Progesterone or estrogen too high?

Can I ask what sort of estrogen you use. I use Evorel patches. I change them twice a week. Thankyou x

Excuse the long post, I thought it might be useful to run down my history so you can see finding suitable HRT isn't always an easy process!

Way back in my 30s, I had a fibroid removed and it seems to have caused premature ovarian failure which went undiagnosed for about 15 years - I ended up pretty much disabled.

I started HRT and things improved in some ways, except I had terrible side effects from the progesterone (initially Uterogestan capsules, 12 days per month, then tried Mirena coil for a year). Eventually I had an hysterectomy because I refused to take any more progesterone.

The hysterectomy has sorted out lots of things, though my energy levels are still pretty low. There were consequences from the hysterectomy itself, too, though that's another story

 

I have used both Evorel and Estradot in the past, two patches per week. They seem to be essentially the same for me, both very effective but both had quite strong palpitation side effects. I've used Climaval tablets too, which were less of a problem, though not all my drs were happy to prescribe them.

Different drs seem to have their 'favourite' meds to prescribe, though they may not necessarily be the most effective meds for everyone.

I've had an estrogen implant for about 18 months, I also use Estrogel to top it up.

I'd use Climaval now, as my 'top-up' because I'd prefer not to have to use a topical gel, but I find it too difficult to cut the tablets up accurately. I eventually gave up trying to cut them up and now use the Estrogel (Climaval seems to be more effective, for me, than the gel).

I also use Tostran Testosterone gel. I have it prescribed for daily useage. I don't have palpitation side effects if I only use it for 4 days a week, but anything more and I get palpitations.

I have lots of problems absorbing medications, it's been a very hit and miss affair, trying to figure out which works, and for how long they'll work. The estrogen implant should be providing enough hormone for me, but it doesn't seem completely effective (yet?).

Palpitations are the most common side effect I get with both Estrogen and Testosterone, but, like I said in my earlier post, now I know what causes them, I'm much less worried about it.

My theory is that, since the palpitation side effect was so similar to feeling very 'nervous', it actually made me feel nervous, even if I was actually feeling quite relaxed (sounds contradictory, I know!). Now I understand what's going on, I just ignore it most of the time (it does get annoying when I'm trying to sleep sometimes, though).

Hope that isn't too confusing, and is of some help!

Forgot to say, one of my peri/menopausal symptoms was palpitations - had 'vibrations' for years before finding out it could be sorted with HRT. 

I take the testosterone for both migraine and depression. Both have been problems since my early teens, but never recognised as symptoms of hormonal fluctuation.

Thankyou so much in your detailed reply. Poor you! Do you recommend me seeing a gynaecologist? My doctor doesn't seem interested and I'm sure is just guessing the dose. Today I have felt all fired up and body buzzing and in overdrive. I don't really know what to try next. What do you think? Xx

Interesting. I don't take any testosterone,perhaps I should do. Where did you find out your hormone imbalance? You have been a great help.

Do you mind me asking what were the side effects of progesterone, uterogestan, that you experienced,as it is something I'm considering.

Glad to be of some help!

I attend the Menopause clinic at Chelsea & Westminster hospital in London. It's pretty much the best NHS place in the UK for this stuff. The bloke who set it up, Prof John Studd, doesn't do NHS anymore, but he has a private practice in Harley Street, if you want to go private. The head of the Meno clinic is Nick Panay, who originally set it up with Studd.

I have blood hormone levels taken just before I have a new implant. I think how a patient actually feels, is regarded as the primary indicator of how effective the HRT is, though.

I don't think the blood tests from the GP are exactly the same as the ones I have through the clinic... Not sure what the difference is, but certainly the testo test is different. The hospital test takes a couple of weeks to get a result, whereas the GP referred test only takes a few days.

First thing is, not everybody has bad side effects from progesterone!

I felt dismal when I was using Uterogestan - headaches, nausea, stomach aches, sore breasts and VERY fluctuating energy levels. The Mirena side effects were more constant, at a lower level of intensity, but still very uncomfortable.

When I had the Mirena removed, the change in how my body felt was, literally, instant - I felt better immediately.

For a few months before I had my hysterectomy, I used estrogen without progesterone and all the above side effects pretty much disappeared, apart from fluctuating energy levels. 

I had only one very slight 'spotting' when I used the progesterone, even though I was on it regularly for two or three years.

If I could have the estrogen without the progesterone, I would choose that now and give the hysterectomy a miss.

Thank you for your reply.

I suffered when I was younger when taking the contraceptive pill. Mood swings, bad temper and bad pms. Thats what makes me wary of taking hormones.

And my sister suffered when taking the 12 progesterone pills of her hrt with tension and irrational temper issues. Wanted to leave her husband!

I guess I can just try and be aware of changes in my feelings.

I'm trying sage and passionflower and meno serene at the moment but the night sweats and hot flushes still draining me.

I think going into it with your eyes open is the most important thing. It's worth keeping a quick daily list of how you feel (even the slightest things) so that you can track anything that may develop slowly over time.

Once I stopped using progesterone, the side effects went quickly, and there were no lasting problems.

I never went down the 'natural' remedies route. I went for 10 years before it was realised that what had been diagnosed as M.E / Chronic Fatigue Syndrome was, in fact, much more likely to be Premature Ovarian Failure. The M.E diagnosis effectively shunted me into the long grass and nobody took much notice of my quite extreme menopausal symptoms (I think this possibly happens to a lot of women who get a M.E / Chronic Fatigue diagnosis).

Have a go with the HRT, if it's uncomfortable stop using it.

I would advise going to a gynecologist for this, rather than a GP. GPs are quite 'timid' about prescribing HRT, and often don't seem to know much about it, really. Gynecologists also have the capacity to prescribe 'off-license' medications. I'm prescribed testosterone by my consultant, whereas my GP isn't allowed to.