Perimenpause - use of EstroGel

[Raddish]

Hello,

reaching out becuase I am having such a difficult time with insomnia due to perimenpause. 20 months ago (July 2021 at the age of 48) I just stopped sleeping. Up all night and very anxious about everything- enough small stuff, and I have never suffered with axiety all my adult life. Within in eight weeks (thanks to friend who is a GP but also specialise in women’s hormones) I got confirmed as being perimenopause with very high estrogen (2325 on blood test) and no progesterone. I was put on Ustrogestan and with in 12 weeks I was stating to feel like my normal self. Fast forward to October 2022 and my insomnia came back. Night after night of no sleep at all. Had my bloods done and on paper my estrogen levels looked more normal and within range at 326. However after no improvement and being told I had depression, My doctor friend (who works at a leading private menopause/perimenapause clinic in London) suggested some EstroGel. Started on 1/2 for a month - no difference. Then 1 pump for another month. Some improvement in mood, but not massive. Then I went up to 2 pumps. Didn’t have any reaction at first and had a week of solid sleep, but then my axiety went through the roof. Panic attacks like I have never experienced, crying out of control, cortisol through the roof, and heart rate racing.

I think that two is too much and I am just going to have to be patient with one pump and given my body time to balance out.

Any thoughts, advice or similar experiences I would love to hear from you. Not worked for five month now and just struggle to even be a mum to me two beautiful girls.

thank you in advance for responsing/reaching out

Rachel xxx

I don’t agree. I have a consultant psychiatrist who has explained the relationship between oestrogen and dopamine. And how my meds and my mental health and overall function is affected by the levels of the two. And it’s blinkered in the extreme to think only supplemental manufactured oestrogen can help. We are one system - diet and exercise and lifestyle is everything in how your body produces or suppresses natural hormones due to excess cortisol or less than ideal choices. I can’t just medicate my way out of adhd anymore than I can hormonal imbalance. It’s holistic. Yes I’m sure some people absolutely do need HRT, but equally this is too easily seen as the solution, when often tackling say insulin resistance is first line in completely changing your body’s metabolic processes and therefore ensuring your hormones are functioning correctly and as a result you feel better. My GP is a metabolic health expert and has put me onto books and so on particularly where mental health is concerned. It all starts in the gut and controlling stress. I don’t subscribe to meds only, despite being medicated! They don’t work well if I put crap in my body.

The link to cancers has been debunked and is very out of date information. It's only if you have a family history and even then some HRT is still suitable.

@Raddish watch this: www.instagram.com/reel/CpTCeUtspgc/?igshid=YmMyMTA2M2Y=

@JinglingSpringbells no, I have been on daily progesterone for the last 12 months after querying it with the GP. My first prescription, and all diagnostic work, was done over the phone in lockdown. I have yet to actually 'see' a doctor about my menopausal symptoms / treatment, but I do feel very well on it.

The NHS has a very one size fits all approach, but issuing progesterone on its own is becoming more common on the NHS as well as privately (I have two other friends who have it on its own) Even the British Menopause Society is starting to advise it, especially for estrogen dominance.

My doctor friend did consult with even our senior colleagues at her clinic and they were aligned - and it did work but now my hormonal balance is shifting (I am moving further down the line)and I need estrogen.

I am having Estrogen now but trying to find the right dose and this balance is proving very difficult. I am having to use sleeping tablets with sleep (been a good sleeper all my adult life until I hit peri-menopause

@Raddish I like to keep up to date with the BMS announcements, so it would be great if you could let me have a link to the info about progesterone being prescribed on its own. That would be appreciated :)

The thing with 'estrogen-dominance' is that all women will have more estrogen in peri as they are not ovulating and the ovaries are throwing out a lot of FSH to try to stimulate ovulation. Post meno no women have any progesterone at all, ever.

Utrogestan affects everyone differently. Many women like it as it is a sedative for them. I hate it, as it keeps me awake! I've never had my HRT from the NHS so don't misunderstand what I'm saying (I'm not just quoting the NHS stuff.)

I'm only suggesting that you might think about reducing Utrogestan rather than looking for the sweet spot with estrogen as they do work in synergy. And the way to find out how much estrogen you need is to use it on its own for a while. I was started on estrogen only for 3 months.

That’s not quite true @JinglingSpringbells . The signs of oestrogen dominance can be seen in lots of lots young women from adolescence… Young women aren’t being taught the specifics about hormonal imbalance and what that looks like and how to regulate their own bodies. Plus low progesterone (mine is) isn’t just down to the fact of ovulation - it’s bad diet, medication, alcohol, gut issues and too much stress before your period - or stringent dieting and exercise and restricting carbs in the luteal phase will stop your body making progesterone as it should. We have to work with our cycles as best we can.

@Raddish another integrative doc suggested cyclogest to me (I can’t get on with Utro) and I might give it a bash. I want to find a combo that I can tolerate bc if I do end up having a hysterectomy (very likely) this year - terrible adenmyosis and 15cm thick womb - then I need to know what I can take if I need it. I want to keep my ovaries but I imagine removing a very large oestrogenised part of my body is going to send me into one. I have no idea.

Which is not to say that HRT isn't appropriate for women but if those patterns already exist it's going I make it harder and possibly exacerbate existing imbalance. Which is why I really like the idea of metabolic reset and then see how you feel and what you need...

@worriedgasper You're preaching to the converted with your ideas about gut health! I'm on the same page- had mine analysed!

Cyclogest is not body identical so if you want to use hrt, bear that in mind.

But I don't agree with you about other reasons for low progesterone- that's pseudo science- sorry. I doubt you'd find any of the UK's menopause specialists agreeing with you on that - the ones doing research and working with women on their heath, not simply following an NHS prescribing script. An awful lot of stuff on the web is not accurate and there are sadly, some private doctors too promoting things that are just wrong.

I don't agree with you. The sad truth is that general medicine in the UK cannot keep up with science. Go listen to Huberman or any other respected scientist in the field of health. And then make your mind up. NHS now only works at point of crisis/ intervention.

@worriedgasper Have I said anywhere that I am praising the NHS or the way it treats menopause? No and I see a private menopause specialist because the NHS would not prescribe off -licence.

The doctors I am talking about are not working in the NHS, solely. I am fully aware of the limitations of the NHS. They are respected, world class scientists, constantly doing research, and menopause specialists with international reputations.

If the point you are making is gut health and lifestyle are very important for everyone and need to be a foundation for everything else I agree 100%.

Please do link to the info about progesterone as a treatment on its own if there are papers on that and statements from the BMS as I'd genuinely be interested.