HRT for perimenopause and return of symptoms - higher dose needed?

[nonsensicalmess]

Hoping for some advice. After a few years of increasing symptoms like night sweats, flushes, emotional swinging and irregular bleeding, a hormone test at the beginning of this year confirmed my estrogen levels were low and confirmed suspicions that I was perimenousal (at 40 ). I started femoston 1/10 and within a short space of time felt like a new woman.

Over the past three months I’ve noticed that in the run up to the bleed (a few days after the tablets with progesterone end) I’m getting a recurrence of my old symptoms. I’m waking at night with sweats, am hotter during the day, fatigued, skin breakouts etc. Is only the week before I bleed. Is this common? Does it mean I need more oestrogen? Had really hoped I’d get away with low dose for longer. Any advice appreciated so I can be as well informed as possible before speaking to my GP.

Just bumping this in the hope I can get a few responses!

Because you are so young (40?) this is classed as very early and you are likely to need a higher dose of estrogen than older women.

The progesterone in the 2nd half of the cycle (HRT cycle) can 'negate' the effects of estrogen BUT there is no point holding out on the low dose if it's not suiting you.

There is no virtue/gain by using lower doses.

My meno consultant told me to use HRT 'properly ' - to get results otherwise there is no point.

Why are you worried about a higher dose? It doesn't mean there is added risk and at your age the risks don't apply anyway . They only start to be an issue for women in their 50s who are post menopause.

Have you ever formally had menopause verified? Do you know for certain that your ovaries have stopped producing oestrogen? (Blood tests & ultrasounds required.) You may very well be perimenopausal in which case, the medically protective benefits of oestrogen far outweigh any risks (skin, bones, brain, cardiovascular system), but I am not likely to be questioned to the same effect

Yes. I had to have my prescription doubled after six months

Have you ever formally had menopause verified?

The OP says she had blood tests and was shown to have low estrogen levels. She says she is in perimenopause.

Thanks all - yes low estrogen confirmed in blood tests and combined with other symptoms indicated peri menopause.

@jingling - I guess the reason I was hoping to stay on a lower dose for longer was to give me leeway to move up incrementally as needed. Maybe further increases won’t be needed for a while though.

I'm newly on HRT & finding some of those issues in the run-up to the bleed, and some problems with progesterone. I think you're correct to discuss increasing the dosage

I think you treat as you go. It doesn’t necessarily mean that you will need higher levels.

As I understand it during peri your hormones are up and down but on an overall downward trend so it's pretty normal that the dose might need adjusting.