedly low.
Yes, I’m sticking (if they will) with them for a bit longer and have doubled the dose to see if my levels improve. If they don’t then a different product will (hopefully) be better. Definitely trial and error. Yes, I was a bit surprised at how low it was. I do feel very flat which isn’t surprising.
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I'm 61, 12 years post meno and on HRT for 2.5yrs.
My Oestrodial level was 'only' 106 when tested by Newson Clinic last December but I felt good at this level. Before HRT (Oestrogel and Mirena Coil) I had flushes, sleep disturbance, itchy skin, palpitations amongst other things. These were all sorted by HRT even with such low oestrodial levels.
I have recently changed from Oestrogel to Lenzetto as symptoms started to return. I'm booked in for a blood test with my GP next week so it will be interesting to see my levels at that point.
I'll just add that Oestrogen and Progesterone prescribed by my GP, I went to Newson Clinic for Testosterone as GP wouldn't prescribe.
Suzie
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Am really interested in this topic too. I wish I'd never heard about the bones optimal oestrodial levels as otherwise id only focus on symptoms. I wish there was a central database where women could put up the levels at which they felt best. Can't believe there hasn't been research done on this
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I doubt it’s that simple, sadly. There may be a feel good ratio between O and P but that requires bespoke P. Also blood tests will vary throughout the day and your own O will rise and fall, even post meno, so very hard to know what’s what in a consistent way. It may be easier 10+
years post meno when there may be less volatility but my aunt in her 80s (not on HRT) is still aware of monthly fluctuations.
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I'm sorry I don't have levels to share but I have lowered my dose from 3 mg to 2 mg of Sandrena - so quite a reduction - and I feel well. It's difficult to unpick because I then decided to stop taking testosterone too to see what happened. So overall - sleep better, palpitations gone, and finally the weight I gained when this all started has just fallen off me. I have been upping my exercise but it is noticeable the ease with which the weight is now coming off. So to conclude, I think I was taking too much oestrogen and I don't think the testosterone was doing me any favours either really. Sensation/libido - getting just as good results using estriol 1% on the outside as the testosterone. I hope that helps although it wasn't quite what you were asking. I'm not going to worry about minimum levels re bones. I think it's all speculative. Diet good, do weight bearing stuff etc.
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I doubt it’s that simple, sadly. There may be a feel good ratio between O and P but that requires bespoke P. Also blood tests will vary throughout the day and your own O will rise and fall, even post meno, so very hard to know what’s what in a consistent way. It may be easier 10+
years post meno when there may be less volatility but my aunt in her 80s (not on HRT) is still aware of monthly fluctuations.
I wonder how much they fluctuate compared to perimenopause , eg would it be between 30 and 70pmol/L or could there be 100s of pmols/L in fluctuation. During the 2 years around menopause day, my dxa scan showed decline even though I was using 2 pumps oestrogel. When I got bloods taken levels were only 80 so I wasn't absorbing and wasn't having the bone protective effects. So that's why I'm a bit obsessional now about trying to ensure I have absorbed enough and blood serum levels are the only way I can think of ensuring this. My symptoms aren't straightforward so it's hard to judge from them( I have chronic pain too which affects mood etc so it's all a tangled web)
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Absolutely, if hormone therapy is being used for bone protection, and well done for getting a DEXA - most people don't get one until they have a fragility fracture, by which point osteoporosis can be diagnosed clinically - then symptoms shouldn't be relied upon to gage whether therapy is adequate.
Some people have minimal or no menopausal symptoms - my mum was one of them, and I had none during brief "chemical menopause" in the context of IVF, so I will be going by blood levels.
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I doubt it’s that simple, sadly. There may be a feel good ratio between O and P but that requires bespoke P. Also blood tests will vary throughout the day and your own O will rise and fall, even post meno, so very hard to know what’s what in a consistent way. It may be easier 10+
years post meno when there may be less volatility but my aunt in her 80s (not on HRT) is still aware of monthly fluctuations.
I wonder how much they fluctuate compared to perimenopause , eg would it be between 30 and 70pmol/L or could there be 100s of pmols/L in fluctuation. During the 2 years around menopause day, my dxa scan showed decline even though I was using 2 pumps oestrogel. When I got bloods taken levels were only 80 so I wasn't absorbing and wasn't having the bone protective effects. So that's why I'm a bit obsessional now about trying to ensure I have absorbed enough and blood serum levels are the only way I can think of ensuring this. My symptoms aren't straightforward so it's hard to judge from them( I have chronic pain too which affects mood etc so it's all a tangled web)
Will definitely be less fluctuations as you get older but post meno can still have some random, crazy ones!
I am like Crispy, in that O makes me feel incredibly ill (including local) and I am post meno about 2-3 years. Progesterone cream makes me feel good for a while and then it seems to irritate my system and high O symptoms break through again so I have given up on taking hormones!
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Thanks all. This is really useful.
Dangermouse - any idea of your current/recent E level? I seem to recall you once told me you felt good at 50? I think. But I might've made that up. ;)
Ok. So it seems a lot go on the bones issue rather than 'feel' good. Yeah, unfortunately my poor bones won't be getting a look in. I won't be able to poison myself for bone health.
Like gilla pointed out on the LN thread, I'm a bit perplexed by the bone health value as my E was sitting at 220 on cerazette last year. And gilla refers to a study looking at bone density in those on the POP, where it keeps E levels low. The study concludes that the use of progestin-only contraceptives leading to an estradiol level between 30 and 50 pg/ml does not seem to lead to an accelerated bone loss. That's between 110 and 183 pm/ol
I guess I'm trying to establish from this thread if some woman 'feel' good at low E serum levels, irrespective of thoughts on bone loss.
Keep the answers coming. ;D
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There are women who never feel the need for hrt so they presumably feel good on lower levels. You're unlikely to find them on here though :). I wouldn't get too hung up about osteoporosis if you don't have any genetic or lifestyle risk factors. IMO it isn't worth feeling lousy on a higher dose of oestrogen for something that you don't have a high risk of getting in the future. Perhaps a dexa scan would help you decide?
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Thanks all. This is really useful.
Dangermouse - any idea of your current/recent E level? I seem to recall you once told me you felt good at 50? I think. But I might've made that up. ;)
Keep the answers coming. ;D
Yes, my last O test in 2021 was 44 pmol. I was still oestrogen dominant though as prog had plummeted.
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Hello again ladies.
I think I mentioned on another thread that a 50 mg Oestrogen dose should result in an Oestradiol level of 200 pmol/ L.
I believe I read that somewhere when looking at what to expect from my current regime. I am not sure if I've remembered that correctly but the information must be online somewhere. I do recall thinking at the time the 200 pmol/L target was mentioned by my nurse practitioner so perhaps it is a standard that they look for.
As other ladies have said, the level you feel good at is probably an individual thing. Frankly just feeling good at all would be a miracle right now!
Take care ladies.
K.
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I had estradiol levels of 44pg/ml (around 100pmol/L) - note the different units used by various laboratories - on a double dose of desogestrel (150mcg daily) for menstrual suppression.
I had no symptoms at all, however being in my early 40s at that time with both parents having osteoporosis, I chose to go back on a combined pill as soon as I could.
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Wow. These results are really interesting ladies.
Thanks so much. This is so helpful.
Thanks Dangermouse. I knew u presented as low. But didn't feel bad on it. Your results are very interesting to me. ;)
Sheila - I completely agree. I won't be taking hrt for any other reason, than a need to feel good.