BHRT

[missy]

Just exploring this topic and I know nothing about it.

Are there any PSers who are taking bio identical hormone replacement therapy who are willing to share info with me? I am way past the beginning of menopause (6-7 years post) and not sure if it is too late and not sure this would even be a good idea for me since I never did well with taking bc pills so not sure I would tolerate BHRT. But I am curious and want to find out as much as I can about this before I find a knowledgeable doctor (gyn, endocrinologist?) who might be wiling to treat me with BHRT.

I did a search here and came up with a few old posts.

Anybody willing to share and help me navigate this topic? Thanks.

 

[arkieb1]

Women's Health

Find information on women's health issues, fitness, and lifestyle at the Women's Health Center

www.webmd.com

I'm sure it's different for everyone but my mother had and has issues with her parathyroid glands (they removed 3 of them from her throat/neck) and could not take some specific types of hormone replacement tablets. Which ones she cannot have and why I'd have to ask her when she gets better....

 

[whitewave]

I use smoky mountain naturals. Amazon.

 

[Queenie60]

Missy - I'm not much help. I tried Bio Identical Hormones about 6 years ago as I had rapid weight gain due to menopause. Being a breast cancer survivor, I was on an extremely low dose, mostly gels and creams. My mammograms began to show suspicious findings and I had constant follow ups which was more torturous than the weight gain. I went off of the hormones, mammograms showed normal and eventually the weight corrected itself with a little help from me! We're all different and there's a different "recipe" for every women however, I would advise my daughter against taking them.

 

[Bonfire]

Missy I don’t know if you are considering this as a treatment for your osteoporosis? As another breast cancer survivor (Hi @Queenie60) I had my bilateral mastectomy one year ago today! Be aware, that ANY type of hormone replacement, bio identical included, is going to feed estrogen receptors in your breast tissue, and with that comes increased breast cancer risk.

 

[missy]

Thanks @arkieb1 @whitewave @Queenie60 and @Bonfire.

Women's Health

Find information on women's health issues, fitness, and lifestyle at the Women's Health Center

www.webmd.com

I'm sure it's different for everyone but my mother had and has issues with her parathyroid glands (they removed 3 of them from her throat/neck) and could not take some specific types of hormone replacement tablets. Which ones she cannot have and why I'd have to ask her when she gets better....

Arkie, how is your mom doing? She is in my continued thoughts. Hope she is doing better and getting stronger each day. Thanks for weighing in with your thoughts.

I use smoky mountain naturals. Amazon.

I will check that out. Thank you @whitewave. How long have you been taking it and what positive effects have you observed and what negative effects if any?

Missy - I'm not much help. I tried Bio Identical Hormones about 6 years ago as I had rapid weight gain due to menopause. Being a breast cancer survivor, I was on an extremely low dose, mostly gels and creams. My mammograms began to show suspicious findings and I had constant follow ups which was more torturous than the weight gain. I went off of the hormones, mammograms showed normal and eventually the weight corrected itself with a little help from me! We're all different and there's a different "recipe" for every women however, I would advise my daughter against taking them.

@Queenie60 thanks for weighing in and same here. My mom is vehemently against it though she doesn't know I am considering it now. I never took anything after menopause and now I am rethinking that due to my OP and other things I read about being in a low state of hormones is not healthy. Granted I am at just the very beginning of my research so I know zero and most likely will end up not taking HRT as I could not even tolerate low dose BC pills when I needed bc. I am glad your mammograms are back to normal and that the weight came off too. I keep reading weight gain is a common side effect with HRT and I wouldn't care for that either.

Missy I don’t know if you are considering this as a treatment for your osteoporosis? As another breast cancer survivor (Hi @Queenie60) I had my bilateral mastectomy one year ago today! Be aware, that ANY type of hormone replacement, bio identical included, is going to feed estrogen receptors in your breast tissue, and with that comes increased breast cancer risk.

Yes exactly the reason. In my mind that is the main reason I developed OP. In 2004 I had a bone density done and I was completely fine and 16 years later I am much below the SD for my age range and in osteoporosis. Granted we have a family history but the loss of estrogen hurt my bones. Though I agree I wouldn't want to change one disease for another perhaps more deadly disease. We do not have a family history of breast cancer though I realize many breast cancer patients have no family history either.

