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196469 tn?1365391575

HRT

What side effects have you experienced since starting HRT.  
I started 1 week ago today and I still have hot flashes and I have been very emotional the past few days.  Is this normal?  I am on antibiotics and have been for 4 weeks for wound separation.  Could this affect the performance of the hormones?
28 Responses
167426 tn?1254089835
Hope Mary sees your post, she is the Hormone Queen on here .  Hang in there.
106886 tn?1281295172
Hi,

I would recommend you go to this thread...it is on page 3 and it was there just now when I checked.

*******4/26 Forgetfulness problems after Surgery
Lisagarr*************

I suggest printing it or saving it to your hard drive, Email it to yourself just so you have the information since it is a lot to absorb. I have been studying this stuff since 2000 and still learning!

In the true sense of the word, HRT would refer to Hormonal Replacement Therapy and I don't mean to split hairs with anyone, but I think of myself on BHRT, Bioidentical Hormonal Replacement Therapy. Frankly, I do not know much about the HRT drugs that are prescribed, such as Premarin and Prempro except that I won't use them. Prempro has Progestagen, or Progestin in it, which is a synthetic Progesterone, and would not be used by anyone without a uterus, since it was mainly developed to counter one of the side effects (although rare) of using the synthetic estrogen (Premarin)...the side effect they were worried about is uterine cancer.

When a woman who has had a hysterectomy asks the doc for a script for Progesterone, she will get a blank stare unless the doctor is familiar with the positive benefits of using Bioidentical progesterone...it is just that the words are often, unfortunetly, used interchangeably.

I would not be without my Progesterone. I use very little estrogen (Vivelle, a bio patch) and I use Testosterone. It should take little time for the estrogen benefits to kick in, although this is a case by case situation, I am sure. As far as the progesterone, it takes three months for it to leave the body after the ovaries are removed and up to three months for it to be replenished. I started to feel so much better after about a month and a half of being on the Progesterone...back in 2001.I had been on Estrogen since the day after my surgery.

I am still on it (Progesterone) and use the cream from a compounding pharmacy and I use bio progesterone pills, too, to supplement the cream since I was needing to raise my levels. I have been under a lot of stress and the progesterone was being used by my body to make extra cortisol.....geez....

Sorry I cannot directly respond better than this. I assume you have called your doctor/nurse about this. Also, I would check to see what type of hormonal therapy you are on....synthetic or Bio....and, grab "The Wisdom of Menopause" by Christianne Northrup, MD while you are at it...an excellent resource.

Best to you ..........and

HI TO STAR!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!


Mary (almost 54!)

242516 tn?1368227505
MEDICAL PROFESSIONAL
all respect to Mary53 and the great encouragement she provides to so many folks on this forum, but i wanted to point out a FDA advisory today:

thought you folks taking bio's, BHRT, would be interested in this report today from the FDA saying that bio's are not better than taking the individual hormones separately.  In fact, it can help to take them separately to individually adjust the dosing for each hormone:

FDA informed healthcare professionals and patients that the Agency sent letters warning seven pharmacy operations that the claims they make about the safety and effectiveness of their so-called "bio-identical hormone replacement therapy," or "BHRT" products are unsupported by medical evidence, and are considered false and misleading by the agency. The pharmacy operations improperly claim that their drugs, which contain hormones such as estrogen, progesterone, and estriol (which is not a component of an FDA-approved drug and has not been proven safe and effective for any use) are superior to FDA-approved menopausal hormone therapy drugs and prevent or treat serious diseases, including Alzheimer's disease, stroke, and various forms of cancer. FDA is concerned that the claims for safety, effectiveness, and superiority that these pharmacy operations are making mislead patients, as well as doctors and other healthcare professionals. Compounded drugs are not reviewed by the FDA for safety and effectiveness.

Patients who use compounded hormone therapy drugs should discuss menopausal hormone therapy options with their healthcare provider to determine if compounded drugs are the best option for their specific medical needs.

