2 to 3 pumps oestrogel

[cocopop100]

I've been on 2 pumps Oestrogel for about a year. I just had my bloods done and my oestradiol is 113 (I'm post-menopausal - no periods). This seems a bit low from what I've read so decided to increase to 3 pumps. I'm only 4 days in but feel really groggy and have a constant headache. I just wanted to know if others have had these symptoms and how long to give it to see if things get better? I read six weeks but wonder if others might say they tended to feel better in a shorter time period, and if I feel rubbish maybe it's too much estrogen for my body? Thanks so much for your advice and thoughts

Surely you should be asking your GP? This is serious stuff - your hormones. Why would you mess around with advice from strangers on the internet?

I’m not asking for medical advice - I’m just asking if anyone has any personal experience of this specific increase. If you don’t please feel free to ignore this post

I do have personal experience; I take oestrogel.

I think the goal is to use the lowest dose that relieves your symptoms. I’ve only ever done one pump, but then I don’t have any symptoms.

If you felt alright on 2, I’d stick to that.

I started on 2 pumps and went up to 3 when I started getting more symptoms and didn't feel as good. I wouldn't change it if you feel ok. I noticed a difference very quickly 2-3 days.
Are estrogen tests more reliable after menopause or do levels still vary?

Hi op.

I am on 100mcg which is the equivalent of 4 pumps. I am still peri menopausal as I have periods despite my Mirena.

I've never had issues with headaches using oestrogen. I have had headaches from dehydration and currently from taking lots of (prescribed, agreed with GP) antihistamines.

Could the headaches be from stress/dehydration/tension? Rather than the hormones?

@YoullWorkitOut my private gynae did a blood test for my hormone levels despite the variability of hormone levels throughout the day etc etc.

I was still having hot flushes even on 100mcg. My levels were around 600 so it was a useful exercise.

Thanks v much for your response. Yeah I think that is the NHS advice but there are some experts like Louise Newson and Felice Gersh who recommend optimal amounts

I'm still in peri, I've been on a high dose patch but wasn't really absorbing it. I added a pump of estrogen about 6 weeks ago now and felt surprisingly awful.

For the first couple of weeks I had physical symptoms - bit of nausea, sore boobs, bit bloated, mild headaches. But I also almost instantly had massive fatigue, irritability and super brain-fog. This took longer to shift than the physical stuff - about 3/4 weeks in the end I think.

I have periods though, so I'd started the extra pump on day 1, and I think it was my period coming which banished the last of the symptoms, clean slate.

It really surprised me how much it affected me because I've been increasing the patches for a couple of years without all that - but then I wasn't absorbing them anyway, so it makes sense.

I think it's just settling-down symptoms, everything was a bit in-flux.

I'm glad I stuck with it - I can actually sleep until my alarm for the first time in 4 years - miraculous!

It wasn't the full 6-weeks. I'm 6 weeks out from starting now and have been feeling better for about 3 weeks I think.

Have you had any positive symptoms? The improved sleep was what made me stick at it.

Yeah the headaches could be from something else as I have chronic fatigue syndrome so feel pretty pants most of the time!

out of interest how did you land on that dose? Did you work your way up to it? And was it based on symptoms?

Hi, yes I got headache symptoms when I started oestrogel, and when I increase the dose.

I use jewellery scales (cheap from A m zon), put the lid of the bottle on the scales and weigh my gel, as I find it’s not very accurate how much comes out. Then use the lid to distribute into inner thighs. One pump weighs 1.25g. And when I needed to increase, I went up .1 a week, so 1.35, then 1.45 and so on.
I also divide my dose, so I do one pump in the morning and one in the evening.

No gp is going to give you directions for that, but it worked really well for me and avoided feeling too groggy. In fact I got the idea of using scales from other mnetters, when the shape of the bottle changed and the pump amount become erratic. So you were right to ask here, I got loads of anacdotal advice here when starting out. My optimal dose is 3mg a day, 1.5 am and pm.