I am so sorry you had to go through breast cancer and a bilateral mastectomy and so glad you are doing well and it is behind you. Continued well wishes and healing vibes being sent your way. And thanks for sharing your thoughts. Like I told @Queenie60 I am probably going to end up with deciding against BHRT (and as you say it is the same thing re cancer risk) but I just want to do my research and make the best informed decision possible for me. I should update the OP thread. I have been meaning to do so.
And happy one year anniversary! I cannot believe it's been a year already. Yay for making it through stronger and better than ever!

 

[whitewave]

What change have I noticed? Well, not much lol. I was using it in conjunction with my primary care doctor and once a year I get a complete hormone panel done though canary club and ZRT labs. It’s free to join and the test panel kit is about $350.

(Que all the reasearch about the unreliability of saliva testing for hormone levels etc)

I hadn’t been feeling well with all of my health issues, lately the meniscus tears and the broken tibia, so to say I was inconsistent in application is an understatement.

My husband is on testerone replacement and my last labs (2 months ago) show me HIGH on testosterone, and low on estrogen and low on progesterone. I also found out recently I’m officially in menopause so idk. I’m also getting gastric sleeve surgery as soon as it opens up, so I don’t really know what’s going to happen with my hormones when I release a ton of fat.

Sorry to be so unhelpful. I was hoping my sex drive would increase, but with quarantine and DH home a lot more and with him generally happier and less intense... well, that problem basically sorted itself.

 

[stepcutnut]

@missy good luck with your journey into researching BHRT! Barbie Taylor MD has a youtube channel as well-interesting information. She does offer personal phone consultations also.

Menopause Taylor – Your Menopause Your Way

menopausetaylor.me

 

[Arcadian]

I'm currently doing bio identical hormones. My advice; find a good doc. I can't say that enough.

I'm at the beginning of this journey, only been at this about 12 weeks. You'll need to get labs for sure.

so at the moment, I take 2mg estrogen twice a day, No progesterone (I don't have a cycle) And also, compounded thyroid with iodine (you can't get it in this country otherwise!)

I take a small amount of testosterone cypronate *spelling* a week in a shot. Yes ladies, you need a it because we make a wee small amount. Super high amounts? Well they can convert but usually not enough for women...

Defy wanted to start me on higher dose of test and I said no. Being I did some research prior, and I suggested a dose I felt I would feel OK starting with, and that was fine. We'll see where it goes with with my next labs. I personally am fine starting small. They wanted me to do a gel and I said no, shot only. I got what I wanted. On the Estrogen you can get as a shot. I decided to start with tab which is fine. I will not ever do a gel because I've seen some horror stories around the fact its not as consistent.

In general for me it wasn't about sex drive, though it suffered some. Its much more about the OTHER side of low hormones. I was constantly tired, I'd wake up every night with my heart beating like crazy. I did gain weight though thankfully not too much, My hair was getting extremely brittle though I was treating it like gold, and my nails...woah...not normal! The anger, the anxiety, the paranoia.....all that is linked to low hormones.

My hair might take a while but I don't have the paranoia anymore, and thats a serious relief! I don't have the weird aches and pains out of nowhere either. And my goodness I'm sleeping through the night which I haven't done in nearly 5 years. Anger issues...they've nearly subsided. Some anxiety but its NORMAL anxiety.

Of all things, get a Doc that will actually listen to you and does not poo poo your blood work, find one that actually treats women, and isn't afraid to work with you on what you need. And you have to be willing to take the reigns as well. Not every doc knows what they're doing out there no matter what they have behind their name.


I use Defy Medical in Tampa, which I do by video mostly. https://www.defymedical.com/

 

[missy]

Thanks @whitewave. Good luck with your gastric sleeve surgery and I hope you start feeling much better. Good news re the quarantine helping some issues!

@stepcutnut thanks very much for the info. I'm going to check that out.

@Arcadian thanks so much for the detailed info...sounds very promising. Finding a good doctor I know is a big part of it. I am not sure how to go about that but will try finding someone who can help. And I am going to check out defy medical. Thanks again!

 

[OboeGal]

I'll echo a lot of what @Arcadian had to say - especially about being willing to take the reins. I've yet to find a doctor that really, truly knows what they are doing around women's hormones, particularly concerning menopause. It's really imperative for women in our stage of life to educate ourselves on how our bodies work concerning hormones.

