Is 2MG estradiol a high dosage?, Should I wait longer than 3 weeks to decide? Options

[Sunny330]

I've been on 1MG estradiol for almost three weeks. My hot flashes and night sweats are much better - lesser in intensity, frequency and duration - but after three weeks on HRT, I'm still getting them. I'm supposed to call my doc in two days to tell him if the 1MG is working - if it's not, he wants to double the dosage. When we settle on the correct dosage of estradiol for me, he'll then prescribe the appropriate dosage of P for me to take cyclically.

Does 2MG of estradiol seem like a high dosage? I see some of the combo pills like Angeliq and Activella are 1MG E, and it just worries me to go up to 2MG, as I want to stay on as low a dosage as possible. I'm 5 years post, and my symptoms have increased to almost unbearable this past spring and summer. Could that be why the E is taking so long to work completely, and maybe the 1MG will eventually do its job, or should I consider the 2MG? I just don't want to give in too soon and double the dosage after only three weeks.

If I stay on the 1MG and it doesn't help me 100%, am I just wasting my time with HRT?

Thanks in advance for any advise or help.

[FoxyRoxy]

I've been on 1MG estradiol for almost three weeks. My hot flashes and night sweats are much better - lesser in intensity, frequency and duration - but after three weeks on HRT, I'm still getting them. I'm supposed to call my doc in two days to tell him if the 1MG is working - if it's not, he wants to double the dosage. When we settle on the correct dosage of estradiol for me, he'll then prescribe the appropriate dosage of P for me to take cyclically.

Does 2MG of estradiol seem like a high dosage? I see some of the combo pills like Angeliq and Activella are 1MG E, and it just worries me to go up to 2MG, as I want to stay on as low a dosage as possible. I'm 5 years post, and my symptoms have increased to almost unbearable this past spring and summer. Could that be why the E is taking so long to work completely, and maybe the 1MG will eventually do its job, or should I consider the 2MG? I just don't want to give in too soon and double the dosage after only three weeks.

If I stay on the 1MG and it doesn't help me 100%, am I just wasting my time with HRT?

Thanks in advance for any advise or help.

Sorry I don't know much about Estrogen replacement but with my experience with Progesterone cream I would stick with the lower dose and just wait a little longer to see if it is effective enough. Sometimes things take awhile to settle and 3 weeks doesn't sound like long enough to see if it's going to be a sufficient enough dose. You may even find in a month or so's time that 1mg is too much when it kicks in better. You must remember it may take awhile to wake up those Estrogen receptors. IMHO I think doctors are too gung ho with dosing up us to the max to try to shock our bodies into accepting any drug and for some of us this just does not work and makes matters worse. Give it a little more time as from your own admisssion things have improved slightly so there is some progress which is better than none .

Rox

[Juliann]

Sunny,

I have used estrogen for a few years and find that for me it helps to split dosage between AM & PM, this helps to keep it more consistant. When I took 1mg of E, I would take .5mg in the morning and take the other .5mg at night. That might help you. Also if you need more, you can add extra on those days that you need too.

I take 1.5mg per day and if I have a really bad day, I take an extra .5mg to help for that day. Some days are better than others, so I tend to go by how I am feeling. I also try to use the least amount and some days I just tough it out.

I think estrogen helps, but you will still have hills and valleys during menopause.

Hope you feel more balanced soon!

Juliann

[skiergirl]

Hi Sunny,
I don't think 2 Mg of estradiol is that high of a dosage if that's what you need to feel better. Are you actually taking estradiol? If so, that is bioidentical--unlike Angeliq or Activella--and so the dosages are not directly comparable.

If you are uncomfortable with doubling your dosage, why don't you just take another .5 mg of estradiol? The 1 Mg pills can be broken in half. Or, maybe another delivery method, would be better. I like the patch (like Climara); others have good results with gels or creams. Transdermal HRT may be safer too, because it by-passes the liver.

Some people need a lot of estrogen to feel good-I'm one of them. It can take awhile (sometimes months) to find the right dosage and delivery method, so you really have to be patient. Good luck!

[Maggy]

I am on the same dosage...I really hope it's not too high

[wordsmith]

I have been using 2 mg estradiol cream for over a year. It is fantastic. No complaints from me.

I wouldn't do estrogen orally. It is safer when delivered through the skin.

