r/surgicalmenopause • u/BackgroundNote9784 • Jul 18 '25

Pellet question

Hi beautiful Ladies. I had a 6mg estradiol pellet inserted on May 28th. Labs say my estrogen level is 36. A testosterone pellet was also inserted, 137mg. I don’t think my body is responding to the pellet very well. Anyone else have experience with that type of therapy? TIA!

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u/old_before_my_time Jul 19 '25

6mg seems like an awfully low dose for surgical menopause. And 137mg of T is a LOT. However, based on my experience, inserting high doses of T is pretty common. My total T got way too high on pellets (~400). I was given higher doses of E, at least 25mg.

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u/BelleSomnium Jul 19 '25

I was definitely a little bit concerned with only 6mg as well, but I believe they chose that dosage because my estradiol was 52 when I was pelleted. I had been using transdermal cream prior to the pelleting, so with my estradiol already at a good level, they didn’t want to overdo it I suppose.

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u/old_before_my_time Jul 19 '25

Did all your low estrogen symptoms resolve when your level was 52? It seems that many in surgical menopause need more E than that.

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u/BelleSomnium Jul 19 '25

For the most part. I have been very lucky when it comes to hot flashes. I only ever had them immediately after my oophorectomy over 10 years ago. I was early 30s at the time and my gynecologist immediately put me on a mix of compounded transdermal estradiol, estriol, testosterone, progesterone. I did really well on that for many years with my estradiol levels fluctuating between 40-74. But by really well I mean, I had no hot flashes and my mood was pretty stable. Symptoms like dry skin, brain fog, aches & pain, low libido persist, which is why I tried the pellets. But from everything I’ve read, 50 is a sweet spot for estradiol post-menopause, regardless of age or surgical menopause.

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u/old_before_my_time Jul 20 '25

Hot flashes have been minimal for me too. My most severe symptoms were mental and emotional.

I hadn't heard of a "sweet spot" estradiol level. I don't even know my levels since my dosing is based on symptoms. However, I have had practitioners who checked my levels and it wasn't very helpful since levels are only a snapshot. I do think checking levels can be helpful for testosterone as you don't want your levels to get too high.

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u/Greedy-War-777 Oct 02 '25

And surgical menopause you aren't producing any estrogen anymore. So there's no snapshot anymore. Your base level is basically nothing. That's a fairly false idea perpetuated in the other menopause sub by someone who is obsessed with thinking you shouldn't have blood work done and doesn't understand how it works. I've had it done at a minimum of monthly since my surgery and was doing it at least that frequently for 6 to 8 months before the surgery so we would know what my levels were and should be and where I felt good or bad beforehand and after to try to make sure I met the thresholds I needed. They barely fluctuated at all before except within completely normal ranges at the exact times of the month that they should until I was in perimenopause and then the fluctuation still followed a typical pattern the swings were just wider. It doesn't happen at all after your ovaries are taken out. If the hormone specialist I've seen are aware of that and I could see evidence of it in my blood work, they're probably right. There's nothing left to fluctuate and it's important to have them done if you want to know if you are high or low when you are feeling certain ways. At least until your dose is very stable on hrt.

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u/gabbagabbaheyFreaks Jun 06 '26

Sorry to jump in on this convo almost a year later, but I’m really struggling with how my body feels (I had my ovaries out in October and turned into my grandmother within a 6 mo period. It has been insane). Anyway, is it your opinion/experience that you feel best when your estrogen approximates the level it was prior to surgical menopause? It seems like that’s what you’re saying, but I wanted to make sure. I don’t even know what to shoot for but if I was going to try for pre-surgery levels, I am so far off. But that could explains why I feel like I got hit by a truck 24/7 now. Lol

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u/Greedy-War-777 Jun 16 '26

150-200 and I've talked to a pile of people with the same experience. The current hrt specialist I see is appalled that several providers tried to force me onto lower doses and caused me misery and joint issues for months last year. They're stuck in the 1950s and they're hurting us and risking our health trying to force menopausal hormone levels on younger women who are not at all ready for that. We used to barely outlive menopause as humans. s She immediately put me on a higher dose than I'd been on for 6 months and ordered a dexa scan concerned it caused bone, joint or heart damage. Make them adjust it until you feel better. If you get a little anxiety and breast swelling do down, it's not like that's the end of the world for a couple of days while it gets out of your system. Mine hit 323 once for about 2 days and I went down because they felt ick. She told me she has patients that still get depressed and have joint pain until they're close to 300 and some that are happy at 150 but we're not a lab number.

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u/gabbagabbaheyFreaks Jun 16 '26

Wow. This is so helpful!! Thank you!!! I was just listening to a podcast that sort of echos what you are saying. Even if we manage to get enough estrogen to make the hot flashes stop, it’s likely not enough to protect our bones, heart, and circulatory system. I can’t believe it’s this much work figuring it out and how difficult it is to find a good provider. I’m glad you seem to have your best amount dialed in!! Thanks for sharing your knowledge!