HRT related: Hello šŸŒ· Please may I ask how much... - Thyroid UK

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HRT related

Amazon07 profile image
Amazon07
ā€¢7 Replies

Hello šŸŒ·

Please may I ask how much HRT are ladies on?

Last night I accidentally left my old Evorel patch on (1 put a new one on every 3.5 days instead of the 3 day /4 day combo) and put on the new one. I realised it this morning and took the old one off. I guess it was still giving me oestrogen because this morning I feel soooo much better, I feel almost human šŸ¤Ŗ

I have been feeling really down lately, as bad as suicidal. Feeling like a failure, not good enough, had a nasty virus for 2.5 weeks and hurt my knee at the gym so havenā€™t been for 3.5 weeks. My eating went out the window, since December Iā€™ve just been eating a ton of rubbish, sugary and starchy stuff, things Iā€™d never normally touch. Feels like my eating disorders are back, just going between binge eating and not eating. I feel like a whale and out of control. I suspect I have ADHD and Iā€™m waiting for my appointment, my GP referred me.

Sleep has been bad too, staying up too late and not having more than 4-5 hours some nights.

I just canā€™t get out of this vicious cycle.

I started HRT in December after no periods for 11 months and having unbearable migraines that lasted for days.

started on 25mg Evorel and 100mg Utrogestan. Iā€™m currently on 50mg Evorel but wonder if I need more?

What is the ā€˜normalā€™ dose for oestrogen HRT? And if I increase the Evorel, do I need to increase the Utrogestan too? I take the Utrogestan every night, no breaks.

I also recently started to add 50mcg Levothyroxin (3 weeks ago) and decreased my T3 to 2x 20mcg (I used to self-treat with 25mcg of T3 3x / day). GP sent me to Endo who agreed to prescribe me T3 but asked me to add some Levo and I agreed to try.

To be fair, the feeling low and eating out of control started before I started HRT or Levo. Only a handful of much milder migraines since on HRT so thatā€™s a definite improvement.

I do have quite a lot of stress on, Iā€™m a fairly stressy person anyway (overthinking, ruminating) but recently thereā€™s so much on Iā€™m finding it very very hard to switch off, mainly due to my daughter being in Year 5 and local secondary schools are rubbish so sheā€™s having tuition to get in to a grammar we are in the catchment of but itā€™s 200% oversubscribed (does that mean 3 people apply for each place???) and my girl is bright but needs to study more to have a chance! Thereā€™s an another v v good secondary but we are waaay out of the catchment, itā€™s oversubscribed and houses in that area are so expensive! Looking at maybe renting ours out and renting one there but all the timings and trying to find out all the details, Iā€™m just feeling so overwhelmed (I only went to university in the UK, Iā€™m from Central Europe so itā€™s all new to me).

And then work and housework and everything else on top of this.

I feel like Iā€™m going to go nuts and my eating and sleep suffers. But had issues with eating since I was 13 and I was groomed by a 36 year old pedofile and I always felt it was my fault. I had my eating annd feelings all in check for the last 10 years but itā€™s resurfaced and I really feel bad and anxious about it.

I had lots of therapies but it seems like none of them helped if the issue is back again.

Iā€™m wondering if increasing my HRT will help me feel like myself again?

Thank you for listening and not judging, I find it really hard to talk about this, and I donā€™t normally do but it all came out and I think Iā€™m going to leave it. Please be kind šŸ™šŸ¼

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FancyPants54 profile image
FancyPants54

You are only on 50mg oestrogen. That's a very conservative dose. You need more. I don't use a patch now. I found them too up and down for me. But when I did, I had 1 x 100mg + 25mg patches.

You do not need to increase your Utrogestan with an oestrogen increase. Utrogestan continuously will cover all bases.

I would say that you are early days on HRT and I had very low moods and felt totally unmotivated at first. An increase in dose to 75mg patch should help. But you might have to live with low mood and whacky eating for a few months. You have also altered your thyroid dose so you have competing hormonal upheaval going on.

I now take Bijuve capsule every night (body identical oestrogen + Utrogestan) and 2 sprays of Lenzetto a day. But I am trying a reduction to 1 spray + Bijuve at the moment because I think it's causing too much fluid retention on the bigger dose.

Amazon07 profile image
Amazon07ā€¢ in reply toFancyPants54

Thank you so much!! That really helps that itā€™s kinda ā€˜normalā€™ how I feel!

I asked my GP for Lenzetto spray but she said she always prescribed the patch for consistent oestrogen release. I know our body doesnā€™t release the same amount every timeā€¦

I have 5 pieces of 25mg patches left, do you think itā€™s ok to add it so Iā€™m on 75mg? Iā€™m just off ā€˜on holidayā€™ (visiting family) so wonā€™t be able to see my GP till after the 12th of April. I can always cut a 50mg patch in half for Monday the 15th and hopefully see my GP on the 16th. I guess I might see by then if Iā€™m feeling consistently better?

Do you think thereā€™s a chance that once Iā€™m on the right amount of HRT, my eating will settle again and the depression?

