The HRT Rollercoaster

24 June 2024

Three months have passed since I began Hormone Replacement Therapy (HRT) following my total hysterectomy and bilateral oophorectomy in February. Starting HRT at the end of March was a leap into the unknown, driven by the need to alleviate the severe symptoms I was experiencing post-surgery. This blog chronicles my HRT journey so far, detailing the ups and downs, adjustments, and insights gained along the way.

Regime Number 1

First Night of HRT: 28/03/24 - 10pm

• Oestrogel: 2 pumps (1.5mg) on inner thighs

• Progesterone: 2 tablets (200mg)

Day 1-8: Daily Dosage and Symptoms

Day 1:

• Progesterone: 200mg

• Oestrogen:1.5mg

• Symptoms: Difficult gel drying time, emotional, teary, sore diaphragm.

Day 2:

• Progesterone: 200mg

• Oestrogen:1.5mg

• Symptoms:Improved drying time (thanks to Dr. Laura Newson’s video). Hot flushes, dizziness, fatigue, cognitive slowness, sharp pains, breathlessness.

Day 3:

• Progesterone: 200mg

• Oestrogen:1.5mg

• Symptoms: Extreme temperature fluctuations, cognitive issues, sore diaphragm, bladder insensitivity.

Day 4:

• Progesterone: 200mg

• Oestrogen:1.5mg

• Symptoms: Pilates and walk-induced hot flushes, cold flushes, fatigue, knee pain.

Day 5:

• Progesterone: 200mg

• Oestrogen:1.5mg

• Symptoms: Itchy neck, fatigue, sharp lower back pains, nausea, loss of appetite, severe hot flushes.

Day 6:

• Progesterone: 200mg

• Oestrogen:1.5mg

• Symptoms: Morning nausea, heartburn, extreme temperature fluctuations, cognitive dysfunction, knee pain, exhaustion.

Day 7:

• Progesterone: 200mg

• Oestrogen:1.5mg

• Symptoms: Morning nausea, cognitive glitches, fatigue, heart palpitations, tingling in limbs, woozy head.

Day 8:

• Progesterone: 200mg

• Oestrogen:1.5mg

• Symptoms:Heartburn, joint pain, morning nausea, cognitive issues, chest tightness, dry skin, exhaustion, vaginal irritation.

Adjustments and Improvements

A follow-up consultation revealed that I needed more oestrogen and less progesterone. The excess progesterone was making me sick, and the low oestrogen was causing persistent symptoms. Increasing my oestrogen and reducing progesterone provided almost immediate relief. My symptoms lessened, anxiety reduced, and joint pain improved. However, the improvement plateaued, and another adjustment was necessary.

Introducing Testosterone

"Men aren’t the only ones to make this hormone; women do too. In fact, women produce three to four times as much testosterone as oestrogen before menopause. It is the same hormone – women just produce lower amounts than men." - The Menopause Charity

After thorough research and discussions with fellow endometriosis warriors, I decided to add testosterone to my HRT regime. Testosterone plays a crucial role in bone strength, cardiovascular health, cognitive performance, energy levels, and overall well-being. Its addition significantly improved my stamina, mental sharpness, and overall motivation.

Current Regime: Regime Number 3

June 2024

• Evorel Patch 100: (Oestrogen) - Patch Days: Mon AM & Thurs PM
  

• Vagifem: - Application: Sunday & Thursday

• Patch Days: Mon AM & Thurs PM

• Androfeme (Testosterone):** 0.5ml every morning

• Blood Test: 6 weeks post starting HRT

Transition: Gel to patches on 03/06/24

Navigating Challenges

Transitioning to oestrogen patches has been challenging, with symptoms like night sweats, joint pain, and mood swings resurfacing. However, I understand that finding the right balance requires patience, self-compassion, and regular monitoring.

I planned to give it a bit more time and to request another blood test to ensure proper absorption of oestrogen. However, the symptoms were getting progressively worse so I decided to reach out to my doctor who suggested reverting back to gel for now. The downside is that application twice a day in the summer months is a little laborious. It will help get my hormones in a better balance ahead of a trip I have coming up. I have booked in a follow up with my specialist to discuss other options.

Tips for Fellow HRT Warriors

• Keep a Log: Track symptoms and hormone levels to find your optimal balance.

• Seek Help: Don't hesitate to ask a medical professional or a friend who has experience.

• Trial and Error: Be prepared for adjustments and tweaks along the way.

Remember, you’re not alone in this journey. Each step, even the challenging ones, brings you closer to balance and well-being.

LBH x

Citation: https://www.themenopausecharity.org/2022/05/01/testosterone-and-the-menopause/