Hormone Replacement Therapy - Pellets

Hi kathleen - have all your other menopause symptoms gone, e.g. flushes, sweats, dry vagina, aches, pains, skin, etc?  It might be too soon to see an improvement in your hair as it may depend on new growth.  I also use vagifem and estriol cream (alternate each night).  I just smear the cream on as it is too messy to insert.  The vagifem does the internal job.

An appropriate amount of oestrogen works for me regarding libido, plus I am taking an anti-androgen which reduces any testosterone I may be manufacturing, so obviously I don't need any testosterone to do that.  When my oestrogen was being compromised by progestin that my dr insisted I take, my libido disappeared.

The next problem we have is getting one's libido back when our husband's is disappearing 

I didn't have the dryness but the heat flashes seem to be subsiding and my skin seems better, so I think it is working! Now if I could sleep at night.....  Yes, the husband's libido......I got mine to take the blood tests, and he says when he knows what work is doing, he will be able to take off to go get implants.  They freak out when he takes off even a few hours.  So I guess things are getting much better, just isn't like snapping a finger and seeing it.  Ha!  I am impatient....

I didn't mean 10%.  100% but my zero key doesn't work right.

 

2300 pmol does seem extraordinarily high - maybe it was the first flush if you were low beforehand.  A research gynaecologist says levels of up to 1200pmol/l are sometimes required to maintain a symptom free state.  So we need to ignore "normal" levels for "normal" women.

The strength of the pellet is more to do with how long it will last.  I use a 100mg pellet which originally was meant to last one year.  It only lasted me 9 months as my body seems to need more oestrogen.  When I went back onto the pellets made by compound chemists (supposed to be exactly the same), they claim they are only meant to last 4-6 months.  They suggested I have two pellets implanted to last longer.

Recently I found that the progestin that my dr insisted I take to have 'balance' between oestrogen and progesterone, was making my oestrogen severely ineffective.  I read up on progestin (which is a drug pretending to be a hormone) and its effects, plus information that surgical menopause do not need "balance" of progesterone and oestrogen, and stopped taking the progestin.  My oestrogen hrt kicked back in and my menopause symptoms subsided.  I am planning on going back to the pellets again, now that I have got that sorted.

With implanted pellets, it is not a steady release.  The body takes what it needs when it needs it.  There is a cycle of requirement during the day.  So morning is different to afternoon, and to night.  I can't remember when we need the most but this information is provided somewhere.  So maybe when you had the blood test, it was when the body required the highest amount.

Mmh could be... I had it tested after 1 week- it was at 1380 then, 4 weeks 2300 and now at 6 weeks 1440.... I also have a 100 mg one... my Gp obviously was a bit in shock, so was I but I didn't feel bad with that high of Estrogen... its not healthy but lol

I wonder if it's depending on compounder to how it's absorbed or how long it lasts? What do you think? I asked the Pharmacy that did mine and they said if the implant was damaged then it could release high Estrogen... so i wonder if my GP perhaps did as he did have troubles taking it out the vial, and then also had troubles getting the trocar in my abdomen etc , was quite bruised after ...

My Gp also said he had ladies that had 2 implants at the time, like 2x 100 mg ones. He used to use them when they where available via Medicare as official HRT method until a few years ago when the manufacturer stopped making them 

Oh regarding progestin, I do take progesterone USP using them vaginal 2 weeks a month. That's the only method I can handle without getting side effects 

My pellet was a plain white tablet with no coating that was visible.  Years ago, one shattered into pieces when my gp picked it up with tweezers.  I had to lay on surgical bed with my incision till another was taxied to the medical centre from the pharmacy where I bought it.  So it could easily break up.

Although if the body only takes what it needs at the time, then why would it absorb more because it was broken up??

My gp had a problem using the trocar too so I looked it up on u-tube and the trocar is supposed to be turned like a corkscrew.  She was just trying to push it in.

The compound chemist insists that theirs is exactly the same as the original ones that Medicare supported.

I continue to use the patches till I feel that the pellet has kicked in, and it usually takes about 3 weeks for me.  I have never had blood tests after an implant to compare, so it is all about feel for me.  I think if you feel good, then it is good for you in this case, it is what your body needs.  If it was too much, then you would be having terrible reactions.  (I don't apply this to everything of course!!!)

Were your blood tests all done at the same time of the day, e.g. always morning, or lunch time, or late afternoon, etc.?

 

As I had a hysterectomy, I did not really need progesterone - except for the fact that I had severe endometriosis throughout my abdomen which the surgeon did his best to remove all that he could see.  A few years later a dr said it would be a good idea to take Provera to stop the endometriosis being activated by oestrogen.  Maybe the adhesion pain I was having was being caused by the endometriosis.  The pain never stopped and I think it was simply adhesion pain, caused by the removal of all that endometriosis, causing my intestines to become stuck to the open wounds.

Then my current dr insisted Provera was a panacea for a host of problems and also required for balance as explained earlier.

