Confusing perimenopause experience with Oestrogel

[Dhcdjsjfkcske]

I was prescribed 2 pumps of Oestrogel (the plan was to adjust and add Utrogestan after a month). I posted a few days about feeling awful on it after trying it for 5 days - completely exhausted beyond belief, unable to function in the afternoons. I had to stop yesterday so I could actually get some work done today and feel SO much better off it (albeit less calm than when on it and with a slight headache). I read something that suggested that in perimenopause oestrogen levels can fluctuate so much that a rapid drop (back to baseline normal levels) can cause menopause symptoms such as hot flashes. So by adding to it I might have had too much hence why I felt MUCH worse on Oestrogel. It is annoying that this is no obvious test that can be done to establish oestrogen levels over levels over time and you are effectively trying to hit a moving target in perimenopause. Has anyone had experience of this issue (have symptoms but feel much worse on eostrogel) and how did you deal with it? Seems pointless to do only one pump which I understand is half of a standard dose? Any thoughts appreciated.

Hi, I am on one pump started last Friday. Last couple of days I feel horrible. My body feels heavy and floating hard to describe. I'm so tired and feel completely down. I'm dizzy and just shattered. I'm debating missing it out today, I have a 9 and 10 year old to look after on my own and can barley lift my arms and legs.
But I feel calmer than normal, I really don't like this feeling. I'm scared to drive to be honest

That is exactly how I felt which I wasn’t expecting at all. I could not keep my eyes open from about 3-8pm after taking it at around 8.30am. Tried at night and did not wake up properly until 1pm even after 3 coffees. I work very long hours so am used to the whole spectrum of tiredness and have never before felt like that. If you continue let me know if it gets better. I wanted to try to push thorough but just couldn’t do it and do my job.

Hi, I didnt take it for a couple of days. But felt I really need to keep trying. So I put a pump on last night and my legs and body feel so heavy already.
Its a nightmare not knowing whether it will get better or not

Sorry to hear it Lisaw- I hope it gets better for you. I was mid cycle when I tried and I am wondering whether it may be worth trying again later in my cycle. I definitely feel better on it, it is just the exhaustion/jet lag feeling that gets me. Let me know how you get on.

Im so confused, I had a massive anxiety attack earlier which I haven't been having since starting it. So I put the gel on and I think it helped 🙈
But still exhausted, and drugged feeling that I can't stand. I do see sone benifits though, I even look better. I'm just going to take it a day at time for now.
Maybe worth you giving it a go, on the first day of your next period might be best to start it.
Good luck and let me know how you get on

It's really hard to know why this would happen @Dhcdjsjfkcske and @lisaw75.

Not dismissing your experiences, but it could be coincidence (ie you'd have those symptoms anyway as part of peri) or even a 'nocebo' effect (where people experience negative reactions as a result of anxiety over something.)

The amount of estrogen in 1 or 2 pumps of gel is very small and it doesn't have an instant effect (ie as you'd get with taking a pain killer or something.) That's why the advice is to wait at least 3 months to allow it to get into your system.

I've used it for almost 14 years. I don't recognise any of the symptoms here, all I had was 'morning sickness' feelings when I increased from 1 pump to 2. I sorted that by splitting the dose morning and then bedtime.

Now, I appreciate everyone is different but estrogen should not make you exhausted- quite the opposite- it's the 'feel good' hormone.

Also, the amount of estrogen in HRT is never as high as our own when we were fertile and ovulating regularly, so that again shows how low the doses are. (far lower than the Pill.)

I hope you both feel better if you decide to carry on with it.

It wasn't my experience but I had to go up to four pumps to get a good response and still get meno symptoms back if I drop that dose down. However I don't know anything about combination therapies as I don't need the other hormones (had a hysterectomy) - I wonder if you will feel better with the Urestrogen? I don't understand the prescribing regimen but if you need both presumably you need both to feel better?

I was told by a meno specialist to start for a month on Oestrogel and then phase in Utrogestan after that.
I lasted less than a week on Oestrogel until I couldn’t cope with it anymore - I haven’t felt that bad in my life and never have medical issues.
I think my question is whether I need any of it. I was experiencing various symptoms (it was hot flashes that finally made me think it was perimenopause) so I assumed eostrogen levels were low but I have read that you can get those symptoms with large fluctuations that can happen in peri (basically high FH resulting in oestrogen which then drops back suddenly to more normal levels). My reaction to Oestrogel was very odd and perhaps it was because it was topping me up too much. Anyway I feel much better since stopping so I may leave it alone for now and try again when symptoms become more consistent troublesome. The whole thing is a bit of a mystery.

Estrogen dominance is the rule in peri, not a lack of it.

You make less progesterone during peri, which acts as a neutralising agent to cancel out the effects of estrogen...so adding more may not be a good idea pre-menopause.

Google estrogen dominance for more information.

Thanks Cailleach, this is really helpful - I went to Newson and two private gynaecologists with meno specialties and none of them discussed this. Prescription of HRT was based on symptoms (sleep issues, hot flashes, heavy periods, sore joints, anxiety etc) as is in line with NICE guidelines etc but it seems that this issue/the variations at play in peri were not considered as a possibility. it seems that things fluctuate so much in peri that maybe it is a bit all over the place and it is real trial and error

There doesn’t seem to be much heavy weight literature on oestrogen dominance - I am looking for type of level of BMJ, Lancet and medical journals on endocrinology. Is this some type of nutritional theory rather than a condition as such? It does perfectly explain what I am experienced but I like (very, very) hard data. It may just be this is random peri stuff rather than anything else but the mystery remains why I felt extraordinarily bad on Oestrogel. It wasn’t something else (ie a coincidental illness) or something psychosomatic. It was just complete and utter chemical ennervation. Anyway will aim to trundle on and see if I need to try it again later.

@Cailleach

Estrogen dominance is the rule in peri, not a lack of it.

You make less progesterone during peri, which acts as a neutralising agent to cancel out the effects of estrogen...so adding more may not be a good idea pre-menopause.

Google estrogen dominance for more information.

The idea of estrogen dominance was started in the US by makers of a progesterone cream, as a marketing idea.

There are no reputable research papers on it (as far as I know!) and all the websites describing it are American and usually selling supplements to 'treat it'.

It's not recognised medically as a condition @Dhcdjsjfkcske

We don't need progesterone post menopause. The only reason we produce it is to change the lining of the womb to make it receptive for implantation during conception.

The reason it's added to HRT is to protect the womb lining and stop it getting too thick.

During peri , FSH rises, to try to kick start the ovaries into producing an egg. If no egg is released, the womb lining continues to thicken which is why some women get heavy periods when the next one arrives.

If it's not suiting you, just stop. Or reduce to a tiny amount- half a pump- and build up slowly over a few weeks.

@Dhcdjsjfkcske Cross posts! The 'theory' was started by a Dr John Lee US) who used it sell a progesterone cream.