How do I know if I need more estrogen?

[WhereAreWeNow]

I'm 46 and I had a mirena coil fitted in October and started on Evorel 50 patches at the same time.
The GP wants to review the prescription at 3 months so I've got an appointment coming up. I'm wondering if I need to ask for Evorel 75.
Overall things have improved for me since starting on the mirena and evorel. I'm less anxious and I'm sleeping better. I feel less like a dried up husk of a woman which is how I felt before.
But my sleep is still far from good and my mood is still quite low. Also I've got a few side effects that I think mean I've got too much progesterone: sore, bigger breasts, greasy hair, spots. I know it takes a while for the mirena to settle so maybe I just need to give it time. Or maybe I need more estrogen to balance the progesterone.
I'll ask the GP what she thinks but interested to hear how others have got the right balance between estrogen and progesterone.

TBH there is answer to your question other than 'experiment'! Your GP certainly can't tell you what to do as she isn't you.

You need to increase your patch and see if that helps. If it does, great.

But it's also worth looking at everything else in your life that can help low mood, like daily exercise, stuff like mindfulness and meditation, yoga, and doing something every day you enjoy. There is also a big drive with MH issues to practise gratitude each day- listing all the good stuff in your life :)

Sorry- don't mean to sound blase. I've used HRT for over 12 years and adjusted the gel as I needed to. I started on 1 pump, went up to 2, and now I'm back to one and a bit pumps. 1 pump suits me fine (that's about a 25mcg patch) as I'm very old, but I need a bit more to control night sweats.

Thanks @JinglingHellsBells. I do exercise and try to do things to improve my mood.

After a frustrating conversation with the GP receptionist this morning, I've just got a text saying they're sending a repeat prescription to the chemist rather than giving me an appointment for a review. So it looks like I won't be able to try a higher dose.

Why would a receptionist be so aware of what you wanted? Did they pass on your question to the GP? Could you not try e-consult so you can set out your question, without it going through a receptionist who may not pass on what you really said?

If you can, it's possible to cut the patch in half so you could do that and make it a larger dose. Obviously you would run out sooner so depends on how much they monitor your repeat requests.

Good questions. They're impossible. I'd already tried an e-consult form before calling. I might try adding an extra half patch. If I feel better on that then I can try again to speak to the GP to request the Evorel 75.

Instead of experimenting on yourself, get Hormones's test privately. You don't need to go to an expensive private clinic, but get test from the lab. I am not sure if I can say any names here, but I always use Medichecks. Register, choose which tests you want, pay and they will send you blood test kit. Choose finger prick test, not venous, do it at home and post it back to them. It is really that simple. I have done mine last year and went with the results to my GP, who acknowledged them as this company is well known and reputable. There are many more labs doing all sorts of tests, too. Medichecks even send drs report with your results email. Tests are not even that expensive- £60-£100.
NHS became like a shop: you need to know what you want before going to see your GP. Otherwise, you will end with antidepressants or a packet of paracetamol.

@primarium is this something you have done for yourself? why and what was the outcome? If you had them done for peri to 'prove' you were in menopause, they are in fact very unreliable. NICE does not approve of blood tests.

I had one blood test (not for menopause but hormones were part of the testing) and it was completely inaccurate which my specialist knew may happen. Classed me as post menopause 18 months in fact before I was!

Unless you are sharing the results with a menopause/fertility specialist, having the tests done is pointless. And finger prick tests are no good.

Drs will say increase or decrease to see if that helps.

Jingling, I did not do test to prove peri menopause, I did hormones' test. It was to check different hormones. And I had to do it at certain time of the months, I think, just after my period- but I can't remember exactly.

I'd been wondering this. I think I'm going to ask to try 50 after this trail of 37.5.

How do you know if you're on too much @JinglingHellsBells? What made you reduce?

I'm wondering if I should try the gel because it would be easier to experiment with dosage than with patches.

Update: I cut an Evorel patch in half on Saturday and used one and a half patches (so 75) and I do feel better. I'll try again with the GP to see if I can request the 75 patches.