Enumerating Estrace's Effects (and Side Effects)

I've been put on a dose of 4 mg of Estrace per day (I chose to take it around dinner every day- it should be taken around the same time every day). Both pills (two) are taken at the same time (as opposed to in two different doses during the day). I had to start Estrace on day 18 of my cycle in my IVF protocol. There are other variations of hormones and timing of hormones that people are put on for IVF though.

My name is Estrace, but you can call me Trouble. . . .

I will be continuing Estrace until my period arrives (day 1 of my next cycle), at which point I cease it (but I'll start it up again after the egg retrieval and this will continue even after the embryo transfer). Last time I took Estrace, I felt absolutely horrible, but as we would later find out, I was also pregnant (without IVF), so I was getting a double whammy of hormones. I was hoping for minimal side effects this time, but given the list of horrifying potential side effects floating around the internet, I should not be surprised that I'm experiencing some.

First, why am I on Estrace? Estrace is a form of estrogen (estradiol). Its most common use seems to be for menopausal women seeking hormone therapy (ie. their estrogen levels have fallen, so they use this to elevate their estrogen levels). Another big use for this drug is as part of the hormonal cocktail used in IVF. It is supposed to prepare the endometrium in the uterus to be of an adequate or optimum thickness for the blastocyst/embryo to be successfully implanted. So, this is supposed to increase the chances of a successful implantation after the embryo transfer, thus increasing the chances of a pregnancy. Obviously, anyone in my shoes who has tried for years to get pregnant and has been unable to (except for the one pregnancy in the spring that ended at six weeks) and who is seeking the aid of a specialist in reproductive medicine and is about to shell out $10,500 for the first IVF cycle of a three cycle plan (where subsequent cycles are less expensive- n.b. if your drugs are covered by an extended medical plan, this could decrease the costs by up to $4,000), you are going to want to do anything you can to increase your chances of pregnancy and decrease your chances of ever having to go through this freaky, unnatural, and very uncomfortable process again, even if it means the temporary discomfort of some drug with weird side effects (or the common concept of short term pain for hopefully long term gain).

Who would think that two such tiny tablets could change the body so much?

The side effects listed on the internet are really numerous for Estrace (too numerous to list) and can range from anything related to nipple discharge and crustiness and breast tenderness, pain, and swelling, vaginal excretions and itching, to sore throat, stuffy nose, exhaustion, irritability, mild depression, gastrointestinal symptoms including nausea and vomiting, bloating, blood pressure changes, hair loss, changes to your menstrual period, break-through bleeding, headache, weight changes, to freckles or darkening of facial skin. So, basically anything that can go wrong in your body (and mind) can go wrong, from the disturbing to the downright disgusting and all of them inconvenient.

At first (ie. the first couple of days), I thought that I was getting a relatively free ride. But at one week later, I'm now having to admit that this is not fun and that I can't wait for my first Estrace taking time block in this IVF cycle to be over (should be about half a week more unless the Estrace makes my period late or early).

At first I noticed horrible headaches, but I often get these from one of my prescriptions, lithium carbonate, so I wondered if it was just that. It having continued, I can see that I'm having more frequent and worse headaches, so it must having something to do with the Estrace. The bloating was quick to arrive, rendering shoes tighter and my rings either unwearable or impossible to remove from my fingers (and depressingly, pants were tighter). I could see the swelling in my face too. I look more tired than usual.

The other two symptoms I noticed in the first day after starting up Estrace again were gastrointestinal discomfort and chaos (gas pains, constipation with loose stool) and my low blood pressure being worse than usual (ie. light headed when standing up, sometimes feeling faint). I was out on a walk the day after my first dose this cycle and I had stomach pains that made the walk unpleasant and then when I was walking up a steep hill, I experienced extreme dizziness (I actually thought that I was going to faint).

Within a couple of days of the initial dose, my husband noted (as delicately as possible) that I seemed more irritable. I disagree, but I suppose he's entitled to his damn opinion (growl!). I noticed increasing gastrointestinal symptoms and my skin was breaking out more. I've had a sore throat that just won't go away completely. More than anything though, it was the exhaustion mixed with bad sleeps at night (ie. trouble getting to sleep, staying asleep, lots of nightmares, and then not being able to get up in the morning and feeling like you haven't slept at all and can barely manage going about your day and not wanting to exercise or go out at all) that I noticed and that have been the most troublesome. I have no idea how someone who has to work outside of home and doesn't have flexible hours can handle this process (hats off to those unsung heroes).

The other most troublesome side effect arrived Tuesday night. I noticed the first signs of what felt like a urinary tract infection (UTI). I wondered if it was just the urgency and frequency of urination that can be a side effect of Estrace. But I felt pain too. I had to take some pyrridium for the bladder pain in the middle of the night (I had some in the house as I've had UTIs in the past, but not for years). I slept horribly. The next day the pain and urgency continued. Another bad sleep followed. This morning I started antibiotics, so that I can kick this infection before I have start injecting myself with new hormones. Levels of hormones like estrogen that are either high or low can lead to reduced immunity, so I'm not surprised that I've come down with this infection.

My long regular walks have not resumed this week, as I have been so exhausted that I feel like I can barely deal with my regular life (and now I have this UTI), let alone working out and walking. Unfortunately, I'm also a perfectionist who is hard on herself, so not doing things that I feel like I SHOULD be doing makes me feel guilty and like a complete failure (which is not improving my mood). I know I need to be gentle on myself because my body is going through a confused hormonal crisis, but I also worry about my health. I just feel exhausted, beleaguered, very anxious, and generally down and I know a lot of this must just be hormonal, but it's hard not to fall into a pit of despair, especially after how hard this journey has been to date. I'm aware that it's not about to get any easier any time soon either.

I guess this next month is just going to be super weird, so there's not much I can do. I just worry if I'm experiencing all of this on just Estrace, how I'm going to feel once I start the injectable hormones and I'm on three hormones or more per day (I keep on picturing the slow moving giant marshmallow man from Ghostbusters- please don't let the bloating be that bad!). Reading about other people's experiences on the internet has helped and hindered. On the one hand, some people don't have a truly terrible time on the hormones, but on the other hand, some people have such a terrible time that they can't continue the cycle and they abandon IVF all together. The information age, having Google accessible 24/7 from mobile and computer, has been both a wonderful and terrible thing.

One day at a time.

Please don't eat me.