Wrong about HRT

[MarieIG]

Thank you. I intended to listen to the podcast a little bit at a time - but listened listened to it in one sitting.

 

[tb001]

I had been on a bio-identical estradiol patch and bio-identical oral progesterone for several years. I tried different types/delivery methods available before setting down with them, including a combo patch (progestin), suppository bio-progesterone, some kind of progesterone device that's inserted in your uterus and stay there for 6 months (I can't remember what is called). I loved my bio-identical estradiol patch from the beginning, but I had a difficult time finding the right progesterone (stomach cramps, sleepiness, strange space-out feeling in the head, etc). But anyway, I wasn't sure if it's OK to be on HRT (even if it's NHRT) at an older age (I'm 61) so that's why I got off mine at the request of my Dr.

I've been off both estradiol and progesterone for about 3 months and I have become very forgetful. It's palpable.

The brain effects are just so huge. FWIW, mine comes in a troche that you have to let dissolve in your gum area twice a day. My dr is monitoring my blood levels regularly as well. It’s $150-200/mo though.

 

[googily]

I went into surgical menopause six years ago, because of continuing problems with endometriosis, which also means adding back in estrogen is counterproductive (since that's what endo feeds on).

I had a couple "waves of warmth" the first few months, but that's it. Maybe the estrogen still hiding out in my fat cells is helping matters.

I had a breast cancer scare last year, and I do have a somewhat elevated risk for it.

After the initial discussions with my obgyn about HRT and why to not do it, no one's ever brought it up again.

I definitely count myself lucky.

 

[tmm99]

The brain effects are just so huge. FWIW, mine comes in a troche that you have to let dissolve in your gum area twice a day. My dr is monitoring my blood levels regularly as well. It’s $150-200/mo though.

How old are you? I liked what I had (bio estradio patch and oral progesterone), but I am getting old (61), so that's why I got off them.

 

[tmm99]

I went into surgical menopause six years ago, because of continuing problems with endometriosis, which also means adding back in estrogen is counterproductive (since that's what endo feeds on).

I had a couple "waves of warmth" the first few months, but that's it. Maybe the restricted still hiding out in my fat cells is helping matters.

I had a breast cancer scare last year, and I do have a somewhat elevated risk for it.

After the initial discussions with my obgyn about HRT and why to not do it, no one's ever brought it up again.

I definitely count myself lucky.

Hey, good for you!

https://www.health.harvard.edu/wome... found that women,most recent two-week period.



"The analysis found that women who had frequent hot flashes had double the risk of having a cardiovascular disease event, such as a heart attack, arterial blockage, or stroke during the study period compared with women who did not have hot flashes in the most recent two-week period. Women who had hot flashes that researchers defined as persistent were 80% more likely to go on to have a cardiovascular disease event in the next 20 years compared with women who did not have persistent hot flashes. "

I'm having several hot flashes a day right now.

 

[googily]

Hey, good for you!



https://www.health.harvard.edu/wome... found that women,most recent two-week period.



"The analysis found that women who had frequent hot flashes had double the risk of having a cardiovascular disease event, such as a heart attack, arterial blockage, or stroke during the study period compared with women who did not have hot flashes in the most recent two-week period. Women who had hot flashes that researchers defined as persistent were 80% more likely to go on to have a cardiovascular disease event in the next 20 years compared with women who did not have persistent hot flashes. "

I'll take it!

 

[HadEnuff]

Haven't heard the podcast... will give it a listen... But it is a topic I have followed. My mom was on HRT. She also developed ovarian cancer (and died of it.) She was well past menopause and still on HRT when she was dx'd with cancer.

I recognize this is anecdotal.

I chose to not do any hormonal therapy when I was perimenopausal and now that I'm menopausal. My sister chose to do some therapy during the perimenopause period to help with hot flashes and other symptoms. She weaned herself off over time.

I will listen to the podcast.

Wow, rodi, it is anecdotal, but it matches with my mom's experience as well. My mom was 75.

I am a male, considered it, tried it, didn't like it for a few reasons. This was 15 years ago. Now, I'm 67 and probably wouldn't be a candidate for it due to rising PSA numbers, and (hopefully benign) enlarged prostate.

