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Avatar universal

Mary 53

Hi there, I am upset about something and wanted your opinion.  I was on vivadelle dot, which I thought was a bio identical hormone.  Yesterday since he wanted me to start on progesterone, he gave me the combipatch.  I asked him if it was bioidentical and he looked it up in some book and said yes.  I was just doing some googling and such on the computer about it, and I saw several different places where it says it is not bio identical.  Do you know anything about it?  Also, are any of the hormones that are prescribed really bioidentical?  Do you mind me asking what works for you?  It seems the more I read the more frustrated and confused I am becoming.  I am sorry to keep bothering you about this, but I am sooo confused I need help.  Thanks so much
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Avatar universal
Hi there, thanks for the reply.  That's too funny, I saw that article somewhere during my search and I liked it the best also.  It was one of the places I saw that the combipatch was not bioidentical.  Then when I went back to look for it again, I couldn't find it, and you found it for me!!!  This is what happened, when he said I needed progest. he said there was a patch for it in combo with the est. but... it was only available in .50 dose of estrogen, I was on the vivelle dot 1, so it was half the dose.  He gave me some estrogen cream to rub into my arm to make up for the difference, if I needed it.  I thought it sounded like a good idea because the vivelle dot 1 is the highest dose, so if I could go lower it would be better.  Soooo I put the combipatch on yesterday, felt okay until today when I started getting hot flashes really bad and started crying and getting emotional for no apparant reason, feeling guilty and stupid for it.  Then it hit me (DUH) that I wasn't getting enough est.  so I went and put some cream on my arm, which didn't work at all.  I ended up ripping the dang combopatch off and putting on another vivelle 1.  It's been about five hours and I am starting to feel better now.  I think I just need more right now, I mean I had regular functioning ovaries a month ago, to having none now.  

I was also reading that we have estrogen receptors which get used to whatever estrogen we give them.  If we are making estrogen naturally, then they are receptive to "natural"estrogen, so the bioidentical ones are readily accepted, if we start on synthetic ones, then it takes time for our receptors to open to those.  Maybe thats what happened to me today also, I was getting even less then half the dose.  Who knows, but it makes sense to me. Have you heard of that also?

I think I might try to stay on the vivelle dot, maybe tapering down on the dose, and get on that progesterone cream, that sounds like a good plan for me.  I think you would agree with that plan too. :)  I have to decide if I want to get another doctor,  who maybe is into the natural stuff more and is more willing to find what works for me.  Mary, I appreciate you more then you know.  You have a big heart to be on and help people like you do.  God bless you, have a good night Merytre (pronounced Mary-Tray) just if  you wondered. LOL
106886 tn?1281295172
H Merytre,
I know...this can get confusing. I suggest printing this article and having it on hand. I thought it gave a pretty good explanation on the differences between the synthetics and the bio's.

I have already copied a small section and will post in a minute so you can see exactly where the Combi-patch is mentioned. It looks like they took estrodial (bioidentical) and mixed it with a synthetic progesterone. Your doctor might have thought that it is natural and in fact it is made from plants, but something changes in the production of it that makes it turn into a synthetic once it is your body.

I recall about two years ago when Cinestin came out and someone commented that it was a bio because it was made from plants...after researching this I noted that it is made from Yams I think...but, during production it turns into a product that is not bioidentical after all. Good for you to be on top of this.

I was on the Vivelle dot for years and liked it very much (I use Bi-est now) I was on a high dose at the time though, 1.0 and now would probably be fine on .75 or maybe lower. I always supplemented this with progesterone cream.

I would look up the website for compouding pharmacists and find a location near you. Call the pharmacist and see what he/she recommends as far as percentage for the progesterone cream. They will probably start you anwhere from 2% to possibly 10%....a half gram two times a day. Call the doctor to speak with the pharmacist and set up the script. That is what I did the first time I got the progesterone. Luckily my doctor was willing to study up on it and the compounding pharmacist was my new best friend. The cream was awesome for me....just that the dose was too low for too long...but, I am on the 10% cream now.