I've been on HRT for 13 years, although I take an extremely tiny dose now. 13 years ago I had absolutely everything taken out, which threw me instantly into surgical menopause. That makes my case extreme and complicated beyond what women in natural menopause are dealing with. In order to make life livable, I've had to learn a lot about how hormones work in the body. One of the things that is important with hormones is the concept of a "critical window" to receive benefits and reduce risks. That means that to use HRT safely, it's best if it's initiated within a reasonable time period of menopause and used continuously for what is likely a time-limited period of time. It is riskier, and less likely to confer benefit in terms of things like heart health, if it is initiated more than about 6 months to maybe a year after menopause, based on current research and understanding. Now, if one is experiencing symptoms that are really damaging one's quality of life, one might reasonably decide that some increased risks are worth it to improve the quality of life even after the critical window is past. One just needs to be aware that there are some increased risks. HRT is also very tricky to do well; one is essentially trying to externally manage something that the body is designed to manage internally, with all kinds of feedback mechanisms that one can't anticipate, and all kinds of complications based on genetic tendencies concerning liver enzyme production, etc. Obviously, in some cases, as Arcadian is finding, the end results are worth it, and some women have good luck in having things work in a pretty predictable way, but others can really struggle. Trying to find a state of "balance" can be very much like trying to dance on the head of a pin.

@missy, there are a couple things I would like to mention in your case. Since you haven't mentioned having ovaries removed, I assume you still have them and they are functioning as they should for your age. If that's the case, they are still making estrogen, even though you are post-menopausal, and will continue to likely until around age 80 or thereabouts, on average, although the amount will gradually decline as the years go by. For women in this stage of life, other important contributors of estrogen are body fat, particularly that little "fat pad" we tend to get abdominally that tends to not go away even if body fat elsewhere does, and conversion of adrenal chemicals to estrogen and just a tiny bit of progesterone, which is also an important player in bone health. (Estrogen has one role and progesterone has a complementary one.) That may be a contributor to your bone issues - that your body fat is low enough that you haven't been getting quite enough estrogen from fat. The body at this stage of life prioritizes estrogen ahead of progesterone, so if ovarian + fat supplies are not supplying enough estrogen, adrenal production will short progesterone for the sake of estrogen. That could put you lacking adequate progesterone, and possibly estrogen as well, to properly regenerate bone.

Now, I'm of course not a doctor, so this is just guessing and opinion on my part, but......perhaps, rather than trying HRT just yet, you might find some help hormonally from focusing on doing everything you can to increase body fat in a sustainable and healthy way. That would provide additional hormone supply, but in a way managed by your body, with preserved feedback loops and such, rather than trying to externally manage it. It would also be a more gradual introduction of gradually increasing hormone supply, which would be more comfortable for you than the more sudden introduction of external hormones. You have additional complications to externally managing hormones, if I'm remembering correctly. One is Hashimoto's. There is tremendous interaction between sex hormones, particularly estrogen, and thyroid hormone levels, and HRT is MUCH more complicated when there are thyroid disorders involved. I seem to also remember that you may have some issues with excess blood clotting - do I have that right? If so, that increases the risk of external estrogen replacement, as estrogen enhances clotting tendencies, and can make an awful lot of doctors very reluctant, if not outright unwilling, to prescribe it.

I guess what I would do, if I were in your shoes, is I would take a very multi-pronged approach to this. Since you have genetic factors involved in your OP diagnosis, hormones would not likely be the whole answer anyway, so I would:

- continue doing what you're already investigating around vitamin D and K2 intake, and perhaps methyl folate as well;​

- continue the bone-building exercises (and adequate protein intake to support muscle growth);​

- work on increasing body fat in a healthy way up to a weight that you and your doctor are comfortable with to increase hormone production and enhance balance in a natural way (and I know that this is something that is an ongoing struggle for you; I would give you some of mine if I could );​

- work on stress control, as increased stress "steals" adrenal precursors away from the sex hormones in favor of cortisol and adrenaline; and​

- add in a medication that you and your doctor feel is the best choice for you (which I also realize is no small feat).​

​

Only then would I, in your situation, look at HRT if I did not feel that the results of the other measures were adequate.

I'm sorry to have written a book - as my DH says, I'm unable to tell a short story! - but I hope something here helps. I'm happy to be of any future help, too, if I can.

 

[Daisys and Diamonds]

Missy please don't take anything that has a breast cancer risk
Melanie had no family history

 

[missy]

@OboeGal thank you so much for your thoughtful and detailed post! I really appreciate it and you got it all right re my Hashimoto's and challenge in gaining fat. I don't think I have a blood clotting disorder though so that is one thing less to be concerned about but yes I am nodding my head with everything you wrote.

