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[Goosieloosie]

How do you know when you need to up the dose of estrogen? I'm 56, 4 yrs post meno & have been on HRT for almost 3yrs & 2& half yrs on my current regime of estrodot 50 patch & utrogeston 12 days so I still have a bleed. This works well for me but for the last few months my mood has been really low, we've recently returned from a fantastic 23day holiday in America which was 2yrs in the planning and I should've been the happiest person ever but all I did was moan at my husband, constantly picking on him and generally I just felt fed up, it actually reminded me of how bad things were with us before I went onto hrt in the beginning 3 year's ago, things improved so much and I felt so much better until this year when my mood has plummeted.  After being on the same dose of Estradot for 2 & half years I don't know if maybe I should try increasing it to see if there's any improvement in my mood? Maybe cut half of another patch making it a 75 dose? I see my Dr next month for my review so I'd like to have something in place to tell her as she's not the most clued up on hrt & actually said she learnt a lot from me when I asked for the Estradot/utrogeston combination! I don't have any other meno symptoms eg: flushes or sweats although I do feel hot all of the time (even without the heatwave) which was what I was like before starting hrt. So I'm wondering if maybe it's time to up my dose?? Any advice appreciated, I just want to feel happy again and not this miserable grump  . I'm currently on day 5 of the utrogeston phase and if I do "up my dose" when should I begin? I would like to start before I go back to Dr so I can let her know. Thank you in advance for any advice

[jillydoll]

Hi goosieloosie
I too am nearly 4years post meno, and I take femoston conti hrt,
I started off in February this year, after a short break from it, but only on a very small
dose, then a few weeks back, noticed symptoms were back, so I upped the dose by another half,
which worked well at first, but now another few weeks on, and symptoms back again, so I've upped again by half, (only last night tbh) and this morning feel a bit better, but I'm booked in with my doc
for next Tuesday, to see if she'll give me the 1mg tablet AND the 1/2mg tablet which I'm taking now,
instead of jumping up to 2mgs. If you see what I mean. (I'm only increasing by 1/2mg each time)
So, if you think your symptoms are starting up again, then yeah, increase a little bit and see how you go. Have you ever had your thyroid checked? I'm going to ask for a blood test to get mine checked out.
If by only increasing by a small amount, gives you relief, then go for it.
It's a shame about your holiday, maybe the stress of it all started things off? I don't know, but it's a
bugger all the time ent it?

Hope you find relief somehow, keep us posted,

Jd x ps, when I was on patches, I used to cut them in half for an extra boost, but at that time they didn't suit me..... bad migraines,.......jd x

[Dotty]

I would say try upping it and see what happens. If it doesn't help then you can always go down again. X

[Goosieloosie]

Thank you both, I did consider increasing the dose before our holiday as I had a feeling then I was going downhill but I didn't want to make things worse by increasing just before a long holiday so I decided against it, kind of wish I had now as I might've felt much better while away but it's one of those trial and error situations isn't it which I didn't want to meddle with just before a holiday. I haven't had my thyroid checked recently at all, once many years ago and it was fine but I'm talking about 13 yrs ago! When do you suggest I begin with the increase? I'm day 5 of 12 of the progesterone course at the moment, should I wait until it's finished & my bleed begins?

[Dotty]

Have you thought about going on a bleed free regime?

[Goosieloosie]

Have you thought about going on a bleed free regime?

I've tried it, I have breakthrough bleeding that went on and off for week's plus now I use utrogestan vaginally I wouldn't want to do that  every night!!

[Goosieloosie]

Just bumping this up as I need advice on when in my cycle to begin increasing the dose, once my bleed has began or ended? I'm currently on day 5 of 12 days on Utrogestan (progesterone) 

[Hurdity]

Hi Goosieloosie

Sorry to hear about your holiday and symptoms.

Well what to say and where to begin?!

First about your thyroid - if there was a problem with this you would be putting on weight ( without overeating or eating the wrong foods, or doing less exercise), feeling very tired - even during the day, and feeling cold - although it's tricky I gather with menopausal symptoms of feeling hot - but cold should come into it somewhere.  These symptoms would be a reason to go to the doctor and suggest a blood test - if they were becoming difficult to live with, I would say. I'm not sure what effect underactive thyroid has on mood although i imagine a slow metabolism might make you feel  a bit lethargic and sluggish?

re the oestrogen dose and HRT generally - I was on exactly the same regime as you and started at about the same time (although I originally used Cyclogest as progesterone prior to 2011). I was happy though - all flushes and sweats gone. However a  group of us on this forum around that time used to say that our zest for life had gone and the dose of HRT we were using dampened our enthusiaism - we weren't depressed or low as such - but just lacked the oomph and excited feelings that the oestrogen highs gave us when fertile and ovulating.

This could be the case with you - but just a bit lower than you would like? As you get further post menopause the oestrogen levels drop away ( dramatically for the first two years following thew last ovulation - although there can still some residual fluctuation and hormonal activity for a few years following that.

In my case - three years ago in my early 60's I started to feel really tired and achey etc after exercise and couple with low libido I started testosterone. which has helped enormously. Soon after this I was worried about my oestrogen/tesosterone balance so increased my oestrogen dose as you want to do. However I didn't go up to 75 mcg - I went up to 62.5 mcg (I didn't want to have too high a dose at my age and because I am on a long cycle). I did this by cutting 50 mcg patches into 4 strips! I managed like this without having to tell the doc - for a couple of years, but when I last went to the doc for HRT review she agreed that it was OK - and prescribed 75 mcg and said cut a bit off which I now do ( I made a cardboard template to cut round!) - this is the cheapest way of doing the increase.

The other thing is I am on a long cycle - I can't remember if you are too - but maybe you don't have problems with the progesterone part? I take the progesterone on a 6-8 week cycle. However lengthening the cycle a bit would give you longer on oestrogen only - so more of the positive.

Another things is some women feel their symptoms come back slightly ( the feeling hot) or worse - when on the progesterone phase of HRT. This extremely hot weather doesn't help!

Good idea to try an increase -  and increase to 62.5 - give it a good long time. There won't be a sudden wow, but hopefully will lidt your mood just that little bit to put you on the positive side of life rather than the negative. For me I have lots of enthusiasm for life and doing loads of stuff and new things I  haven't done before - so it has had a positive effect I would say. Just a word of caurtion - I am sure you owuld know if it was oK ie whether you've had bleeding/womb lining problems etc in the past ( or fibroids?) which means you might need to stick with a medium dose oestrogen and not lengthen your cycle. Also some woemn find if they increase by too much paradoxically it can cause an increase in flushes - not sure why

When to try? No time like the present - it doesn't really matter - get snipping!

Hope this helps and good luck!

Hurdity x