Let me go walk the dogs for a bit...I will check later to see if you have questions, okay? Good luck.
Return to Articles & Resources

Bioidentical hormones how are they different from synthetic hormones ?

According to Census data from 2000, there are about 37.5 million women reaching or currently at menopause (ages 40 to 59). For many consumers, "natural" implies "safer". That perception explains the demand for natural products. Often however, the manufacturing of natural products are not well-regulated and the significance of the word "natural" has different meanings for consumers and manufacturers.

Natural hormone replacement therapy (NHRT) is a misnomer. Bioidentical hormone replacement therapy (BNRT) is the proper term. This article will explain the important differences and why you should use Bioidentical hormone replacement therapy.

Bioidentical Hormone Replacement Therapy

Bioidentical hormones have the exact molecular structure as those made in the human body. In other words, the two are indistinguishable from each other. Bioidentical hormones produce the same physiologic responses as those of endogenous(bodies natural hormones) hormones. The Food and Drug Administration (FDA) considers bioidentical hormones to be natural regardless of their source, and as a result they cannot be patented.

Misconceptions About Bioidentical Hormones

Many women are unfamiliar with the significance of bioidentical hormones, it seems they are more concerned about the source of the hormones rather than the effects produced by those hormones. Bioidentical hormones can be extracted and derived from a variety of different sources such as plants (soy or yams) or animals (pigs or horses). They can also be produced synthetically. However, hormones of plant or animal extraction that are bioidentical to human hormones are still not completely natural in the purest sense, because they undergo a laboratory process and several processing steps before the bioidentical end product is obtained.

The Important Issues When Deciding Bioidentical Therapy

Natural hormone replacement therapy involves two important issues. The source of the product, trying to acquire a natural source from plants and the end product, trying to obtain something bioidentical. Which is more important? The physiologic effect, which occurs with a bioidentical product. This should be the most important focus, but women are most comfortable with hormones that are obtained from a plant source and that are as bioidentical. Few commercially available products fit this description. But, thanks to WHI (Womens Health Initiative) findings that exposed the failure of synthetic hormone replacement, women are selecting what has been available for over 20 years, bioidentical hormones that are plant derived.

Pharmaceutical companies profits come from patents that insure them seven years of profits, where no other company can manufacture a product like theirs. Hence, the cost of this product is determined totally by them.

There are several new products that have been marketed as being natural because they are derived from plants such as soy or yam, but few are truly natural because they are not bioidentical. Sometimes, a bioidentical hormone is combined with another completely synthetic non bioidentical hormone, and the results is advertised as a natural product. Premarin for example is advertised as a natural estrogen replacement therapy because it is derived from the urine of a pregnant mare but it is not bioidentical to human estrogen and has been found to have devastating effects on women. The manufacturer of this product is beginning to prepare for the national class action suit for the greatest hoax on women in the last century. The benefits that they claimed women would receive were not only false, their drug actually ended countless women's lives.

Bioidentical Hormones-Allvia Progesterone

Allvia pharmaceuticals use natural plant compounds to create the bioidentical hormone progesterone. The percentage used is 1.6% or 20mg per dispensing dose. 20 mg has been found to be the appropriate dose for women needing to supplement with progesterone. Allvia must comply with the regulations of the highest grade (United States Pharmacopoeia(USP)).

The following information on commercially, compounded and natural hormone replacement products is featured. The source of the ingredients is listed, and whether it is considered bioidentical.