As for taking the reins I am far too familiar with doctors not getting it right and dancing on the head of the pin so to speak. My thyroid disease and adrenal issues are still not well managed IMO and complicated doesn't begin to explain it agreed. And I have known for a long time now that part of the reason I cannot get my thyroid and adrenal issues resolved is due to the imbalance of my sex hormones which to date no doctor (gyn, end, rheumatologist, internist) has mentioned.

Despite the fact my endocrinologist always tests my sex hormones he has never once addressed the fact my testosterone, estrogen and progesterone are very very low. I have been researching thryoid and adrenals for the past 2 plus years and I still don't feel like I have a handle on what I need to do and while the endocrinologist is knowledgeable and a lovely man he isn't able to help me to get to the point I need to be. However I continue trying and I am better off I think than I was 2 years ago. But still not where I wish I was.

I am many years post menopause so not sure what that means for me re HRT. I have read that there is a window but I didn't realize it was such a narrow one.

I am going to reread your post and digest it all and continue my research and if I could find a knowledgeable hormone specialist to help my journey I feel I could get this issue sorted out. On my own I am not sure I have the capacity given all my hormone issues to fix this. I haven't gotten as far as I was hoping I would get re y thyroid and adrenals so I will see if I can find someone to help team with for good hormone health.

Thank you again. I so value your input and hard earned knowledge. I am very pleased you have found the right combo for you and are doing well.

 

[missy]

I'm currently doing bio identical hormones. My advice; find a good doc. I can't say that enough.

I'm at the beginning of this journey, only been at this about 12 weeks. You'll need to get labs for sure.

so at the moment, I take 2mg estrogen twice a day, No progesterone (I don't have a cycle) And also, compounded thyroid with iodine (you can't get it in this country otherwise!)

I take a small amount of testosterone cypronate *spelling* a week in a shot. Yes ladies, you need a it because we make a wee small amount. Super high amounts? Well they can convert but usually not enough for women...

Defy wanted to start me on higher dose of test and I said no. Being I did some research prior, and I suggested a dose I felt I would feel OK starting with, and that was fine. We'll see where it goes with with my next labs. I personally am fine starting small. They wanted me to do a gel and I said no, shot only. I got what I wanted. On the Estrogen you can get as a shot. I decided to start with tab which is fine. I will not ever do a gel because I've seen some horror stories around the fact its not as consistent.

In general for me it wasn't about sex drive, though it suffered some. Its much more about the OTHER side of low hormones. I was constantly tired, I'd wake up every night with my heart beating like crazy. I did gain weight though thankfully not too much, My hair was getting extremely brittle though I was treating it like gold, and my nails...woah...not normal! The anger, the anxiety, the paranoia.....all that is linked to low hormones.

My hair might take a while but I don't have the paranoia anymore, and thats a serious relief! I don't have the weird aches and pains out of nowhere either. And my goodness I'm sleeping through the night which I haven't done in nearly 5 years. Anger issues...they've nearly subsided. Some anxiety but its NORMAL anxiety.

Of all things, get a Doc that will actually listen to you and does not poo poo your blood work, find one that actually treats women, and isn't afraid to work with you on what you need. And you have to be willing to take the reigns as well. Not every doc knows what they're doing out there no matter what they have behind their name.


I use Defy Medical in Tampa, which I do by video mostly. https://www.defymedical.com/

Hi @Arcadian, how are you doing now on the HRT? I think it’s been about a year you’ve been taking them. What are your thoughts and how are you feeling?

 

[inne]

I have never taken BHRT, but I have worked as a researcher/writer for a company that specializes in it and learned a lot about the industry. Unfortunately, what I found was that the company I worked for was incredibly unethical, and they are not the only ones. I urge anyone considering any form of HRT to go to a legitimate medical specialist. Some BHRT providers promote discredited theories, receive training from disreputable organizations, etc. And I don't mean a few isolated quacks - there are clinic franchises that have very questionable practices as their core.

BHRT can be amazing. Just get it from someone you can trust.

 

[Begonia]

I have osteoporosis too. 15 years ago I tested fine, went into menopause 10 years ago at 44 and voila! OP. Tried Fosamax and made me sick sick sick. Following this keenly @missy!

 

[missy]

I have osteoporosis too. 15 years ago I tested fine, went into menopause 10 years ago at 44 and voila! OP. Tried Fosamax and made me sick sick sick. Following this keenly @missy!

