For women only: what's your experience with hormone replacement therapy?

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@SouthFloridaMom9, I am convinced that using BHRT is not just a placebo thing. I feel that it really makes a difference on so many levels. However, someone I know received the pellet therapy (they insert BHRT in pellet form, into your butt), but the problem is that if you get too much, you have to live with or counteract the side effects until it wears off, in three months. She got too much testosterone, had acne issues, and was chasing her husband around the house (poor guy). :smiley:

I always take that, “within range” stuff with a grain of salt. So…it’s normal for women to have unmeasurable levels of certain hormones, at a certain age. Measuring zero is within range for one’s age for testosterone, but is that actually a good thing? Within range can mean absolutely nothing, because maybe it’s normal as we get older to be fatter, slower, weaker, dumber and have less energy, but is that what we want?

I realize my clinic and BHRT can be somewhat controversial. However, there are a number of women who will never go back, and that says something. The lady who took the pellet therapy, said that they shut her clinic down (apparently a congressman’s wife had some issues with the pellets, and made sure those clinics were closed). She said there were all these women standing around the clinic, crying :frowning:

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My friend also had the pellet implanted and they do seem to have a hard time getting the dosages correct. She too was chasing her husband around the house and calling him at work telling him to come home. Never thought her hubby would ever get sick of too much sex but it appears he did!!

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That’s hilarious, riverbirch. Maybe the husbands should get the pellets at the same time so they can keep up!

That said, I would not want the pellets, because if they try the wrong dosage out, you’re stuck. Easy to adjust if you have adverse effects with a pill or a creme.

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@LBowie - ugh… I didn’t see your message until after I called the pharmacy. I spoke with the pharmacist and he told me no, not to cut them in half, that they ‘wouldn’t work’ that way. But I’m pretty sure my GYN told me one time a couple of years ago to not throw out my .1 when he decreased my dosage to .075. Then when I went down to .05 I’m pretty sure I remember telling him how I now had three different dosages in my medicine cabinet and his saying not to throw any of the other two out in case we ever wanted to experiment with alternating dosages or if I ever needed to, I could cut a .1 in half to get a .05.

So not only this, but I asked them when the generic prescription that my GYN had called in for me would be ready, he looked it up and saw that instead of e-prescribing the generic yesterday, the GYN actually just re-prescribed the name brand, which they don’t have. UGH!!! So I asked the pharmacy if they would call the doctor’s office tomorrow and get the orders for the generic patch. And I will then call him myself and ask if I can cut it in half. I mean, with H working in the pharmaceutical industry, I like to give pharmacists the benefit of the doubt, but I’m pretty sure my GYN told me I could cut it in half.

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Teri, the pharmacist is just trying to C(his)A because pharmacists have to follow the prescription. They would defer all off-label dosing to docs.

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@teriwtt - we have a lot in common it seems. My husband also works in the pharmaceutical industry! I totally hear you on chasing down all those prescriptions, backorders, etc. It is frustrating. WHen I went on the (useless) Duavee, I had to get a “discount card” from the manufacturer (Pfizer). It made me a little annoyed and it was still expensive since my insurance did not cover – $86/mo. Not that CombiPatch is any cheaper…I still have to call the gynecologist to change my prescription. I am using CombiPatch that was prescribed by my PCP slightly in error – she thought I had the all-clear on the Pap but was actually still undergoing some testing. SO I cancelled it since I got the Duavee. But now I hate the Duavee and want the Combipatch again. It has gotten so complicated I dread even calling the gynecologist!
BTW, I also had tried the Climara Pro ealier, but it didn’t work – did not stop hot flashes and I got breakthrough bleeding on it. It seems the CombiPatch is the only thing that works for me that I’ve found. They all seem to have the same estrogen but different progesterone versions.