Is your progesterone USP a bioidentical true progesterone (i.e. prometrium (?)) which is available by script and is on PBS now or is it a progestin/progestogen?

I have also read that progesterone is best taken at night so you can sleep during the negative symptoms, one being fatiguing (why we would want those negative symptoms!, unless we really had to take it), while oestrogen is best taken in the morning because it is generally energising/uplifting, which really can only apply to tablets or perhaps the vaginal form that you are using.  So perhaps our body absorbs oestrogen best in the morning.

So questions keep arising.  I have read a very informative website called "A Survivor's Guide to Surgical Menopause".  There are no research references which I prefer to have, but one could search for those if necessary for back up, or not, the information provided.

There is no mention of pellet implants though, as I suspect it was written after they became unavailable.  Maybe someone has brought it up in the forum pages which I have not joined into.

 

I did all my blood tests in the morning but not at the same time no.

True that, if is the body that takes what it needs then it wouldn't matter if it's broken or not. 

I personally don't feel that high levels affecting me negatively besides the interrupted sleep, like i have issues sleeping through. No sore breasts, water retention etc but with super high levels ? 

Are you from Australia as well? If so, may I ask which pharmacy you're getting your pellet from? 

I generally like to stay on the pellet, it's just way easier than mucking around with patches, which often also aren't available (estradiol) as supplier has had quite a few times delays and then it's a constant change around with gel, lower patches together to mske up the dosage etc. when I used patches I used 100mcg ones and 1.5-2 at the time and had to change every 3 days... my body seems to like the higher levels I think..

For awhile I also used injections, they where great too besides the needle using every few days, but unfortunately they're discontinued hence pellet now which I really want to stay on

It is reported that oestrogen is highest in the morning as our body needs more in the morning than any other time of the day.

Australia, yes - Stenlake Compounding ... , Sydney

I also prefer the implanted pellet, but a couple of the times, the pellet did not appear to work for me so I had to go back on to patches, which also did not work well for me and I was getting serious head sweats.  Even when I was putting a new one on every second day. 

After reading more and more about it, I eventually worked out that the Provera (progestin) that my dr insisted I take (then she doubled it) to balance my hormones was the trouble.  Progestin is an antagonist of oestrogen and it was making the oestrogen so ineffective the oestrogen pellets/patches were failing me.  Also I found out that progestin stores in the fat on the hip and thighs and does not show up in blood tests.  Another reason why drs think you have a low progesterone.

And Provera progestin is not a progesterone - it is a drug pretending to be progesterone and does not work in the same way.

Besides that I don't really need progesterone as I had a hysterectomy.

So I stopped the Provera mid June and am now monitoring how I feel with just oestrogen alone (like I used to be for years before this dr interfered with it) and it has come good - no more head sweats, dryness and loss of libido (I had major hair loss too but I will have to wait for that to come back), so I am ready to go back onto pellets  .  The pellets got the blame but it was the Provera.  I will be asking for a script next time I see my gp.

My body needs lots of oestrogen to function well too.  Currently with the patches, now that they are working ok, I put one on Monday, and the second on Thursday, but that leaves Sunday as a non-effective patch day.  So I top it up with gel.  As I have been making notes, I find that I get the sweats on Sunday night and am overheating during the day and Monday.  I have recently read that the gel is not as effective as it should be for a whole day.  So, until I get the implant, I will use the Sunday gel morning and night.  (It is Sunday, and I have already forgotten!!!!)

 I had never been offered injections, probably because I was extremely happy with the pellets (until interference).  "When you are on to a good thing - stick to it".  It is so important to do your own homework.

Sleeping - I don't have a problem sleeping unless there is something troubling me.  I am exhausted early (haemochromatosis) and have to retire to bed often with flu symptoms which disappear once I am lying down.  It is so annoying as there are still things I want to get done, but it is impossible for me to keep going.

 

Oh ok stenlake, I have used custom medicine they are quite a lot cheaper but was thinking I might try the stenlake ones... how big are their 100 mg ones? As the custom medicine was quite big I found, like defs more then a rice corn one which I read is the usual size? I prob say it was nearly 1 cm by 5 mm diameter...

The injections I got online not via script. You didn't get them on script here either. I was just over the patches and as said beside having to stick a needle into myself the injections where good. 

Yes you said the progestin was interfering , glad I'm not taking it then as the doc also given me progestins as I do have my uterus still... decided but to take the natural micronised progesterone usp instead . They also offset Estrogen to a part as it's progesterones job, but since I'm having a uterus there is no way around it. I take it 10-14 days a month deornding on mood, sometimes only every 1.5 months to induce a period really.

Hoping the pellet stays still some time at the level it is now as I'm actually feeling quite good with it

I measured a pill that I think is about the same size.  It is about 8 mm in diameter (pellet could be slightly less).  And perhaps 1.5 millimetres thick.  Yours does sound large.  It was at least $120 plus postage.  A 50mg is almost the same price, so 100mg more economical - if one can say that at that price.

