How many pumps of oestrogel are you all taking once you’re in menopause?

[Cherryblossom200]

Hello!

Just curious I think, I’m almost 51 and well over a year of no periods. I currently take two pumps of oestrogel at night before bed. I’m fairly petite and 5’3 so I don’t think I need loads. I know this is the baseline like amount. I want to start a third pump soon because I’m finding during the end of the following day I’m starting to feel anxious again.

Just one which appears to be enough to stave the hot flushes off. My friend takes two.

Three now same age and post menopausal. Was two but a year ago the joint pain started up again.

2 last period was 18 months ago

Ok, I thought you’re supposed to up it once you’re in menopause. I read some women take 3/4 pumps!

52, no periods for 11 months, 3 pumps (2 on nights I use oestrogen cream).

Ah ok, looks like you’re all on similar amounts as me then!

It is very variable and you really can't go by others' experience. Some women are happy on one pump, others may need anything up to four. Two is the starting dose, rather than a baseline, because it suits many patients, lots never change from it.
Often younger women may need higher doses than older ones

I’m definitely menopausal and nobody has said about increasing it and I had my review recently.

out of interest if you increase oestrogen do you have to also take more progesterone?

I’m 52 and in peri, on the Mirena but still have the odd period. I started HRT 5 years ago and it’s helped me so much, I was in a state. I started on 2 pumps and have slowly increased it to 4 to keep symptoms away due to my dwindling naturally occurring oestrogen.

I’ve not had to take additional progesterone with increasing the Oestrogel,

A lot of the big symptoms have gone. I had horrendous anxiety and feeling incredibly low. That’s subsided but I still get spiralling thoughts and anxiety at times, this hasn’t totally gone and feeling of flatness which I think might need testosterone?!

I’m going to try upping to another pump tomorrow but in the morning and see if that helps.

No. I get my progesterone from a Mirena coil, so it's a fixed amount.

Two here and definitely post-meno, my main symptom was hot flushes and they have totally gone, I have the Mirena for progesterone..

It’s individual as to how many pumps are needed - 1-4 is the dosing schedule normally. I usually start women on 2 pumps daily and go from there, adjusting dependent on symptoms.

Bear in mind when you increase to 4 pumps daily you need an increase in your progesterone dosing. It may be necessary to increase progesterone at 3 pumps daily in some women.

Testosterone is only indicated for libido, not mood, and usually only started after bloods have been done for testosterone levels, and once oestrogen/progesterone have been optimised.

You should have done. BMS and NICE guidance is to increase oral progesterone if on high dose oestrogen (which 4 pumps is classed as).

I get a period and I am on two pumps daily and I take a nightly tablet that’s suppose to stop periods. I keep meaning to go back but I did go back twice and was told it takes fine to settle. I have been on since Jan

@SidgeI have no libido 🤣 I haven’t done for about two years! I had bloods done a couple of years ago and my testosterone levels were fine. But I’m sure they must of decreased now so I’m going to ask for my hormone levels to be re-tested again.

Definitely worth asking!

Interesting. I was on Kliofem (combined pill) for 10 years and have just switched, aged 60, to Oestrogel pump and a Progesterone tablet. I started with 2 pumps.

I've been on this for 3 months now without much issue from swapping over, but this month have felt incredibly hot again and have also had a light period for the past 4 days. I've not had a sodding period for 10 years!

I'm wondering whether I should contact GP this week and suggest perhaps I need 3 pumps? Nurse did say I could go up if I needed to. @Sidge - you sound like a HCP, does the return of the hot sweats and the period sound like I'm not getting enough Oestrogen now?

@Sidgesorry for the questions, I’m assuming you’re a doctor/nurse? But my brain doesn’t seem to stop spiralling into negative thoughts about friends/life etc which I never had until the menopause and I’ve not really been able to sort this part out! I don’t know if it’s the lack of estrogen or if I’m doing something wrong? 😑

Disclaimer - You need to speak to your own HCP but I wouldn’t be concerned by a bleed within 3-6 months of switching regimens, however you may need a change of progesterone (either dose or product).

If you’re symptomatic then you might need an extra pump.

I found upping the oestrogen completely resolved the flatness & anxiety.

I just feel I have no zest for life 🤣 It’s horrible! Ok I’m going to try an additional pump tomorrow and see how I go.

Mood is a hard one to manage with HRT - sometimes life is the issue, or other mediations or therapies might be needed as well. Anxiety can be improved with oestrogen but not automatically and just increasing the dose (especially with a concomitant increase in progesterone) may not be beneficial.

It’s a balancing act and tricky to achieve sometimes. Have a chat with your HCP 🙂

Thanks @Sidge😊