HRT dilemma - switched from Oestrogel to Lenzet... - Thyroid UK

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HRT dilemma - switched from Oestrogel to Lenzetto, too early to consult Newson’s?

Serendipitious profile image
22 Replies

I’ve switched from 3 pumps of oestrogel to 3 sprays of Lenzetto. It’s only been a few days but my symptoms of insomnia for a start are worse. Now I wake up at 4am and don’t get back to sleep at all. So sick and tired of this. Also going to the loo more. I’ve been completely non-functional today. Too tired to do anything and I can’t sleep during the day. Gums have started to become sore and teeth sensitive. Initially I improved on oestrogel having started HRT in October 2022. In the last 2 months some symptoms returned. I upped dose from 2 pumps to 3 but still no change. Hence the switch to Lenzetto. However now I’m feeling this isn’t working either.

Agreed with GP to continue with Lenzetto for 3 months last week. GP is reluctant to prescribe oral oestrogen. She will then test hormones again in 3 months. She’s also recommended a DEXA scan. I reported knee and ankle issues.

I’m wondering if there’s any point in carrying on should I just go and see somebody at Newson’s? Newson’s don’t need a referral. Or should I stick it out for longer? Will a Newson’s doctor just recommend a similar course of action? Different regime?

I don’t know what to do.

😫😫😫

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Serendipitious
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22 Replies
Peanut31 profile image
Peanut31

Hi

You mention bladder issues, you could be suffering from vaginal atrophy.

I take vagifem daily for this.

I’m with Newson health and I will warn you they are not cheap for consultations.

I started HRT back in June 2022, under my GP, but if the GP didn’t agree I had an appointment with Newson Health.

I’m still under Newson health as feel they have more knowledge than my GP.

Newson health prescribe me testosterone as part of my HRT.

They do listen to patients and do have experience, but sometimes I feel they are too quick to tell you just to increase your HRT.

I did stop HRT back in January 23 after being on it since June 2022, as felt awful. However, I think I was having too much oestrogen as I am peri menopausal.

I’ve started back on HRT as my symptoms are too severe to not have any, but, I’m taking it slowly with increases and on 1/2 pump of gel a day.

Best wishes

Serendipitious profile image
Serendipitious in reply toPeanut31

Peanut31,

Thanks for responding. I take a similar product called Vagirux but twice weekly previously. I’ve upped it to 3 times a week as the letter I got from the local hospital said I could use it upto 3 times. I’ve only done that since I noticed Lenzetto hasn’t been helping.

Interesting to know that your GP didn’t follow Newson. I wonder if it’s worth me asking for a private referral first. I might need to stick it out on Lenzetto for longer. I’m so fed up though.

How did you feel awful?

lolajone profile image
lolajone

look into the dose. 3 sprays of lenzetto is less then 3 pumps of gel in terms of dose so the dose has been reduced hence why you have symptoms returning

lolajone profile image
lolajone in reply tololajone

3 sprays of lenzetto is equivalent to 2 pumps of gel…… I looked it up 😁

jeanw18 profile image
jeanw18

Hi Serendipitious, Due to my menopause symptoms (or I blame it on them, it may be other stuff e.g. thyroid problems). I've been on HRT patches for years / then onto the oestrogel latterly. My symptoms became bad again (fatigue, anxiety / low mood being main 3). I have also started a new job, so the anxiety has also heighted with this too. I ended up going private and saw a consultant 3 days ago - who did not do any blood tests !, but just promoted using Lenzetto spray and referred me onto GP so I could get the prescription for free!! So I am intrigued to see how you get on this with . He thinks I am on a fairly low dose with the gel (2 pumps daily), wants me to try Lenzetto for around 6 weeks 3 sprays during day, 1 at night), if symptoms dont get better he's going to MAYBE try testosterone gel, but I could tell he is not keen on this due to side effects (some lasting), which it has given people. Could take me weeks now to get the Lenzetto prescription, so will be watchint to see how you get on :)

Serendipitious profile image
Serendipitious in reply tojeanw18

jeanw18,

Well I hope you get on well with it, I've given up on Lenzetto after 8 days. I felt even worse on it. I dont get why the max dose is 3 sprays although I uppped to 4 sprays in the last 2 days. I was already struggling on 3 pumps of gel when I was ok for a long time on 2. I just dont get it.

