There's an hrt injection?!

[BrassicaBabe]

So quick back story. I use a lovely private medic. I've been on patches since 2020. Over the years I've upped my dose at various points. The last 9 months I've had a TERRIBLE ride with mental health. In Feb my patch was upped from 75mg to 100mg. In May it was upped to 200mg after blood test results showed my oestrogen was still very low. I believe over 100mg is "off licence". But my blood test results showed that my oestrogen was sufficiently low to warrant it. (Poor absorption?).

I'm feeling a heap lot better than when I was using the 75mg patch. But I'm not yet "normal". There is still a way to go. So I've started googling about oral oestrogen. I'm starting to think that for better worse oral oestrogen might be better. But Google throws up injectable oestrogen. I did not know that. Anyone have an opinion on this?

(I tried the spray but that gave me migraine. Each and every day)

Umm. That was long way around to ask a quick question.

I don't know if this works for HRT but it does in pain management so might be worth trialling. Have you come off it all, had a rest, then tried again? If you have what happened?

Oh heavens. Joking. Not joking. I think if I came off the patches I'd be suicidal.

Is there any chance you mean the implant rather than an injection?

Can you link to the info you found?

@BrassicaBabe

Read a wide range of options - just increasing the dose may not be helpful, in fact reducing it can counterintuitively help. I would definitely consider getting a second opinion - remember your private doctor gives you what you want to keep your business

@BrassicaBabe I've had a quick google and it doesn't seem to be advantageous in any way even if it was available. It's an injection that has to be given weekly or monthly (so not something you'd want to be doing to yourself, presumably.)

What dose and type of progesterone are you using when you're on such a high dose of estrogen?

Has anyone discussed your mental health and whether it's directly related to hormones? Are there other measures you could use rather than just adding more estrogen?

Also (very important point) my private consultant (who is a hormone expert) says that tests for estrogen when using HRT are useless (they don't do them.) They told me that to be accurate, an estrogen test has to be done over 24 hours as the level fluctuates by the hour.

So I'd question if the advice you're being given is the best.
I don't think any dr is unethical enough to offer something just to keep you paying to see them, but there are different opinions and levels of experience.

@JinglingSpringbells interesting. Thank you. The injection question came after a quick google to be honest when I was reading about transdermal vs oral oestrogen. And I was researching because of what appears to be poor absorption with the patches. I am as certain as certain can be that my MH struggle is linked to menopause. When I upped the patch from 75 to 100 I felt better (incrementally only) within days. Yes, I agree; I'm confident that my doc isn't prescribing just for the cash.

How much progesterone are you using?

That's a huge dose of estrogen. The BMS guidance is 200mgs a day for women on 100mcg patch so you would be doubling that!

I'd query the blood tests.

They are rarely accurate.

Talk to your GP and ask to be referred to an NHS specialist who will give you completely impartial advice. If you're this sensitive to your hormones and need such a high dose it will need continuous monitoring and many GPs don't do that for private prescriptions.

There is also an implant, my mum was on it back in the late 1980s. Her GP had an interest in surgery so he did the implant every 3 months.

It's worth talking through all your options.

Are you taking testosterone?

Have you tried gel ? I wasn’t absorbing from the patches so switched it gel and it worked.

There aren't NHS menopause specialists in many areas and even if there were, the wait could be months or longer.

As the OP is seeing a private doctor, they would organise /do the blood tests. There seems to be a scepticism on this thread about a dr working privately being biased or working unethically. Not sure why.

Scepticism isn't my concern, getting the prescription on repeat and making it sustainable is.

I don't understand what you mean.

If someone sees a private consultant, the prescriptions come directly from them, in the post or at the appointment. It's a private prescription.

I’m a ‘non-absorber’ so I have an oestrogen pellet inserted every six months at the menopause clinic of our local women’s hospital. Tbh it only works for about six weeks so I use gel again as soon as I start feeling a dip even though it’s a bit of a waste of time, it’s better than nothing.