[gillK]

I have been using 2 mg estradiol cream for over a year. It is fantastic. No complaints from me.

I wouldn't do estrogen orally. It is safer when delivered through the skin.

wordsmith, I wonder where you place 2 mg on the spectrum of dose. Do you consider it high-end, mid-range, or what? I'm asking because I am in a lousy state just now, lackluster in mood, low energy, crummy focus. I feel like I'm depressed, but without the sadness or thoughts of worthlessness. No hot flashes or palpitations. I posted about my horribly fragmented thinking last month and have concluded it was part of an awful stress/shock response related to very bad medical news. With encouragement from PS, I upped my gel to around 1.5mg per day. Now, I'm using 2 mg and still don't feel well. I am really tempted to double that, but fear I'll get 'hooked' on that higher dose. Can you please let me know where you place 2 mg on the range, and also your thoughts on the time lag between consistently feeling well and momentarily feeling well, as in a few hours after application. I need some consistency and, in my befuddled state, fear that my estrogen receptors have become permanently extinct. Hope this makes sense. Thank you, thank you.
GK

[Sariah]

GillK,
Maybe the way you are feeling is not due to low estrogen. I can't remember if I've asked this before (if I have forgive me--I am becoming like old people who continually repeat the same story ) but have you had a full thyroid panel done? Your symptoms are suggestive of low thyroid. A frequent complaint of hypothyroid people is foggy thinking and a decrease in intellectual capabilities.

[gillK]

GillK,
Maybe the way you are feeling is not due to low estrogen. I can't remember if I've asked this before (if I have forgive me--I am becoming like old people who continually repeat the same story ) but have you had a full thyroid panel done? Your symptoms are suggestive of low thyroid. A frequent complaint of hypothyroid people is foggy thinking and a decrease in intellectual capabilities.

Hi Sariah - Bless you for coming to my aid. Yes, I had the whole panel back in February when I was feeling very, very well. I PM'd you the #'s. My labs were like an A+ report card. My main sense right now is one of disconnect, drift and total ennui. Like I've lost my compass.
GK

[wordsmith]

Hey Gillk,

From what I have seen on this board, the range of transdermal estradiol goes up to 2.5. I once pressed my pharmacist about how high it could go, she didn't want to answer me, but she finally did say 4, 4.5.

If you are not flashing or having insomnia, I wouldn't bet on it being low estradiol.

How are your breasts doing? Any redness or swelling signalling too much estrogen?

Are you taking progesterone? That could be throwing your estrogen receptors off, especially if you are doing the 200 mg or even the 100 mg orally. If so, you could stop the progesterone for up to 3 months with no harm and see if you feel better.

You wrote on 4/3 that you had a TSH that was quite low. But then you write that your lab report was good, so maybe that corrected itself? As you know, anything .4 or lower for TSH is low; ideally it should be between 1 and 2. (Mine is .85; I felt even better when it was 1.26.) Since you have been hypo before, my guess is thyroid. I agree with Sariah. Do you have the other symptoms of hypothyroid, hair falling out, cold? I am not a thyroid expert, I am sure you know more than me.

As for the wearing off of the estradiol, I do the 2 mg in the morning and find it wears off about 8 hours later. Sometimes I get some flashing then, and just stick my finger in the pot and rub a smidge on. It is fairly even before that, but I would say the peak would be between 1 and 4 hours after application. That is when I am dancing around

Well, I think we hijacked this thread, sorry ladies. I find myself on the sythetic hormones thread and don't know how the heck I got here

[manyboys]

Are you taking progesterone? That could be throwing your estrogen receptors off, especially if you are doing the 200 mg or even the 100 mg orally. If so, you could stop the progesterone for up to 3 months with no harm and see if you feel better.


Hey there,

I agree with wordsmith on this.
I have been taking just 1.5 mgs of Estrogel and 100 mgs. of Prometrium. In the beginning I felt fantastic except for some fatigue from the P. But after a few months, I began to feel estrogen dominant AND more fatigued. So, at that point I felt that nothing was working. I wasn't getting the benefit of the E except that, yes my night sweats and day time hot flashes were gone.
The other night I forgot to take the Prometrium and next day started to spot so I stopped taking it all together and let myself have a period (first one since May 08 damn it all).
Anyway, I'm still taking the E albeit at .75 mgs and no P and I feel pretty darned good again.
I believe that the progesterone was upping my estrogen levels and making me feel E dominant.
I've got some blood work owed to me and once I see how that looks I'll have to decide what to do.
The progesterone really has thrown me for a loop.
It's definitely worth considering.

