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Estrogen Replacement Therapy and weight gain???
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Estrogen Replacement Therapy and weight gain???

I'm going to lose my mind with all this hormone stuff. I take .90mg of Premarin daily and my weight is slowly going up, up, up. I am hanging onto 30lbs from chemo and it's all around my stomach! I'm eating less, starting to exercise and have gained 2 more lbs. Is it my Estrogen? If I lowered my dosage (which I want to anyways) would that help the situation at all? I know that having more fat around your abdomen can increase estrogen levels in your body - is that still true if I have no ovaries? UGH...when will I ever be normal again!! Mary... will trying the progesterone cream help me to lose some of this weight even if I still take the estrogen? Thanks in advance for your input ladies!
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This topic has been a hot one for me, since I was already close to being a plus size when my reproductive hormones decided to go bonkers several years back.   One problem is that body fat stores estrogen, so that is the means by which your body has "more" estrogen; it can build up as a "reserve" if you gain fat (not a problem with muscle weight gain).   Then, if you begin losing weight (i.e. burning fat), this stored estogen is released.

I have a friend who lost some weight after started a progesterone supplementation.   For me, progesterone causes weight gain, partially from water retention.  If it's not one thing, then it is another, isn't it?!
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Hi Tybear,

Let me know if you can find some posts that mention names of places to check on the web. I know we exchanged information a while back regarding progesterone. I think it was the one where you asked Dian about it and I jumped onto the thread. Also check anything that looks hormonally related...it will most likely have my name on it, but there are others who are pursuing the bioidentical hormones and if you go to the archives, you will find even more info. The problem is..it can get very confusing, so if you want to get just some info from here (print it to read later so you won't get hit with a ton of stuff at once)and then check out the various websites that would be helpful.

You need to get a base...a foundation of information so that it becomes clearer to you. The information on the hormones do vary a bit and different people have different opinions. That is why you need to research this stuff so that you can formulate your own opinion and also advocate for yourself.

I just posted information explaining the difference between wild yam cream and progesterone cream. It is on the hysterectomy forum on this website. It an older thread...from May, I think. But, you will see my name and I wrote it specifically to "Giddychick"...also, there are other threads I answered over there such as a response to Celine147 about post-hysterectomy symptoms. There are a few negative comments on that thread...ignore them and just be there as a "learner." That's my new attitude, anyway!

If your doc is giving you Premarin, I would be totally shocked if he would not allow you to start on bioidentical estrogens and also bio progesterones (do read the note to giddychick the more I think of it, because there is sooo much confusion about this. One is a bioidentical product and the other is a drug, but you will need to know this when you ask your doc for a prescription). These hormones really saved me. But, until I added the progesterone, I was lost.

I know I am not being terribly specific to your question...or maybe I am, but gosh there is sooo much to this stuff. I think that Premarin can cause wt. issues, but, yes, since it is supposed to mimic estrogen and you have nothing to oppose it (don't take progestins...such as prempro, in fact your doctor would not give you that since you do not have a uterus...so, he may very well ask you why on earth you want to take progesterone since you don't have a uterus....this drives me crazy. That is why I want you to look up the other posts so you can be ready with information). But there are so many side effects alone that this would have me wondering why he would have any issues with giving the bioidenticals to you except that he just probably does not know much about them....which is often the case. If he tells you they don't work or they have not been studied....write me and I will go to his office and I will ..............sorry, I get a bit passionate here.

Gotta go do some dictation since I have been putting it off all day. THINGS will get better. I have been a weight watcher since I was 11...and I have worked (I am trying not to say "struggle" with my weight for years...tried to stay ahead of the game, so to speak. I gained about 25 pounds during the first six months after my surgery. But, I was so fatigued from the two surgeries and I was doing a new internship ...I did not work out once all that time and I need to exercise. Also I was on estrogen only. I discovered the progesterone 9 months after my hysterectomy. It improved my life dramatically within two and a half months.

Awesome.

A disclaimer...forgive the "he" adjective if your doctor is female! And...I did not edit today.....

