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[Miranda_lady]

Using universally low dose estrogen and heavy handed doses of progestogen works out best for the system as it avoids the need for any monitoring, minimises bleeding related consultations and investigation, and stops most women complaining of hot flushes, keeps them economically productive and their vaginas in a usable condition for men, outcomes which are considered the ceiling in terms of therapeutic objectives.

This I swear just blazed a new neural pathway through my brain 

I agree

[Miranda_lady]

If and when it is me, I will be entirely comfortable taking the dose of estrogen that allows me to not just survive but thrive.

The NHS is driven by rigid, cost focused, population level guidelines.

Have you had blood levels taken on your prescribed dose of estrogen? This may help reassure you that you are not being overtreated.

Additionally you can get a scan periodically to monitor your endometrial lining - this will be my choice rather than blindly taking elephantine doses of progestogen.

I have had them taken and as I mentioned oestrogen was high, but I didn't mention that the SBHG was also high ( so holding onto the free oestrogen apparently) however I have tried to reduce multiple times and end up a wreck and have failed to do it) Again private specialist was fine that this was high.

[Miranda_lady]

If and when it is me, I will be entirely comfortable taking the dose of estrogen that allows me to not just survive but thrive.

The NHS is driven by rigid, cost focused, population level guidelines.

Have you had blood levels taken on your prescribed dose of estrogen? This may help reassure you that you are not being overtreated.

Additionally you can get a scan periodically to monitor your endometrial lining - this will be my choice rather than blindly taking elephantine doses of progestogen.

Yes, I will get a scan periodically.
You're right about population level guidelines.

[juliaC]

I too am concerned about possible overdosing with progesterone.  I have taken last week 'off' as far as my conti patch and stayed with estradiol.  I have much less prolapse symptoms, much less fatigue, seem to be getting things done without effort or deliberation.  Just functioning basically.  But now I need to switch to the conti patch as I was only giving myself an extra week with estradiol.  I'm now dreading it as I have a busy week ahead, at the same time I know the importance of progesterone.

I'm intrigued that there may be overdosing of progesterone for some women as I had a feeling my prolapse symptoms came about with hrt and not before, and during the conti phase.  I also have had in this last week on estradiol only some 'suggestion' of my body producing it's own progesterone as I've had the feelings I get in this phase of the cycle, just gentler.  Relaxed instead of crushing fatigue.  Enjoying sugary foods rather than needing them to move..

Hopefully this week I will have communicated with Newson Health or my private local clinic.  I finally get it, I am not going to get anywhere with my GP (hate to say that as I had a brilliant GP in the past).  Read the Newson and Glynne paper, very interesting.

[Miranda_lady]

@juliaC. Can you try the body identical progesterone rather than the progesterone in the patch as this is synthetic. I actually like my progesterone days ( so long as I'm on the 200 and not the 300 mg) as I sleep a lot better.

[Miranda_lady]

Hi all. I thought you may be interested to hear that I've had a call from the NHS menopause clinic this morning to say they've asked the ' specialist ' that I saw last week to stand down as he wasn't trained enough and he was bringing the menopause clinic's standards down as he was giving out incorrect information. He had had complaints. I'm feeling a little bit more optimistic that perhaps NHS and private specialist can schedule achieve joined up care for us. I want to thank you all for all your advice. If it wasn't for you all, I probably would've tried to reduce more oestrogen. As it stands I've still reduced by one pump as I want to see if I can cope with being on a slightly lower dose. It's been 1 week now and last night I had night sweats, but I think this is all withdrawal related?

[Miranda_lady]

If and when it is me, I will be entirely comfortable taking the dose of estrogen that allows me to not just survive but thrive.

The NHS is driven by rigid, cost focused, population level guidelines.

Have you had blood levels taken on your prescribed dose of estrogen? This may help reassure you that you are not being overtreated.

Additionally you can get a scan periodically to monitor your endometrial lining - this will be my choice rather than blindly taking elephantine doses of progestogen.

I really really appreciated this reply. Xx