Cathy

[wordsmith]

Manyboys,

I thought it was good to get a period. This means the hormones are working, doing their job. And shedding that lining is good, too. I wish I could get a period.

So... I didn't quite get what you meant by estrogen dominant by taking too much progesterone. I thought too much P takes up the receptors of E and so leads to symptoms of *low* estrogen. (Or am I missing a subtlety?) As an aside, I recall reading in Dr. Vliet that only 5% of woman are estrogen dominant in peri, the majority of us are struggling with too low E. Or because we are fluctuating, we may be estrogen dominant for a few days or hours, but we plummet soon enough.

[Sariah]

Hi Sariah - Bless you for coming to my aid. Yes, I had the whole panel back in February when I was feeling very, very well. I PM'd you the #'s. My labs were like an A+ report card. My main sense right now is one of disconnect, drift and total ennui. Like I've lost my compass.
GK

I'm so embarrassed, I should have remembered our recent PMs about this. I think it's because I do get PMs from others asking about their thyroid so with my meno brain it's almost impossible to keep track of it all.

Could you have blood sugar issues?

[manyboys]

I had been getting the feeling that when I take the P, it pushes the E too far and I feel like I did when I was peri and in fact E dominant.
My boobs became swollen and fibrocystic, I retained water big time, was headachy etc. In peri I had terrible fibrocystic breast issues from E and when I entered menopause my levels seriously dropped to nothing and that problem went away completely. I was so happy about that. Not so happy when it came back with supplementing.
Without the P on board, I feel great. No lumpy painful breasts, no swelling (I've lost a few lbs. in as many days so it's all water) no headaches.
Also, this is how I felt if I ever went over the 1.5 mgs of Estrogel.
I now know that my body needs 1 mg. tops of the stuff.
My problem is taking the Prometrium. Unfortunately, it only comes in the lowest dose of 100 mgs. I have to decide what to switch to.
And, oh yeah. I'm getting a good period. Thanks for wishing it on me.......;-O

[Sariah]

Hi Sariah - Bless you for coming to my aid. Yes, I had the whole panel back in February when I was feeling very, very well. I PM'd you the #'s. My labs were like an A+ report card. My main sense right now is one of disconnect, drift and total ennui. Like I've lost my compass.
GK

GK,
Are you at all fatigued or tired? Any other symptoms? How is your heart rate? Are you cold or hot?

[gillK]

GK,
Are you at all fatigued or tired? Any other symptoms? How is your heart rate? Are you cold or hot?

Sariah, and everyone else who's been kind enough to post. One, thank you all for your suggestions and help. ((( all ))) I appreciate it so much. Two, I feel like I've derailed this thread so I'm going to shut up, shortly. Three, my sense of what's wrong with me is that the very bad medical news of early March, recent surgery and pending biopsy results are the problem. All of it has me in some kind of managed panic that, I'm sure, is responsible for this low-energy, disorientation, fragmented thinking and drift. I'm sure there is a hormonal fall-out from it, but honestly don't know what.

Body temp/heart rate fine, and blood sugar must be OK - I eat small meals at regular intervals. I don't have estrogen dominant symptoms and am not on (the detested) progesterone now. My last full round was in early February. I tried just a dab mid-March and it was a huge mistake. Just got rid of the two-week mild migraine it set off. Yes, in 2/09 my TSH was very, very low but T3 and T4 within range. For now, I'm just going to stay with my 1.5 mg - 2.0 mg estradiol/day, adjust to this news, keep the faith, rest as much as possible and take everything a day at a time. If this doesn't resolve, I'll get another round of testing.


Thanks again to all of you. You're the best.
GK

[manyboys]

Hi gillK,

What ever it is you are dealing with, I wish you luck and a good outcome. I know that waiting for this kind of news is a horrible thing and definitely takes it's toll on your body.
Try to take it easy and hang in there.

Cathy

[Sariah]

GK,
I'm so sorry to hear you are dealing with a scary medical issue. I did not realize it was you that it was happening to, thought it might be a family member. No wonder you are a wreck. I pray it all turns out well for you and that you will be able to be calm and at peace.

