DebiR, Just posted an answer ...go to 'Hot Flashes' 03/16/06

[Mary 53]

Hi...I have not been able to post for several days. So, I was catching up today and saw the question under the "Hot Flashes" thread. Sorry I didn't get back to you sooner. Take care, Mary

[Mary 53]

Hi, Sorry for the confusion on the "tweaking." It is a long story, but I had a bad time this fall when I was trying to make sure my hormones were balanced and the right strength. I was feeling "off." I am working with my old pharmacist now and he has consulted his consultants to see what was causing my problems. He adjusted my dose of progesterone. I use that separately from the bi-est. And, I went off the estrodial patch (actually it is a Dot and it works better than the old Vivell patch, which had fallen off frequently) that I'd been on for five years so that I could switch to the bi-est cream. And, we brought all of my hormone strengths down which scared me. But, Rob the pharmacist, explained that we could "blow out the receptors" if the progesterone was too high (and this different doctor this fall had it way too high for me...the pharmacist caught this) Yet, to balance the pro. and the est. we had to bring down the strength of the estrogen. I was really nervous about this. But there was a fear that I was in Estrogen dominance and even though it was with the bio's...you really want and need balance. Well, I am thrilled to report that it is working like a charm. I am amazed. I am feeling so WELL today...I could tell the other day that things were dramatically looking up. But, that is all I meant by tweaking. We tweaked a lot of stuff!

Estrodial is stronger than Estriol. So, if the ratio is 20/80 meaning 20% estrodial, and 80% estroil, well, then, that is a balanced amount due to weakness or strenth of the type of estrogen. Estrone used to be a part of Tri-est. But, it was decided that it was an unnecessary estrogen. It is prevalant in women in the menopausal women and made (hmmm...or used...or stored...would have to check) in fat cells.

I just heard something on absorbtion. It takes about two minutes for the cream to be absorbed. I might be off by a few minutes. But I recall being shocked that it was only a small amount of time. So, use and wait a bit and shower away.

And, you are right that it is easier to play with the dosage of the cream compared to the patch...which is another reason the pharmacist...(and, even the doctor I saw this fall, whom I was not terribly impressed with) wanted me to switch to although I was briefly on it years ago.

I am back with my old doc and my old pharmacist...and, I am not feeling quite so old myself thanks to their help. And, I did not give up trying to fix it...I will look at this as another learning experience. Mary

[AnotherKatie]

AND my patch keeps falling off or getting a kind of fold in it. I read in the "destructions" (as my kids used to call instructions) .... "Patch may fall off in a hot bath or shower" HELLO, you DORKS who write this stuff, who DOESN'T take a HOT bath or shower?  Are you suggesting I take a COLD bath or shower now that I have an estrogen patch???  OK shutting up now.
Take Care .... All My Sisters of the Battalion.... Love Katie

[DebiR]

I have yet to have a hot flash so maybe it is too soon but I swear to you I am having cold flashes.  I cannot get warm.  I am on the biest with progesterone.  Started yesterday.  The only thing I think I have as far as symptoms is that kind of weird anxiety mixed with feeling overwhelmed.  Of course, it could be that it will get better when I get the path report!

[DebiR]

Katie you are scaring me...is it that bad?  I will go search out your cranky post.

[Mary 53]

Sorry....I just double checked and all the stuff posted. I will go and read your post now, Katie. My...such high tech problems on top of dealing with menopause. Oh well, I am glad it posted. See you in a bit. Mary

[Mary 53]

Hey DebiR and Katie, The last two posts..one from me and one from Katie have not posted. I suspect a technical problem. Oh well, shall we start a new thread and call it "Hot Flashes II"...ok, I will start it but I will still refer people to the thread for the bulk of the information...there is a lot there from all of us.

Just so I don't hold you in suspense, DebiR, I do use the progesterone (and bi-est) everyday but Sunday per my phamacist's request (Doctor is in the loop, but the pharmacist really knows his stuff). Darn...I wish the other letter had posted. I will add to this or to "Hot Flashes II" tomorrow. Talked about progesterone and uterus's (?)(and the compounding pharmacists organization's response to the drug company's claim that bio's and other componding drugs should be under more scrutiny or eliminated. The article was fantastic)...

Katie, my new prescription for the bi-est and progesterone arrived over a week ago. I can already tell a huggggeeee difference. I am starting to feel so much better. It has been a rough few months.

So, what is going on? I think I can honestly say that I think I know how you might be feeling...but, I am assuming that there is something physical going on, and that is enough to deal with, but is something else going on? The thing that comes to mind is that there are some problems going on regarding getting the bioidentical hormones.

I will be around tonight on and off. Husband in North Dakota for Hockey finals. A true hockey lover!

[AnotherKatie]

OK maybe I exaggerate, not quite serial killer...maybe...cereal eater??
DebiR, I TOTALLY get that...weird anxiety mixed with overwhelmed! That is good description of it.
Chocolate isn't even working, now, you gotta know, it's really baaaaaad! Are there any over the counters things that you can get, anyone know of?  This is Canada though, can't even get that one you guys can buy for sleeping. My gyne just says "all you need is the Estroderm patch" and the guy who does bio identicals here is booked solid for months. My GP is away for six weeks too.  Yee Gawds it's a conspiracy!
Katie
PS oh and my dog smells bad too, I think he rolled in something. Just great.

[DebiR]

I just read your post.  Gosh I feel so bad for you that the guy is booked for so long.  I did not see the compounding pharm. I just got the script from my GP.  I started a while back and did a search on docs in my area that worked with compounding pharm.  This was a year or so two ago - after my radiation when my ovaries where kind of fried and I started having really bad peri symptoms.  I found this doc and she prescribed compounded progesterone.  It helped some.  But then I had the surgery this week and ovaries removed and she just called in the script for the Biest with Progesterone added.  
The anxiety and overwhelmed feeling comes in a wave.  It's like this big feeling of dread or bad omen or something.  Very scary and dark.  I can generally avert it now but I do think that is because I am on the cream.  The day after my surgery it hit and I just sat down and cried.  Is there anyway you can get your doc to just call in a script to the compounding pharm?

[DebiR]

I just read the hot flash thread thoroughly!  Lots of good info from you - thank you so much.  I am on the Biest with progesterone.  The pharm. said it is the middle dose.  When you say "tweak" what do you mean?  I think he said there were three doses.   So is the balance of Estradiol and Estrone (is that the right one?) the same in each dose or do you tweak that?  Or are you tweaking how much prog is in the mix?  Also, how long do you think it takes for maximum absorption to happen?  I sometimes don't get my run in till mid day and I don't want to put it on in the morning if I am going to shower in two hours but then I hate to wait.   I can see how the patch would be generally better but it doesn't seem like you get as much with the patch as the cream in terms of balance.

[AnotherKatie]

Yo Mary, If you see this, can you please read my very cranky post at the end of the Hot Flash thread, I am too grumpy to even go to the cyber party today.  Gonna eat worms instead.
Katie the Potential Serial Killer due to Unopposed Estrogen and Surgical Menopause Misery

[Mary 53]

Hey DebiR, I just checked my post for the Hot Flash thread. I cannot find it! I see my name there...from me to you, but no post. I know sometimes it takes awhile. If it does not show up, I will just post again and I will try to use that thread, or I will start a new one. It was a little long (surprise!) but, I do think, very informative. Mary