That’s really interesting you felt better on 2 pumps than 3. I guess sometimes it’s down to trial and error.
yeah my understanding is that estrogen levels fluctuate far less throughout the month after menopause

Thanks so much for your message. This is super helpful to know that for you it was worth sticking it out. I remember I felt pretty rough when I first went on HRT but it did settle and then I felt fine so just wonder whether, like you say, there’s an element of the hormones needing time to settle. V glad you found something that works for you!!

I haven’t really had any positive symptoms yet but it’s only 4 days. So happy for your sleep - what a gift that is!!

My consultant, (one of the most respected in the UK), has never done blood tests on me as they believe they don't work/ aren't accurate. (I've used Oestrogel for over 15 years with ongoing reviews every few months.)

There are some proper scientific papers on this (all online) which show that accurate estrogen readings can only be achieved by a 24 hour test.

You judge HRT dose on symptoms.

If you've had a blood test - who did that?
If it was your GP, did they not advise on a higher dose?
If you sent a blood sample off somewhere, it won't be accurate.

The guide to dose is how you feel.
If you have symptoms you can increase the dose gradually.
You don't need to go to 2 or 3 pumps. You can do 2 pumps and a half pump.
My sweet spot is 1.5 pumps.

If you feel ok on 2 pumps I don't know why you'd want to meddle with the dose based on some test that is 99% likely to be inaccurate.

@cocopop100 I started on 50 aged 44.

In two months I went up to 75 and then after another two months went up to 100.

My night sweats were brutal and each dose controlled them for a while then they came back.

I still had them pretty on and off for a year after the HRT started.

Brilliant GP didn't make me wait three months each time thankfully.

I had a medication review this morning and had this conversation with the pharmacist. I am taking 2 pumps on each arm, so 4 in total. She said this was the maximum dose and if I wasn’t really feeling much benefit then it would be sensible to consider reducing the dose.
Anyway obviously I’m not a doctor but this is a conversation you may want to have with a professional.

Thanks so much for this and I love the jewellery scales tip! Do you mind me double checking how it works? So you place the lid on the scales and then pump out the gel on to the top of the lid? And then just put a little bit more on every few days? That’s genius - I’m totally going to do this. I do wonder if I increased by too much. Thank you!!

It's not necessary to do this.

Application varies a lot depending on how thinly you spread the gel, not just the amount.

You can adjust the dose simply by pressing the plunger on the pump and dispensing a tiny amount. if you want to- it's a bit wasteful- you can pump out one pump onto the lid (for example) and just divide it in half or quarters.

You really won't feel any difference by adjusting it in minute quantities through weighing it. I'm sorry to contradict another poster, but those tiny amounts are not going to make any difference.

I was advised to start with a 'pea' amount and build up. That was really simple- roughly less than half a pump then a bit more after a couple of weeks etc.

I went up to 3 pumps at one time as night sweats weren't being controlled. Now, many years post menopause, I need one pump and a bit.

Also you don't need to change the dose unless you feel it's not helping your symptoms. Unless you've been advised by a specialist doctor.

@cocopop100 I appreciate you told a previous poster you didn't want 'medical advice' but she was right. Even if you don't want 'medical advice' it's relevant.

I'm only posting again out of concern because there are perhaps some downsides you aren't aware of it's- not a 'lecture'.

If your GP had said 'Okay, if the current dose doesn't control your symptoms, try 3 pumps' - that would be okay

There are risks to increasing your dose. Some women on 3 pumps have to increase their dose of Utrogestan- this is in the guidance on endometrial protection. It's a conversation you should have with your doctor.

(Not all doctors agree with L Newson on the figures you've seen and her patients are having their HRT prescribed privately with ongoing monitoring.)

I think I really under-appreciated how long it takes things to settle - I was just seeing the really obvious physical sore boobs etc symptoms settling and thinking that was it.

I had quite clear negative symptoms to resolve though - lack of sleep, hot flushes, mood symptoms. So I've felt the relief of those as my 'positive symptoms'.

I think if I felt reasonably OK I'd not mess with anything. I really hate changing anything in my HRT because I know I'll feel worse for a period when it's all in flux.

Now that you've started I'd have thought it would make sense to just wait 6-weeks to let it settle and then evaluate ?

Hope you feel better soon !