[goingcrazytoday]

I feel like I could use a gallon of estrogen UGH.

[kackle]

When I started progesterone I felt terrific, after two months it threw me into estrogen dominance. The progesterone made my body make more estrogen. It made me very ill.

[manyboys]

When I started progesterone I felt terrific, after two months it threw me into estrogen dominance. The progesterone made my body make more estrogen. It made me very ill.

This is how I felt....:-(
Now, I haven't taken the P for a week and have lowered my dose of E. Boy, today I had all kinds of old symptoms come back; weepiness, anger, frustration, dizziness and I felt very short tempered.
It's obvious that I can't not take some E, but I really do not want to take the Prometrium.
We'll see what tomorrow brings.

[kackle]

This is how I felt....:-(
Now, I haven't taken the P for a week and have lowered my dose of E. Boy, today I had all kinds of old symptoms come back; weepiness, anger, frustration, dizziness and I felt very short tempered.
It's obvious that I can't not take some E, but I really do not want to take the Prometrium.
We'll see what tomorrow brings.

When I lowered the progesterone dosage my emotions were all over the place. Looking back now I can see it was the fluctuation of the hormones(that the prog caused) that gave me those same symptoms. I also had blurred vision. I was also on testosterone at the time. I went off of that too

[manyboys]

When I lowered the progesterone dosage my emotions were all over the place. Looking back now I can see it was the fluctuation of the hormones(that the prog caused) that gave me those same symptoms. I also had blurred vision. I was also on testosterone at the time. I went off of that too

Hey there,

I don't want to hijack this thread, but want to ask you what you are taking now, if anything?
I can't even lower the dose of Prometrium because the 100 mgs. is the lowest dose. For now I'm ok, but I will need to find some other form of P, or stop taking HT all together.
How are you feeling?

Cathy

[avalina]

Hey Gillk,

From what I have seen on this board, the range of transdermal estradiol goes up to 2.5. I once pressed my pharmacist about how high it could go, she didn't want to answer me, but she finally did say 4, 4.5.

If you are not flashing or having insomnia, I wouldn't bet on it being low estradiol.

How are your breasts doing? Any redness or swelling signalling too much estrogen?

Are you taking progesterone? That could be throwing your estrogen receptors off, especially if you are doing the 200 mg or even the 100 mg orally. If so, you could stop the progesterone for up to 3 months with no harm and see if you feel better.

You wrote on 4/3 that you had a TSH that was quite low. But then you write that your lab report was good, so maybe that corrected itself? As you know, anything .4 or lower for TSH is low; ideally it should be between 1 and 2. (Mine is .85; I felt even better when it was 1.26.) Since you have been hypo before, my guess is thyroid. I agree with Sariah. Do you have the other symptoms of hypothyroid, hair falling out, cold? I am not a thyroid expert, I am sure you know more than me.

As for the wearing off of the estradiol, I do the 2 mg in the morning and find it wears off about 8 hours later. Sometimes I get some flashing then, and just stick my finger in the pot and rub a smidge on. It is fairly even before that, but I would say the peak would be between 1 and 4 hours after application. That is when I am dancing around

Well, I think we hijacked this thread, sorry ladies. I find myself on the sythetic hormones thread and don't know how the heck I got here

Hi There,
I've been on bio-identicals for about 3 months now and am having a horrible time. You sound really knowledgeable and I thouht maybe I could pick your brain. I started with 80/20 .625 of bi-est cream per 1 ml. a day. DID nothing for me. My major problem was waking up all night long feeling hot. SO--I tried .625 for about a month and then the doc upped it to 1 mg. of 50/50 bi-est (.50 mg. estriol and .50 mg. estadiol)per pay per ml. Can't really say that this has helped much either. Anyhow, from what I've heard it is the estradiol that is suppose to help with sleep. While I was on the 80/20 of bi-est I started noticing tender nipples and a strong vaginal odor. Someone said this could be from the estriol. So--anyhow I am still struggling with the 1 mg. of 50/50 bi-est and the tender nipples are really painful. Don't know what to do. I have a uterus but the progest pills really bothered me--caused bad gastro issues so I am going to cycle them every two months. EGADS--this is a nigtmare. So--I don't know if I should continue with the 50/50 cream for a while longer--I've only been on it about a week or if I should stop the whole hormone thing. ANy help would be appreciated. thanks. avalina