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[Grumpymum]

I managed to get Estradot 100 patches Christmas Eve! Hurray! Boots have been unable to get my normal dose of 75 for six weeks and I happened to ask in a Lloyd's Pharmacy when I was visiting another town for them to say they had the 100s and after a frantic phone call to GP managed to get prescription for them. I've used the higher dose patch for a couple of days now. I can't say the 75s really resolved my problems, still anxious, hair receding, aches and pains, lethargic, no energy, so thought trying the 100s as they are was worth a go. However the last two nights I have found that even though I have slept I haven't felt rested and felt I didn't sleep (if you get what I mean) and was wide awake at 6.30 but now feel dozy. Now I'm not sure if this is due to the higher dose or just a poor sleep that I get sometimes. Any ideas ladies? Happy belated Christmas and New Year.

[Foxylady]

Hi grumpymum, I'm with you with the sleep thing! I initially started HRT around March time everol sequi, greatly helped some symptoms but not others so changed to everol 75mcg, again more imporvement in symptom control but sleep has never completely been resolved for me although it was much better until around a month ago but especially last 2 weeks really bad again (hot flushes/sweats, braing fog, irregular bleeding etc). EXhausted falling asleep from 8pm ish, force myself to stay up until 10pm then usual pattern is fall asleep straight awake but wide awake anywhere between 2 - 4hrs afterwards. This morning awake 3 until 6am. Not great when working full time. Anyway as is well known shortage patches, today is my first day on the oestrogel, so far so good as in not as messy as I had expected from some of the forum posts. Will just have to see how it goes and if I don't notice any imporvement will go back to GP see if I can up the dose (maybe try upping it after a month or so!).
I have tried so many different things over the last 3+yrs to try and help my sleep I really couldn't recommend any one magic fix, although the biggest difference to date has been starting HRT. All the best Grumpymum, hope you get some relief from the torture of wakefulness. x

[Erika28]

Higher estradiol and the right dose gives me: more energy, more desire to do things, heightened libido and a raging desire to engage with members of the opposite sex!. I'm happier and sleep better. Genital sensitivity returns. My skin and hair become softer. My memory improves as well. I feel more confident and sexy. I feel young again!

In my experience, estrogen applied intra-vaginally seems to work the best. No idea why!

[Wilks]

Hi,
I switched from Estradot to Evorel earlier this year when Estradot became unavailable. I switched to what should have been an equivalent dose, but I was absorbing the Evorel better, so it turned out to be too high a dose for me. It was giving me visual migraine auras every couple of days for 3 months and my oestradiol level was more than twice what it had been in several previous tests. When I dropped down a dose back in September, the migraine auras vanished.

[Sgtvhilts]

Go for it - see what happens.
I am currently on 2 mgs of Femeston orally AND 100mcg of patches. Very, very long story........see previous long posts of mine. 50 & peri
I now feel I am on the correct dose, all my symptoms- and they were the usual suspects, all of them-have gone, but it has taken about 12 weeks on this dose for it to happen.
Lots of people will say I'm nuts for going so high, well maybe- but I sure was nuts before with peri symptoms. Then I get people saying about breast cancer; indeed, I might be upping the risk, but importantly I might have got it anyway or might never get it and put up with awful meno symptoms, I might also get run over by a bus tonight. One thing is for sure, now symptom free I am enjoying life right now. Erica 28 (above) you are sooo right, I actually like feeling enamoured by the opposite again, haven't felt like it since my 20's LOL- I even jumped a 5 bar gate last week- not related to anything to do with the opposite sex, just the local cows!!!
I wonder sometimes if any of the ‘standard' doses are high enough. Many people on here are still riddled with symptoms.
I will start a controlled reduction in about a year, at least I will control my oestrogen decline and see what I am prepared to tolerate the ‘cost benefit' thing.
I am told, and read on here that once peri is done then it does become more ‘stable'

[Erika28]

Interestingly enough, breast cancer is more common in women AFTER 50 when estradiol and progesterone are low.

Search through randomized trials and HRT and cancer. See what the results are. They will surprise you!

[Sammiejane]

sgtvhilts and erika

do either of you take progesterone? and which one ?

do either of you take testosterone ?

did you start testosterone at the same time as estrogen and progesterone if you have P

thanks

[Sgtvhilts]

HI
Yep i take progesterone.  I am on Dydrogestone.  It is the only one that doesn't chance the risk of me getting sectioned! LOL.  All the others for me were Sh*ite.  Nut job or sick in a matter of days.
Because dydrogestone doesn't come alone, i take the Femeston 2mgs sequi orally & patches.
No i don't use testosterone- never occured to me.  What does that actually do.  I have enough body/facial hair and wouldn't want to grow more muscle or i woudl defo resemble Geoff Capes!!!.
I am on contiunous high Oestrogen and 14 days worth of prog.  Working well.

