I hope it's OK to ask a question unrelated to the thyroid here.
About four weeks ago, I decided not to use Estrogel, which my hormone doctor put me on five years ago, along with bio-identical progesterone (Utrogestan, 200 mg, at bedtime day 15-25 of cycle; Estrogel is to be applied to thighs, stomach or chest day 5-25).
In the past month, I have experienced some rather strange symptoms which I first thought were thyroid-related (I recently increased my daily dose of NDT slightly as it was getting colder). But now, I am beginning to wonder if those symptoms are caused by low estrogen rather than too much thyroid hormone...? Those symptoms are:
No longer sleeping as well, waking up several times during the night and/or waking up before 5 am and unable to go back to sleep, sweating profusely one minute, then feeling cold the next, more tired than usual, forgetfulness, even feeling slightly depressed for no obvious reason. And, my period is late. My periods have always been like clockwork, but now it's almost a week overdue and I cannot remember when that last happened. I will turn 48 in two weeks.
Has anyone tried to wean off estrogen and experienced similar symptoms? I am honestly considering going back on it as soon as I've had my period.
I should add that I did use Utrogestan as usual, one capsule (200 mg) at bedtime for ten days this past cycle. The reason I decided to see if I could go off Estrogel was that I have read some articles claiming you should never use estrogen for more than five years, as prolonged use will increase the risk of breast cancer...but I am not sure if that only applies to the synthetic version (the Hertoghe doctors, of course, only prescribe bio-identical hormones)?
It is possible then, that the problem is not actually low oestrogen, but oestrogen dominance. The important thing is the balance between oestrogen and progesterone. You might like to look at this website, which does sell Bio identical progesterone cream, but also has very informative articles explaining the importance of oestrogen/progesterone balance.
Thanks, I'll have a look at it! However, I have to admit that I have felt less well in the past month, since going off estrogen...when I actually expected the opposite.
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PS. It's interesting, but I have never heard a Hertoghe doctor mention estrogen dominance, nor is it mentioned in any of Dr. H's books...once you're over 40, you are prescribed both E and P. Maybe progesterone cream has some benefits compared to progesterone pills (Utrogestan)...?
Without actually measuring your oestrogen and progesterone levels, it is difficult to be certain, but generally speaking, oestrogen continues to be produced in the fat cells of the body, whereas progesterone is usually the one which falls more, since its main production site is the Corpus Luteum in the ovaries, and the ovaries themselves. As egg production/quality decreases, so less progesterone is produced. That is why most women will find by adding a small amount of progesterone only, symptoms decrease.
Well, I had my E and P levels measured before starting treatment five years ago, both blood and 24 h urine...but as far as I remember, the doctor looked at each lab result individually, and did not compare the two.
Also, my hormone doctor always asks me to have labs on day 21 of cycle, whereas my OB-gyn (who ordered labs at my annual check-up a couple of weeks ago) told me to go to the lab on day 3 of period to have estrogen levels measured...as far as I know, estrogen levels will drop during the second half of your cycle, meaning they will always be lowish on day 21 of cycle...?
At 48 I would hazard a guess that what you are actually experiencing is approaching menopause - all your symptoms fit with that. It is happening now because your prescribed hormones have actually been compensating for the decline in production by your own body.
Yes, I believe you are right. I found a very interesting article explaining that the symptoms of estrogen deficiency and dominance are the same, except for one thing: how often you have your periods. For the first time ever, there are more than 28 days between my periods, and it seems I am even skipping a period...which points to estrogen deficiency, not dominance...given my age, that is to be expected:
I'd look at getting the oestrogen before you start noticng vaginal atrophy - that is excruciating. If you are approaching menopause, you probably need at least 2, if not 4 hormones - in the right balance.
My hormone doctor has prescribed estrogen and progesterone, and is testing testosterone levels the next time I'm having labs done this summer. Please tell me which one(s) I forgot...!
sorry you're feeling so rotten at the moment. I too take estrogel and EVOREL patches alongside levothyroxine.
It might help if you could share a little more info.
Why were you originally put on HRT 5 years ago? You said your periods were like clockwork?
Why have you decided to come off it and is it purely to do with risk?
How much estrogel were you using?
I'm slightly concerned that you said Estrogel can be applied to the chest? This is absolutely not the case and should never be applied to the chest. You should never apply estrogen near or on the breast area. Who advised you on this? Neither should it be applied to the stomach.
It should be used on the arms and inner thighs only.
If you have recently come off your HRT then your body will be going through some major changes and it sounds as though you did it fairly abruptly too.
