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How do you know if you are taking the right amount of Estrogen? How do you know if you are taking the right amount of Estrogen?

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  #1  
Unread 06-14-2011, 07:07 PM
How do you know if you are taking the right amount of Estrogen?

Had a total Hyster on June 1, and Doc immediately started me on the .05 Vivelle.

I already have very low levels of Estrogen for my age, levels were always around 8 or 9 and Doc was concerned when he found my ovaries to be atrophied.

So he and my normal Gyno decided to start me on the .05 and see what happens.

The surgeon said it could take a month for everything to settle down and see if I'm on the right dose.

My Gyno said it's easy, not enough and I'll have Hot flashes, too much and I'll have achey boobs.
She said I should feel neutral with no PMS symptoms and just neutral.

Well I don't have achey boobs, thank goodness I hate that. And I haven't had a hot flash, but have had a couple of night sweats but I got those before surgery.

I definitely don't feel neutral, I am ultra weepy and moody.

But I know that could just still be from surgery.

So how do you know when you are on the right dose???

Do I wait the month and see if I get any hot flashes? If I don't get hot flashes does that mean I'm taking enough?

I never got hot flashes before and my body wasn't making enough of it's own Estrogen, I just had night sweats 4 days before a cycle. So maybe I won't get hot flashes no matter what?

Ugh, so confused!!!

I have my 2 week post op tomorrow will ask questions then but wanted some input from my Sisters before hand.
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  #2  
Unread 06-14-2011, 07:28 PM
Re: How do you know if you are taking the right amount of Estrogen?

It's good to give things about 6 weeks or more to see as it takes a while for your body to stabilize on ERT and especially after surgery. My ovaries quit early too and my E was rock bottom prior to their removal (post hysterectomy). I was used to no estrogen (or very little). But I had hot flashes and woke up drenched and knew I wasn't getting enough.

Best thing is to talk to your dr about your symptoms. I kept increasing the patch dose but unfortunately I was not able to absorb the E from the patch and after 5 months of trying, I switched delivery methods to Femring. I felt better within days.

Hang in there. The first few months are rocky, lots of symptoms that might lead you to wanting to change things a lot. Best to give it time and write down all your symptoms including when you change patches, etc... you will soon see a pattern of when you feel better or worse.

The ultra weepy sounds like low E, but like I said, you're so early post-op that it could also be your body struggling to adjust to things. Hope your appt goes well tomorrow.
  #3  
Unread 06-14-2011, 09:25 PM
Re: How do you know if you are taking the right amount of Estrogen?

Hi Calypso,

Thanks for your response. There is so much to consider.

I should have added that I just turned 30 in April and we have no way of knowing how long my Estrogen has been low. I have never had normal cycles.

We started checking my levels in 2009 when other medical issues starting coming up. I also have Adrenal Insufficiency and Thyroid Problems along with Dysautonomia (homeostasis and blood pressure disorder).

I was happily shocked when I finally got my Docs to agree to a Hyster and they actually thought it would help all my other symtpoms as things were flaring around my cycles.

Now my surgeon is super glad we did it because he was very surprised to find my ovaries shrunken and shriveled to almost nothing and one with a big cyst on it.

We had checked my Estradiol several times on day 3 of a cycle and it was between 8-12 over several months. We checked it the day before surgery on day 21 of cycle and it was 32, doc said normal level for someone my age would have been way over 47 where the range starts for day 21.

My Progesterone is also non existent on labs on day 3 and way below level on day 21. But my FSH is fine.

May I ask how you figured out that you weren't absorbing the E through your patch??? Were your levels being checked or were you just going by symptoms?

My Docs are surprised that I wasn't having hot flashes with my low levels, but I did get night sweats right before a cycle.

I'll see what my surgeon has to say tomorrow. I'm going to ask about putting the patch I already have on my Bum just to see if that could bump it up just a little bit.

Thanks again for your response and input, much appreciated!
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  #4  
Unread 06-14-2011, 09:35 PM
Re: How do you know if you are taking the right amount of Estrogen?

I realized within 3 months of my hysterectomy that my ovaries had quit. The estrogen level was post-menopausal level (<32). I tried estrogen patches at that time but felt awful (was on synthroid at the time) so quit them - felt irritable, moody, gained weight... Didn't think much about it as I was busy, busy and had moved to acreage so was working hard daily. Hot a lot, but never considered hormones.

9 years later when I was experiencing vaginal bleeding (no uterus but ovaries remained), I had an ultrasound which showed large pelvic mass around one ovary/tube. I had lap surgery where endometriosis was widespread (despite very low estrogen levels). Right before the surgery, I had E levels checked and didn't find them out until after surgery (ovaries removed as well as endometriosis) that estrogen level was below 32. So I went by blood serum testing. Tried the patch for 5 months after surgery (BSO) and dr did not believe I was not absorbing the patch. Felt like crap but she kept increasing the dose (up to 0.1 plus 0.05 patches). She didn't believe me until she tested estrogen level again and it had not increased past <32. So I switched to femring and within 4 days felt immeasurably better and got my E up to 110... Looking back, not 100% sure if it was all the new method of delivery or both the new method of delivery plus getting off synthroid and onto armour thyroid instead. I think it was a combination of both.

Later, about a year later, on Armour thyroid, my endocrinologist switched me back to synthroid (while on vaginal estrogen) and once more my estrogen plummeted to 20. Something about the synthroid blocking my estrogen levels... back on armour thyroid now and vaginal estrogen, and I can get my E levels up to 400! I like the E around 200-300 which is where I feel good.
  #5  
Unread 06-16-2011, 02:30 AM
Re: How do you know if you are taking the right amount of Estrogen?

Hi Calypso,

Again thank you for your input.

We have lots in common, I glanced at your profile, Horses would be the main thing....LOL

My Docs have given me desicated thyroid, NP Thyroid by Acella, I just haven't started it, they said I could whenever I want I just don't want to get side effects from that confused with side effects from the E.

Appt was good today, a little quick, my surgeon was late, have another appt in 2 weeks and he said we can talk more then.

He said pretty much what you did, that I shouldn't change doses this quickly, I can if I want to, he gave me the go but he said things take a while to settle.

He also said that going by hot flashes for me may never be a good way to go because my E was so low for so long, and we really don't know how long, that my body may be far past the stage for getting hot flashes, only time will tell.

I am getting vastly different opinions between him and my Gyno, and they are in the same practice.
He says each time I switch doses it takes at least a month or even 6 weeks to know the effect, so not to go back and forth.
Gyno says I would know within a couple of days of going up or down in doses whether or not I like the effect, so if I go up and a week later feel crummy go back down, and vice versa.

Both of them believe in going off symptoms, not levels. They both believe in bioidentical too. My surgeon says I won't need Progesterone, but Gyno says she'll give me a scrip for cream so I can try it, but suggested to wait for a month out from surgery.

Ugh......I have help books on the way.....and of course all my sisters here!
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