Read the complete 2008 MedWatch Safety Summary including a link to the FDA New Release regarding this issue at:

http://www.fda.gov/medwatch/safety/2008/safety08.htm#Menopause
448414 tn?1205873164

With great respect to the FDA, I have done my own research and I'm only conveying the facts I have learned about BHRT. (With respect to you, MD).
Please keep in mind the FDA approved the HRT replacement that included the progesterone that was created from horse urine years ago- that caused so much cancer in women and wasn't removed from the shelves for years, (with company knowledge of the problem) until the an action had to take place...
The FDA will also state, that Testosterone treatment in women is 'not approved'. Feel free to look it up. Personally, I do not make testosterone naturally. Nope... Not a drop of natural testosterone in my body- '0 rads found' per my test results- Free open what ever. With this being said, (my opinion only here) the FDA needs to relook this statement and get with the times. They address men but not women. Without testosterone, my life would be in disarray as this hormone is essential to a mirad of things to provide health and well being- not just for sex.

BHRT isn't safer I agree: as anything added to the body can cause a risk...no two bodies are alike. Though it has been proven that BHRT can be metabolized by the body. Synthetics that are used, your body just has to deal with the dosage and side affects occur....(i.e. Testim (which I was on) when applied in the same location eventually will cause fuzzy hair growth in the location of application, adema, etc-see testim reactions on their website, etc).
BHRT is compounded to mimic the body's natural hormone composition per the readings and research I have done. Synthetics do not- they are a 'version' of the body's hormones naturally created... meaning a deviation in the makup (to allow patent). it is believed and only makes sense, that pharmaceutical companies push the synthetics because they can patten the formulas, raise the price and cause you the comsumer/ patient to pay the high prices... with no guarantee of safety. BHRTs are not unique in any way as the natural composition can be created over and over without patten infringement-because its a natural formula. Therefore limiting the price they can put on it as anyone who can compound, can make it and lower their price. So business wise... it's not a good investment to have what others can create in an open market... medical business 101. BHRT that is compounded is best recommended for individual application vice mixing it all up together. I have 2 seperate tubes to apply and in different locations- place a capsule I take as well.

I wish you luck to all who are considering BHRT I am new into the BHRT world but anything is better than wanting to jump off a cliff because it's easier to die than wake up each day or growing fuzz on my back.... I am finding the will to live and enjoy being alive.... as each one of has to find what works for us individually.
Avatar universal
Thank you for taking the time to wander into this issue!  I must say I do enjoy your insights and humour (not a spelling error, I am Canadian :) on your many and varied posts on the Medhelp site.  

You refer to the FDA.  

Please could you take the time to read this text from Drerika.com  

Wyeth has won FDA approval for its new antidepressant Pristiq.
Yes, the same FDA who has just told us "bioidentical hormones" don't exist, the same FDA who has told compounding pharmacists to stop using Estriol, the mildest of estrogens when it helped hundreds of thousands of women with menopausal symptoms.
Yes, the FDA whose mandate is to protect the public has spoken again. This time, it didn't take one of its hundreds of FDA approved dangerous flops off the market, this time it has added yet another antidepressant to an already endless list of drugs that don't work to the market. Unfortunately this is proof yet again that the FDA is more anxious to protect Wyeth's profits than the wellbeing of the American public.
This is a particularly ominous development for women - Wyeth is also asking the FDA to approve Pristiq as a drug to reduce hot flashes in menopause.
Pristiq is the successor to Effexor XR, whose patent expires in two years.
Sales of Effexor last year were $3.8 billion.
By the way, Effexor is not exactly a great drug either.
Just check my blog on the topic and read about its side-effects and disastrous record when it comes to attempting to get off it.
But let me get back to what matters. The new drug provides a lucrative new revenue stream for Wyeth. How lucrative? Well, on the day it won FDA approval (February 29) Wyeth stock soared 2.5% while the rest of Wall St tumbled 315 points. Did I mention any benefits to patients? I would, if I could think of any. One thing I'd like to ask the FDA and Wyeth is how many people (women) have taken this drug for how long before it got through the approval process? And by the way, did anyone have any adverse reactions we might consider serious enough to skip the drug altogether? The prospect of Pristiq being approved for menopause is truly disturbing and proves the FDA has relinquished any pretence of protecting women. Treating menopause with anti-depressants is ineffective and dangerous. If women are depressed during menopause it is because their hormones are depleted and most conventional doctors discard their symptoms and tell them they are just getting old and should just get over it and go away. The sensible and caring way to deal with the problems of menopause is to help women understand what happened to their bodies, how their diets affect the way they feel, how exercise improves the symptoms, how stress management helps them get the sleep they need, how supplementing their hormones with bioidentical hormones can help them get their lives back on track and enlighten the world with the wisdom they acquired along the way.
The solution is not going to be found in giving them another drug to become dependent upon. Instead, the FDA is making it harder for women to find safe, sensible alternatives. You'd think they'd done enough favors for Wyeth.