 

[Vacation4us]

Ok bad on me. I have 3 tubes of Premarin in the cupboard. Guess I will give it a shot. I just hated the “mess”. I only took it 2-3 times, not enough to notice a difference. Just told DH we have to give it another try. With our insurance it was only $10 a prescription, MD only prescribed it twice a week.

 

[audreyh1]

I read that the estrogen created past menopause is mostly estrone, which is considered a bad estrogen (causing breast cancer) and overweight women have more circulating estrone in their bodies. (Incidentally, synthetic estrogen has a very high concentration of estrone in it.) My obgyn back in California said she prescribes progesterone (without estrogen) to some patients routinely, just for that reason. She might have told me how often (I feel like she might have said once a year for one month), but I can't remember for sure.

Disclaimer: I'm not a doctor but I read "Screaming to be Heard" by Elizabeth Vliet MD years ago. She mentioned that some of the progesterone creams over the counter can be too strong and it could cause some side effects. (I think she mentioned worsening of diabetes and loose joints (more injuries?)) but again, I am not sure. I read the book about 10 years ago.

My estrogen did drop a lot after menopause, but so did my progesterone. My doc tries to maintain a healthy ratio of estrogen to progesterone. I use a prescription compounded cream. My hormone levels are routinely tested.

 

[tmm99]

Ok bad on me. I have 3 tubes of Premarin in the cupboard. Guess I will give it a shot. I just hated the “mess”. I only took it 2-3 times, not enough to notice a difference. Just told DH we have to give it another try. With our insurance it was only $10 a prescription, MD only prescribed it twice a week.

Although I'm sure those two people (a social psychologist Ph.D. and a surgeon) who wrote the book meant well, I wouldn't just decide to take any kind of hormone supplements because of it. I certainly wouldn't take Premarin (made with horse urine with a lot of estrogen-type compounds that are foreign to the human body). I read that Premarin contains (amongst other hormones), 49% estrone (a type of estrogen postmenopausal women predominantly produce, which is often linked to breast cancer), 22% equilin, and 13% dihydro equilin. It does contain 3.6% of 17-beta estradiol that's identical to what women produce before menopause (the type of estrogen you want to supplement with in postmenopausal), but that's a very small percentage.

I would rather go with an FDA approved/regulated pharmaceutical bio-identical version of estrogen (17-beta estradiol) if I'd go with HRT of any kind.

Just my opinion.

 

[tmm99]

My estrogen did drop a lot after menopause, but so did my progesterone. My doc tries to maintain a healthy ratio of estrogen to progesterone. I use a prescription compounded cream. My hormone levels are routinely tested.

Oh good! I wasn't sure if you were buying it OTC which is really crapshoot.

 

[Freedom56]

Yes, either specializes or is ready to test and react using the latest science, as opposed to "do what they've always done". I have a feeling many people are being treated (or probably not being treated) in the latter category. That's why I thought that getting up to speed on the latest science using the book or podcast was important.

Finding a reputable doctor who specializes in this was not easy even in a county with 10 million people with some pretty good healthcare providers. My wife found four doctors of which one retired five years ago who was one of the best doctors in this field. The other issue is that other than the OBGYN visit and blood tests, the medications (customized per patient) are customized and not covered by insurance.

 

[tb001]

I would rather go with an FDA approved/regulated pharmaceutical bio-identical version of estrogen (17-beta estradiol) if I'd go with HRT of any kind.

Just my opinion.

I may be wrong, but I don’t think the Bio identical hormones are fda approved products, though they are regulated. I believe most are compounded.

I believe my dr mentioned tapering off in 5 years or so. I’m 50 now. The biggest impact has been on my sleep quality. For the first time in years I’m sleeping well most nights.

And freedom, either Drs are becoming more educated or I got super lucky. I had done zero research, just went to a dr people raved about in general, and he put me on them. But yes, expensive.

 

[athena53]

Ok bad on me. I have 3 tubes of Premarin in the cupboard. Guess I will give it a shot. I just hated the “mess”. I only took it 2-3 times, not enough to notice a difference. Just told DH we have to give it another try. With our insurance it was only $10 a prescription, MD only prescribed it twice a week.

Wow. I bought the cheapest Medicare prescription plan and I pay something like $365 before I hit the deductible (I make sure to refill if I'm running low near the end of the year). GoodRX and others no help.

