Questions regarding an oestrogen cream (Ovestin) and its effect specifically on hypothyroidism but also in general

[Noelnoel]

This morning I visited my GP for an abdominal examination because of raised liver enzymes. As our conversation progressed and I mentioned other niggles she offered a blood test there and then for rheumatoid arthritis, organised a pelvic ultrasound for tomorrow (I know, amazing!), a stool sample and a prescription for an oestrogen cream/gel called Ovestin because I mentioned zero libido

I had early onset menopause at 41 and ever since have struggled with menopause-type symptoms such as hot flushes, insomnia (currently much improved) weight gain and other symptoms which could equally be attributed to my hypothyroidism. Since taking Metavive I’ve made lots of progress with sleep issues, anxiety, hot flushes but the weight gain is a horror. I’ve managed to stabilise it and have lost ounces here and there but it’s stubbornly refusing to go anywhere in a quantity worth talking about. My last blood test was promising in that frees had risen and have since increased my dose and so expect levels have improved further. I’ll know in a day or two. More importantly though I feel well - amazingly, I always have - sleep much better and more engaged with life, friends and family

All that aside, after years of refusing HRT I’m now tentatively interested in exploring it but feel largely clueless about it. I’ve managed with a yam based progesterone oil, which is somewhat helpful, but I can’t help but think I could possibly feel so much better with some HRT help. However, despite GP’s assurance that as long as it isn’t oral oestrogen, I need not worry about oestrogen dominance or weight gain, I remain nervous to use it. I’m also concerned that it might interfere with my efforts to remain optimally dosed on Metavive

At this stage I don’t want reading material because I’m feeling rather bogged down with researching PA but instead wondered if anyone has had similar concerns/experiences around this subject. I’d be very grateful to hear your outcomes

Thank you

[WitchingHour2point0]

I'm afraid I'm waiting to start HRT so can't help there.

My only comment is around your bone health. If your estrogen is low and has been for some time you raise your risk of osteoporosis. Have you had a DEXA scan?

[Noelnoel in reply to WitchingHour2point0]

Hello Gloaming

Here’s the thing, I believe I have oestrogen dominance and pretty sure a gynae once mentioned it when diagnosing my endometriosis. Haven’t had a DEXA

[WitchingHour2point0 in reply to Noelnoel]

Estrogen dominance doesn't automatically mean you have enough estrogen though.

Both estrogen and progesterone can be low in or below range so long as oestrogen higher than progesterone you'll have estrogen dominance.

[Noelnoel in reply to WitchingHour2point0]

Estrogen dominance doesn't automatically mean you have enough estrogen thoug

Thank you for putting it like that because I hadn’t thought about it in that way. It’s given me a different way to think about it. However, over 30 years ago I was diagnosed with severe endometriosis to the point the gynae told me I wouldn’t conceive again. He also talked about how oestrogen-dependent endometriosis is and ever since I’ve been wary. Even though my menopause was debilitating I avoided HRT. And now, after my Hashimoto’s was misdiagnosed for years and then finding this forum where so many others have been put through hell with their GPs, I have a mistrust of them. My current GP is wonderful but still, I’m wary

I asked why only oestrogen and not just progesterone and now I can’t remember a thing she said. I’ve been reading about this particular brand and there’s no mention of it for libido, just vaginal problems and dryness, none of which I have so I’m puzzled why she prescribed it and terrified of gaining more weight, having looked at mumsnet where many say they gained weight

For me, it’s a minefield that I don’t yet fully understand. Is there a reliable test that post-menopausal women can do to ascertain hormone status. The balance app has been recommended for asking questions but will try looking again because I couldn’t find the facility the first time

Thanks again for your insightful and interesting comment

[Buddy195 Administrator]

Well done for getting an ultrasound so quickly!👍

Regarding HRT, it may be useful to have a look at Dr Louise Newson’s free Balance App, as I find it really useful for comparing HRT medications & having up to date research articles. There is also an ability to post questions.

healthunlocked.com/redirect...

Personally HRT has helped me enormously and I have had no ill effects. Quite a few people report needing slightly more thyroid medication when taking HRT, but I actneeded slightly less. It seems very much a balancing act to see what works best for you as an individual.