You can read more on her site.  Hey she may be a snake oil salesmen in the opinion of some, but I like reading what she has to say.
Thanks again and best wishes from
Katie
PS I went through surgical menopause two years ago, my doctor has me on the Estradot patch and I use bioidentical progesterone cream.   The estrogen patch works far better when I use the progesterone.
106886 tn?1281295172
WOW...I could have sworn that I posted a comment to the doctor's comments way back in January. I read the article he referred to just the day before. Wyeth was/is lobbying big government to do away with the bio's (AGAIN. GOSH...I write letters and sign petitions to try to halt this ridiculous issue each year) and the FDA responded by trying to get SEVEN????? seven? compounding drugstores to stop using Estriol, which is used all the time in Europe and has been used sucessfully for years. It is newer to this country. I have used it for non-systemic vaginal atrophy help as well as part of a mixture of estrogens (estrodial and estriol) but I now just use Estradial.  

Also, accusations that the bioidentical hormones have not been studied is a comment that does not have a leg to stand on in my opinion. Shall I send them references to where they can get a study?

Interestingly enough, and Katie may have covered this (it is late and I am tired)...more people in government and in the courts are looking at this action and wondering why government is getting so involved in all this...and telling women what they can and cannot use AND wondering why the FDA is leaning toward listening to the lobbying efforts of a large pharmaceutical company.

I also will never forget the report done by Katie Couric a few years ago when the head of the North American Menopause Society (a doctor) got on camera and said that the bio's and the synthetics were treated no differently in the body. Well....The Day AFTER the two-part show was aired, the North American Menopause Society put out a disclaimer on the CBS news and admitted it was "Wrong"....that in fact the bios and the synthetics do NOT act the same way in the body. There were differences...oops. Was I the only person in America watching this the day after the big airing of the show which was laced with misinformation.

Then yesterday, Dr. Erika Schwartz sent out a newsletter all about the Wall Street Journal and the attention it is paying to the bioidentical hormones used for menopausal women (remember that Synthroid and insulin are both bioidentical hormones) and that they are now questioning the statements put out by the big pharm. companies who product the synthetics.

Time for bed. Hoping someday allll of this will e much clearer and available for women without the feeling we hae to jump through hoops.

Goodnight.

Mary
178345 tn?1242539846
I have been on vivelle dot patch for 9 months...I still experience slight hot flashes and occassional mood swings..I try very hard to remember to change the patch and when I am a day or 2 late thats when I notice I feel different. I have tried to go without and suffer many other symptoms so I am only 41 and need to be on the patch. I dont take progesterone since I dont have a uterus..other than that I dont really suffer from any other symptoms.  Any questions feel free to ask! gia :)
Avatar universal
Don't confuse Progesterone with Progestin.  They are totally different.  Progestin is a synthetic that is not the same as what your body manufactures.  Bio identical progesterone is as close as they can replicate what your body manufactures.  Think about diabetics and insulin.  That too would be considered a bio.
Progestin causes uterine cancer, and other bad things, yes.  Progesterone is a different thing all together.  You need progesterone.  Google the two.    
And To Mary53, you must get tired of repeating yourself sometimes!!  But I thank you every day, you helped me more than you will ever know!!
Regards,
Katie
178345 tn?1242539846
i am so confused....why do I need progesterone?? none of my Doctors has suggested this since my hysterectomy last May!!! I am on 0.5 2x a week on the vivelle dot patch. Please explain this to me as I just went for my yearly checkup and when I asked my Doctor she said no progesterone needed because uterus was taken out. I am new to all this so if you can give me further details I would appreciate it. Thanks, Gia
106886 tn?1281295172
Gia,