Hi @Begonia are you taking any meds now for your OP?

I have never taken BHRT, but I have worked as a researcher/writer for a company that specializes in it and learned a lot about the industry. Unfortunately, what I found was that the company I worked for was incredibly unethical, and they are not the only ones. I urge anyone considering any form of HRT to go to a legitimate medical specialist. Some BHRT providers promote discredited theories, receive training from disreputable organizations, etc. And I don't mean a few isolated quacks - there are clinic franchises that have very questionable practices as their core.

BHRT can be amazing. Just get it from someone you can trust.

Thanks @inne it's a complicated situation as they are interrelated. My thyroid hormones and sex hormones etc.

I am taking Evista so far with no side effects that I know of...my new gyn wants me to go on HRT specifically progesterone (for help with sleep) and estrogen for help with bone health. But then I have to go off Evista. She likes Evista but said it takes 2 years to see if Evista is helping the bones and HRT has other benefits that I could use. And that the breast cancer risk is the highest within the first year and if we monitor diligently I should be OK. And because I am so active blood clot risk is minimal. IDK what to do.

To complicate matters I am on thyroid meds which estrogen interferes with and I take my thyroid meds every 4 hours four times a day and estrogen needs to be taken 4 hours apart from thyroid meds (and other meds) so I do not have enough time in the day to take all my meds that need to be separated by 4 hours.

I don't know the best option for me. It's always about risk benefit ratio and there is no perfect solution that I know. The question is which treatment(s) would be my best choice. IDK. And while I am seeing the appropriate medical professionals (endocrinologist and gynecologist ) I still don't know.

 

[Ally T]

Hugs @missy . I had no idea women's health around perimenopause & menopause could be so complicated. You'd think by now, with everything scientists & Dr's know, they'd have figured it all out.

I'm going to follow this thread. As you know, I was told in August that I am in a well established perimenopause & have PCOS. I went to the Dr due to another sudden hair loss episode, fatigue & a slight weight gain i just haven't been able to shift, thinking thyroid. Other than that I felt great & all things considered, I still do. But since then, right on cue, I have developed the most painful & sensitive nipples (sorry tmi) like PMT on steroids (or early pregnancy boobs), my skin sometimes feels itchy & my face burns when I remove my makeup, despite having used the same products for years. My lips burn & need constantly creaming. My periods have been bang on 27/28 days forever, but these last 3 have pushed out to 34, 30 & 32 days between, so I feel slightly fore warned & have been able to mentally process what's about to begin.

BHRT isn't regulated here, so I am currently trying to nurture my body the best I can. I eat well (& what is recommended as I approach these years, so lots of beans, leafy greens, soy, nuts, whole yogurt etc) I exercise most mornings & I try to calm my mind. I'm happy for the little tummy to stay if it's going to help.

My maternal grandmother died from breast cancer, my mother has had some breast cysts drained over the years & wasn't allowed HRT after her full hysterectomy aged 50 & I suffer sebaceous cysts, though thankfully not many, not large & not in obvious places. Consequently my Dr wasn't keen to look at HRT yet, especially as my current symptoms are so mild & don't really bother me. I am hoping going forward this continues, but she was very clear that I was to go back if things change. My mother was absolutely fine without HRT & had no issues from the sudden upheaval (no flushes, sweats, mood swings etc) & is 77 now. My oldest sister is 55 & has also shown no symptoms apart from slight hair thinning.

It's awful that we have to go through this. And it's awful that it can last for so many years.

Big hugs to everyone suffering right now.

 

[Begonia]

Hi @missy. No I'm not taking any meds. I have a lousy doctor who has retired and I'm without at the moment. Things are shut down here and it's hard to open this problem up and figure out what to do. I'm concerned as heck about it too. I take vitamin D, K and calcium in a few forms but all the gyms closed months ago and my resistance training stopped. I'm trying on my own without equipment which isn't the same. Personal trainers are so expensive. I can hire one for outdoor training but the $100/hour price tag is high for us right now as the constant threat of layoffs hang over our heads. You can see where my worry lies. Once I figure out if my kidneys and bladder are OK (cytology next week), I'll revisit this. Rambling...sorry.

 

[Arcadian]

Hi @Arcadian, how are you doing now on the HRT? I think it’s been about a year you’ve been taking them. What are your thoughts and how are you feeling?

