Thanks so much Girlagogo for checking in. Sadly, my testosterone was and continues to be low despite my being on regular testogel, at least at my last tests which were in June, next ones will be done in September (and I absolutely agree with you ATB that T will affect all those symptoms). I hope you managed to get it prescribed for you Girlagogo.
The most likely reason for non absorption seems to be my high SHGB which has actually increased since I wrote in February and the most plausible explanation seems to be the low weight/bmi which I can't seem to raise despite best efforts, if anything they've further decreased by a small amount (thanks for the lowering SHBG tips Marchlove, only thing I haven't tried there is the saliva cortisol test so might look into that).
At the same time my plasma estradiol finally did go up (after a 3 month switch to patches sent it re-plummeting to 160) and at last count was at about 500, achieved by taking 5 pumps of estrogel daily though at Chelsea they say I might need it to be up to 800 pmol for hormonal depression, also my high SHBG is likely to affect its absorption as well, though probably not as much as for the T.
But even this increase has definitely helped, particularly for mental state which was dire, dangerously so at times, and stamina/muscle strength too are better though there is still room for improvement, particularly in the second half of the month which is still tough.
Prof Studd might say this but I don’t know what he’s basing that on or why his recommendations should carry more weight than many others…
Prof Studd based those recommendations on decades of prolific studies that saw him awarded a D.Sc for his research findings and the Blair Bell medal from the Royal Society of Medicine to the doctor who has made the biggest lifetime contribution to their speciality.
Setting aside accolades, virtually all the advances in meno/HRT that are now increasingly mainstream were pushed by him in this country, and subsequently by his pupil Nick Panay, eg. the move away from equine estrogens, transdermal delivery of estrogen, the use of micronized progesterone, the benefits of testosterone for women (not only for libido as many dinosaurs are still claiming), the ad hoc dosing of progesterone to accommodate prog intolerance, and, more widely, the idea of individually tailoring treatments.
And perhaps even more than the strictly physiological aspects, he was the first gynaecologist here to consider the mental health aspects of menopause (and PMS), the - for some women - debilitating anxiety and depression that it seems many doctors still either ignore or write an autopilot AD script for.
Much of the research he and Panay conducted included numerous studies on estrogen’s effects on bone density where he amply demonstrated that the skeletal response is very much dose-dependent and proportional to the plasma oestradiol level obtained with HRT.
So while low dose E2 might increase bone density (though it seems odd that the 2004 Ettinger study added high calcium & vit D supplementation to the estrogen – given that they too both help bone density it’s not clear how they could differentiate which component/s made the difference and by how much), it’s likely to increase it more at a higher dose and one of the specific categories Studd identified as being vulnerable in this area are precisely low BMI women (he also founded the Royal Osteoporosis Society so was far from a casual visitor to the world of bones).
As he asserted, treatments need to be tailored so while I might look into my 80-something mother getting an ultra-low dose of E2, that would not be the right approach for many younger women and almost certainly not for thin middle-aged women (and even less so if they had hormonal depression and/or other debilitating symptoms).
Apart from the improvement of my mental wellbeing, concretely I can also say that my recent follow-up DEXA saw my previous osteopenia-level hip and NOF scores decrease by 1 and 2 decimal points respectively so that now I am right on the borderline of ‘normal’ rather than firmly in the osteopenia category.
So yes, as far as I’m concerned the recommendations of Studd and his followers carry much more weight than others and incidentally inform the guidelines of most of the progressive practitioners around today in this country, eg. Newson etc. (I was also given the 300-400 pmol minimum in Italy where there’s also a lot of advanced research on HRT).
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Topic: Need to raise oestradiol blood levels - what to do? (Read 2810 times)