Mary
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Oh my...after all the help you have provided everyone...I think I can help you.

Did you take the capsules? Use cream? or drops under the tongue? Since I would start writing a chapter if I don't know which delivery system you used, if you don't mind, I will wait for your answer...I am going to assume ahead of time, if I may, that you won't mind answering this question.

Till Later...Mary
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The last go-round was with Prometrium (capsules).  Fortunately, I don't need them anymore.  My thermal ablation in March solved the issues with the "excess" or "unopposed" estrogen.   But I am still curious about the information that you can offer; you are the resident expert in this matter!
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Hi, I want to leave one quick message, but check later on tonight. I will have time to make this more complete...but, I, too, was on an oral preparation of progesterone. I had a "Paradoxical Response" to the oral and do sooo much better on the cream. More tonight...

Mary
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If fat stores extra estrogen, then I have enough for my lifetime and my grandchildren!!!  Seriously, I am starting to have hot flashes 6 weeks post-op.  I get and hot flash, then a mild headache.  What's up with that?  It happens everyday!
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Hi Mickey and Brettspike...

Just some more details.

In the fall of last year I went to see a specialist who deals in "anti-aging" ...fancy term for a doc who dealw with hormones but not an endocrinologist. I had been on micronized progesterone from my compounder (and doctor) at 2% and the Vivelle patch 1.0 mg. (Vivelle is bioidentical). But, I was wanting to see about adjusting doses. Starting to "space out" again...like looking at my desk for one item, seeing it, and then still looking for it. Missing appointments. Urinary issues starting up again.

The new doctor took blood samples. First time ever I had a test for hormone levels. My estrogen was just "okay" ..testosterone (I use that too) was just okay but progesterone was hardly there at all. I decided to stay on the estrogen patch for the time being since I did not want to switch everything at once. My progesterone was increased and switched from cream to an oral form which I had to put under my tongue.

Progesterone is a natural diuretic and in theory should not cause weight gain and in fact can promote weight loss when necessary (estrogen is cited as a weight "maintainer"). But, I started to balloon. Talk about distress. My "middle" grew about six inches and my poor little 36 barely A's were crying for a larger bra.

Of course I started to research like mad. The worst was when the leg cramping started. This was just horrible. It would wake me up crying in the night. I was losing sleep and getting very irritable. More research.

Progesterone (or lack thereof) is related to the leg cramping...not cramps per se, but pain in the bone really. And then I found comments on Suzanne Somers website that some people do not do well on oral progesterone (abreviation from now on to Pro)and that they gain weight, become bloated, retain water, etc. I found a reference to this in Dr. Uzzi Reiss's book "Natural Hormonal Treatments." It is called a paradoxical response to pro.

I then found all sorts of support on leg cramping and Pro. I called my old compounder in desperation. Then I went back to the "new" doctor since I was scheduled for a check up and another blood teat. The doctor insinuated that this was all in my head. That did not go over well:) but, I sat there and just nicely advocated for myself. He said since there is such a strong mind/body connection that it (the pro) might be affecting me this way since I think that it might be. GRRRRRRRR

By this time we'd discovered a thyroid condition. I had been suspicious of this for some time. SO, I am grateful to this doctor for allowing me to go on Armour Thyroid and I am not falling asleep at red lights after work now. Thyroid problems and menopause seem to go hand in hand.

But for the thyroid condition, I knew I would not stay with this doctor. I stayed on the progesterone until the third month check up. The day the blood was drawn I ran to the store afterwards to pick up some over the counter progesterone and opened it in the car and used it there. I slept so well that night...no leg cramps. I stayed on the vivelle patch and the testosterone. But the delivery system on the progesterone seemed to really play havoc with me. I lost five pounds the first week. Water weight, I am sure.

The last blood test results showed that my progesterone levels had not changed except for a .02 increase. So...where was all that extra pro going? Not sure. Speculation that it was going to make cortisol.