All the symptoms you state could easily be lack of oestrogen.
Hope to hear from you.
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Thank you so much for your extensive reply and helpful suggestions!
I was originally put on HRT five years ago, a month before my 43rd birthday, by a so called Hertoghe doctor in Belgium. The reason was that lab analyses (blood and 24 h urine) showed suboptimal levels of estrogen and progesterone. At the same time, I was diagnosed with adrenal fatigue and put on Medrol.
I thought I read somewhere that Estrogel could be applied to the chest area, but I have to admit I have always applied it to my inner thighs, for the simple reason that feels like the most natural thing to do.
The only reason I decided to go off Estrogel (and yes, I used it from day 5-25 in October and then did not use it at all in November, I just took Utrogestan from day 15-25) was because I read that a woman should not use estrogen for more than five years. The same restriction does not seem to apply to progesterone.
But I am beginning to wonder if I don't need estrogen...if my adrenal glands are not producing optimal amounts of hormones to begin with, why would I need to supplement all other hormones but not estrogen...? I am beginning to consider adrenal fatigue a life-long condition, and not something you can cure by taking cortisol for a limited period of time...
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PS. Another thing I have noticed lately, but I have no idea if it's related to low estrogen levels, is that my blood pressure is slightly elevated (this morning, it was 139/96 upon rising). My BP is usually around 120/85.
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Hi Anna,
You don't say whether or not you live in the U.K.? I'm assuming outside or have you been privately purchasing your HRT and Medrol?
The five years usually stated for oestrogen therapy is from the point at which you would have naturally entered menopause.
I'm still a little confused as you don't say whos care you are under for your HRT? GP? Endo? Hertogue Clinic.?
I'm not a great fan of these clinics that run bloods, dole out hormones and then offer no follow up care .....usually at huge expense.
I am under an endocrinologist who sees me every 5 weeks ( nhs) and balancing hormones takes time and patience. It's a tricky business and needs a professional eye. I have been his patient for 2 years and we are still tweeking!
I take levothyroxine, liothyronine sodium and estrogen. ( I have no uterus so don't need progesterone).
Could you explain who is handling your long term care? What follow up did this Clinic provide you with? Who supplies your hormones?
Sorry lots of questions but may help others to answer too.
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No, I'm not in the UK, I'm in Belgium. And I am seeing a so called Hertoghe doctor who is in private practice (but used to work in H's practice in Belgium).
I tend to agree with you about the way they do business; they charge you a fortune and, once you are on all these hormones, you only see them once a year.
The only reason I go to one of those doctors is because I wanted to try NDT, and there are no endocrinologists (to my knowledge) in Belgium prescribing NDT or accepting a suppressed TSH.
But I have an OB-Gyn who has now ordered some tests (estrogen, testosterone, LH, FSH). It will be interesting to see what she has to say about my levels.
The best advice I have seen so far comes from an RN and Nurse practitioner in the US. She has written a book called "Female brain gone insane" about menopause. She also works with natural hormones. I wish I could go and see her...she used to do phone consults, but no longer has the time.
One thing is certain: this past month, I have felt a lot worse than I have in years, and symptoms have emerged for the first time, like panic attacks and sleeping problems. I cannot help but wonder if stopping Estrogel has something to do with it...I continued to take Utrogestan, and maybe that was a mistake as that is likely to create some imbalance between estrogen and progesterone levels...
Hi Anna,
I'm starting to get a fuller picture here. Low Thyroxine and low oestrogen levels are notoriously difficult to balance. So many of the symptoms cross over.
My endo tends to concentrate on levelling off the thyroid first and then concentrating on the oestrogen levels.
Since stopping the oestrogen you've had all those horrid symptoms so it may be a lack of oestrogen causing them. Your symptoms are certainly consistent with low oestrogen.
I would really advise you to see a GP who would pass you over to an endocrinologist. I'm not sure how your health care system works. When it comes to hormones it is far better to have one person over seeing everything.
when my oestrogen is low I have total insomnia, dreadful constant anxiety and panic. Sweating, dizziness...just awful.
You may find going back on your hormones is the answer but I'm not nedically trained so please consider consulting a doctor.
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Thank you, yes, I will try to find a knowledgeable doctor. Easier said than done...
My symptoms are exactly those you describe; insomnia, panic, anxiety, sweating, dizziness...you could be describing me.
