to be concerned re SKY HIGH oestrogen levels (on HRT)?

[Hedgehogscanclimbtrees]

I had blood tests recently for something and, since GP had recently prescribed low-dose testosterone to add to my HRT regimen but I hadn't started it yet, I asked if they could check my hormones at the same time (so we have a baseline).

My oestrogen levels have come back at 3,782. Apparently post menopausal levels are normally under 500

When I queried this, the receptionist expressed surprise and said she'd get the surgery's pharmacist to call me. A week later I got a call from said pharmacist. He seemed surprised at 3,782 but said "it's probably just due to your HRT" (I'm 53, been on HRT about 1yr: 4 pumps oestrogel + sequential progesterone) and "probably best to reduce to 3 pumps". No suggested followup with GP.

I am worried about such a high level. Doesn't it increase the risk of cancer? I had (have?) an ovarian cyst, can that be connected/aggravated?

What sort of things could cause such a high reading?

What would be appropriate investigation?

I would be getting retested to make sure there wasn't some sort of error with that high a level. Did you get your levels checked as you increased doses up to 4 pumps? How much progesterone are you on, I presume you are still perimenopausal

I'd be worried too.
My friends and I are all on 2 pumps of oestrogel... 4 seems like a heck of a lot!

Do you have high oestrogen symptoms, like headache and sore boobs?

4 pumps seems a lot. I’m on one pump and it totally eliminates hot flashes, sleep issues and dryness. Were you advised to take so much? Or did you feel you needed it? Are you on continuous or cyclical hrt?

Googling suggests making sure the test is not from the same limb as the drug is applied to and to take bloods either before applying or over 4 hours after trying. I would suggest repeating bloods taking this into consideration first.

@benefitstaxcredithelp I was started on patches, then gel - three pumps, then told I could go up to 4 pumps after 3 months. I was on 4 pumps for a while before this bloodtest (so hadn't just gone up recently).
The progesterone is cyclical: 200mg on days 1-14 every month.

@TheFreaksShallInheritTheEarth No headaches or sore boobs. But losing lots of hair in shower, could that be connected?

@MILLYmo0se No they didn't test levels as I went up, should they have?

This sounds daft but I don't really know if I am perimenopausal or properly menopausal since that bleeds you get when you stop the progesterone on days 15-30 are apparently 'fake periods'

Wow that's useful to know, thank you

Normal (if there is such a word with menopause) is 2 pumps of gel, 100mg of progesterone - if taken continuously.
if you increase your gel to 3 or 4 pumps then you can take 200mg of progesterone.
you seem on a high dose of gel and low dose of progesterone (assuming it’s continuous - I think the dose changes if you still have periods)

id ask for a repeat blood test and in the meantime speak to your Dr about the dose to confirm it is right for you.

Why did you go on HRT in the first place? Were your symptoms not resolved with 3 pumps daily?

We don't routinely test oestradiol levels but I would want you on 300mg progesterone daily on 4 pumps, or discuss reducing your oestrogel dose depending on your symptoms.

@RunningJo That would fit - I've checked back &, after patches (which included progesterone) I changed to gel at which point GP prescribed 200mg cyclical progesterone alongside 3 pumps, then 4 pumps.

If symptoms (hot flashes) are under control - then what is the optimum oestrogen level for a woman on HRT (for maintaining bone health, preventing cognitive decline etc)

@@Sidge I went on it primarily for hot flashes

I am a bit scared now, it sounds like I have been on too much oestrogel & too little progesterone

I’m honestly not sure what the optimum dose would be, everyone is so different as well, so what suits one person, may not suit another. I’d definitely pop back to the Dr to discuss it.
It may be that this is your perfect dose for side effects etc but if you ask the question at least you know.

The optimum dose is one that is the lowest dose possible to control your symptoms. So if you have 2 pumps daily with no hot flushes etc that's OK. If you need 3 or even 4 pumps to control your symptoms that's OK but you may need more progesterone.

We don't prescribe above 4 pumps daily and would refer.

No you don't have to have the levels checked as you increase, just wondering if you had....
Did you apply the gel to your arm before the bloods were done?
Why was the gel increased to 4 pumps, was 2 or 3 not sorting symptoms?
Were you perimenopausal a year ago when you started HRT? That would explain you being on cyclical rather than continual progesterone, but afaik you can change to continual after 12 months on HRT. For 4 pumps of gel it would be at least 200mg of progesterone every day when taking continuously so I don't think you are on enough now if its 200 for 15 days of the month