I just don't know what to do next. Supposedly my estrogen level is really high (488) (I'm taking BHRT) and I feel fine during the day but some nights are just awful. Last night I was anxious and my back was burning. I don't think I slept at all. Burning up and anxiety are signs of low estrogen aren't they? Amazingly I feel o.k. today. I was thinking about a stressful week ahead so I'm sure that made things worse. I'm also training hard for a running event but yesterday I didn't exercise much at all. I know I'd do better if I gave up the hard training but I really hate to do that--it's part of who I am. I'd like to see an endocrinologist because my last blood test just doesn't match my symptoms, but the doctor I see for my HRT won't give me a referral. I'm just really really sick of all this.

Do you train on the days you wake up feeling bad? No idea anymore what high estrogen symptons would be...I've just found that it seems like hormones can shift so fast you can't keep up with them.
When I feel rotten I cut it all back and just go out Nordic walking and play around with free weights at home.
Perhaps you could try a different med if it started anywhere near when your BHRT started. Do they know that you are a competitive runner? Sounds like you need a Dr. that understands your lifestyle.
Hugs
Girlsmom

[quote name='skiergirl' date='May 19 2008, 09:17 AM' post='223862']
I just don't know what to do next. Supposedly my estrogen level is really high (488) (I'm taking BHRT) and I feel fine during the day but some nights are just awful. Last night I was anxious and my back was burning. I don't think I slept at all. Burning up and anxiety are signs of low estrogen aren't they? Amazingly I feel o.k. today. I was thinking about a stressful week ahead so I'm sure that made things worse. I'm also training hard for a running event but yesterday I didn't exercise much at all. I know I'd do better if I gave up the hard training but I really hate to do that--it's part of who I am. I'd like to see an endocrinologist because my last blood test just doesn't match my symptoms, but the doctor I see for my HRT won't give me a referral. I'm just really really sick of all this.




I know that you are getting very cross with your body but to be fair if you are training hard for a running event you are doing very well.
Many of the ladies here have found it difficult to leave the house or go for a walk, they have been so badly affected by their symptoms. I had to give up my sport and some days am glad to survive the rigours of the day and believe me, I used to be fit. This is a time of transition and I believe that we have to modify our lifestyle, just a bit during all the changes. Perhaps your body is begging for some consideration in all this. BHRT is not the answer to everything.
Hope you feel better soon,


Regards,

XIII

Hi,
Yes, my doctor knows I am a competitive runner. I don't think she's ever dealt with anyone like me though. I do notice my symptoms are sometimes worse on hard workout days--but Sunday was a rest day and I did almost nothing. Then Sunday night I had a bad time. I know I shouldn't complain--I am lucky to be able to run at all, let alone compete, and I am otherwise pretty healthy. I know I should probably ease up on my body--but I really don't want to! Maybe I do need to try a different approach to my HRT but I've already tried several different things.

If your doctor won't give you the referral you want, you need a new doctor. What is she afraid of....that another opinion might make her look bad???? She is not acting in your best interest.

Supplements...Calcium, mag. and the like.
Perhaps you can speak with her about how you could support your body through this. What are the symptoms that made you start HRT?

See a doctor with a specialty in Sports Medicine. You are an athlete, which puts you in a specialized group of women. Therefore, you need to see a doctor who treats athletes and physically active, competitive sportswomen. Your body is used to training hard, so why listen to a doctor that treats average people?

I used to get the burning back thing when I first started using the bio-identical Progesterone cream. After a few months of pure h*ll from it and mounting symptoms I didn't have before I started it I had the one and only hormones blood test the doctors would allow me. My Estrogen was at the very very low end of normal and P was relatively high for the time of my period when it should be zero. Symptoms of low E are similar to symptoms of high E and the same for P so it's hard to know where one starts and one leaves off. Somedays I feel like I'm E dominant and most other days I feel like I'm E deficient and everyday I think I'm P deficient but my body hates P so I'm doomed. Have you had your E levels checked since being on the BHRT?? And at differing times of your cycle like days1-3 day 14 and again at day 20 to see if it is fluctuating?? Are you following Dr Vliets beliefs or Dr John Lees??

