HRT Question

I know some out there have done a lot of research but I need help! I am 32 and in surgical menopause from removal of ovaries with Stage 3 OvCA (but still have uterus). I have decided that as I have low estrogen receptor activity path results, I will use low-dose HRT for the time being. Now that I have moved to the US I have gotten very negative responses re HRT from Doctors. I need to stop using the dermal patch (allergy to adhesive and breakthrough issues) and asked my current doctor about alternatives and he said that the normal pill will do.I can't find any information whether this is true. Is there a difference between the contraceptive pill and dual hormone HRT? Any thoughts on using the contraceptive ring instead? This seems a lower dose as it is absorbed locally and doesn't require the liver pass for absorption. But I can't find any information about the vaginal ring as HRT.
Any information will be a help as my doctor didn't give me a good vibe that he knows his stuff about young women and HRT!

[Mary 53]

I just posted a ton of information on the Hysterectomy forum on this site. Check the thread, "What to Expect" for starters. Or, you can read my profile and (try to) sift through the ....568 posts I have done...YIKES!!!!   There is other info there, but much is about hormone replacement and resources. Try especially going back aways (under "My Posts" or Posts..cannot recall what it said). Also, if you would consider putting just something in your profile even if is just that you are female....then you will have a profile and you can leave messages for others.

This is a huge topic. And, it is a topic that is controversial. And, sometimes you will not get correct information (as you have already experienced) and other will say don't go near hormones...My take on this is you simply must do the research for yourself. I have a few resources named on my profile.

Frankly, and this is just my opinion, but I am surprised your doctor would consider putting you on synthetic hormones. But, you may have to see either a different doctor, or take info to your doctor, or see a specialist, if/when you persue this issue. The thing is, even the bioidentical hormones can get you into trouble if you are not balanced, but balance is key...balance between estrogen and progesterone. And, when you reseach you will learn of some of the protective benefits of progesterone so you can make an informed decision.

There are different types of estrogen and one will be made by your body if you don't supplement it because the body craves estrogen so the fat will make Estrone, a strong estrogen. Then if you are not supplementing this with Bio progesterone (NOT progestins like Provera....Nooo) then you are kind of back to square one in my opinion. But, this is where research is key.

Check out the posts I mentioned...and, consider turning blue :)

I have been posting for almost two hours and I need to go work out so I can keep up some energy for more posts.....It took me forever to get the answers I was looking for and so I am happy to share my info...it is my passion.

Mary

[Mary 53]

OK....WOW!!!!   That was fast. You're blue :))

Take care, Mary

[hopeshell]

Well...my gyn/onc was totally against any HRT for me.  I am 37 and have had severe menopausal symptoms.  It is tough.  I think the HRT is risky for you not only becaue you have OVCA but because they really believe it increases breast cancer risk.  I asked my dr. about the bioidentical hormones but he still didn't think that was the way to go.  It really isn't even recommended to dabble with herbal phytoestrogens like soy or black cohosh but I have tried both out of desperation.  I have found that black cohosh relieves my hot flashes and helped with vaginal dryness.  Of course, more time passes and I may have gotten better anyway.  I am not sure of an answer for you.  But, depending on which menopausal symptoms you find most distressing, there is likely someone on this board who has found a helpful alternative.  Where are you from?  Welcome to the US.   Shelly

[Mary 53]

As I said, this is a controversial subject. I will just encourage everyone to do the research. My Oncologist started me on the bioidentical estrogen the day after my radical hysterectomy in 2000, but to my surprise did she did not say a thing about the progesterone. I will say that using the Progesterone was the single most life changing event for me. But, I read three books on the topic before even discussing it with my regular doctor. And, we proceded with caution after that. That was back in
2001....

Totally agree on the caution about phytoestrogens since again, you are adding estrogen that will then again be unbalanced. But, and, this is where I will have to leave it short of copying all the information I have, there is some research that indicates there is a protective measure to be gained by adding the Progesterone, such as making the estrogen cell receptor sites less prone to taking in estrogen...and, again, you will continue to make estrogen (estrone) as a by product from the fat in your system.


Even with the help of the bio's I am back in Osteopenia (again...after coming out of it 5 years ago by adding the progesterone in the first place, which helps build bone) even thought I work out regularly....I have bladder issues with some atrophy, which thankfully has been better lately. Surgical menopause hit me (and it will be different for all) very hard and that is what sent me on a mission thinking there had to be something out there I could safely take to help me cope, since I was not coping well.