The following list is from information from Dr. John Lee (considered a Pioneer in Progetesterone research)

Benefits of Progesterone (whether producing naturally in the body or through using Bioidentical (also known as Botanical or Natural) Progestreone:

Helps use fat for energy and keep it off hips
Natural diuretic (water pill)  
Natural anti-depressant
Facilitates thyroid hormone action
Normalizes blood clotting
Increases libido
Normalizes blood sugar levels
Normalizes zinc and copper levels
Restores proper cell oxygen levels
Prevents endometrial cancer
Helps prevent breast cancer
Increases bone building


All due respect to your doctors, but I know this is a confusing area and the way I look at it, well, it is a specialty. Luckily my doctor was willing to learn about the benefits of using the progesterone when I presented the idea to him back in the summer of 2001 which was about 8 months after my surgery. By this time, I had been suffering from the lack of progesterone since three months after my surgery...(it takes about three months for the progesterone that is in your body before the surgery to totally leave the system. It was then that I started to feel as if I was losing my mind. I know that sounds dramatic, and I honestly would not wish this on anyone, and not all are going to feel this way, but I felt this way and had no clue why. But, I had learned the value of research years ago and so I was on a mission, although my mission took the form of a book practically landing on my feet at the Grocery store of all places. It was Northrup's book on Menopause. I had a bit of a history with Northrup since it was the information in the first book she had written that got me through a bout with Severe Cervical dysplasia after I was told by my first doctor to "Wait." I did not wait and ended up in surgery for near cervical cancer. This same doctor was the one who brushed me off when they found the cyst that later, when drained, had malignant cells in it. I was with my current doctor by this time. I was starting, too, to feel the power of advocacy. So it was in this vein that I approaced my doctor (top guy in MN) about using the progesterone. The Oncologist had put the Vivelle dot on me the day after surgery without a word....that was it.

The compounding pharmacist in a little town south of here actually "taught" my doctor about the value of progesterone and I know from seeing my doctor for my yearly exams that many of the women he works with now use the product.


MORE in a Second....
106886 tn?1281295172
Part Two....The way it got all messed up with the whole "you don't need it cuz you don't have a uterus" thing is this:

When women use Synthetic estrogen like Premarin, they need a progesterone to protect the uterus from the rare cancer, Uterine cancer. But, progesterone cannot be patented and so the company that makes Premarin came up with a Progestin, as Katie pointed out, and they called it Provera (Depo Provera is a relative of this). The two drugs together, Premarin and Provera, Equal Prempro. It is now theorized that the Progestins are what helps create the big mess in the synthetic world of hormones. The snythetic estrogens are not great either ( I, like you, would only use a bio estrogen like Vivelle) but that Progestin is nasty.

HOWEVER.....Progestin and Progesterone gets used interchangeable. And with all the drama surrounding the hormone issue, well, the first thought a person in the medical community who is not well versed in the Bio hormone issue, thinks of using a Progesterone or Progestin to protect the uterus. Well, here is the deal. There are so many more cell receptors in the brain than their are in the uterus. When we get cramps after a menstrual period (used to at least) it is the lack of Progesterone that causes the cramps. I will tell you that a newer problem for me over the last two years has been horrid leg cramps that I experience when the levels of progesterone in my body are low.

I have printed some more info that follows this. I have info on my Profile, too, in the Journal section. I have old posts on this too (Gosh...I have about 950 posts...Yikes).

I know that you know I am not a doctor. I am in Childrens Mental Health. I am also someone who needed to research when I was feeling lousy.

Check out the books and/or websites for the authors of the books that I referenced on my profile to learn more. You really need to arm yourself with information about all this, so you can feel the most comfortable with your decisions. I see my reg. OB/GYN for exams and I see a specialist in hormones (that finally accepts my insurance...that is another ISSUE....it never ends)...and, I think she is great.

