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[Tc]

. Again im unsure if the dose im on is too high or too low for me at 37? I do suffer with joint pain, etc now also...i feel 90 not 37.

Shell. Younger ladies especially under 45  in surgical meno sometimes need higher levels of eastrogen than their older counterparts.
 
But i have found higher doses  might not necessarily mean higher levels. . if you are not absorbing the patch well you may not be getting much from it even though it's considered a high dose. You may find  you absorb more on another method at a similar dose.

 Have you had a blood test. It might help in assessing if you are absorbing enough from the patch  ? 

It seems getting  E levels right for the individual to control symptoms is key to any HRT regime   

 You mention tibolone. It may not be enough eastrogen for you but i know of some ladies with no uterus who  choose to take progesterone alongside eastrogen to counter the effects or "balance" hormones. Obviously a careful consideration as progestins have their own side effects.

Certainly testosterone is an important factor, particularly in surgical meno. Half of our T production has been lost. T decreases with age So at your age without surgery your T would naturally be higher than say myself at 54 so it's probably a good idea to explore this.

Even at my age (suremeno at 53) I was offered T because it's widely accepted that there is a significant drop after ovary removal.

I feel for you. I know how intolerable migraine is.

I hope the specialist is able to help. Xxxx

[Shell]

Hi Tc,

Well I've just come back from my GP after refusing countless attempts at him trying to put me on antidepressants and explaining im only down because of the continuing migranes etc, he was not willing to change my HRT method, said this dose is important as Im young and need oestrogen for my bone health etc...which I already am aware of. I asked if I could maybe chsnge to the gel and have the option to lower it, but also have an extra pump if the dose didn't suit. I explained that the continuity of gel may be beneficial to me as it seems the patch changes are my issue, but have been outright refused and prescribed Topirimate instead for migrane prevention (im very reluctant to take this as the side effects are crazy) plus I know why I have my migranes they have been this way since I was 11 years old. 

As you say I believe the delivery method is not working for me, and maybe the gel would be tolerated much better? Im wondering if the 100 is too much for me, and that could be where the issue lies.

I have been prescribed testosterone aswell, but was reluctant to try it. I think a blob a few times a week could be beneficial? As you can tell I'm at a total loss with not many options it seems.

Thanks for your advice, if only doctors knew half of what we seem to.

[Shell]

I had a blood test last year and was on this regime, I was told my levels where 1700, I dont even know what that means or equates to if im honest.

[shrosphirelass]

Shell, do you have a menopause clinic anywhere near you? You could ask your GP to refer you, that's what I did. I had to wait about 6 weeks for an initial appointment. The clinic would then advise the GP on what to prescribe. I was asked if I wanted gel or patches.

Thanks Kdee for getting back to me.

[Tc]

Hi shell. Do you mean 1,700 pmo/l?
Ive got my blood results sitting in front of me and according to the range on mine That's  at the top end of the mid cycle range which during a natural cycle would be the highest point. Different labs may have different ranges. But I still believe 1,700 is at the higher end.

During your natural cycle did you find migraines were worse during mid cycle  ?

I think it's important  you get a more up to date blood test.

I'm trying not to sound angry but docs with an attitude like yours (I've come accross plenty) realy make me mad

Very few women find the right regime for them straight out the gate. He should know that "tinkering" with dose and methods is more often than not required. I dont understand his reluctance to let you try the gel.

  Is there another doc in the practice you can see or a practice nurse? Or  Can you ask to be referred to a  meno specialist?

Xxxx

[Shell]

Hi Tc

Im honestly not sure what form the 1700 reading is in, I was just given the number and told it was fine 

I have asked to be referred to the specialist menopause clinic, but think I may have a wait before I'm seen. However at least its a step in the right direction.

I suffered pre and during my period with migrane, and also at ovulation...pretty much any type of fluctuation would trigger a migrane.

I ended up asking to also speak with a different doctor who was much more understanding thst not one size fits all.

I agree an up to date blood test is needed, hoping that will be done soon to give me an idea of too high or low.

Xx

[Shell]

Shropshirelass

Hi yes im being referred just the dreaded length of time it might take to be seen. Fingers crossed it isn't too long.

Xx