Yes, give it another try. It takes a month or two to "ramp up" so you shouldn't expect any effect after just a couple of applications.

 

[tmm99]

I may be wrong, but I don’t think the Bio identical hormones are fda approved products, though they are regulated. I believe most are compounded.

Estradial patches such as Vivelle Dots have been around for at least 20 years and they are approved by the FDA. You do not have to take the compounding route.

 

[tb001]

Estradial patches such as Vivelle Dots have been around for at least 20 years and they are approved by the FDA. You do not have to take the compounding route.

That’s interesting. I hadn’t realized Vivelle was bioidentical. This is one of the few areas of my health where I just did what I was told and did no research. I just felt so much better! That said, what I’m taking is expensive. It’s a combo E, P and T product. I’d love to see if I could get the same benefits from a less expensive medicine.

 

[sengsational]

Thank you. I intended to listen to the podcast a little bit at a time - but listened listened to it in one sitting.

It's easy to get drawn in when listening to smart people having an intelligent conversation.

 

[bluelight]

I'm 63 and have been on HRT for about 10 years. Started on the Estradiol patch and was slowly weaned down to the lowest dosage, now I am on the lowest dosage of Estradiol tablets.

Even with an immediate family history, my mother died of breast cancer at age 42, both my previous and current gynecologists (we moved 4 years ago) have determined that for me the positive benefits of HRT outweigh the risk.

 

[drcha]

I'm a retired gynecologist and I want to not answer specific questions for people (because you should take your queries to your own doc) but to back up what the OP says. There are pros and cons and each person must consider them individually, in collaboration with a knowledgeable practitioner who knows your history. I have been on hormones myself for 12 years. For me, I consider the benefits greater than the risks.

The media does a piss-poor job of reporting most scientific information. The data are rarely black and white enough to conform to tidy sound bites.

While I'm on the soap box, most of the stuff people do to stave off the ravages and diseases of aging and decline are not that effective. If you want to stay well for a long time there are 3 very simple things that just about everyone can do, all of which will cost you little or nothing. 1-Refrain from poisoning yourself with smoking, illicit drugs, or excessive alcohol consumption. 2-Eat more plants and fewer animals. 3-Exercise every day.

 

[Earlygirl]

Thanks. I am thinking of going back to my doc and tell him that I'm too miserable without something. It looks like Bezwecken Hydration Ovals is estriol-based, which is a much more benign form of estrogen (less strong compared to estradiol and usually produced by pregnant women). I could mention to him about estriol cream, but overall I just don't feel very good without some estradiol for my brain and I'm definitely losing my pep, but maybe I'm supposed to feel old like that as we age...

What has worked for me is Estrace, and I have also used 1% Estradiol cream made by a compounding pharmacy. It's a local application rather than a systemic one. I would be in pain without the cream! I don't know if my brain is declining...my pep is, but I am 65. My previous doctor said the local application is safer. However, going on Medicare now and switching doctors, so I am going to ask the new doctor what they think about HRT.

 

[Vinnygret]

I listened to a podcast on hormone replacement therapy for women and found out I was mostly wrong in my thinking. I thought it had been proven that it increased breast cancer risk, universally. Wrong. I thought it's only plus was to reduce menopausal symptoms. Wrong.

https://peterattiamd.com/caroltavris-avrumbluming/

The above is two+ hour interview of a pair of people who wrote a book called "Estrogen Matters". The interviewer is Peter Attia (a "longevity focused" MD clinician and podcaster).

What surprised me the most is the apparent protective effect hormone replacement seems to have on so many "really bad" and feared diseases such as Alzheimers, diabetes, colon cancer and more. There are contraindications, like if you have existing high risk of CVD, your chances of an event go up slightly in the first year, but then down later. But HRT even helps protect against atherosclerosis as long as you're not in the throws of it already. And, unlike what was in the headlines, HRT probably isn't going to increase the likelihood of breast cancer. They talk quite a bit about why many of us came away with that wrong idea (but no true smoking gun).

Anyway, I thought if this post led some people to learn more about this topic and then ask their doctor about it, it might make for a few longer, healthier retirements.

