Finding the Unique Mix for You
11th October 2024
Reaching a Turning Point with HRT
I finally feel like I’m reaching a consistent level with my HRT. For the first time in a while, I feel more like myself. I have energy, I’m able to stay active (not as much as I’d like, but better), and I’ve had fewer bouts of nausea and vestibular issues. The last few weeks of my new regime have been positive, and it feels like a breakthrough.
Struggling with Oestrogen Absorption
In my last post, I talked about how I was struggling with oestrogen absorption. Despite trying three different brands and doses of patches, I wasn’t seeing any improvement. My body just wasn’t responding. The lead-up to a recent holiday was particularly tough. I was dealing with extreme fatigue, brain fog, dizziness, and had no energy whatsoever. To make matters worse, I barely slept while I was away - just 2-3 hours each night for four nights straight. I pushed myself to make the most of the trip, but I ended up paying for it when I got back.
Switching Back to Gel
After speaking with my consultant, we decided to switch back to gel instead of patches. I returned to the regime that had worked for me before. Within two weeks, I felt well enough to get back on my feet. I exercised more, slept better, and felt mentally sharper. Around this time, I travelled to the US, and although I was worried about jet lag, I managed to adapt quickly with some herbal sleeping aids and morning exercises like swimming or gentle walk/jog sessions. Hydration helped too, and by the time I got back, I felt much more balanced.
Progesterone Challenges
I had a follow-up with my consultant shortly after returning. A blood test showed that my oestrogen levels had dropped significantly, which I had anticipated. My consultant assumed it would be too high. We increased the gel dose and added more progesterone. His view was to combat the growth of endometriosis (there is little medical evidence that this works). Four weeks later, I started to feel better, but the higher progesterone levels brought back some old symptoms - joint pain, nausea, and chest soreness. I was also dealing with vestibular symptoms again, waking up dizzy with a foggy, cotton wool feeling in my head, which lasted throughout the day. Cognitive function took a hit, and the back and thoracic pain returned, leaving me feeling stuck.
Tracking the Numbers
We decided to run a series of blood tests over four weeks to monitor my levels of oestradiol, FSH (follicle-stimulating hormone), prolactin, and eventually testosterone. My consultant suspected that there might be ovarian remnants left post-hysterectomy, which could be interfering with the HRT. This led to a pelvic ultrasound to investigate.
I went into the scan feeling hopeful, but honestly, I wasn’t expecting to find anything. My past scans for endometriosis had often shown little despite years of discomfort. But this time, as the sonographer scanned, I felt a dull aching pain, which turned into a sharp pain on deeper inspection. He confirmed there was an endometriosis nodule near my recto-vaginal wall - the same area where I had previously had endometriosis.
Only seven months post-hysterectomy and major bowel/bladder excision surgery, and it’s already back. It was a disappointing discovery, but not entirely surprising. I knew going into the surgery that it wasn’t a cure, but I had hoped for better relief from thoracic symptoms and overall quality of life.
Moving Forward
The surgery did help in some ways - I’m no longer fainting monthly or dealing with collapsed lungs - but other pains, particularly in my torso, have increased. Digestive issues and bloating have returned, along with some new struggles, like vestibular symptoms that come on suddenly and make me feel as though I'm going to collapse. I had two recent funny turns whilst away, colour drained from my face and my legs weakened.
A noticeable change came when I stopped taking progesterone two weeks ago. The vestibular migraines have stopped, I haven’t had any dizzy spells since, and I can finally eat before lunchtime again. Although the last couple of months have been challenging, I’ve fought hard to maintain some consistency, build fitness, and reduce the pain. But it’s clear now that achieving these goals may be harder than I anticipated.
A Glimmer of Hope
Despite ongoing thoracic pain, I’m feeling better in other ways. Sometimes it feels like my life goals and hopes are out of sync with my body’s ability to cope during menopause. But I won’t give up. I'll have more data from my bloods by November so that, coupeld with tracking my symptoms will hopefully paint a picture and in turn create a plan.
I’ll keep you updated. Remember - keep going, you’ve got this.
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