Back with old doctor..old compounder. Better except for the urinary stuff. And, I use vaginal suppositories of estriol ( a very weak estrogen known to protect agains vaginal atrophy which can lead to urinary problems). We reduced my estrogen and I am now on a lower dose and it is bi-est (two compounded estrogens) but I am going to have a saliva test next week so that we can see where my levels are before we go changing things again.

Bretts....headache and hot flashes sounds like estrogen issues. The estrogen and pro will stay in your body for awhile...excuse me..estrogen will still be there (estrone is the estrogen produced in the fat during menopause)..but your levels are off and maybe low (I know for sure that low levels cause night sweats and that hot flases can be caused by fluctuating levels. Headaches are often a hormonal symptom.

Glad you posted. Keep researching. I did not have problems with the things you mentioned because I was on estrogen but I was unopposed by not having pro. Much better after that.

Mary
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My situations have revolved around excess or unopposed estrogen.  I have tried several types of the progesterone supplementation, including creams, pills, and the capsules.  I get the same symptoms from use.  It was frustrating.  I would leave my doctor's office after an annual exam with a stack of prescriptions so that I could try one after another in an effort to find something that would work.  

My  problem has been that, whichever method and type of 'Pro' I used, I start out fine, then develop the problem "symptoms" as the treatment progressed for a few months.   Right now, things seem OK since I had the thermal ablation, and I am not having some of the original symptoms that led to prescriptions of Pro in the first place.

I, too, sleep better when taking Pro so it has been frustrating to not be able to endure an extended treatment period.  One thing that I know about my body is that I gain weight when I do not get enough sleep.  I once set a routine whereby I was certain to get 8 hours of sleep each night, and lost 10 pounds without any modification of my diet or exercise routine.  I suspect that most of my weight problem revolves around my lack of really good and restful sleep.

By the way, another cause of leg cramps is low calcium levels.  I've had this problem since puberty/pre-puberty.  If I do not take calcium supplementation, then I will be crippled by leg cramps in a matter of days.  About 99% of the time, the cramps occur at night, in bed, while I am asleep.  Yes, they wake me!
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Thanks for posting that information. I have read much about the sleep/wt loss or gain connection. I have been trying to get myself on a better schedule sleep wise and I think that your post just totally convinced me that this will happen...I will follow through. Weight control has been a huge issue/concern all of my life. Diabetic issues are huge in my family. I lost a brother to the complications of that disease nine years ago. I have worked so hard to stay out of trouble with insulin-related issues. I have been successful, but still have to stay on top of the weight game.

I just feel better..so much better, when that area of my life is under control. The scary part for me is that I can see that if I did not watch that area of my life, it would so easily spin out of control. As I said, I have been doing this since I was 11. Finally lost my extra weight for once and for all (until perimenopause and then menopause hit) in college and then discovered aerobics when I was 30 in 1983...so, I know what to do, and still there are roadblocks or challenges that this menopause presented to me. I just keep plugging away.

But, Mickey, I want to address the comments you made and I appreciate the details. Just last Friday I spoke with my compounding pharmacist whith whom I have worked since 2001. Interestingly enough, he actually referenced the type of comment you made.

I am currently frustrated and want to increase my dose of bi-est and progesterone, but we decided to get a panel from a saliva test to see where my levels are before we talk about increasing doses. He said that they have discovered that in the past going by symptoms alone as was the norm for quite some time (rather than blood tests or saliva tests for blood hormone levels) was not always the best route since just adding increased doses was helpful for a while but then would sort of backfire as the months went on since the extra hormones played havoc with the cell receptors for estrogen, progesterone, and cortisol, etc. and women were getting the very symptoms they were at first trying to control.

My frustration comes from my thinking that adding increased doses of what I already take will be the answer, but Rob is concerned that there is an imbalance we are probably missing .....so, we shall see after the saliva test. I know even this is controversial since I hear that now blood serum tests are the preferred measure. But, Rob is most familiar with the saliva tests and he is the one who has the most knowledge about all of this. He said that in the past few years the pendulum has swung from not testing and using just symptoms to testing more frequently for hormone levels before adjusting doses.

