Help. How do you know if HRT dosage is too low?

[Chocogoingcuckoo]

Hi all,

I'm 35 and peri-menopausal due to premature ovarian failure. Been on femoston 1/10mg since mid 2014.

Seen the practice nurse today for B12 jag and she was saying she reckons I should be on a higher dosage of HRT because of my age. However, the doctor has previously said I should try coming off them because of my age?!

As soon as I get midway through a months supply I am majorly irritable, sweaty, mood swings, emotional, small things are magnified. I also get brain fog.

Any advice would be great thanks!

I thought the advice for women who'd had a surgically induced menopause was to take HRT until roughly the age of natural menopause (round about 50). NICE guidelines here - though I can't find anything about surgically induced menopause

You might find the menopause matters website helpful too.

My old GP was happy to up my dosage when I complained I was starting to get hot flushes again (age-related rather than surgical menopause) - in fact he said his experience was that the low dosage treatments rarely worked, even though it was the default to start with. (My new GP sadly is already making "review your HRT" noises ).

Thanks Hedgehog, mines isn't surgically induced just bad luck unfortunately. I'll have a gander at the links thanks. The nurse made me a docs appointment for next week to ask for a higher dose.

The dr who says you should come off it ought to be shot. What planet are they on FFS! The advice is to stay on it till 52 at least with POF- any muppet knows what! It's all online.

Yes, 1mg is unlikely to be enough for you as at your age you should be full of natural hormones. I'm on 1.5mgs and am much older than you.

Look at the Daisy Network website- run by consultants who specialise in POF.

Haha. Thanks will have a look.

Update. Doc doubled my dose (under duress from the nurses advice, he didn't think it would make any difference). Now taking Femoston 2/10.

Any ideas how quickly I will feel the benefits?

You risk osteoporosis if you stop the oestrogen before you are 50. If you have your womb you still need to take progesterone for 7-10 days a month to protect you from endometrial cancer. And after three days or so of stopping the progesterone, you might or might not bleed. If you don't it's not a worry but you are giving your body the chance iyswim.
Are you on tablet hrt? Is it combined oestrogen and progesterone? You can get gel form - oestrogel which is better absorbed and stops it going through the digestive system so limits some of the potential problems of hrt. Or there are patches. Both are better than tablets and better for your health.

Just checked and femoston are tablets. ( They also are a split pack, some contain just oestrogen and some have both oestrogen and progesterone so you are fine there and not at risk of endometrial problems. )
I'm on oestrogel and on four pumps a day, each pump has .75mg. So 3mg a day.
You are on 2mg so you have room to manoeuvre. But you can go up steadily in dose if you need it when you are used to 2mg.
More importantly is going back to your GP and asking to go onto a gel or patch. I've tried both and prefer the gel. The tablets are not bio identical and generally considered quite old school and not the best now. The gels and most patches are bio identical.

NB. You will need to make sure then though that you get progesterone to protect your womb - ultestogan is a good one and is bio-identical too

You being so young really need the best available as you'll be on this stuff for a good few years like me at 42.

Oh, and and finally, I take it the b12 is for pernicious anaemia? If so, it is an autoimmune disease and POF can be caused by an autoimmune response too. I have an underactive thyroid and hashimoto's and various other autoimmune probs too. It would be well worth keeping a check on other autoimmune conditions that might present. Like hypothyroidism and diabetes. Don't want to worry you but worth saying.

Patchouli- just to add, the oestrogen in Femoston is almost the same sort as in gel - estradiol. The progestogen is dydrogesterone which is close to our own progesterone and not that different to Utrogestan. In women under 50 there are not the same risks using tablets as there are in older women. The main risk of tablets are potential blood clots which are rare in young women anyway. Not disagreeing with you per se, but just don't want the OP to be really worried.

Thanks for the info.

They haven't figured out why I need B12?!
They've ruled out anemia and gastritis but that's interesting that POF can be caused by an autoimmune response, I didn't know that. Still amazes me that doctors don't look at the bigger picture. Will point this out next time I'm in.

