Is this a normal reaction to oestrogel?

[Castaspella]

Day 4 (yesterday) of just one pump (was going to move to 2 on day 7). Awful migraine, worst in years and hideous left breast pain. Is this normal on adjusting? I began taking the gel first day of my period so am also day 4 of cycle.

I’m worrying that maybe i don’t need hrt after all and what if I’m doing myself harm by taking it when I don’t need it. I’m on the younger side (43) so had to push. Symptoms mainly exhaustion, brain fog and low mood

I felt awful with the gel but much better with the patch. I think it gave a more consistent dose. That said it normally takes a few weeks to get used to any HRT and for side effects to stop/symptoms improve. I was only 41 when I started it and glad I persisted with it.

I also reacted badly to the gel but was fine on the patch.

I don’t do well ok the full dose (2 pumps) of gel, by day 4/5 I get headaches, breasts are like melons, I feel jittery and anxious.

I have found that I can tolerate about 1/2 a pump daily and that’s about it. Any more and the symptoms come back

It’s good you can adjust the amount with the gel without doing anything with the progesterone. I really hope I adjust - I desperately want it to help me feel better not worse!

There shouldn't really be any difference between a patch and gel as it's exactly the same type of estrogen. So I'd not consider swapping (yet) OP.

Why not reduce the pump by half? You can just press the plunger halfway and use a tiny bit. (That's what I was advised by my consultant.) I did that for a few weeks.

I'd also not rush to move to 2 pumps. Definitely not after 7 days. You need to allow a few weeks before increasing.

Are you doing other lifestyle things to help- exercise, good diet, etc etc? HRT helps but it'll work better if you can work on your exercise, diet etc.

Thanks for this @JinglingSpringbells, really helpful. I presume I don’t have to reduce or do anything with the progesterone if I’m reducing the gel? I will delay 2 pumps given what happened yesterday I think.

i do quite well with my diet but I must admit that as I have my period I’ve been a bit rubbish with sugar this week. I tend to eat lower (but not low) carb and I do intermittent fasting when routine allows along with 10k steps a day (though missed that on my heaviest period day.) open to hearing anything that’s worked week for you! So much to learn and try but I’m hopeful the end result will be positive 🤞

You don't need to do anything with the progesterone when you reduce the gel.

There are many options which, sadly, most GPs are not aware of yet you might benefit from (usually available from a specialist or well-informed GP.)
For example, for women who don't get on with progesterone (ie have side effects) there's the option of taking it less often (called 'long cycle') .

When I started HRT (I was early 50s) I was on estrogen only for 12 weeks to get the dose right. This was with a private menopause specialist.

I'm not suggesting you try this as it is done with medical supervision, but mentioning it in case you find you have any problems so you can consider seeing a specialist privately to tweak it all.

That’s really helpful, I appreciate the advice. I must say, this experience with the gel is making me nervous about the progesterone so I’m happy to know about the “long cycle” strategy - if I have problems I can ask my GP about it so thank you

Just an update to say I woke at 5 this morning with what I thought was a migraine but doesn’t seem to have developed into one..yet. But one thing I have noticed (maybe it’s just a fluke) is that my skin looks so much better and I look less washed out and tired, despite the migraine. Maybe that’s nothing to do with it but …