6 months after hysterectomy

I had a total hysterectomy about 6 months ago and I had some pretty major menopause symptoms until I got on 1mg of Estrace.  Things have been going great until the last week or so.  I've started having hot flashes, skin burning and tingling, severe anxiety and muscle pain.  I haven't missed any of my medicine.  Why is it doing this?  Will I have to increase my dose?  Someone please help.

[Machelle Seibel, MD]

It is difficult to say what is happening without more information. It is best to talk with your doctor to be sure something else isn't going on to cause this. However, in the short run, some people find taking their medication at night is helpful as Estrace has a short half life. Others also try doubling up the medication for a few days and if it is better, go in and talk with their doctor about changing the dose. Also, some other medications such as antiseizure medications can have a negative effect on estrogen levels. It is possible that your needs have simply increased. Estrace 1 mg is a real dose but it is still a smaller, rather than larger dose. When there is a sudden change, the best thing is to talk with your doctor who knows much more about you and who can do an exam and get lab testing.
Machelle M. Seibel, MD
Machelle M. Seibel, MD