Do you think not enough oestrogen can also cause fluid retention? I definitely feel like I have much less fluid retention with this additional dose of oestrogen I had!

I hope you can get your HRT sorted too, so itā€™s all good for you! šŸ™šŸ¼šŸ’šŸŒ·

FancyPants54 profile image
FancyPants54ā€¢ in reply toAmazon07

My HRT is good. It's just a minor adjustment. The first 2 days of dose reduction landed me with a migraine but that's normal for me. I always had 2 day migraines before a period. It's as the oestrogen drops. But that's settled now and I feel fine.

Yes it's normal. Patches don't necessarily give consistent dose whatever your GP thinks. It can absorb differently on different skin. I got a big dump on the day I changed my patch and then ran out before next change day. The same happened to me with gel. I could feel the hit and the drop. Spray is more even for me but we couldn't get my blood levels high enough with only the spray (partly because some of the spray devices don't work as well as others!) so we added in the Bijuve, which was a game changer for me.

Experiment. What's the worst that can happen? Not much. Just make sure you don't run out of patches before you can get the next lot. If you cut them in half, remember to cut down the length of the patch so that you can still peel the backing off! I got that wrong first time.

I'm certain that your carb needs and mood will settle when you have enough hormone. Both are good indicators of dose. Especially mood. For me, anxiety was a sign I needed to drop back at first. Now my indications of too much seem to be leg pain and fluid retention. Much like the build up to a period.

Amazon07 profile image
Amazon07ā€¢ in reply toFancyPants54

Thank you so much, thatā€™s so so helpful! šŸ™šŸ¼šŸ’

I have enough patches but yes, might need to cut 1x 50mcg patch, thank you for the cutting tip!!

I know what you mean re absorption from patches! Maybe this is hideous but Iā€™m worried about showering and having a bath has gone out the window, because the patch seems to come off, even though itā€™s supposed to be waterproof!

Iā€™ve not heard of Bijuve, is that an oral oestrogen-progesterone combo?

I am really not good at telling if my emotional symptoms come from low hormone levels!! I have no idea how to tell! šŸ™ˆ

FancyPants54 profile image
FancyPants54ā€¢ in reply toAmazon07

It's early days for you yet. But you will get the hang of being able to interpret your emotions and what's causing it over time in the end. Don't worry for now. Your patch dose is low. Try an increase.

I could not keep the patches on properly either, which makes a mockery of the dose. So I covered it with this amazing stuff. Well, as my preferred place for my patch was my bum, my husband had to apply this as there are so many layers to peel off! But it works wonders. I used surgical spirit on a cotton pad to clean the area before I applied my patch and it's cover and also to remove old glue when removing them.

amazon.co.uk/gp/product/B07...

That stuff was a game changer for patch usage for me. It's totally invisible and no amount of baths or showers or swimming will remove it.

Bijuve is indeed the first and currently only combination capsule of body identical oestrogen and Utrogestan.

Jamima profile image
Jamima

Hi Amazon07 - it might be worth asking your gp for a sex hormone blood test and that way you can get a better idea of how much youā€™re absorbing/need to increase. Louise Newson has some good info on her site re. average levels for bone and heart protection. Iā€™m way post meno now but have used HRT in varying doses and types for over 12 years, Iā€™ve never got on with progesterone/progestins and see it as a necessary evil, so you may like to consider a different progestin as utro can be rough on some women, I canā€™t function on it. There are lots of options and routes to consider and also testosterone if your libido/stamina are flagging. Itā€™s probably best not to chop and change too much until youā€™ve got your thyroid stable as thereā€™s interaction between the two. Iā€™m using Lenzetto just now and really like it but itā€™s considered low dose so you would potentially have to use a lot. Oestrogel or Sandrena is another option and many women find better absorption rates with gel. Itā€™s really individual.

dina7 profile image
dina7

HRT has been miraculous for me (better late than never!), my migraines have stopped and I've been able to reduce my thyroid replacement (Metavive). I use the gel so can't advise on patches but would just suggest to increase the dose slowly ('cos you're likely to get a migraine if you do anything too fast). I'm also on testosterone and it does take a while to work out all the right doses, so I hope you can get the blood tests. I see a Louise Newson doctor as my GP refused to give me HRT (though I do now get the gel on the NHS), expensive but worth it as I feel sooo much better.

I would highly recommend the Glucose Goddess Method as that could be a game changer for your moods and get you back to a healthier way of eating. (It's not a diet, you can eat whatever you want as long as you eat it at the right time and in the right order, and take your ACV!)

Sleep is pretty crucial and going to bed and getting up at the same time every day really does help. But I think transitions can be hard for people who've been abused so if you have a partner who could insist on dragging you off to bed, or a friend who could ring you and stay on the phone till you've got yourself upstairs, that could be helpful.

Good luck with getting an ADHD diagnosis, that's not easy but you've done well to get a referral and if you do get medication that should help you feel better too. Unfortunately there's not one silver bullet, it's trial and error and tweaking many things but you'll get there and the better you feel the easier it is to make more changes.

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