However, there is one thing I have been wondering. I will turn 48 in a couple of weeks, and the average woman has her last period at age 52 (I read somewhere). After that, her body basically stops producing estrogen. But if I have those terrible symptoms now already, does that mean that I will never be able to go off estrogen, and will have to use Estrogel or a similar product for the rest of my life, even though my body would no longer be making any estrogen on its own...? I hope you understand my question, even though I don't find a good way to put it...
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Hi Anna,
It is difficult to supplement hormones without shutting down your bodies owned production. Hormones work on a feedback loop.
If you put oestrogen into your body, your own body will stop producing it. That is the risk and the reason why we shouldn't play around with hormones.
You've stopped your oestrogen but it sounds as though your body hasn't woken up and started producing its own oestrogen. This is why you need to see an endo. At least you are seeing an obs gynae.
I have no ovaries. I am not supplementing. I am replacing.
After menopause a women still produces a substantial amount of oestrogen from her ovaries and fat etc to protect the bones.
I will continue to take a tiny amount of oestrogen only for ever. But only a small amount.
You will gradually be able to reduce your HRT but not yet. You haven't even hit the menopause yet!!
I take a combination of T4 and T3 for thyroid. I have central hypothyroidism which is complicated and difficult to level off but my NHS endo is great and very patient. I see him every 5 weeks.
I did take NDT in the past but I'm just too complicated and have to explain it to every NHS doctor I meet so I'm happy to stick with synthetic.
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Thank you so much again for taking the time to answer my posts!
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Can I ask what you take for your thyroid?
I would be willing to go to the UK every once in a while to see a really good doctor, but every five weeks or so would not work out for me...unfortunately, as your doctor sounds really great.
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This night was terrible; I woke up countless times, drenched in sweat, and my heart was beating so fast I feared it would give up and stop any second...this was by far the worst night so far. This morning, my period finally started (a week late). I'm glad in a way, as I was planning on going back on Estrogel today...if I feel better today, I think it's safe to assume that low estrogen was the cause of my recent symptoms.
Now I am at a loss, not sure if what to do if indeed I feel better from now on. Go back on Estrogel in five days, as prescribed by doctor, or wait and see if my body can produce estrogen on its own? I know, you should be able to ask the doctor who prescribed the hormones these questions, but they just say: "No, you need the hormones for the rest of your life". These Belgian hormone doctors are, first and foremost, anti-aging doctors, and of course I no longer have the hormone levels of a 22-year-old...do I sound cynical? Perhaps. But all those doctors take a lot of hormones themselves. True, they are all hypothyroid it would seem, but they also treat adrenal fatigue and declining sex hormone levels in themselves. They also inject themselves with human growth hormone (something I've been offered but declined, and not only because it's incredibly expensive and not reimbursed by social security). What I mean is that, at one point, you have to ask yourself if you take hormones because it's medically justified, or just to feel and look younger...? I cannot say I worry much about getting older, but I'm not even 50 yet so maybe that day will come...but, right now, I am only interested in maintaining hormone levels that allow me to live a normal life without feeling run down and depressed all the time. I don't care about reversing the aging process.
I have low estrogen too and it started at the same time as my TSH increased and I get confused too whether my symptoms are low estrogen or low thyroid.
I wish I could find more articles on low estrogen and thyroid. I have menopausal estrogen levels since coming off the pill at age 35! So much so that I ended up with chronic cystitis for about 2 years.
Yes, I am back on Estrogel (day 5-25 of cycle) and Utrogestan (progesterone) 200 mg day 12-25 of cycle (doctor originally prescribed the latter to be taken day 15-25 of cycle but I changed it two day 12 as my cycles have been getting shorter and shorter), and I do feel better. I have not been sweating for the last few days, and I have been getting three nights of uninterrupted, restful sleep. This tells me I need both E and P.
I too am taking bioidentical HRT same as you. When i first started taking estrodiol i was getting headaches so stopped taking it but carried on with the progesterone which was okay for a couple of weeks and then found it wasnt really helping. I had a problem at the time with ovarian cysts which seem to have gone away for the moment possibly with the help of increasing levothyroxine (dont know for sure though!) . Having increased my levo (probably not still optimal) and still not feeling great i decided to go back on the HRT. I started off just with estrodiol which didnt seem to give me a headache anymore and havent yet added back in the progesterone but i will be doing that. One thing i have noticed a pattern of is the terrible mood swings i am getting prior and during ovulation, along with very bad bloating. Im not sure whether taking estrodiol is good for this due to decline in estrogen during this time or whether to add in progesterone now? I feel like what i think i need to do is contravening probably what i should be doing if you know what i mean?
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