I'm doing well! I've had my ups and downs with it, because it can take a while to get your levels right, but I think so far, its been good! I feel like a human again, not crying at the drop of a hat. and my goodness no hot flashes since!!! I do get heart palpitations though still but its way less. (I've been checked out for heart stuff and my veins, and they saw no blockages . So, I may still need to add some additional E, but I need to make sure I don't get too much because of my health history. basically I may always have heart palps because I can't take the E I need to get rid of them. I do take small amount of T, pretty tiny in comparison to the E these days. Not taking any P at all. I've tried and it makes me a little nutty....lol P is heart protective, so I may try again someday.

On the physical side, my hair looks fabulous. Its not as thick as it once was but I have only one small bald spot left and its so freaking soft and finally really holds on to moisture! No more straw hair! I did cut my hair (it was needed) and its grown a lot since. I haven't had this type of hair growth since my late 20's.

My nails are OK. they still grow really long and are strong, they're not as brittle anymore. That has more to do with the daily collagen though. And my skin looks great. I never had wrinkles anyway but def. softer, not as rough.

My weight has stabilized I think. I went through a weird weight loss thing which I attribute to anxiety/stress of the pandemic...I'm that type that will lose weight when really stressed. Lost near 30 lbs. I didn't need to but it didn't exactly hurt either...lol I can't lose any more though it will make me look bad.

Dealing with the pandemic stuff?? well, I still get anxious but not as bad as I normally would Being on the HRT has helped me manage that way better than I would otherwise because there would be multiple nights where I used to just not sleep. Now I sleep. I might have 1 night a month where I just won't sleep compared to before where it was nearly a week of it a month.

 

[Arcadian]

@missy I read what you're going through above and your dr is pretty much on target. the HRT will help you get some things in order. you will have to monitor yourself really well and don't start off too high. P is something I had some issues with and for now I'm OK with out it (my levels are actually not that great but pretty decent) And E will help you resolve a lot...you can always go up when you need, so start low. I take E in shot form which you don't see the issues with. Also one more thing;
You MIGHT have to take more thyroid or you might not. The labs will tell the story. I haven't had to take extra so what happens with one, may not happen with someone else.

Distant hugs because its a bear, womens hormones are really not straight forward.

 

[missy]

@Arcadian thank you so much for your helpful and detailed post and hugs too. I am glad you are doing well and have things controlled.

If I may I have another question. My gynecologist wants me to start synthetic non bio identical hormones to start. For various reasons. But I am hesitant. What are your thoughts?

My gynecologist said we could go to bio identical if necessary but first to try the regular synthetic (covered by insurance) hormones. She Rxd 100 mg progesterone for 2 weeks and then increase to 200 mg progesterone and she prescribed 1 mg estrogen to take with the progesterone at bedtime. Does that sound right to you?

Thanks so much for your input.

 

[Arcadian]

@Arcadian thank you so much for your helpful and detailed post and hugs too. I am glad you are doing well and have things controlled.

If I may I have another question. My gynecologist wants me to start synthetic non bio identical hormones to start. For various reasons. But I am hesitant. What are your thoughts?

My gynecologist said we could go to bio identical if necessary but first to try the regular synthetic (covered by insurance) hormones. She Rxd 100 mg progesterone for 2 weeks and then increase to 200 mg progesterone and she prescribed 1 mg estrogen to take with the progesterone at bedtime. Does that sound right to you?

Thanks so much for your input.

It sounds to me as its more of a comfort issue for your doc, i.e., its what they know. How your body manages a shot versus a pill is different. Pills by mouth take a different pathway and have to go through the liver and shots typically bypass that. You get much more out of the shot than the pill and with the pill, you have elevated risk of blood clots and other not so happy things. Shots are NOT the most comfortable if you've never given any to yourself but they can be managed once you've done it a few times. Also you get more relief/quicker relief from the shot.

I would also suggest that if possible, that progesterone should be as a suppository (front or back) because by mouth you'll sleep but you might feel like crap in the morning. Try it and see if pill form dosen't cause any issues and works, if it dosen't work, go the route of a suppository.

Many years ago I've tried the synthetics but frankly did not do well on them. The unfortunate part is many of us have very little choice to go that route. Your DR can and should consider the shot form of Estodial Valtrate ( Delestrogen ) or Estrodial Cypionate. both of which is available in the US. Both of those should actually be covered by insurance. You can also get Estrodial as a bio identical in a 2mg pill in the US. should be covered by insurance without issue but if not, they're not terribly expensive especially if you use good rx app.

