"A return of night sweats, flushes, not sleeping and so on is very indicative that your hormones are not quite in balance. I recommend all my patients have a blood test once a year as part of an annual review to see where their oestrogen is at and whether an HRT adjustment is required."
If several months have passed and you are seeing no improvement in your menopause symptoms, it could be one of the signs that HRT is not working for you. You might need to increase your dose of HRT, specifically the oestrogen you are taking.
The aim of oestrogen replacement should be to achieve blood levels, which correspond to those of the early follicular phase in pre-menopausal women. Indeed, blood levels of estradiol associated with the standard dose of HRT (1 mg of oral estradiol or 50 mcg estradiol patch) are between 150-370 pmol/L.
Symptoms of low estrogen can include: Hot flashes, flushes, and night sweats are the most common symptoms of low estrogen. At times, blood rushes to your skin's surface. This can give you a feeling of warmth (hot flash).
Side effects related to the hormone Oestrogen – breast tenderness, leg cramps, skin irritation, bloating, indigestion, nausea, headaches. Side effects related to the hormone Progesterone - premenstrual syndrome-like symptoms, fluid retention, breast tenderness, backache, depression, mood swings, pelvic pain.
Estrogen helps protect the heart from disease, potentially by maintaining higher levels of good cholesterol, called high-density lipoprotein (HDL), in your blood. Lower estrogen levels, especially during menopause, can increase your risk of developing heart disease.
Changes in your hormones during menopause can impact your mental health as well as your physical health. You may experience feelings of anxiety, stress or even depression.
Women in the prime of their reproductive years have estrogen levels of 400, progesterone levels of 25, and testosterone levels of 100. Target levels for treating menopausal symptoms are 50 for estrogen, 10 for progesterone, and at least 40 for total testosterone and 1.3 for free testosterone.
Optimal Result: 200 - 1000 Ratio.
Balancing Your Hormones: Treatment Initiation
According to the NHS, typical timelines for improvement are: Several weeks to feel the initial benefits of HRT. Up to three months before the effects are fully realized.
1) You are tired ALL the time.
This is often because the oestrogen used in HRT is the most active form of oestrogen and it's also a pretty big dose of it. This oestrogen is very stimulating. If we have already been dealing with quite a lot of stress, our nervous system can struggle to deal with this much stimulation.
In addition to—and, often, as a result of—these physical changes, HRT often changes how you see yourself. In very real ways, using HRT to address symptoms of hormonal change can help you feel younger. It can give you more energy, elevate mood, and increase sex drive.
Estrogen can reduce menopausal symptoms like hot flashes, night sweats and vaginal dryness. If you have a uterus, you'll likely need to take progesterone along with the estrogen. Estrogen without progesterone increases the risk of uterine cancer.
Your brain has a lot of estrogen receptors, and when estrogen declines, so does some of the regulation that it provides. For example, estrogen helps control cortisol, the stress hormone. When that regulation is weakened, the increased stress response can result in crushing fatigue.
Too little estrogen can lead to a low sex drive. Too much of it can cause infertility and erectile dysfunction. Excessive estrogen can cause gynecomastia, or enlarged breasts.
Your skin also becomes thinner, because the levels of collagen and elastin also dip along with estrogen. The hormone estrogen is responsible for making skin look younger due to the hyaluronic acid it produces. Estrogen not only affects your skin but also your muscle mass, metabolism, and energy levels.
Hormone replacement therapy (HRT) is medicine used to treat the symptoms of the menopause. It is common to have side effects in the first few months of taking HRT. These usually settle on their own within 6 to 8 weeks. Side effects include weight gain, irregular bleeding, feeling sick (nausea) and skin irritation.
A review approximately 3-4 months after starting or changing HRT is a good time to assess both satisfaction with the HRT prescription and its effectiveness in treating menopause symptoms. By this time most start-up symptoms (if any occurred) should be settling.
Yes. HRT is known to improve sleep, mood and hot flushes, all of which may disrupt your sleep and lead to tiredness. However, HRT comes with risks and is not suitable for everyone.