Good luck. I will stop now and leave you to read the rest if you want. Or, print it off so you can digest all this. It IS confusing. I hear you on that!

Mary
*********************************************************************************************
Many women are on Progestereone therapy only, whether they have reached menopause, surgically induced or not.  However, if you do the research, talk it over with a doctor you trust who knows a lot about hormones and the effect both protective and harmful of the female hormones, some women decide to use supplemental estrogen such as Estrodial or Estroil. One of the reasons women use estrogen is to help keep the receptor sites open so that the body can UTILIZE progesterone.

I will have to dig out my books, but I believe progesterone uses the same cell receptor sites as estrogen. Progesterone will balance the estrogen effects and so even if you are not taking supplemental estrogen, you are making some estrogen as a by-product of a substance made in the fat of menopausal women. It is called Estrone and it is a strong estrogen. But for women with no ovaries some do elect to take estrogen, but not the synthetic type of hormone used in Premarin which comes with a separate list of problems.



There are some women who may not take estrogen. The amount that many typically take results in amounts approximately equal to six times LESS  than what was in your system before menopause.



And, again, if the estrogen is balanced with progesterone, you avoid "estrogen dominance" and all the ill effects that can come from that. Estrogen Dominance is the term coined by Dr. John Lee. When women start to skip ovulation, which can start as early as the early 30's, then progesterone is not produced and if you start skipping ovulation more frequently, you become so low on progesterone...then the estrogen in your system becomes dominant. This can happen even when your estrogen levels are dwindling as in perimenopause. So, even a small amount of estrogen without progesterone to balance it out can cause problems. Without my progesterone supplementation, my husband, even at age 60, makes more progesterone in his body than I do!  I believe it was Dr. Lee who did a study with women over the age of 80 who were given progesterone supplementation. They did so well on the supplemental hormone...they cited even being able to play bridge again...think clearly, etc., amongst other things.



As far as learning about progesterone and what it does for the body, google Progesterone, the New Estrogen, or Progesterone, the estrogen alternative and also, a great book, "The Wisdom of Menopause" by Christianne Nothrup, MD. Simplystar mentioned Dr. Lee's website and Katie mentioned Dr. Erika Schwartz's site. Both excellent.





The suspicion is that my cervical dysplasia and my ovarian cancer were both caused by estrogen dominance. If only I'd known....I would have been on progesterone years ago. I'd heard a little bit about it in the early 80's but did not bother to look into it. I am not sure where I would be without it now. In fact, I just put some on before I posted! For me and many others who have had a surgical menopause and have been allowed to take bioidentical estrogen, progestereone, and testosterone, the results have been helpful. My hope is that all of this confusion will some day be cleared up and more health care professionals will have a better understanding about all this.


Avatar universal
Oh boy don't we know how confusing it is!!!!!  I feel for ya!   I was told the exact same thing by the gyn, but, my regular doctor is OK with me adding the bioidentical progesterone cream to the use of the patch.  The Vivelle dot patch is considered bioidentical, so you are doing great there!  (wheeew eh).  
I have to tell you.  My GP who is very honest told me he had like 10 hours of traditional hormone training 30 years ago, and he is always interested in new developments!
The trouble is, doctors refer to PROGESTERONE and PROGESTIN as if they were the same.  They are not.  Most doctors really don't know a lot about this issue.  
Yikes.  It is a pretty long story and have to go yell at my dogs.
When Mary first explained this to me, I was like  "CAN'T HEAR YOU" (hands over ears) and I refused to figure this out.  Gradually, mostly because I didn't feel as great as I thought I should, I read a lot about this issue.  Have you read Mary53's posts? and beach3281s posts above?  They are a great starting point.  
The uterus thing you mention is because the synthetic estrogen caused uterine cancer, so they introduced PROGESTIN to try and protect those who still had a uterus (because it was used for menopause symptoms).  The two things are different!!!  Progestin is garbage.  Progesterone is considered by many, there are some who disagree, you have to figure it out for yourself, to be necessary for our optimum health.  My GP says it leaves the body quickly and he doesn't feel it will do me any harm.
GOOD LUCK!  Gotta dash
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