Hi lovely ladies, I’ve recently seen my GP for a full HRT review and bloods after being on Estradot 50mcg and Utro 200mg (sequential) for about a year. Overall I feel good and most of my meno symptoms have eased apart from extreme fatigue on busy days.
I know hormonal blood tests are of limited use but my oestrogen is still low at 150 and my testosterone low at 0.5. My GP is happy to prescribe testosterone but I wonder if I should first try upping my oestrogen? Only problem is that she says I’ll need to balance it with more Utro if I go up to 75mcg Estradot or above, and I really really hate Utro!
Also, annoyingly my triglycerides (part of cholesterol) are high and my HbA1c is borderline high even though I already have a very healthy diet, don’t drink, I exercise and am a ‘normal’ BMI. GP wasn’t too worried and said ‘that’s just perimenopause’ but it does worry me a bit.
I just feel like I can’t get my health under control in spite of working so hard to do so. I used to be very healthy with no meds which I know is a privilege but now I feel at a total loss as to how to optimise my drugs and my lifestyle! It’s just quite overwhelming.
If anyone has had hormone levels similar to these, or been in a similar health situation, I’d love to hear from you. I feel a little better just ranting already.
I tried to vent to hubby but he just said, oh yeah we’re all getting old, all the same stuff is happening to me.
I don’t think so! 
If you're still peri-menopausal then blood tests are very inaccurate and just a snapshot of one particular day - levels will vary with your natural cycle. That being said - for a post-menopausal reading that is a bit on the low side but it also depended when in your patch cycle the patch was changed - once I had mine done and it was just before I changed my patch and the levels seemed pretty low - lower than that (I think around 90 something), so when they were redone it was half-way through patch change and they were way higher - around 200 - if I recall correctly. (I've since increased my dose).
So would be helpful to know where you are in menopause ie what your periods were doing in the 12 months leading up to your starting HRT?
In terms of increasing progesterone - although the licensed dose is based on trials using low and medium oestrogen doses, and the amount of progesterone is dose dependent (ie higher oestrogen doses generally require more prog to protect the womb), it does not automatically follow that you would need more progesterone if you increase the oestrogen dose, and the British Menopause Society only recommended increasing the progesterone if the dose being used is not controlling the bleeding or the lining is thickening.
Oestrogen levels could be one way to ascertain this though as above they are inaccurate as you know - and you could be guided perhaps by your bleed - whether there is anything that concerns you eg if it is especially heavy or if you are getting bleeding at the "wrong" time - though this can also happen if your own cycle overrides the HRT as will happen especially in early peri.
Testosterone - again levels are not an indication becausr they are so inccurate for women but if you have low or no libido then this is indicated, off licence - especially post-menopause, irrespective of measurements.
Yes good idea to make sure oestrogen is at a decent level before replacing T as you don't want to become T dominant but I would ask for a retest and make sure blood is taken, say, the day after you change the patch, if you can - but if you are peri you won't know where in the cycle you are. Once it has been redone then maybe you could go for an increase in oestrogen. You should also really be guided by how you feel on this dose? In my case I was prescribed 75 mcg from 50 mcg which I had been on for years, but I cut it down to about 62.5 mcg - because I'm old (in HRT terms) and also don't like taking prog!
Depends how old you are also?
I have high cholesterol and since I started having it measured almost 10 years ago it always has been. I'm not sure about Triglycerides but my total is 7.42 last measurement and non HDL is 5.34 though the ratio of Total to HDL is within range. I also have a very healthy diet and resonable amount of exercise, (but could do more), normal BP, weight OK but just about on the limit ie could do with losing 7 pounds - but I have a medium frame so not "fat" as such!! My GP said some people genetically have higher cholesterol.
You can work out your QRisk score online using the latest tool (Qrisk3 I think) which will give your stroke risk - and this varies with age, weight, BP and CH readings. Because I'm now 70 it puts me at 10 which strictly speaking is the levels at which NHS recommdned intervention but so far I am just changing my diet a bit more ( cutting cheese right down, almost no butter, swapping out white rice and pasta for wholemeal etc and seeing what happens).
What are your actual readings?
HbA1C - what levels was yours? Mine was on the limit ie 41. It should be easy to reduce this by cutting out/down on sugars and refined carbs, I would have thought, if yours is in the pre-diabetic range?
Try not to worry!!!
Hope this helps
Hurdity x
Author
Topic: Review of blood tests (a rant) (Read 897 times)