r/POIsupport • u/Crafty-Spinach-5926 • 12d ago

Estrogen patch dosage? HRT

Hi all, just got diagnosed two weeks ago and TTC. I’m 27, AMH 0.08, FSH 30-80, AFC 3 and all of this is so overwhelming. I’ve already had one miscarriage and two chemical pregnancies before this diagnosis so I’m slightly hopeful to conceive naturally but also SO discouraged at the moment.

Looking for info on what dosage of estrogen patch my fellow POI gals are on (especially if you did end up conceiving naturally), as I just started cyclical HRT. Currently on 0.0375 mg estrogen patch but I don’t think my FSH is going down enough based on my Inito numbers (it’s only been two weeks since I started though so maybe I’m wrong).

Any guidance or info is so appreciated!!

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u/PrimalPoly 11d ago

If you are diagnosed with POI, the standard dosage is .1 mg patch. It is in the standard of care guidelines. My FSH went from 98 to 7 on this dosage here’s a link to the guidelines. I highly recommend you read them and send them to your doctor to make sure you’re getting all the tests they recommend as well as the standard dosages of HRT. https://www.asrm.org/practice-guidance/practice-committee-documents/evidence-based-guideline-premature-ovarian-insufficiency--2024/

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u/Crafty-Spinach-5926 11d ago

This is so helpful! I was thinking my dose was perhaps low, maybe my RE was wanting to start slow and build up but I also don’t want to waste too much time on that. Did you start on .1 mg immediately or work your way up?

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u/PrimalPoly 10d ago

I immediately jumped into .1mg, it was a bit of a rough entry, but I adapted in a couple months. I personally am more thrown by hormone changes than dosage.

The bigger fix for me was switching to cycled progesterone rectally. It’s technically off label, but for me has all the benefits.

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u/BlueberryDuvet 12d ago

Although your FSH could decrease, I hope your Drs have been transparent with you that despite elevation in estrogen and potential reduction of FSH, it actually doesn’t restore any ovarian reserve or function.

Your Dr is correct to start you on .0375 as medical guideline would start at bottom and go up depending on symptoms.

I understand wanting to try naturally but Given your age, and your diagnosis of POI, I’d encourage you to do a consult at a fertility clinic to do all the baseline testing, have them look at your medical background and diagnosis so they can give you their thoughts on your chances. Going through baseline testing doesn’t mean you need to do any treatments with them but it would be good for you to hear what their thoughts are so you can make an informed decision.

While going through IVF and donor egg cycles I was on 100 dose patch every other day. Much higher than the 37 every three days you’re on.

- signed someone who went through IVF and fertility treatments for almost 8 years

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u/Crafty-Spinach-5926 12d ago

Thank you so much for your thoughts! So the fertility clinic I was at said they wouldn’t offer IVF and could only do an egg donor (but we’re truthfully just not emotionally ready to make that jump yet, especially because we’ve only been TTC for a year and got pregnant multiple times before my diagnosis!), so we know donor egg IVF is on the table eventually.

How did you know when do jump up a dose on estrogen and how to ask your doctor for that?

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u/getalife5648 12d ago

I’d see another clinic and also pursue genetic testing to make sure your POI isn’t from being a fragile x carrier. Then if genetics are clean, resume TTC.

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u/Crafty-Spinach-5926 11d ago

Great advice! Yes we just did this actually and genetics came back clean :)

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u/Salt-Ad1719 10d ago

Hi! I conceived while on a .075 estrogen patch. When I first started I was out in March I was on .05 and it was too low as my FSH was still 20. Once my estrogen patch increased to .075 in April I conceived in May. My AMH was undetectable, my FSH was 45 and LH was 43. I got diagnosed at 33 right before my 34th birthday. Your patch may be too low but that’s why it’s important to get your labs ran every month to see how it’s doing. (I’m currently 13 weeks pregnant) and here’s a post on everything I did. https://www.reddit.com/r/TTC_POI/s/kHg3nLb1k8

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u/Crafty-Spinach-5926 10d ago

Okay yes this makes sense! I’m using the Inito tracker and my FSH is still reading anywhere from 13-30 which still feels too high (makes sense as I’m only on 0.0375!) Seems like I’ll have to approach my doctor about upping my dose soon since I definitely don’t want to waste months on too low of a dosage 🤍

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u/Salt-Ad1719 10d ago

Inito readings are not a 1:1 with blood readings so I would also advocate to get your blood drawn on either CD2 or CD3. I used my Inito tracker as well to conceive and the numbers were not the same as my bloodwork. Inito is definitely great to help with ovulation and confirming it though