[Sammiejane]

hi

have you had any sides effects from the femoston i have enquired about this with menopause but they won't let me take it cause i smoke and it oral higher risks !

which annoys me as should be my choice x

thanks

[Erika28]

sgtvhilts and erika

do either of you take progesterone? and which one ?

do either of you take testosterone ?

did you start testosterone at the same time as estrogen and progesterone if you have P

I take testosterone too.

[Sgtvhilts]

Hi sammy Jane.
I have a terribly selective memory and always, always forget to tell them I smoke 20+ a day.
Shame that...........
No- I get no side effects from dydrogestone- thankfully. It is the one and only progesterone that doesn't either drive me mad or awful nausea. I was like that on the pill and could only take marvalon.

[Erika28]

Hi sammy Jane.
I have a terribly selective memory and always, always forget to tell them I smoke 20+ a day.
Shame that...........
No- I get no side effects from dydrogestone- thankfully. It is the one and only progesterone that doesn't either drive me mad or awful nausea. I was like that on the pill and could only take marvalon.

Smoking significantly decreases the bioavailability of estradiol when taken orally.

https://www.ncbi.nlm.nih.gov/pubmed/4047104

To elucidate the effect of smoking on estrogen metabolism, we examined 136 postmenopausal women treated for one year with one of three different doses of combined estrogen-progestogen or placebo. The women were grouped according to smoking status, and serum levels of estrone and estradiol were measured before and after treatment. The results showed reduced levels of both estrogens in smokers as compared with nonsmokers in all three dosage groups. This reduction was most pronounced in the high-dose group (4 mg of estradiol), in which the serum levels of estrone and estradiol in smokers were only 50 per cent of those in nonsmokers (P less than 0.001 and less than 0.05, respectively). In contrast, no significant changes could be demonstrated in the corresponding placebo groups. Moreover, it was possible to demonstrate significant inverse correlations between the number of cigarettes smoked daily and the changes in the levels of serum estrone and estradiol, respectively, (P less than 0.001). This study suggests that an increased hepatic metabolism of estrogens results in lower estrogen levels among postmenopausal smokers. This may contribute to the reported risk of osteoporosis among smokers.

[pants46]

Really interesting Erika, thankyou.
I found out that smokers typically start meno earier (by about a year). I did not know it makes hrt less effective.
Was the hrt in the trial transdernal or pills ? Does that make a difference ?

[Erika28]

Was the hrt in the trial transdernal or pills ? Does that make a difference ?

Oral. Yes, it makes a difference!

https://www.ncbi.nlm.nih.gov/pubmed/10425465

The aim of this study was to determine the impact of the administration route and cigarette smoking on plasma oestrogen levels during oral and parenteral oestrogen replacement therapy (ERT). Fourteen healthy postmenopausal women (six smokers and eight non-smokers) were recruited for a prospective, randomised, crossover study at a private outpatient medical centre in Oslo, Norway. All patients were randomised to receive cyclic therapy with oestradiol and norethisterone orally or by the transdermal route each for a 6-month period. Plasma levels of oestrone (Oe(1)), oestradiol (Oe(2)) and oestrone sulphate (Oe(1)S) were determined using highly sensitive RIA methods before and during hormone replacement therapy given by the oral and transdermal route. Comparing smokers and non-smokers, plasma levels of Oe(1), Oe(2) and Oe(1)S were all found to be 40-70% lower in smokers compared with non-smokers when ERT was given orally (Oe(1)S, P<0.05; Oe(1) and Oe(2), P<0.01 for both). Oe(2) given orally caused a higher Oe(1)S/Oe(2) ratio but also a higher Oe(1)/Oe(2) ratio compared with parenteral therapy in smokers (40.2 versus 7(.)0, P<0.01; and 3.2 versus 0.8, P<0.05 respectively). No significant differences in these parameters in the different test-situations were seen in non-smokers. Except for a lower level of Oe(1)S in smokers (non-significant), no difference in plasma oestrogen levels between smokers and non-smokers was observed during parenteral therapy. In conclusion, cigarette smoking has been shown to have major impact on plasma oestrogen levels during oral but not during parenteral Oe(2) replacement.

[pants46]

Thanks Erika.
As an overweight smoker I am not allowed to take the pills anyway, as there is the increased risk of blood clots. But it is interesting to know that pills are actually less effective for someone in my situation. I'll be sticking with the patches, for now at least. 🙂