confused regarding HRT and bloodwork results

[robinsview]

Hi, I am a 49 (soon to be 50 year old:) woman.  I had a TAH in 2005. I was on estradiol 1mg. for almost 2 years, I alternated 1 and then a 1/2 a day for a year or more. Then it was recommended that I get off of HRT (by one doctor) so I kept cutting back until I was taking a 1/2 a day and then every other day. Not long after I started feeling edgy, weepy, more achy, etc....etc.... So, I went to a different doctor and he prescribed me the birth control pill, ortho tri-cyclen.  I wasn't thrilled about taking synthetic horomones, but found that I was not able to afford the saliva testing and compounding horomone route of treatment (I have no health insurance).  The first month I did notice heartburn, constipation, a little dizziness , however the mood swings, weepiness and muscle aches improved. I am into the second month now and I am having the same symptoms plus some breakouts and anxiety. My last appt. I really wanted to try the estadiol again with an otc progesterone cream (because since adding the progesterone the aches and pains are much better, can't believe I suffered with them for 2 years thinking it was normal after surgery).  But once again the doctor convinced me to stay on the birth control and take a daily asprin to protect against blood clots and get my mammograms once a year, which I do.  I am very confused and what to do what is in my best interest.  My gut tells me that I should not be taking birth control.  Also, I had some blood work done recently and when reviewing the results the only thing the doctor mentioned that was out of range was the hemoglobin Little Low at 11.6 and henotocrit at 33.8, but he didn't mention that my platelet count was high at 412. Isn't this about how your blood clots? How do you get your platelet count down? Could this be risky being on birth control?  Any insight would be greatly appreciated ........thank you .......R

[Machelle Seibel, MD]

If you felt well on the estradiol that you started on, it is likely less estrogen than the birth control pill and should be a reasonable choice for you. While taking a birth control pill is not necessarily bad, it isn't necessary. Taking a baby aspirin is a good thing for both men and women after 50. If progesterone makes you feel better than stay with that also, though it isn't required since you had your uterus removed. As to your blood count, it isn't clear why your blood count is low and your platelets high. Maybe the aspirin is causing intestinal bleeding or there is some other loss of blood as you no longer menstruate. Discuss this with your internist or see a hematologist.
Machelle M. Seibel, MD

[robinsview]

correction ...............I had a TAH/BSO :)