In the short term 1mg of synth esto is not much but if thats all they're willing to do, then start there, it won't hurt, but its really not a lot when your tank is already at empty.

I had nothing in the tank...I started with 2mg of estro a day. You will NOT overdose or even go that high at that level, its just a stepping stone so to speak. you will like many of us HAVE to go higher levels as we get closer to something more normal.

I take my estrogen at any time of day. When I was on the pill form, it was with a meal as uptake was better with some additional fat. Progesterone strictly was a night time thing.

Your blood tests are going to be very important going forward. Your doc should push for decently high levels of estro if you have no other health concerns because its extremely body protective for women, but if there are health concerns like cancers, then should be dosed accordingly.

 

[jaaron]

Sorry, I'm short on time so haven't read the replies to this-- apologies if I'm repeating things others have already said.

I plan to have them pry my BHRT along with my Armour Thyroid out of my cold dead hands. I'm (apparently) very sensitive to hormones - had hyperemesis gravidarum all three pregnancies and was never able to tolerate any kind of birth control pills -- and have had zero issues with this. It's overseen by my GP and a gynaecologist with a specialisation in it. My blood levels are checked about every three months and we make any necessary changes to the formulations, although a lot of the dosing is done by how I feel rather than numbers. Both doctors say that the numbers really only give a snapshot of your levels at that one particular moment.

I use a cream on the inside of my wrists in the morning and a lozenge that dissolves between my gum and cheek at night. Both are blended specifically so the proportions and levels are easily changed when necessary. The lozenge has oestrogen and progesterone and a tiny amount of testosterone, the cream is oestrogen and progesterone only as I'm very sensitive to testosterone.

I hope you find a solution that feels right for you.

 

[missy]

It sounds to me as its more of a comfort issue for your doc, i.e., its what they know. How your body manages a shot versus a pill is different. Pills by mouth take a different pathway and have to go through the liver and shots typically bypass that. You get much more out of the shot than the pill and with the pill, you have elevated risk of blood clots and other not so happy things. Shots are NOT the most comfortable if you've never given any to yourself but they can be managed once you've done it a few times. Also you get more relief/quicker relief from the shot.

I would also suggest that if possible, that progesterone should be as a suppository (front or back) because by mouth you'll sleep but you might feel like crap in the morning. Try it and see if pill form dosen't cause any issues and works, if it dosen't work, go the route of a suppository.

Many years ago I've tried the synthetics but frankly did not do well on them. The unfortunate part is many of us have very little choice to go that route. Your DR can and should consider the shot form of Estodial Valtrate ( Delestrogen ) or Estrodial Cypionate. both of which is available in the US. Both of those should actually be covered by insurance. You can also get Estrodial as a bio identical in a 2mg pill in the US. should be covered by insurance without issue but if not, they're not terribly expensive especially if you use good rx app.

In the short term 1mg of synth esto is not much but if thats all they're willing to do, then start there, it won't hurt, but its really not a lot when your tank is already at empty.

I had nothing in the tank...I started with 2mg of estro a day. You will NOT overdose or even go that high at that level, its just a stepping stone so to speak. you will like many of us HAVE to go higher levels as we get closer to something more normal.

I take my estrogen at any time of day. When I was on the pill form, it was with a meal as uptake was better with some additional fat. Progesterone strictly was a night time thing.

Your blood tests are going to be very important going forward. Your doc should push for decently high levels of estro if you have no other health concerns because its extremely body protective for women, but if there are health concerns like cancers, then should be dosed accordingly.

Thanks again for such a detailed write up @Arcadian. It is so helpful for me and I appreciate you taking the time to share. The synthetic progesterone had soy so I cannot take it. I wrote to my gynecologist re the patient portal yesterday asking for a telemedicine appointment because I wanted to discuss BHRT and instead she just wrote back she Rxd BHRT for me at a speciality pharmacy and they should be contacting me about it. I did want to speak with her first because I wanted to discuss different delivery options but OK. We shall see if the pharmacy calls me and what she prescribed and how it goes.

Sorry, I'm short on time so haven't read the replies to this-- apologies if I'm repeating things others have already said.