Well, you should do what you think is best for you, but my three quarters of my right breast says "no more for me, thanks." When I asked the gyn who did my hysterectomy how long I would take the hormones (the lowest available dose), he glibly replied, "for the rest of your life, which, incidentally, would have been considerably shorter had I believed the clear mammogram I received in February of 2000 and had skipped the breast self exams which found my tumor that November. At 48, I was a good little patient, doctor knows best. Also, I was taking Premarin and was blissfully unaware of the torture of horses that goes on in order to manufacture that HRT. I was ignorant. I never thought to ask any more other than how long I would have to take it. But the production of the drug is a crime against sentient beings who have no say in the matter. I was over 60 before someone clued me in on the NAME of the drug: PRegnant MAres urINe - Premarin. Yes, I had more hair, slept better and found it easier to manage my weight, but once you have had breast cancer, your perspective changes. But, as I said, you (plural) should do what you feel is best for yourself. As for me, I'd read more than one report. Chemotherapy was no fun.

 

[Vinnygret]

And some of us don't. Breast cancer notwithstanding.

 

[Vacation4us]

Wow. I bought the cheapest Medicare prescription plan and I pay something like $365 before I hit the deductible (I make sure to refill if I'm running low near the end of the year). GoodRX and others no help.

Yes, give it another try. It takes a month or two to "ramp up" so you shouldn't expect any effect after just a couple of applications.

Thanks for that info. I have already taken my second dose this week.

As for Premarin being made from horse urine, who cares if it works and doesn’t increase my risk of having a stroke. I want my sex life back! Instead of the Sahara Desert and pain I now experience. Bio identical hormones have not been proven to cause less strokes.

When my mother had her second stroke the neurologist said it was 100% the HRT when recovered my mom went to the OB doc I as a OB nurse had hand picked for her just to let her know. She was like OH! Now this happened 20 years ago and since then there have been multiple studies but keep in mind your OB isn’t going to be the one to treat your stroke. There will always be a disconnect there.

 

[Kristinia]

At my doc's request (and I agreed to his request), I weaned myself off of NHRT (Estradiol patch and oral progesterone) at the beginning of this year. (I'm 61.) I cut my patch by 25% over a few months. It was good for a few months and then, boom! Hot flashes started. I have a fan all over my living room so I can turn one on closest to me when they hit. I also started taking a few capsules of soy isoflavone which seems to help with the frequencies of the hot flashes A LITTLE. I've also noticed that I am much more forgetful and sadly, I feel kind of dry... I may go back to my doc and see if he can do something about that... (Estriol cream??) Another thing I've noticed is that I'm less bloated (my rings are looser).

This was definitely me about a year ago. Came off of HRT after being on it over 30 years (early histo) and everything fell apart. I cried easily; gained weight; and dry....it was horrible. So went back to my dr and begged to be put back on HRT. She said the research indicated high risk for breast cancer. So she put me on Premarin cream (administered at night) and a low dose anti-depressant. Things are so much better now. So not sure if research is correct but I won’t go back on it now that I have found a way to live a happy life without taking it orally.

 

[Mansderm]

I'm a retired gynecologist and I want to not answer specific questions for people (because you should take your queries to your own doc) but to back up what the OP says. There are pros and cons and each person must consider them individually, in collaboration with a knowledgeable practitioner who knows your history. I have been on hormones myself for 12 years. For me, I consider the benefits greater than the risks.

The media does a piss-poor job of reporting most scientific information. The data are rarely black and white enough to conform to tidy sound bites.

While I'm on the soap box, most of the stuff people do to stave off the ravages and diseases of aging and decline are not that effective. If you want to stay well for a long time there are 3 very simple things that just about everyone can do, all of which will cost you little or nothing. 1-Refrain from poisoning yourself with smoking, illicit drugs, or excessive alcohol consumption. 2-Eat more plants and fewer animals. 3-Exercise every day.

Retired MD, too and agree 100%. I'm on BHT for about 12 years now and plan to continue. It is generally not covered by insurance. I just don't feel like myself without them. I've had genetic testing for cancer susceptibility and am low risk. My thoughts might be different if I were high risk. Exercise is very important and I'm pretty sure I would be less motivated without my hormones because without them, I was pretty apathetic to everything and I cant see spending the 20+ more years that I may have to live as an apathetic blob. Fortunately I did find a doctor who said "every woman is different" and she was willing to work with me to find a relatively safe way to treat me.