Oral HRT no longer effective, options?

[slidingdrawers]

I'm late 40s. Started on HRT this time last year for peri symptoms. I went on oral HRT (Femoston 2/10) due to patch supply problems at the time. I've found the HRT effective but over the last couple of months many of my symptoms are starting to return, particularly my anxiety and night sweats. My periods are becoming painful and though still regular are lighter. I had horrendous flooding prior to starting.

I'd like to have a think about my options before talking to my GP. I'm aware I'm probably on the highest oral dose which is currently not meeting my needs. I'm happy to consider a consult with a private menopause specialist if necessary.

Could you ask to go on to Oestrogel (transdermal) so that you can tweak the doses? I think it is supposed to be safer, too, than oral HRT.

Thank you. I'm guessing the oestrogel is dosable to higher levels than I'm currently getting via the oral route?

You can increase number of pumps you use; however, I was up to 4 pumps a day with no decrease in my symptoms (night sweats, etc), so my ob/gyne is now trying me on patches. Unfortunately still having symptoms so I'll be trying highest dose of patches next.

The gel (Estradiol) doesn’t work for everyone. It worked for me at first, but then I just stopped absorbing it properly.

I found that as my natural oestrogen levels fluctuated (and finally fell to nothing), there wasn’t one thing that worked consistently. I am now seeing a hormone specialist and take oestrogen, progesterone and a minuscule amount of testosterone in the form of a lozenge twice a day. I haven’t felt this good for years.

I am glad to hear that you are feeling well!! I have days of that too - feeling amazing/light-hearted and like my old self. Then other days where I haven't slept well, am anxious and irritable. (I must be lots of fun to be around lol). I am hopeful to get where you are - hopefully once my own estrogen levels stabilize to whatever and then let the HRT do its thing at a steady rate.

What kind of estrogen are you using?

Thank you both for your replies.

I know the NICE guidelines are not to routinely check oestrogen levels for women over 45. Ibizafun I'm guessing from what you say you are having yours done to guide what will work best for you? Is this is a private specialist you are seeing.

I hope you get a regime that works well for you Chocolatetrufflecake.

slidingdrawers Yes it’s a private specialist as my symptoms were so severe. It’s trial and error.

It might be that you get better results with the transdermal HRT so worth having a chat.
I know that some women are also helped with testosterone. It can be given on the NHS but it's the sort of thing some GPs would prefer to leave to a specialist.
Many GPs will refer you to a specialist menopause clinic if HRT isn't working effectively for you, so it's worth asking that question before you go private.

Thank you. GP has changed me to Oestrogel alongside the oral progesterone so I will see how I get on with that.

@slidingdrawers

Thank you. GP has changed me to Oestrogel alongside the oral progesterone so I will see how I get on with that.

Good luck!