[Noelnoel in reply to Buddy195]

Hello Buddy

Thank you for the recommendations. The app looks interesting. Does one have to be a subscriber to ask questions?

Very glad HRT is working for you, it’s reassuring to hear that it’s just a matter of balancing thyroid replacement with HRT

Will also check out the link you provided

Thanks again

[Noelnoel in reply to Buddy195]

Hi again

Have searched and searched and can’t find the questions facility you spoke of. Are you able to give directions

Please don’t hurry to answer tonight, I’m very happy to wait. After the weekend is soon enough. Have only posted the question now so that it’s one more job ticked off

[AlStaff28]

Hi, I’m a huge advocate of HRT and have combined oestrogen and progesterone patches. It completely stopped my hot flushes and initially helped my brain fog but I think my other problems contribute towards that. I see a gynaecologist for menopause symptoms and I also have Vagifem on prescription which totally helped me. Please don’t be afraid of HRT. Xx

[Noelnoel]

AlStaff thank you for naming the products you use and your reassurance. My interest in trying it has grown over the last couple of years but I didn’t have the brain capacity to take in the research. Now I’m sleeping better I have a bit more focus and concentration capacity

Can you tell me why your GP prescribed both and not just oestrogen, as my doctor has done. I thought she was going to get me tested when she said we ought to talk about HRT but she said: No, in view of your zero libido, no need. I thought this surprising given all the testing we have to do with replacing thyroid hormones

[E_lizab8]

Hi, I'm now 75 and had a hysterectomy at 41, and have been on HRT ever since, ( using an oestrogen gel), my hormones were never tested either. I was disgnosed with Hashi in 2009 and put on Eutirox but didnt ever feel very good on it so started taking Metavive in 2019, and since then I havent had any problem with using HRT and Metavive, hot flushes are almost nil now and sleep and wellbeing has greatly improved since I've been taking Metavive.

[Noelnoel in reply to E_lizab8]

Thanks E_lizab8

What brand and strength is yours? As I’ve just explained to Gloaming, I mentioned my lack of libido to GP but on researching the product it seems it’s use is for vaginal issues (which I don’t have) and there’s no mention - at least anywhere that I can find - of its use for libido, so I’m puzzled

Glad to hear of your success with Metavive. Marvellous stuff!

[RedApple in reply to Noelnoel]

Noelnoel, It sounds as though your GP isn't at all knowledgeable about HRT. You've been prescribed the very lowest possible dose of oestrogen, which will have little to no effect on libido. It's unlikely to cause weight gain either as it's a very localised application of this hormone. Is there another female GP in the practise you could see?

[Noelnoel in reply to RedApple]

Thank you RedApple

She’s one of those lovely GPs who actually listens. She’s been very supportive on my thyroid journey but I fear you might be right. I’m reluctant to approach any other GP in the practice as my experience of them has been poor

At the moment I’m exploring the Louise Newsom balance app that Buddy recommended but it’s wall to wall info that I’m finding hard to follow and can’t find the facility to ask questions. Frustrating but I’ll keep trying

[RedApple in reply to Noelnoel]

I haven't used it myself, but this links to a postcode search tool that might tell you if there's an NHS (or private) menopause specialist within reach of your location. Worth a look. thebms.org.uk/find-a-menopa...

[Noelnoel in reply to RedApple]

Thank you very much RedApple

[E_lizab8 in reply to Noelnoel]

Its called Oestraclin but as I live in Spain I don't know if its available in uk. It contains 0,6mg of Estradiol per gram of gel and I rub some into my stomach every day it hasn't made me fat as far as I can tell.

Info on package

[E_lizab8 in reply to E_lizab8]

More from the package

More info

[E_lizab8 in reply to E_lizab8]

Last foto of info

Last info

[Noelnoel in reply to E_lizab8]

That’s really helpful. Thank you for going to the trouble of doing that

I take it you’re happy with it

[E_lizab8 in reply to Noelnoel]

Yes, I have had times when I stopped taking it for a while like a few months and I certainly noticed the difference.

