Anyone else on oral oestrogen?

[CuriousRunner]

Can you tell me what you were told about the differences/risks etc? Why they are taking tablets etc?

There is NO QUESTION of me not taking them. But I didn't take much information in during my last appointment ☹️

I was using 2x100mg patches. But my blood oestrogen levels were STILL through the floor. And my symptoms were still unmanaged. So we've switched to 2mg or oral oestrogen. Symptoms no better and blood oestrogen only picked up A LITTLE. No really, levels are only a tiny above the average level for a MAN!

(Preemptively mentioning to those who want to talk about that blood tests aren't useful/recommended . They aren't useful for DIAGNOSIS. But they are useful to see therapeutic levels/impact. AND levels change a lot in PERI menopause. The other side of menopause and blood tests are more stable)

Interested to know how and why you ended up on oral oestrogen. What dose you are on because I'm assuming that many folks have also tried and not got on with transdermal? What were you told about the risks? I'm broadly aware of increased blood clots, but I'm active and healthy. I don't think this kind of oestrogen is "body identical".

(Today I am NOT COPING. And the long slow process of finding the right type of hrt and the right dose is pushing me to the edge ☹️)

Wasn’t given an option. Heard the patches aren’t very good for staying on.
Maybe just cause it is summer at the mo! I find thigh chaffing worse then ever this year, whether I’ve put a few extra pounds on and that’s maybe not helping.

Just do one pump of the estrogel AM and take progesterone capsule evening.
Could go up to two pumps before the next review but I’d rather have the bigger dose of Progesterone.

Our surgery doesn’t blood test. I’d have deeply love to have seen the pregnancy blood test carried out before the hysteroscopy procedure.

Read the risks but really feel it is helping overall.

@CuriousRunner I posted this last week. It does confirm that testing estrogen when on HRT is not helpful.

Sorry you're feeling so down. How long have you been on HRT?

Were you given 2 x 100mgs patches by the NHS?

(It would be considered outside of licensing unless you were given a corresponding dose of progesterone.)

Following on from numerous posts about testing estrogen levels, this is the recent statement by the BMS on this.

There is no recommended systemic level of oestrogen in association with use of HRT and response to treatment with HRT should be based on symptom control.

Checking serum oestradiol levels is influenced by many factors including the timing of the dose and type of assay and cannot be assumed to be indicative of levels over a 24-hour period.

[In other words, you'd need to be constantly tested over 24 hours to see the overall level of estrogen.]

Routine testing of oestrogen levels is unnecessary and is associated with an unnecessary cost both to the NHS and patients in private clinics.

Oral estrogen is associated with blood clots but far fewer than the Pill.
The reason is it's absorbed through the liver first and this can change the lipids in the blood, making clots slightly more likely.

There are many women quite happy on tablets but the overall advice is to use transdermal which doesn't add extra risk.

The only thing to consider is that tablet form is often harder to absorb as a lot is lost in digestion. So from a 2mg tablet not all of that would be utilised.
Are you using a continuous combined type of one with a separate progesterone?

I take Tridestra which is a 2mg oral tablet of estrogen, this is taken for 3 months followed by two weeks of progesterone followed by a withdrawal bleed.

I’ve had patches and gel, but don’t get on well with progesterone, so with Tridestra I only have to take the rotten hormone once every three months. I found the patches to be fine, although I’m a bit forgetful and would mess the days up for changing it 🤦‍♀️. The gel irritated my skin due to the alcohol in it.

I would sooner have a patch, but can’t follow the Tridestra regime with it, as I presume the trials just haven’t been done. I wish I didn’t have a uterus, that way I wouldn’t need progesterone. I dread it, my husband can’t believe the person it turns me into, and this lasts for 3 weeks in total, two weeks of taking the shit then the bleed, which is bloody painful.

I need the HRT, I have vaginal atrophy that will never go away and estrogen helps dampen inflammation. I also have M.S and was much worse without the HRT.

I’m aware of the blood clot scenario, but I’ve never smoked and rarely drink alcohol. In fact my yearly intake is probably my weekly allowance. I follow the intermittent fasting diet, which has enabled me to lose my menopause weight, it’s wonderful and I’m never hungry. I also take Tostran testosterone for energy and libido, I’m all sorted, it took about 4 years to get a suitable regime but I’m happy with it 🤗

Thanks @JinglingSpringbells

Let's agree to disagree on the blood test front 🤣 For me they confirm at the moment how I'm feeling.

I've been on hrt for about 4 years. But things have gone seriously awry in the last year. And since Feb this year we've been trying hard to find the right dose/ treatment

All of my hrt has been privately prescribed. The 2 x 100mg patch also. I knew that it was "off licence". And we'd spoken about the progesterone approach (which the doc had peer reviewed). But for whatever reason the patches weren't being absorbed. Hence shifting to tablets.

And now I'm taking 2mg. And still feeling RUBBISH.

AND I've got testosterone cream ready to go. But we've agreed that I won't start using it until we've nailed an oestrogen approach. (The same technique I use in engineering troubleshooting....only change ONE THING at a time 🤣🤪)

Hi @Snippit thanks for commenting. I was half listening to a podcast today. And I'm sure I heard something about MS and menopause. I think the comment was that HRT was hugely the right/better answer. (Sorry. SO vague!) Have you also got vaginal oestrogen?

@Snippit Just to add, you can absolutely create a 3 month cycle on gel or an estrogen-only patch and a progesterone. I did this for 6 years (and am still doing it now although shorter than 3 months.)

You won't have this option with a GP as it's off-licence. I see a private gynae so if that's an option for you it's maybe worth considering.

I'm crossing my fingers for you @CuriousRunner that the tablets work.

So sorry you’re struggling. I wasn’t properly supported to know the risks on oral oestrogen and despite no history of breast cancer in my family, was diagnosed with it recently. The oral hrt I took was a risk factor. I am sorry to raise it but it’s not something I was warned about or counselled on.

do please ensure you’re properly advised. The mental health side is so very important too, which hrt helps with greatly.

I don’t want to upset people but just wish I had been told and had had better hrt support.

@Bimblesalong I'm really sorry to hear of your diagnosis.

I wonder who told you that there was a difference in risk with tablets and patches/gel?

The difference appears to be the type of progestogen, whether it's synthetic or body-identical. There is a table of 'risk' for the different types.

Women using only estrogen have a reduced risk of breast cancer (even if it's a tablet form.)

I wish you all the best with your treatment and recovery. x

Thanks. A doctor friend (who I trust) told me as did my surgeon that the hrt I had taken orally increased the risk. I’ve also seen it in the risk factors on cancer websites. I know bioidentical topical is better but it was never something that was discussed with me.

I was told that gels would have been better as they are localised rather than the oral tablet that is systemic.

my cancer is oestrogen sensitive cancer.

thank you for your kind words and kind wishes.

Thankfully I can get away without vaginal estrogen, 🤪

I thought you could, I have seen a private menopause specialist and strangely she was unsure about this. Her suggestion was to have an trans vaginal ultrasound in the beginning and to monitor, I have lost confidence in her. She isn’t a consultant, she’s a menopause specialist Dr who used to run the NHS menopause centre before the funding was pulled, so I think she’s still kinda following NHS guidelines.

I’m ok on Tridestra, but my only issue is that it has lactose in the ingredients, I know progesterone does as well, and I’m lactose intolerant 🤪. With the progesterone I don’t take it every day, unlike the estrogen. So I’m taking some tablets that help my body to digest the lactose. Why would anyone put lactose in a tablet 🤷‍♀️. It’s been such a battle, but I can’t give in, it gives me a quality of life 🤗