The fact is that I thought I was losing my mind three months after the surgery...mentally, physically, libido-wise, etc. I still have issues with blurry vision, muscle aches and joint aches that hit me hard if I am not hormonally balanced, confusion (you should see the letter I wrote Medhelp while they were changing all of these forums....nice, but honest...like...I have to get used to something else now!!!!)....thyroid, leg cramps that about killed me...for months when my progesterone was too low, chemical sensitivities (testosterone issue) to the point of almost losing a job 5 years ago all because of a co-workers perfume and the headaches I suffered from daily until she blessedly stopped drenching herself with the scent (and I had my testosterone rebalanced. I can tell you of the times I have thrown out perfectly good things...like the silver plated earings my husband got me on our 26th anniversary...just because I had spaced out...oh, and my favorite watch...in the trash bin. I used to be the queen of Multi - Tasking. Not anymore. The bio's are not perfect, but they help and in my case I have benefited from their use. And, yet, I know these will not be for everyone.

Could it all be worse? Of course...I know that. I came on Medhelp ages ago (heck, 569 posts ago) to help me come to terms with the whole "what if" issue....How was my cancer caught so early? What was the purpose of all of it...is there a purpose?  And, then...why was I feeling so awful and so depressed and so overwhelmed wondering how I was going to go on living a sane life. That's how it was for me. It may not be that way for everyone. But, I dug into research. I don't have all the answers...but, I can direct. And, so, I have pledged some of my time to sharing my info with anyone who wants it. And, if I can offer hope/help to even one person, then okay.

Not sure if I have a big point here...except, I hope everyone understands where I am coming from. If we didn't ask questions...we would not learn.

And, I had a very rough day in the Day Treatment world (I teach trouble youth and they seemed more "troubled" today than ever....)

Mary

[SimplyStar]

My daughter toughed it out after her debulking surgery and took no HRT, she was 49 at the time and peri menopausal, she took quite a few natural additives, non hormonal , and retained a sense of humor and activity. Now 19 months later she feels quite "normal" , By the way to those of you that know Leslee her CA125 has finally started down on the Doxil. Lost 60 points last time. Has had 8 infusions so far.

[Kimchi]

Saw my ONCGYNO yesterday and asked her about an herb I read about that is good for osteoporosis...She nixed it because it also increases estrogen.  She said that anything that triggers increase in estrogen and HRT is a big NO for women with ovarian cancer.
So back to the drawing board to find something natural for osteoporosis.

[Kimchi]

So glad to read that Leslee's numbers have finally come down...She survived 8 infusions of Doxil???Even after the blisters on her feet...A real trooper.  Wonder if this is the most anyone has had of Doxil on this forum?

[hopeshell]

By progesterone...is something like Emerita's progesterone cream good or do you need to have it specially made?   What do you think of black cohosh?  I sort of think I shouldn't be using it.

[SimplyStar]

Kim check out the NativeRemedys web site  we use quite a few of their products   they list several for osteoporsis  some women can be on doxil for 12 months, I read that was usually the limit

[Mary 53]

What I totally don't understand is why doctors are ignoring the benefits of Progesterone. There is even controversy now about Estrogen being of much use regarding osteoporosis in that it may prevent bone loss, but to what degree? if any...yet there are research studies that show that Progesterone will build bone...testosterone, too, will have this effect.  And, since our bodies make Estrone as a by-product of our body fat, women are still unprotected from the harsh effects of the strong estrogen, Estrone.  And, so we are back to square one regarding a hormonal imbalance, as I understand it.

The prevailing theory is that my cancer and the previous severe cervical dysplasia and dyplasia's after that were caused by hormonal imbalances. No HPV was indicated. So, I was not about to leave my body in a state of imbalance again. And, I was concerned about getting breast cancer, too, and so this is another reason I researched the importance of hormonal balance and particularly progesterone and the benefits it gives regarding protection from breast cancer. It has to do with the Progesterone decreasing the estrogen sensitivity of the cell receptor sites for estrogen.

I wrote some more info about Estrone on the hysterectomy site if anyone is interested. Although now that I think of it, much is repetitious. But, this is a confusing issue. I wrote a few author's names there, too.

Just make sure if anyone asks about these things...make sure the health care practitioner knows you are talking about Bio Progesterone and not Provera, which is often called Progesterone, unfortunately. We have receptor sites for Progesterone in our brains, lungs, etc.

Well....just some more info to toss around. Wishing it was 100 years from now and we knew so much more.

I am not a doctor. But, for 7 years now, the products I use have always been under a doctor's supervision. I also have always had a prescription for the items I use.