[dayoff]

Giving estrogen without progesterone sounds odd. You will be low on both and you need balance. I'd ask again for clarity. If Ovestin is just a vaginal cream I think its extremley low dose so maybe that's her reason? Us thyroid patients are usually low in pregesterone according to a hormonal doctor I seen but I have no idea if that's definitely the case and i'm sure we all differ. Maybe someone more knowledegable with better memory than me can advise on progesterone and the thyroid but im sure it is significant. I did improve massively on a progesterone cream but 3 years in it built up in my system and gave me a rare toxic effect. I would not discount tablet or the coil but i'm not ready for HRT quite yet. Seeing what osteoporosis done to my gran I will not be shy in taking HRT.

[Noelnoel in reply to dayoff]

It sounded odd to me but then I know so little about it. Will delve further and see what I come up with

So sorry to hear about your gran …

[Buddy195 Administrator]

I posted in this section of the Balance app

I posted a question here

[Noelnoel]

Ah, yes! I saw that and decided I needed to look for a section that actually said “questions”. Sorry, I tend to take things literally

Thank you so much for sending that. Was happy to wait but grateful you did it so soon

[sparkly]

Yes ovestin is just a cream to help alleviate dryness and irritation down below. It does not increase estrogen levels one bit nor help with libido.You shouldn't be worried about starting hrt it can literally give you your life back, did me. You might find your libido could return once estrogen levels are adequate, did me.

Also not sure if you had ovaries removed which doesn't help with libido as a quarter of your testosterone is made by them so your almost certain low on that. I know its normal not to be offer progesterone if ovaries are removed but since progesterone is a calming hormone and if it's utrogestan this also has a very welcomed side effect of being a sedative for a lot of ladies, me included. From being in the wide awake club to now out like a light and getting 7,8,9 hours, it's my sleeping aid. Also feel calmer on it. Ladies can get it prescribed if no ovaries for that reason but its a battle I think.

Then once on estrogen and perhaps progesterone then after a few months if symptoms settle and you feel OK then it's time to battle for testosterone. It is a post code lottery and down to specialist if gp unable prescribed but can be the missing piece, it was for me. You do have say it's for libido as that the only reason it can be prescribed but it's so much more than that for a lot of ladies. I found it was amazing and also think having thyroid issues it has helped with that.

Hrt isn't an overnight fix and can take months to start kicking in or just to find what works for you but for me it truly saved me.

I do recommend you join a couple of good menopause groups on fb as you'll learn so much, if you message me I can help with that.

There is always debate whether hrt makes you gain weight but it's just the decline in our hormones and the constant ups and downs in oestradiol levels that is the culprit.

I'm now post menopause and really balanced at the moment both sex and thyroid hormones so things are positive. Hope not given too much info and put you off.

[Regenallotment Ambassador]

very interesting read, I have my women’s health appointment to ask a similar question in a few weeks. I’ll be interested to compare notes.

Did anyone mention testosterone for libido? Might be worth looking into?

I’ve really struggled with the balance app, couldn’t figure out where to find the info so Buddy’s pic really helped me too!

Let us know how the ultrasound goes.

🌱

[Noelnoel in reply to Regenallotment]

Very happy to compare notes Regen. Sharing and comparing is a great way to get answers and ideas and hopefully quicker solutions

I’ve seen testosterone mentioned on here but haven’t looked into it very deeply. My appt last week was to have my abdominal palpated in connection with high liver enzymes but because my GP is a good listener I mentioned all sorts of things including a throwaway comment about libido. On questioning me I heard myself saying there hasn’t been any intimacy between husband and me for about 3 years! Shocking but somehow I’m not interested and I now realise how selfish I’ve been in not addressing it

Anyway, although I’ve refused to consider HRT in the past perhaps now’s the time to. I’m post-menopausal but still get awfully hot, so help with that and getting a bit more sleep would be fantastic and if it improves my libido then that’s a bonus and some weight loss would be so good for my self esteem

So, to the ultrasound. All normal apart from a few tiny fibroids which have shrunk and apparently so have my ovaries. Shrivelled and barely visible were the radiologist’s words. Not a great thought but my GP obviously thinks my lady bits could do with help too, hence the Ovestin. If only she’d asked me I would’ve told her my vagina is neither dry nor atrophied (well, as far as one can tell) and saved her the prescription because I’ve looked into it and found that Ovestin will be no help whatsoever with libido. Especially for me who has minus libido!

The Balance app is a crazy mess isn’t it but if I can get to grips with it I’m sure it’ll be a great tool