Do I need more oestrogen?

[Teenthree]

55, mirena plus evoral 100 patches. Still ovulating. I’m getting the most incredible night sweats, I don’t sweat at all in th day, even in the gym and yet I wake up soaked. My sleep is very disturbed too.

Can I take more oestrogen?

Depends… if you’ve been using this dose of patch for 3+ months (following Nice Guidelines to give it time to work) and still experiencing symptoms, the next step would be to see your doctor to discuss. It’s possible you’re not absorbing the oestrogen and your doctor might switch you to a different regime to see if that works better for you for example Oestrogel or do a blood test to check. Note that if in peri menopause your symptoms will still be fluctuating massively.
As 100 patch is the maximum approved dose your doctor is not obliged to prescribe higher, and if other options don’t work they might refer you to a menopause specialist

Thankyou - I’ve got some bloods being taken next week so that should be interesting.

What is a menopause specialist likely to suggest? Can they go off label?

Treatment is first and foremost based on symptoms. If blood tests show you are not absorbing the oestrogen it would probably be first suggested by a Dr or consultant to try a different regime that you might absorb more effectively eg gel, spray or oral tablet. Again 3 months would be needed then reviewed. A menopause expert might go off label after trying this first. It's not really known what the progestogen dose should be to oppose an estrogen dose above the approved max.