Wow! That's really being sensitive to your E levels. Can't say I've ever had those experiences, Eve. We are all so different, even as we are all so the same.

Clara

Here's a study among many Ive read read concerning smoking and oral estrogen metabolism... I can just tell you how I can feel the difference with transdermal E

One thing Ive wondered though is how smoking effects PM metabolism??? I do know I needed up to 5000mg PM to really see results and feel good

YES I know I should just quit smoking

However, it has been proven that, depending on the type, duration and intensity of nicotine consumption, smoking can reduce or completely cancel the efficacy of orally administered estrogens. Not only does smoking diminish the otherwise well-established beneficial effects of estrogen on hot flashes and urogenital symptoms and its positive effects on lipid metabolism, i.e. by reducing cholesterol, but smoking also specifically reduces estrogen's ability to prevent osteoporosis. The reduction or loss of therapeutic efficacy is mainly caused by dose-dependent elevated hepatic clearance, partially in conjunction with lower estrogen levels, and has been demonstrated only with oral estrogen applications.

http://www.ncbi.nlm.nih.gov/pubmed/15638743

http://www.researchgate.net/publication/8092083_Smoking_estradiol_metabolism_and_hormone_replacement_therapy/file/9fcfd5091226151133.pdf

Im gonna order more gel and up my gel dose and lower the oral E...

Its expensive though.... REALLY want IM injections or pellets

Based on the preponderance of evidence, smokers are likely to require higher doses of hormone replacement therapy (HRT) to achieve comparable clinical effect to that observed in nonsmokers. However, uptitrating the dose of HRT in smokers to achieve a desired systemic level or clinical response may simultaneously increase risk for adverse effects that are primarily driven by hepatic rather than systemic exposure.

http://www.ncbi.nlm.nih.gov/pubmed/14973414

Im gonna order more gel and up my gel dose and lower the oral E...

Its expensive though.... REALLY want IM injections or pellets

Based on the preponderance of evidence, smokers are likely to require higher doses of hormone replacement therapy (HRT) to achieve comparable clinical effect to that observed in nonsmokers. However, uptitrating the dose of HRT in smokers to achieve a desired systemic level or clinical response may simultaneously increase risk for adverse effects that are primarily driven by hepatic rather than systemic exposure.

http://www.ncbi.nlm.nih.gov/pubmed/14973414

Good point Eva, I smoked for 36 years, on one particular day I just put them down, mind you it wasn't easy at all. I'm sure you know the risks, I'm also pretty sure you know that quitting will increase the effectiveness of E dramatically regardless of delivery. Sorry, I know mother hen here, lol.

Okay, I'll be the mother hen. QUIT!

Clara

Easier SAID than DONE after 31 years straight

Anyway this is a very good paper on E metabolism and routes of administration....

http://www.hormonebalance.org/images/documents/Kuhl%2005%20%20Pharm%20Estro%20Progest%20Climacteric.pdf

Thanks, Eve. Tough read though.

Clara

Easier with coffee, licorice tea, a healthy dose of E gel gooped on and of course a smoke

Hmmn.... Wondering what would happen if I crushed up an E pill really good and snorted it like cocaine

J/K LOL

You missed your calling, Eve. I'm thinking pharmaceutical researcher.

Clara