I plan to have them pry my BHRT along with my Armour Thyroid out of my cold dead hands. I'm (apparently) very sensitive to hormones - had hyperemesis gravidarum all three pregnancies and was never able to tolerate any kind of birth control pills -- and have had zero issues with this. It's overseen by my GP and a gynaecologist with a specialisation in it. My blood levels are checked about every three months and we make any necessary changes to the formulations, although a lot of the dosing is done by how I feel rather than numbers. Both doctors say that the numbers really only give a snapshot of your levels at that one particular moment.

I use a cream on the inside of my wrists in the morning and a lozenge that dissolves between my gum and cheek at night. Both are blended specifically so the proportions and levels are easily changed when necessary. The lozenge has oestrogen and progesterone and a tiny amount of testosterone, the cream is oestrogen and progesterone only as I'm very sensitive to testosterone.

I hope you find a solution that feels right for you.

Glad it is working well for you @jaaron. I am interested in hearing more details when you have the time and energy. I like the idea of a lozenge (what are the fillers in the lozenge?) and cream and I too am very sensitive to hormones. I could not even tolerate the fillers in Armour unfortunately so am on NP and T3 but still not near optimal but that is another story for another day. Hope all is well by you and happy holidays. XO.

 

[jaaron]

Hi Missy,

The lozenges are in a PEG (polyethylene glycol) base. When I first started on them, they also added some kind of sweetener. I subsequently asked them to leave it out as I'm not crazy about artificial sweeteners. They do have a slightly bitter taste, but I didn't find the sweetener did much to alleviate that anyway.

I'm happy to tell you the makeup of what's in them if you think it would be helpful?

I'm sorry that you're still struggling with the thyroid stuff. I don't know if this is helpful, but getting my hormones stabilised and under control with bhrt had a very clear positive effect on my thyroid issues.

 

[missy]

Hi Missy,

The lozenges are in a PEG (polyethylene glycol) base. When I first started on them, they also added some kind of sweetener. I subsequently asked them to leave it out as I'm not crazy about artificial sweeteners. They do have a slightly bitter taste, but I didn't find the sweetener did much to alleviate that anyway.

I'm happy to tell you the makeup of what's in them if you think it would be helpful?

I'm sorry that you're still struggling with the thyroid stuff. I don't know if this is helpful, but getting my hormones stabilised and under control with bhrt had a very clear positive effect on my thyroid issues.

Thanks so much Jaaron. It’s a mountain of health issues and I don’t know where to begin anymore. It’s disheartening all these years later and I feel worse off than before. :/

I am very glad you have these health issues under good control. You’re my inspiration. I’m not giving up but I’d be lying if I said there weren’t times I feel it’s all too hard.

 

[missy]

@Arcadian how is your BHRT going and how are you feeling?

I am reaching out to Defy Medical based on your recommendation as I don't feel my gynecologist has a good handle on how to prescribe for bone health. She is great for gynecology in general but for OP specifically not so much.

I just wanted to ask you if there is a specific person you could recommend to me for BHRT at Defy Medical. Thanks.

 

[Arcadian]

@Arcadian how is your BHRT going and how are you feeling?

I am reaching out to Defy Medical based on your recommendation as I don't feel my gynecologist has a good handle on how to prescribe for bone health. She is great for gynecology in general but for OP specifically not so much.

I just wanted to ask you if there is a specific person you could recommend to me for BHRT at Defy Medical. Thanks.

Any of them should be OK Just make sure that you let them know you don't want to be stuck on a bunch of testosterone and thats it. if you have any cancer concerns, def. discuss it.

Defy has some amazing Dr's better than the average GYN, but, you also have to still be your own advocate and put your foot down if its something you don't want to do. (they will listen at least!)

Its been a day...lol

I'm probably going to shift my meds a bit. This is normal, most of us have ebbs and flows which is natural. Waiting on my blood results.

 

[missy]

Any of them should be OK Just make sure that you let them know you don't want to be stuck on a bunch of testosterone and thats it. if you have any cancer concerns, def. discuss it.

Defy has some amazing Dr's better than the average GYN, but, you also have to still be your own advocate and put your foot down if its something you don't want to do. (they will listen at least!)

Its been a day...lol

I'm probably going to shift my meds a bit. This is normal, most of us have ebbs and flows which is natural. Waiting on my blood results.

Thank you. I hear you and second that. It's been a day here as well. Every single day it's been that kind of day for a long while. :/

I am exhausted advocating for myself with doctors who are clueless. I am so tired @Arcadian. I hope you find just the right dose to make life easier and better and sweeter. Sending you many well wishes. I really appreciate your help.