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@Massmomm: Like you, I never had much problem with perimenopause or menopause, except a few stray hot flashes here and there, so I never considered HRT. But sex was very painful, and nothing OTC helped much, so my GYN prescribed the Estring (FYI, you can get a savings card online to limit the cost to $5/month). Estring is a ring (like a diaphragm without the dome) and you replace it every 3 months. It took a few days, but now I don’t even notice it there. That got rid of the extreme pain, but there was still discomfort, so she added Estrace cream, 1 g 2x/week. I had a bad reaction to the Estrace (severe itching and rash), so once that cleared up, she substituted Premarin cream, still in addition to the Estring, 1g 2x/week. (There’s a savings card online to print out for that one, too.) So far, the combo is working. Feel free to pm if you want more info.

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I cut my Combipatch in half. Both my Internist and gynecologist are onboard with cutting it.

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D was on estrogen to induce puberty, then estrogen and progesterone. She started on Vivelle dot and 2 different endocrinologists, both at the state’s childrens’ teaching hospital, had her cut the patches as we worked through different strengths.

On a side note, I’m not much a fan of electronic scripts. They have caused me many more problems than paper scripts ever did. Our family has a lot of monthly meds, and I can’t count the times the doctor’s office called in wrong med, wrong dosage, brand name vs generic, and wrong quantity–all of which we review in office and I take in a list of current medications.

In the day of paper scripts, I knew they were correct, in-hand, when I left the office. Now it takes multiple pharmacy trips and calls back to dr. office. These are from many different specialists, so it’s not an isolated office thing.

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It’s a very nice thing to have a personal relationship with the pharmacy and main pharmacists. A smaller neighborhood pharmacy opened up by my folks’ house and I immediately transferred all my Rx and H’s and our kids, plus my folks’ Rx so that they are all at one place. We also get all our immunizations there, so they remember us and fax all the records to our physician. It has saved some grief because one of our relatives happened to try to get a 2nd flu shot this year (having forgotten he already got one) and they remembered and gently reminded him and did NOT give him a 2nd one.

They will also call me when appropriate and help me get the correct reimbursement from my insurer. They’re happy to contact the MD to get a new Rx when the existing one runs out as well. It is so much nicer than the larger pharmacies where none of the staff know your name and you’re just one more person’s Rx to fill. They will also tell me if they think a different Rx might be better for me than the one I’ve been prescribed and we will have a discussion and change as appropriate. I LOVE it!

Sorry, I have never taken BHRT. The most I did was consume a lot of Soy Milk when I was in perimenopause and menopause. I had NO problems that I can recall. My mom and sibs also said they were pretty symptom free as well.

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@LBowie - I almost hesitate to type this here because I won’t win any friends, but my Minivelle patch co-pay for a 90-day supply was only $63 the first time I filled it in 2016 and $40 the second time I filled it (am just about to get the third time), and my progesterone pill was $51 for a three-month supply for the first fill in 2016, and didn’t cost me anything the second time I filled it. I am very, very lucky - I get that.

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That sounds like an awesome deal, teriwtt!

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I cut mine in half for years, it’s fine!

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So, I seem to be starting with menopause. Periods were always very regular, they got a bit irregular for a while, now I haven’t had one for 3 months. I’m 54. The hot flashes aren’t severe, but VERY frequent. I have more than 12 per day, and 3-6 per night. At night they mostly seem to be in my legs; during the day, they are more upper body. I don’t get sweaty, but they wake me up and I have to throw off all the covers, even on a cool night. Then in 5 minutes I put them back on and go back to sleep.

I have put on 10 pounds over the past year, and can’t seem to lose it. I don’t have the energy or motivation I used to have, and while sex is pleasant and not painful, I haven’t had much of a sex drive for quite a few years. I’m also getting quite a bit of painfulness and stiffness in my hips whenever I sit or sleep for a while, and some in my knees.

Do you think HRT would help any or all of these things? What should I be looking for? I’m kind of confused by all this talk of testosterone, estrogen, progesterone, etc. We don’t have fancy medical care where I am, no longevity clinics or anything like that. Also, I have a high-deductible health plan. It sounds like it’s expensive?

Guess I should find myself a doctor and ask some of these questions.