Sorry for all the questions

Rox

Hi everyone,
Thanks for all the input--all of you amaze me with your knowledge. Girlsmom, I started on the BHRT about 8 months ago after trying two different oral contraceptives (prescribed by my gyn) for my symptoms of nighttime anxiety and irregular bleeding. The first bcp stopped working and the second higher dose one made me depressed--I also started having nightime anxiety and hot face while on that bcp. I then found my current doctor by calling our local compounding pharmacy. Along with the BHRT I take supplements--the GNC Women's active formula vitamin, magnesium, calcium (with D and K) and flax seed. Everytime I ask my doctor for a referral to an endocrinologist, she says "they probably won't prescribe bioidentical hormones." That may be true, but I'd like to find out if there is something else going on. I don't have to fill any prescriptions for synthetic hormones if I don't want to!

I live in a relatively small community and it's hard to find a doctor who will prescribe BHRT. My primary care doctor (male) told me flat out that "he doesn't know anything about menopause." My gyn is really good but I get the feeling he really doesn't want to deal with any complex hormone issues either. Armadillo, I like your idea of the Sports Medicine doctor. I wish I could find someone who understands the connection between exercise and hormones. Armadillo, I know you lift weights alot--do you notice any connection between exercise and how you feel?

Rox, I had my hormones checked on day 20 of my cycle and I was taking my BHRT. I take estradiol every day and cycle my progesterone (Prometrium). My progesterone was kind of low (I had been taking the Prometrium for a few days) but my estrogen was sky high. That's what's so strange! I definitely am not a fan of progesterone--I've read both Dr. Lee and Dr. Vliet--and I follow Dr. Vliet for sure. I'd like to check my hormones more often but the tests are so expensive and my insurance doesn't pay for everything.

I feel great for about 3 to 4 hours after an intense workout, but remember, I am postmeno, and my hormone profile is different. Here is an excerpt from Dave Draper's website, IronOnline, that may be of interest:

Hormones begin dropping by around age 35, about 15 years before the average menopause, so it's really something for us all to be aware of. Things to look for include unusual moodiness, more difficult menstrual cycles, memory loss, depression, low sex drive, difficulty sleeping, weight gain (or failure of proven weight loss programs), low energy, anxiety, migraines... the list goes on, too. It's tough stuff.

Most GYN docs don't test for hormones at such young ages. You'll have to ask for hormone testing -- insist, maybe, depending on the doc, in which case it's time to search out a new doctor, and as long as you're doing that you may as well find a local hormone specialist rather than the OB doc you're probably seeing out of habit. At any rate, a hormone panel is the place to start because it may spell out the answers and eliminate some of the trial and error that makes up hormone balancing.

Not that you won't have your share of that, though. Hormones work together in the body, and bumping one up effects another. Bodyfat effects hormones, as does exercise and stress. That's good, because the healthier you get the more stable your hormones, but it still takes a lot of tweaking to get things right. Worse yet, our natural hormone levels continue changing throughout our lives, so what's fixed this year won't necessarily stay fixed. Offsetting that, once you've been through the process, you'll have a good idea what's going on and can tweak as you go along. Remember, this is as individual as it gets; what works for you won't work for your sister or your mother without personalized adjustments.

For that reason, if you decide to optimize your hormones, test one hormone at a time and leave all others stable. This takes a couple of months per trial, and that may include increasing or decreasing that hormone for another couple of months, so seriously, just balancing estrogen could take six months to a year, before you start on progesterone, for instance. That's one reason for getting the blood panel done first so you start with the hormone that's the most out of balance.

Another way to get started is to determine the biggest physical complaint and start with the hormone most likely to address it. A woman who had a healthy sex drive and finds it gone should go directly to testosterone first (a whole 'nother bucket of worms, mentioning testosterone to women, who have mostly been brought up to think of it as the bad side of macho). On the other hand, increasing depression for no apparent reason is an indicator of low estrogen and often a low dose of estrogen will bump a woman right back to normal, while at the same time offering other benefits.

Now, all this is assuming the rest of your life is in order. If your marriage is falling apart, your kids are in trouble, your job's on the line and there's never enough money in the bank, forget about hormones and address the life problems first, because no amount of hormone intake will fix what ails you.

Unless, of course, your life problems are a direct result of your increasing moodiness and nobody can get along with you, in which case a dose of estrogen will fix you up by tomorrow.

Naturally there's much controversy over hormone replacement. One that's sure to come up is the study that was discontinued a couple of years ago, however there were particular elements to that study that should be mentioned: The hormones used were synthetic ingredients made from mare's urine. If the tests were done using natural hormones, most researchers believe the outcome would have been different. The lesson to that story is to make sure the doc prescribes natural hormones.