Hi, I have the same problems with Femoston. I have also POF. May I ask how you are doing right now with the higher dose? I am using Femoston 2/10 but symptoms keep coming back in a cyclic pattern including migraines.

Hi there,im new to this n wow reading through alot of posts i can relate to alot after being in denial about menopause for months,i recently was prescribed 2mg elleste duet and tbh sat looking at the box for atleast 2months tln myself its not happening and i can cope without these,how wrong was i,im 48 on saturday and surprised my partner is still here with me,moods jeezo,up n down and stressing over the slightest of little things that would normaly not bother me,i feel miserable,had a very active sex life till recently were i just cant be bothered atall,i went back to gp yesterday who has told me im defo showing all the symptons and must start taking the 2mg dose one a day asap,but what she didnt advise was,when is the best time of day to take this tablet,i have my wee grandaughter this wknd so dont want to start them today,might sound silly but im so fearfull of these and in fear of any side affects but also know i have to start them wich i plan to do fresh start monday of nxt wk once wee one is away,can anyone tell me roughly how soon they will start to take affect?,and is it better to take it in the morning,just want to feel myself again as so depressing,slight sweats not to bad,(were trbl cpl mnths ago,but settled),more mood and trbl fatigue,felt so alone in this until reading other ppls views,and also started acting as if i have ocd with certain things as my partner put it,just want the old me back again instead of the angry hermit ive became as hate going out now also,was out with dogs other day n a lady approached with an agressive dog and to cut a long story short,it led to this woman being abusive n jeezo i felt the anger feeling building in me then i turned abusive towards her to point it was like a bitchfest over bloody dogs,but point being i could feel myself esculating that feeling of rage was building again so i walked away,so much going on and im being told i need to take this elleste duet and everything will return to normal,sounds like a wonder drug with risks to me but if it helps ease all these symtons then monday nxt wk it is and ile see how i get on as i just cant carryon being miserable like this anymore,my family have ntcd a big change also n just want to help and see me back to the usual funny witty person i once was,sorry for going on n on

Why won’t you take your hrt Bilo? What’s your fear, it’s only bringing up levels of existing hormones.

When i started oestrogen only hrt I felt better within days.

HRT is not like taking paracetamol; it doesn't work within hours. It may help you in a week or so but the rule is to give it 3 months.

You are unlikely to have any side effects in the first 14 days. Some women find they get PMS or feel low when onto the 2nd half of the tablets which are like the progesterone part of a normal cycle. However, don't go imagining problems that aren't even there. You may have no side effects.

There is no benefit in waiting till Monday. Just start today. It doesn't matter when you take them- daytime or evening.

I’m 52 this year taking Evorel Sequil
Patches Nearly a year. Found it fantastic at the beginning but getting the symptoms had before on it again. Achy joints night flushes tiredness. Do you think I need to up my dosage?

Is this thread still activ

Pollyperky ....you seem to know what you are on about when it comes hrt...would you be willing to give me some advice?

@Satch123456 ive only been on oestrogel x 2 pumps for 6 months going great but then some symptoms have come back anxiety being one of them , I visited Dr Louise Newson clinic this week and they have advised to go to 4 pumps, your own oestrogen levels flutuate and drop apparently which is why we get returning symptoms until you find the right dose and type for you . Have a look at the website and instagram she has soooo much information she is doing amazin things to help educate GP's Newson Health is the clinic website and she also has one uner menopause_doctor. Take a look. im hoping my extra pumps put me back on track x :-)

Hi all. I am completely lost in myself. My anxiety is through the roof! I have just been told to increase oestrogel. How long roughly will it take for improvement in my anxiety please?

Need help please at a loose end to whats happening hope some one can advise me. Been on estradiol pessaries for a full treatment have surve burning been but on kilovance been taking them for 17
days and the burning is so uncomfortable

@PollyPerky
Was just having a read through the menopause posts you seem to be very clued up this I need some help with my own menopause if you could oblige.
Thank You in advance
@CFergie