Sorry I do hope it works for you.

RachelP03 profile image
RachelP03

You may also like to look into progesterone as this is a very calming and muscle relaxing hormone so it may help with your insomnia. Quite often this is prescribed at the same time.

Serendipitious profile image
Serendipitious in reply toRachelP03

RachelP03,

Thank you I’ve been taking 100mg of Utrogestan from the start.

DiNL profile image
DiNL

hi there, I’m on Lenzetto too. Have been on 3 sprays since December. My gynae has advised moving to the gel as Lenzetto is known to be much weaker than the gel. I know it says 3 sprays is equal to 2 pumps of gel but everyone I have spoken to says that Lenzetto is quite weak. It suits me, but my colleague has had to move to the gel (2 pumps) from the Lenzetto and feels a whole lot better for it. We are all so different… hope you find the combination that works for you soon.

Serendipitious profile image
Serendipitious in reply toDiNL

DiNL,

I've switched back to oestrogel as of today. I felt a lot worse on Lenzetto after a week, only sleeping 2 hours if that even with sleeping tablets and genitourinary symptoms even worse. I switched to 4 sprays two days ago but I couldnt risk carrying on with it. I don't also get why they say 3 sprays of Lenzetto is the max dose. Even 3 pumps of oestrogel didnt help me when previously for months I was better not perfect on 2 pumps. I really dont get it.

radd profile image
radd

Serendipitous,

We were previously discussing the progesterone dose should be equal to that of the oestrogen and Utrogestan is now being prescribed off license to 200mg daily.

The British Menopause Society guidelines are -

'The dose of the progestogen should be proportionate to the dose of estrogen. While no data is currently available on the endometrial effects of high doses of estrogen and the optimal dose of oral or vaginal progestogen in this context, women who require high dose estrogen intake should consider having their progestogen dose increased to ensure adequate endometrial protection (e.g. micronised progesterone 300 mg for 12 days a month instead of 200 mg in cyclical HRT regimens or 200 mg daily on a continuous basis instead of 100 mg in continuous combined HRT regimens).'

thebms.org.uk/wp-content/up...

Also lolajone is correct in saying 2 oestrogel pumps is equivalent to 3 Lenzetto spray. The British menopause Society state this in a slightly ambiguous way -

'Oestradiol spray Lenzetto three sprays (40 mcgm) would be equivalent to the oestrogen dose in Evorel Sequi.

Oestrogel one measure twice a day would be equivalent to the oestrogen dose in Evorel Sequi'.

thebms.org.uk/wp-content/up...

Serendipitious profile image
Serendipitious in reply toradd

radd,

Thanks for this. I just dont understand why even on 3 pumps of oestrogel I felt rough. I've got the oestrogel back and I'll try 4 pumps. Oestradiol blood results were very low too, as per last post. Think I need some help with this too from a good endo, might contact yours, because GP this morning was going on about my TSH etc.

radd profile image
radd in reply toSerendipitious

Yes, he'll up your P for sure 😊

if things were working ok on the oestrogel at 3 pumps and then symptoms started returning it would have made more sense to just go to 4 pumps rather than switching method. Also 3 pumps of or lenzetto spray is now recognised to be the equivalent of a max of 2 pumps of oestrogel so you’ve essentially gone down in dosage.

It sounds like you just needed a dose increase. Can you go back to your oestrogel and do 4 pumps? It can take 3 months in theory for a dose to settle but if your symptoms are immediately worse I’d just swap back, it won’t do any harm.

I’ll attach the conversion dosage chart for lenzetto from Newson Health. Lenzetto seems a bit hit and miss with dosage. I hope that helps x

Lenzetto doses
Serendipitious profile image
Serendipitious in reply toKnackeredandcross

Knackeredandcross,

I have to say I'm feeling knackered and cross myself. I slept about 2 hours last night despite taking Zopiclone and Melatonin. I called the GP and got the Oestrogel back. I will try 4 pumps. Honestly I just realised that all my symptoms are returning including urinary incontinence which I'd forgotten about. Thanks so much for the chart too. The GP I was talking to was talking about my TSH and thyroid hormone too. I think I need to get in touch with a good endo.

