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[donnacrichton]

Good afternoon I actually posted on the other forum before noticing there was a post menopause chat. I am currently 52 and have been on hrt for about ten years under a specialist. It took a long time to get the right dose for me but have been on 100mcg Estraderm and Mariana coil for about six years. Always had issues with anxiety but other symptoms were under control. Since January I have had fatigue like I have never had before. I have had about ten urine infections as they keep coming back. I have put on two stone and have a belly like I have never had before but could be diet related. I am someone who went to the gym everyday but now I am just exhausted. Anxiety is through the roof. I have acquired heartburn no idea if that is related. Obviously I was put on a high dose as I was very young. How do I know my body needs a bit less estrogen as I have aged 14 years since being menopausal. I have just had full blood work done and all was fine but never thought about it being hormone related until today. Maybe I need less now I’m older? Anyone had experience x

[joziel]

You probably need more, not less.

This is what happens when the population gets brain-washed by the BMS to think that 100mcg is 'high' dose. It's not, and you don't know how much you are absorbing of it either. (I'm assuming it was tested with your recent bloods? What was the result?)

At 52, your own hormones are now failing and you are becoming increasingly dependent on HRT. As a result you likely need more E, not less.

Gaining weight around the belly is a classic sign of low estrogen, that's why it's called 'menopause belly'. Fatigue, anxiety, UTIs - all this is classic low E. Are you on local estrogen as well? (Vagifem pessaries, Ovestin cream?) That would help prevent the UTIs. Many women need both local E and systemic HRT. You should be able to get local estrogen on the NHS easily, alongside your 100mcg patches.

You may well need to go to a private clinic to get prescribed a dose which is above 100mcg because GPs are reluctant to prescribe above the licensed dose.

Please don't be afraid of higher estrogen levels if you need them. Personally, I'm on 6 pumps of gel and 200mcg patches - and sleeping better than ever, although still not perfectly.

You don't need ever to reduce or stop your HRT. You can remain on it until you die. I fully intend to!

[sheila99]

I agree, I think you need more not less. I'm probably just post meno and have recently noticed a fall in oestrogen too. Have trialled 125mcg for a week now and the symptoms are on their way out. If you have any spare oestrogen I'd suggest you do the same then you can decide if it's worth a private appointment to get it regularly. Personally I'm starting to think the mantra that you need less post meno is a load of hogwash!

[donnacrichton]

Thanks for the reply. I don’t have falling estrogen levels as I have had my ovaries removed in 2019 due to hormone fluctuations for ten years previously. I also intend to stay on estrogen for life but I am now at a natural age for menopause and not just surgically induced. I absorb the patches well and have done for many years. At one point I was on six pumps of estrogel also and that was so high I felt ill. The uti and joint pain and fatigue iare all new and I have been on the 100mcg for years and been stable so my dose hasn’t changed. I have been researching my symptoms and frequent uti’s and fatigue are documented for high estrogen. I remember being on really high doses years ago in my early forties under a specialist unfortunately I was discharged during covid. I was just wondering if anyone else had similar issues having to reduce the dose as I am now at a natural age and might not need the 100mcg x

[joziel]

It's possible that for some reason you have stopped being able to absorb the patches. We don't know why but sometimes that can happen and sometimes can mean you need to switch to a different product (ie back to gel).

It really would be worth getting the result on your estradiol test, or getting it tested, before deciding what to do. It is much easier to do that than to go the wrong way with the dose.

Frequent UTIs are not commonly found with high estrogen at all. Nor is fatigue. It is usually the opposite, people feeling wired and pumped. Joint pain was one of my first low estrogen symptoms during peri.

There is nothing about a 'natural' age for menopause and needing to reduce the dose. Everyone's dose is individual.

[bombsh3ll]

I agree none of the symptoms you describe are characteristic of excess estrogen. Your current dose may or may not need increasing - I certainly wouldn't be thinking of reducing it.