 

Wow that is a difference! 1.5 mm thick vs 5 mm... I defs will try stenlakes one next time around! Maybe I can talk my GP again into a 100 mg one despite the high reading... I'm still sort of not convinced that it's the pellets fault or insertion... 

It doesn't make sense being basically the same price for 50 and 100 hey? Custom medicine ones the 50 is actually more expensive , strange 

Remind your gp that 100mg just means it lasts twice as long as the 50mg - nothing to do with strength of absorption.

50 vs 100 price - I guess they consider they put in the same work to make either, the content price is probably negligible.

What I did notice about the price, is that it is much the same price as the originals years ago.  It was never on PBS when I used it.  The only thing is we have to pay postage on it.  If you buy two, the postage price is the same - not double.

Yes I shall do that I might pay another test next week so to see where the levels are. It might put his mind at ease seeing it was only at 1 stage that high ... so far I hsve 1300 - 2300- 1400 (1 week- 4 weeks- 6 weeks). I rather not muck around with patches again, it's nice not having hot sensations with hot days as we have right now (today 37 and I don't even feel it being hot Hahahaha , last year on the patches I thought I was dying at 37 as I still had overheating sensations)

They're pricey that's for sure. But then if they last minimum 3 months it's like 40$ a month. Honestly on patches I would've spent the same even on pbs as I used 1-2 at the time every 2-3 days so a 8 pack would last me just a bit over a week, plus running to the docs to get scripts all the time. And then I had a none pbs for them too and had to pay full price.. so the pellet for me isn't more expensive and heaps less hassles 

The heat we feel is phenomenol.  I keep asking "is it hot, or is it me?"  I am told, it is me!  Even on the hottest days, I don't see anyone sweating as much as I was and it is all on my face and hair.  It was so amazing to wake up with dry silky hair when my hrt started working again.

Try googling "what are the optimal levels for estradiol in a post-menopausal woman on HRT".  You should get an answer from Dr Farook Al-Azzawi, of University Hospitals of Leicester NHS Trust.  This might help you with your gp.  I have not found a research paper written by this dr on this particular subject yet - a lot to wade through.

Good luck with it and let us know how you go.

 

Hahaha I think that's a standard with us menopausal females : is it hot or is it he? lol! Most time is us but if it's not we go "thank god for that!" 

I'm still on occasion, such as this morning wake up with sweats , but not super drenched. It also happened when my Estrogen was up the 2000... 

I found the article thank you my Gp should be alright hopefully, like he is aware of me needing higher levels we figured that one out over the last 2 years. Just 2300 was a bit way over the top 

Saying that it might just been a one off as mentioned before, so we shall see

When are you getting your new pellet or you already have it?

I should send away for it now - I try to only visit gp every three months when I need scripts renewed.  I was going to ask for 2 x100 mg but I think I should see if 100mg works for me again rather than waste that much money.  My patches are now working for me - not totally but oestrogen is working for me now, after stopping the progestin.

 

Mmh yes I think I probably would go first with 1 100mg one and see how that works . 

I defs will ask my Gp for another 100 mg one and will use stenlake. My GP told me he had ladies in the past where he needed to insert 2 x 100 mg so beats me... could also just be a dodgy compound who knows... there's even differences in the progesterone usp products so why not in the Estrogen ones

That's great they're working for you can't believe no one gotten on to the fact that the progestin was offsetting the Estrogen to that extend 

Hi manuela

See my response to LouLou below.  Now I have to tell you that the last pellet that I had implanted was different.  I reckon it was about 4 mm long and 2 mm in diameter and even looked pale green in the package.  It looked like a coloured pencil 'lead', whereas before it looked like a white round tablet.  My gp says, no it has always been an elongated pellet but I saw the previous one, and watched the nurse pop it out of the packet and it missed the tray and almost rolled onto the floor.  After a second or two, she picked it up with her bare fingers!!!  But it was going to be too messy and inconvenient to not use it and wait for another one to be shipped to me, so I did not say anything.

Not only that it was almost $20 dearer.

Well it's now 3 months since my pellet and until 2 weeks ago I felt great even stopped my antidepressant. My levels where 1400-1200 then but now I'm feeling depressed again, crying, boobs deflating again too. My level a week ago was still 1000 so still high but I wonder if perhaps for my body it is too low? I did feel young and sexy there for a while now I feel old and meh again... I don't think my gp will give me the new implant already ... maybe ad patches, and ideas? 

I would add patches in that case.  I am still using patches 2.5 weeks after implant.  I just have not felt the 'surge' yet.  Generally it is 3 weeks for me, if it does not happen by then or shortly after, I just don't know what is happening.  To me it would mean the compound is not correct, or the application is not correct.

Telephone the company and speak to a chemist and tell them of your experience.  We should let them know.  I have in the past and at this stage they are blaming the gp's implant abilities.  However, she does not do anything different to another dr whom I saw when I was able to buy these pellets from the pharmacy.