Just throwing some thoughts out here. Could be you went through all of the testing and still had the problems with the hormonal help. Darn. As much as we know about all of this stuff it can be such a challenge, can't it? Thought I would talk about my situation though, thinking that there might be a piece in there that could be helpful to you should you be faced with the need for hormone assistance in the future. I hate to think that my good old progesterone let someone down! Ok...I guess I shouldn't make this so personal, huh?

Take care, Mickey, and it was nice chatting with you. Certainly let me know if you have any thoughts, though. I always enjoy reading your posts.

Mary
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I have never heard of a compounding pharmacy - do we have those up here in Canada? Can you buy Progesterone cream over the counter or will I need a prescription? And, will lowering my dosage of Premarin (I'm actually really happy on Premarin, other than the weight gain) help me to lose some of the weight? HELP!
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Yes we have them in Canada, but it takes some work to figure it out.  I can help you a bit with this.  You need prescriptions.  I am in Calgary, where are you?
Katie
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I am in Barrie, Ontario. My very best friend is leaving on Friday to do a 9 week placement in Calgary at a hospital there for occupational therapy. I hear it's beautiful!(I also hear it's expensive there too!)
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Thanks Katie for responding to Tybear's questions. I know from you that compounded products can be obtained, but not sure of all the details.

I think Northrup addresses using bio progesterone along with a Premarin type product. But, honestly I am not sure and I know it certainly would not be her favored combination. I recall reading that in some instances maybe this combination was done, but it is not in my realm of thinking since I never considered being on Premarin myself. One would think that there would be relief from some of the symptoms or side effects caused by the imbalance and/or the side effects of the Premarin, but this is where my knowledge on this subject ends since I am most familiar with hormones I use.

Mary (with a capital M!)
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Here is a starting point....  www.drpettle.com    How far is Barrie from Toronto (sorry, dumb Albertan!)  If it is not close, you could call them and ask for some suggestions in your area.
What I did was, I took my Dr. Reiss book to my GP and explained that I wanted to add some progesterone to my bio-identical Estrogen patch, (Estradot 50).  I am convinced you need to be on them both.  He looked at the book with me (now nice was that eh) and determined an amount from the book.  It is 10% ... 1ml twice a day.  The compounding pharm told me that was a bit high, but I am going to use it up and then get a scrip for a lower dose.  My GP admitted he knows very little about this.  At first I was very skeptical about all this stuff (I am doubtful about alternative things at times) but I did my research and I know I am on the right track.  I have noticed a big reduction in hot flashes, and I have only been on it a week.  Also better libido, sleeping significantly better.  You will meet with resistance about compounded hormones... they are not a big money maker for drug companies, as they cannot be patented, so, they try to "sweep them under the rug" so to speak.  Keep reading, and Mary and I will help you when we can!

Your friend is coming at a good time, it is almost warm some days now! (haha) Yes it has gone nuts here and is very expensive, it didn't used to be.
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I had the saliva testing.  This testing was done several years ago.  At that time, I had symptoms that led my doctor and I to believe that I had hormonal 'issues,' but we both wanted to be certain before I started taking any medications.   I do not recall the exact results now, but I did have lowered progesterone levels which resulted in the situation of excess or unopposed estrogen.  

Yes, I too feel better when my hormones are more in line.  I just wish that they would stay that way.  I am glad to know that other women have suffered from the same situations as I have, with the medications "turning" on me!  I have some sensitivity issues with medications, and had thought that I was just having more of my usual personal predicaments.

The side effect of the thermal ablation was completely unexpected.  My doctor outlined all the possible results, including possible complications, but she did not mention the possibility that my hormonal situation would be improved.  It was only after the procedure, and after my first post-procedure menstrual cycle, that the issue was even discussed.  She told me that I am not the first patient she's had who benefitted in this manner from the ablation.  However, as the benefit is not a listed effect or side effect, she hesitates to mention it to patients.  I guess she would not want to give anyone false hopes...but the complete disappearance of all the usual PMS symptoms, as well as a general improvement in my feelings (of 'well-being' I suppose I can say) was worth the cost of the procedure.  

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