One more thing....I am surely not against using products that are not hormonally based, but in my case, it was necessary. If you hear of any other products of interest that are not estrogen based or otherwise hormonally based, I am always interested. Knowledge is power.

Mary

[Mary 53]

I will have to get out Northrup's book (It is under my bed :)) to check out the Black Cohosh issue. I know she speaks to it and I used to have the info memorized (I know... I am kind of a research junkie) but I will have to check. I think she is sort of okay with it, but again, she would stress balance. I will check and get back to you either Wed or Thursday night. There are some products sold over the counter she has a problem with since they only mask the symptoms of menopause ...I will see what I can find out.

I have used the Progesterone you mentioned. I have used FemGest and Progest mainly when I have had to get otc Progesterone. I recall being very frustrated with one of the doctors I was working with about 5 years ago. I was having horrible leg cramps. I mean debilitating. This doctor was okay but was just getting into the hormone (industry?) and he more or less suggested that I had it in my head (only in my head) that my low level of Progesterone was causing the leg problems. I had done some research that week and was convinced I needed more. This was before they started doing more blood tests more frequently with a better understanding of what to look for as far as balance and blood values (Hope that made sense...it is getting late). After my last visit with him I ran accross the street to the mall for a jar of Femgest and put it on in the car. Honestly, that night the cramping went away and I slept. I now use a rather high dose of Progesterone. But, for some women this is not uncommon. I use 1/4 teaspoon of the 20% Progesterone cream two times a day. The Oral version of the bio, Prometrium, did not work that well for me. I was able to open the caps, however, and use the cream on my body until I ran out. Going through my liver with the Prometrium did not work for me...and, this is not all that unusual. The manufacturer does not promote cutting open the capsule and using the cream on the skin...but, I got this info from "The Wisdom of Menopause" and it worked well for me.

I know that you know I would not be comfortable telling you to use the cream...that is not my intent. But, if you are specifically asking if I know about that brand, I can say yes...and, in fact, I think that brand is for the Progest. I Know Northrup recommends Progest and Femgest...(her book came out in 2000 or 2001).

Take care and I will check on the Black Cohosh.

Mary

[hopeshell]

Thanks so much.  I appreciate the info.

[nyc lady]

I was on HRT after my 2nd surgery and I developed what the doctors believe is an ovarian remnant cyst.  They immediately took me off.  At that time I was on bio-identical (estrodial).  I am not allowed to take OTC, herbal or any thing that contains black cohosh, as it is said to mimic estrogen.
I suffer from all the effects of menopause, the bad night sweats that wake me, vaginal dryness, loss of sexual interest.....but...to me these are much easier to overcome then taking the risk of HRT.
As Mary 53 (my true hyster-sister) has stated, there are alot of opinions and alot of personal choices....Not an easy decision to make.

Good luck to  you.
Pam

[Jan214]

I went through menopause in 2005.  It was June, July & August and I was done.  GP said she'd never seen anything like it.  Wasn't dx until Oct 2006 and had not had any problems associated with post menopause.  Now I am wondering if the fatigue etc could be because of menopause in addition to this cancer ****.  My onc told me the other day that I could do bios.  I just don't know anymore.  
SS: Congrats on Leslee.  My last CA125 had only come down 1 point.

[OzBron]

I will check out the information but to be honest I am just more confused! I am 32 and struggling at the moment mentally/emotionally and I am not sure whether some of this is hormonal. In some ways I just can't cope with the idea of menopuase yet with still  trying to sort out what to do now I am finished the first battle. My 3month followup was very good with low CA125 (single digits) but with Stephers passing and Becky having a bad time at the moment (they both share my cancer type and stage) I am just slightly freaking!
At the moment I just want to postpone dealing with menopause till I really feel I can be positive I am in remission. I was getting sever night sweats and bot flushes (would randomly go a lovely beetroot color). As I am so young to be menapusal I worry about bone density/osteo in the future and premature aging (skin) and weight gain (yes I know - vain.....), I find it very hard to find information for those menopausal through surgery at a young age.
The problem is I have no idea whether this pill I have been given now is right or not. I don't think the Dr would have even heard of bioidenticals. The Dr said that in a month we will do bloodwork to check hormone levels - I guess I wait till then or discuss it with my OvCa Dr at the end of Feb at my next followup and do some more research in the meantime.
Thanks for your comments.

[Kimchi]

Check out comment from Doctor Choy today under
"ovary loss raises 'dementia risk' "