However the new onset fatigue, urinary and GI symptoms and increasing abdominal girth really do warrant investigation, in particular an ultrasound and a CA125 if this wasn't done on your recent blood tests.

[donnacrichton]

Thank you so much for the replies I question my sanity when it comes to hormones! I have been referred for a bladder scan but been told it is a long wait. I didn’t consider that I might need more when 100mcg has been sufficient in years. I have put on two stone which I am now dealing with and I’m aware that might also contribute to the pain and fatigue. I think I will go private and get some bloods done as my gp is useless. X

[CLKD]

Hi!  also even when ovaries are removed, there may be enough stem still attached to pump out hormone.

U mention 10 urine infections: has a urine sample been sent to a Lab to be 'grown' and any bug treated with appropriate antibiotics ?

Also, has any1 over the years mentioned vaginal atrophy which can mimic repeated urine infection-type symptoms  .  Do read the various VA and bladder issues thread, make notes
;-).

It may be worth while you starting VA treatment ASAP.  As oestrogen levels drop the body may become dry, inside and out, including the vulva and vagina.

If U are extremely tired and putting on weight: when did U last have a thyroid function and VitD blood test?

Let us know how you get on.

[donnacrichton]

The urine infections have had blood and white cells in them. Some of the cultures have come back clear. I asked about estrogen pessaries and the doctor said as long as I don’t have dryness or atrophy they would not be required as I would have enough systemically. Thyroid was checked and all ok so back to weight loss group. The weight could explain the joint pain as it is knees and hips no upper joints and also the fatigue. That all fits around the timing for fatigue too. I was just curious if anyone had to drop their estrogen as they got older. The only thing that doesn’t fit with the weight is the urine infections as I have no dryness at all quite the opposite. Thanks for taking the time to reply it is appreciated. X

[CLKD]

Most dip stick tests show what your urine has in it and your GP is WRONG 


I wasn't dry either.  Is there a Nurse Practitioner with more sense in the Surgery?  Ring and ask for VA treatment, U don't have to be examined.

[donnacrichton]

Thank you so much I will contact the practice nurse. Unfortunately the only way I will get it is to say I do have VA it is a battle constantly with them x

[Ayesha]

I find the Nurse Practitioners to be a godsend, they seem more up to date on all things related to menopause going on my last review.
I've posted a link in Jules thread that will surely help you, hopefully!

[Turkish delight]

My 2 cents is that I agree with everything everyone has said.

But if you are reticent for whatever reason then lower it and see if that helps.
Theres more than 1 way to skin a cat, for want of a better phrase, you can approach it from lowering or increasing.
It's really up to you, but please don't be afraid of body-identical estrogen, I'm afraid of a lot of things but estrogen isn't one of them.
Your body knows what to do with it and craves it, it's been coursing through your body since puberty.

You'll soon know whether you're in a better place by lowering but my sense is the same as others,
an increase is the way to go.

TD

[bombsh3ll]

Please do check if your Ca125 has been done. I do not just mean a bladder scan, I mean an abdominal and pelvic ultrasound to exclude a mass.

Do you still have your ovaries in place?

[donnacrichton]

My ovaries have been removed. I have an embedded coil back in March so every bit of me was canned lol thankfully no masses. I have seen all my internal organs. My gut was to reduce it but I really do think the weight gain has a part to play. It was just the UTIs they kept saying you can’t have another one and yip. They would only give me three days of antibiotics which meant it kept returning. I’m annoyed I asked about peas Aries and was shrugged off. I lived on this site for about six years so have read a lot of stuff. I am takin Dmanos from Holland & Barratt as a preventative but I feel like I’m the edge of an infection all the time. I’m going to put a straight request in by prescription and they better not blow me off this time. Is it vagifem? If so is it every second day you use it. I can’t remember as this is one symptom I haven’t been plagued with until now. My biggest symptom is usually anxiety and constant UTIs is embedded in my brain this year 🤷‍♀️