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HRT question after Hysterectomy and bilateral oophorectomy
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HRT question after Hysterectomy and bilateral oophorectomy

I had a hysterectomy with bilateral oophorectomy and appendectomy due to severe endometriosis which had infiltrated my ovaries and was all over my other organs as well (plus a lot of endometriosis was also removed that had adhered to my bowels, bladder, and appendix) .  To help me avoid radical menopause sypmtoms, my doctor immediately started me on a .5 mg. Vivelle-dot estrogen patch after surgery, and I felt fine.   Two weeks later, he added a 100 mg. daily dose of prometrium to my HRT therapy to avoid recurrence of endometriosis growth.  My problem is that I am having unpleasant side effects from the prometrium, including exhaustion, minor headache, and lightheadedness.  I don't like how it makes me feel.  What other alternatives would you suggest to the 100 mg. prometrium?  Can I take a lower dose or cream that would possibly lessen these side effects?  I would prefer to take only the estrogen, but my doctor is concerned that it could stimulate the regrowth of endometriosis.  Thank you for your feedback.
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393685_tn?1325870933
I have been doing a fair amount of reading regarding HRT therapy. What I have learn is somewhat controversial on traditional HRT hormone replacement not actually having the correct molecular make up of the actual human hormones.

The stuff I have been reading about HRT is actually made up from other molecular components found in horses.

I am not sure on the med you are on - but is sounds very similiar to the two I am reading about. Premarin, Provera. The main ingredient is Premarin which is short - from my reading of pregnant mares. This is a horse hormone that is labeled as equillin. There are no traces of this hormone equillin in the table of human hormones. The second component in Prempro is called Provera stated progesterone - but its really not human progesterone or progesterone at all.

Human estrogen is actually a blend of three different molecules. Estriol, estrone and estradiol. These are specific blends to each individual and they have got to be properly balance for the individual to maintain wellness and ward off disease and counter act with human progesterone and testosterone for balance.

I am not on HRT nor have I had surgery - but recently I was found estrogen dominant by specific labs that aren't commonly used. I am still in the beginning stages of balancing progesterone and estrodiol to maintain my wellness. I however require compound treatment to make this balance work.

You can learn more about this option by reading some studies with a doctor named Dr, Jonathan V. Wrights work and clinic. I am in the beginning stages of learning this line of treatment.

I just thought I would share the information.
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775732_tn?1246128744
Hi Karen
I had mine so long ago, I read Stella's comment as well - Anyway, since prometrium is a progesterone, that, if I read correctly is bio-identical to our own body's; the side effects listed were what you listed, I think they're suppose to subside - I don't know and you didn't say how long you've been on it.  It did say you shouldn't take if you're allergic to peanuts.  Talk over what you're feeling with your doctor;  I know there is a chance of regrowth.  Sorry I know I didn't contribute much.  But I will say a prayer.
Hope you feel better soon.  
Serenity  
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Thank you both for your comments.  I really appreciate it.   I spoke to my doctor and she switched me from the 100 mg. oral Prometrium to a 50 mg. compounded progesterone cream and I can play with the dose to work for me.  I started on a very small amount and I felt much better than with the oral Prometrium.   This is tricky business, but I'm sure I'll figure it out.  Thanks again, Karen
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1671919_tn?1303845058
I hope you are still active on here.  Your post was from 2009.  Please let me know if you are, Ive had similar procedures done and for the same reason, endometriosis. My remaining ovary was taken out April 5th, and have started on Vivelle.  I would like to ask you a few questions and hopefully receive some insight in what to expect.  Thank you, Kim
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4864509_tn?1360198708
Hi Kim,

Found this old post from you while looking into HRT. I will be having my remaining ovary removed in a few weeks and am quite concerned that they work with me on HRT. I know that I will probably most likely need something to even me out and I understand that bio-identical hormones, balance between estrogen/progesterone/testosterone, and side effects are major issues with this. Have you found certain tactics helpful to you since your surgery? Hope this note finds you well. Thanks! Kat
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Avatar_n_tn
Hi Kim,
I'm so sorry I did not see this post of yours from almost 2 years ago.
Did all go well for you?  Let me know if you have any questions.  I was able to find an HRT therapy that is working well for me.  I use oral estradiol (.5 mg - I used to use Vivelle Dot .05, but my body stopped absorbing it, so I changed to the oral type) and a compounded bioidentical progesterone cream (1 mg. dose, although I use less, made at a compounding pharmacy) that I rub on to my wrist or upper arm or stomach (I move it around so my skin doesn't build up resistence to it).  I have hormone testing annually to make sure my balances are right.  I feel good on this regimen.  How have things been going for you?
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Avatar_n_tn
Hi Kat,
I thought I would respond to you too.
I have a great Nurse Practitioner who specializes in bioidentical hormones and all kinds of blood testing.
I was able to find an HRT therapy that is working well for me.  I use oral estradiol (.5 mg - I used to use Vivelle Dot .05, but my body stopped absorbing it, so I changed to the oral type) and a compounded bioidentical progesterone cream (1 mg. dose, although I use less, made at a compounding pharmacy) that I rub on to my wrist or upper arm or stomach (I move it around so my skin doesn't build up resistance to it).  I was not able to use prometrium because I had bad side effects from it (I felt dizzy and exhausted when I took it).  I have hormone testing annually to make sure my balances are right.  I feel good on this regimen.  About testosterone, I was tested, and found out I had bound testosterone (testosterone that is chemically bonded to a protein called Sex Hormone-Binding Globulin) showing in my tests but I needed more free testosterone so my body could use it.  My doctor recommended I take a stinging nettle root supplement (which unbinds testosterone).  It worked, as my test later showed.  Another interesting thing....I had been losing hair for a long time and could not figure out why.....my NP tested my vitamins and I found out I was lacking in vitamin D, so I started taking 3,000 mg. of vitamin D daily and my hair loss subsided a lot.   I hope this all helps you.
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