Should I up my HRT dosage?

[GinAllAround]

Long story short, early menopause 4 years ago at 42, HRT since 2021. Main symptom was lack of period and poor sleep but this soon became hair thinning, joint pains, hot flushes and unstable moods too.

I started on 2 pumps of oestrogel which worked well for everything except the hair and the doc suggested I up it to 3 as I'm still under 50. I did this. Then when the gel shortage struck, I was moved to 75mg patches.

Lately I've noticed that my moods and sleep aren't great again, and the joint pain is back. My hair is no better either! My prescription must not have been updated at the GP lately either as I recently received one for 2 bottles of Oestrogel.

I saw the consultant last year who suggested I up the gel to 3 pumps, she did say I could make it 4 if that wasn't working. Would supplementing the patches with a pump of gel per day do the same thing? I'm reluctant to move back solely to the gel as 4 pumps would mean each bottle only lasts a fortnight, and I prefer the convenience of the patches.

Anyone?

There was a 'comment' last week in the press from the BMS which said that some women (not you) are using too much gel given by private meno clinics (above the licensed amount) but also that estrogen products should not need to be combined.

Ideally, you should try to increase your patch to 100mcgs.

This doc shows types and doses- page 3.

www.womens-health-concern.org/wp-content/uploads/2022/11/27-WHC-FACTSHEET-HRT-Doses-NOV2022-A.pdf

One pump of gel is 0.75mgs of estrogen, so it's probably going to give you more than a 100mcg patch.

Maybe try half a pump of gel until you can see your dr and discuss a 100mcg patch?

You can just press the pump down a little way on the gel, or half a single pump once it's dispensed.

I would, I'm on patches and the joint pain was too much, I now use one and a half patches, feel so much better!

It does sound like you need more - but as others have said, this really needs to be discussed with your GP first.

Definitely clear with Gp. BMS is starting to recommend more progesterone with higher patches, worth asking about that. (300 cyclical, 200 if continuous)

Perhaps ask to check thyroid is ok too

Thanks all, that's really useful. I think I was influenced by seeing Davina's Instagram where she puts on a patch and then adds a pump of gel!