TiggerMe profile image
TiggerMeAmbassador

Do you dose all at once? I use 2 squirts first thing and another 2 squirts mid afternoon. It all depends how well you absorb but initially I used 6 squirts just to kick my levels back up.

It's so much easier to tailor your dose with Lenzetto rather than slime

Serendipitious profile image
Serendipitious in reply toTiggerMe

Eeyore100,

I was using 3 pumps all in one go. I might have tried 2 once in the morning and third in the PM once or twice. I feel like I'm back to square one again. Not sleeping at all, sensitive teeth, aches and pains, needing to pee a lot and sometimes having urinary incontinence 😭

Since being on Lenzetto for over a week I've gotten even worse 😩

TiggerMe profile image
TiggerMeAmbassador in reply toSerendipitious

I'd give yourself another couple of squirts before bed, I think the 3 dose limit is just the usual legal guff, how can it be the same if you are 60 kilos or 160 kilos?? You need what you need and have to work out for yourself how much you are absorbing, go by your symptoms as we tend to do with the thyroid. I found as my levels picked up I needed a little more T4 to balance things up

Serendipitious profile image
Serendipitious in reply toTiggerMe

Eeyore100,

Makes sense. They lowered my Levo at the same time slightly after 3 months. Dunno if that had an effect. But how can that affect oestrogen blood results?

Last blood reading of oestradiol was 90. At this rate to get it up to where I feel comfortable I may not have enough places to apply the damn stuff. Ugh maybe I’m overthinking it.

So it’s ok to apply it at night too? Don’t they say it needs to be morning and at the same time each day?

TiggerMe profile image
TiggerMeAmbassador in reply toSerendipitious

Hmm, if you are under with your thyroid it has a knock on effect to oestrogen production which is the first to drop off and everything else as it may have slowed your tick over...

I don't remember ever being told when to apply it, I'm post meno so just looking for a steady supply, I would often wake in the night with some awful realistic dream if I was low so I keep a Lenzetto next to the bed and add a squirt, if I've had a stressful day or I'm a bit unwell I have an extra dose then too... our immune system runs on oestrogen 🤯 Who knew!!

You can use both Gel and Spray needn't be either or...

I would say, much like adding T3/4, you need to find your rhythm with HRT and add it when it suits you to the dose that alleviates symptoms, but be mindful of the cross over symptoms with low thyroid and peri

What are your current thyroid results?

Serendipitious profile image
Serendipitious in reply toTiggerMe

Eeyore100,

When I went to Boots today they had another supply of Lenzetto which I’d requested on Friday but I refused it. Had a particularly sleepless and difficult weekend and just lost faith in the Lenzetto. I’d only been on it for just over a week. Should have taken it too. Think they must have earned their commission or whatever it is and kept the meds too. Oh well.

Thanks you’ve been very helpful and reassuring.

I believe you commented on my thyroid results in my last post which wasn’t that long ago. Maybe a week before.

TiggerMe profile image
TiggerMeAmbassador in reply toSerendipitious

Sorry don't trust my memory...Ok... went rummaging

Thyroid 11/4/2023

TSH 0.28 miu/L Range 0.27 - 4.2

FT4 15.4 pmol/L Range 12-22

FT3 3.3 pmol/L Range 3.1 - 6.8

So I did! I'm like a scratched record aren't I 😉

Eeyore100

12 days ago

I'd be much more concerned with your low T3/4 levels! (I was on my knees with those readings) classic crossover symptoms, these lows will be having a knock on effect with your oestrogen levels as your system slows down and prioritises more important functions

What was your FT3/4 when you were on 100 levo every day?

Certainly worth trying Lenzetto which I find very good and easy to adjust your dose, with this reading being your bottom end you may have just caught a down day as things still fluctuate, but you won't know what your absorption is like unless you take another test after slapping on some oestrogen. I find my levels drop quickly which is a good thing as you don't want to over do it else it can inhibit you conversion of T4

But your immediate issue is getting your thyroid levels up 🤗

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