A brief overview to get us started:


Estrogen: Depression, moodiness, memory loss, low energy, migraines, PMS, sleep problems, poor sex drive, vaginal dryness, skin tone, premature aging


Progesterone: Anxiety, migraines, PMS, osteoporosis, sleep problems


Pregnenolone: PMS, memory loss, depression, low energy


Testosterone: Poor sex drive, lack of muscle or difficulty gaining muscle, osteoporosis, excess weight, skin tone, premature aging


DHEA: Depression, memory loss, low energy, excess weight, poor sex drive, premature aging, lack of muscle or difficulty gaining muscle


Thyroid: Lack of energy, PMS, premature aging, fuzzy thinking, excess weight


Melatonin: Sleep problems, memory loss, osteoporosis, premature aging


HGH (Human Growth hormone): Lack of muscle or difficulty gaining muscle, anxiety, low energy, excess weight, osteoporosis, memory loss, sleep problems, depression, skin tone, premature aging

Someone told me the other day that doctors get some sort of kickback for *not* doing referrals.....not sure if it's true or not,but it would make sense because if i go to a specific clinic/hospital they would lose money if i was sent somewhere else....

Thanks Armadillo. I'm going to check out that Web site. Dave Draper really seems to know what he's talking about. I think part of the problem with me is that there just aren't that many women my age who do the kind of training I do. I suspect it's because meno itself is enough stress without adding the stress of hard training too. I don't want to give it up though--other than hormone issues I am really healthy--I never, ever get infections or even injuries. I always feel great after my workouts too--(except once in awhile when I over-do it.) It's at night when I get symptoms.

If I decide I still want a referral from my doctor I think I will explain that I still want to keep seeing her for my BHRT, but I just want to make sure I don't have some other problem.

You are exactly right. But there still are some women our age who compete in sports at the Master's Level (over 40 or over 50, depends on the state) that are breaking all pre-conceived notions of what a menopausal woman CAN do. Think of yourself as a trailblazer, who defies current stereotypes of middle aged women. It doesn't make for an easy go of it, especially when your doctor, friends and family think you're "too old" to train hard. Stay strong, and keep pushing back. Show then what a powerful woman is capable of.

Hi Skiergirl - Just a thought, but do you use your full estradiol dose all at once in the AM or do you spread your dose out over the day? If you are using a patch then I guess this post will be moot but I've found that I have to break my estradiol dose up to get through the day. While I am not even close to the serious athlete you are, on very physical days (walking nonstop at a fast clip at work for 12 hour shifts) I would hit a brick wall about 9-10 hours after taking my dose and could suddenly not even pick my legs up to take another step. Even splitting the dose to every 12 hours did not change the estradiol drop time no matter how much I used. I had to change to every 8 hours dosing to keep from hitting that brick wall. This is with using Estrogel, when I tried oral estradiol it wore off by 4-5 hours maximum.
The more physically active you are the faster you are probably going to 'chew through' the estradiol. You will metabolize it faster and require a higher dose than the average couch potato! Dr Vliet has mentioned this a couple times in her blogtalk radio programs. When you had your blood level checked, had you taken your full dose that AM before intense exercise was done? Because you may have gotten a much lower reading if you had it checked in the evening after working out as it wore off and your anxiety started kicking in. You can have a high blood level during peak release and be back down to post meno levels in way less than 24 hours depending on the half-life of the form of estradiol you are using.
Hope something in this is helpful for you!

Thanks for the words encouragement Armadillo. Sometimes I think I'm crazy (no-- sometimes I know I'm crazy!) for trying to train and compete the way I do. Niteowl, I really wish I could have my estrogen checked at night when I'm having problems. I had my bloodtest at 8 a.m. and I hadn't even worked out (didn't have time that morning). I always feel best in the mornings so I'm not surprised my levels would be highest then. I do have a Climara patch (.1 mg--highest dose) but I almost always supplement--now I'm trying a compounded estradiol cream. I put the cream on in the evening at about 6 p.m. I figure that will help top off my estrogen levels at night when I tend to have problems. When I was supplementing with the oral estradiol, I even tried taking the dose twice a day, but it seemed to work better if I took the whole dose in the evening. I've also been taking a compounded very low dose testosterone cream for the last week, even though I had no symptoms of low T (my blood levels were a little low though). I haven't noticed any difference yet with the T. My doctor said low testosterone could cause hot flashes. I didn't argue with her but I've never hear that before!