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I am a cancer survivor. It would be dangerous for me to take hormones. However I must admit that I have had 2 hot flashes…and one was the onset of the flu. No symptoms/no drugs…

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We have high deductible insurance too. Insurance requires a 90 day script. Costs of generic estradiol and progesterone are not that high–I paid $12 and $10, respectively, on my first 2016 fill. They may be on the “cheap” lists for major pharmacies. D is on brand name and it is considerably more expensive.

57

I had a rough peri-menopause when I began to have awful flooding irregular periods. Nutritionist suggested going to the doctor for a prescription or trying OTC (over the counter) bio-identical progesterone. Seeming like a lot less work, I tried the OTC progesterone and got relief from the flooding periods within a few months.

It was never the perfect cure-all that some reading might lead one to believe, but I believe it has eased the transition.

Now that I’m older, in my early 50s, and my periods are much lighter and even more irregular, I began to notice different symptoms, that suggested to me that my estrogen was also decreasing (dry, dry, dry).

I then switched from a progesterone only OTC product to a combo progesterone-estrogen bio-identical OTC product. I use OstaDerm-V by Bezwecken. I take half the recommended amount on the label, in a divided dose, upon waking and before bed. I buy it through Pure Formulas online, sometimes Amazon.

I haven’t ever had a hot flash (knock on wood), but I seem to be having less troubling symptoms than my peers who are complaining about being unable to sleep, burning up with flashes, or having rages.

Over the summer, I decided to break up with my nightly glass of red wine or two. In addition, I now walk the dog first thing in the morning for anywhere from an hour to two hours, often listening to podcasts or an audiobook. I also snagged the Dawn Simulator Lamp from the daughter’s room who didn’t want to take it down to school. I think these three steps have helped to improve my sleep and take my sense of well-being up a notch or two. Disclaimer: all kids are out of the house now too and it feels more peaceful.

I did get a “surprise” mini-period about a month ago, and I was very emotional the days beforehand. Once I saw there was going to be a bleed, I had one of those ah-ha moments. I’d say my moods have been steadier since not cycling regularly, every month.

I’ve lost weight, and that is concerning. Looking a little gaunt. Need to pick up some weights.

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I was surprised to read so many of you advocating for HRT that I went to check whether perhaps the research had changed the outlook on HRT. Here’s what the Mayo Clinic is saying: http://www.mayoclinic.org/diseases-conditions/menopause/in-depth/hormone-therapy/art-20046372

Basically, it’s not recommended unless you have early menopause or really nasty symptoms.

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@dmd77

It get confusing (at least to me!) when one tries to tease out what trials were using combo products (E + P) or single hormones “unopposed” and then what trials were using bio-identicals (or not). Not to mention, I’m not sure about dosages.

Here’s a short article from Health.Harvard.edu with an intro about the attitude change towards hormone therapy, and at the end a list of common FDA-approved hormones for menopausal symptoms, including a column on whether they are bio-identical or not.

http://www.health.harvard.edu/womens-health/what-are-bioidentical-hormones

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The Mayo Clinic publishes a book, The Menopause Solution, by Stephanie Faubion, who’s Director of their Women’s Health Clinic & their Office of Women’s Health.

The book’s very well-done. It provides an overview with good details. From the Cover- “A doctor’s guide to relieving hot flashes, enjoying better sex, sleeping well, controlling your weight, and being happy!”

Personally-- I (&my family :wink: found peri-menopause, when I tended to be unpredictably irritable or moody, more difficult than menopause in that I haven’t had hot flashes. At worst I might feel overly warm after a hot bath/shower before bed. Treated peri-menopausal symptoms early in the process with birth control pills.

@Massmomm - your menopausal symptom, plus urinary urgency, have been my main complaints. I use local estrogen, Vagifem, a very small tablet of estradiol, inserted vaginally. Anther local estradial treatment is Estring and Estrace (see @buenavista).

In terms of general health or concerns about exposure to estrogen, low dose local estrogen, unlike systemic estrogen (often referred to as HRT) does not need progesterone to prevent hyperplasia (ie growth of tissue in the lining of the uterus). I’m not certain if Estrace cream at high doses is supplemented with progesterone.