Bioidentical Estrogen
106886 tn?1281295172
Merytre, do you see the Combi-patch? It is the second one from the bottom.
This is from the article.
Combination HRT Replacement (2 or more hormones), Non Bioidentical
108861 tn?1227249648
Mary Tray!  I wondered!  Those of us named Mary love diversity in names and you have that.  Is it French?  I named my daughter Caitlin thinking it was unusual but when I returned from the hospital I saw a Kodak commercial about little Caitlin Brown who could load her own camera!  SIGH!  Now you hear the name everywhere spelled a million different ways!  Guess it is more imprtant what we do with our names than what they are!  Another Mary
106886 tn?1281295172
Hi, and I am glad you found the information helpful. Too funny that you had seen the info and then could not find the patch and then another Mary comes along and finds it! Us Mary's need to stick together.

Ah, the cell receptor issue. I do know that we have cell receptors for Progesterone in our lungs and in our brains. And, there is information about how if you have low estrogen (because the body is always making estrogen from a by-product in the fat that we have once we have hit menopause) then the receptors for progesterone are sometimes not as available to the progesterone. In other words, estrogen is like the key that keeps the receptors open for progesterone. It is one reason I most likely will not go off estrogen supplementation. I do not plan on going off progesterone as it is. Dr. Northrup has tons of info on cell receptors...and, it is very readable, if you know what I mean. More on Northrup in a moment.

Dr. John Lee's book on progesterone (something like "What You Wanted to Know About Menopause but Were Afraid to Ask") talks about 80 year old women in a nursing home who were put on progesterone who were amazed at the increased quality of life they experienced. They could play bridge with ease again and were elated. And, you and I have talked before through this site about the bladder issue. Already since I have increased my dose of progesterone about two months ago, I have had about fifty percent improvement in that (leaky) area. Thank Goodness!

Must reads....Northrup, Chrisianne, she is an MD and wrote "The Wisdom of Menopause" ...my constant resource. Also, Uzzi Reiss is great although he does not give as much info as Northrup regarding surgical menopause. Dr. Erika Schwartz is excellent at explaining why the need for hormones(bio) is so great in our culture now. Check Amazon for her stuff. I found her book at a Half Price Book store and still cannot put it down. Yes..I read research books for pleasure reading before bed. I know.

I still see my regular Ob/Gyn for yearly check ups and for years he has okay'd my scripts that were filled by the compounding pharmacy (I got the Vivelle dot at Target pharmacy) and I will still go to him, but I have found a Urologist who has a woman on staff who is an expert in all this and I see her now for my bioidentical hormone treatments. I just had my blood drawn the other day to see where my levels are since we changed a few of the doses when I first saw her in September. And, I was shocked but the insurance company covered the visit... So, you may have options and yet you might still be able to see your regular doctor for other things. It is hard to find someone who knows a lot about all this and I do hope that this is changing. But, it is another good reason to do much of the research yourself so that you really know what you are talking about.

Goodnight ...take care,

Minnesota Mary
106886 tn?1281295172
Geez Louize...is that last paragraph did not make sense, let me know...I just read it over and I thought, Huh? It is getting very late....

I will check the thread tomorrow.

108861 tn?1227249648
Wow!  I bet you do have a unique moniker!  My daughters middle name is Neva, also russian in origin.  She's tried to change to that but Caitlin is cemented in!  Have a great day Mery!  MV
Avatar universal
Jeez, I don't know about the cancer with the hormones, I know some opt to use them.  It seems a shame to suffer with hormone problems  on top of everything else though.  I would ask the doctor about that for sure.  I am sure Mary can tell you more about that, hopefully she will be along.  Once again, as I have told you before, your daughter is lucky to have you looking out for her like you do.  :)Merytre
106886 tn?1281295172
You can buy progesterone cream over the counter in the states (I am assuming you are in the United States)...I am not saying that you need to get this...again, I am not a doctor...but, it sounds like your doctor said it was okay, although then there was the mix up and all with the synthetic product and the low dose (I agree that  your body was probably crying out for the regular dose especially since you just had your surgery recently). It sounds to me like the doctor was trying to make it easy for you by giving the combination patch...and yet all this chaos ensued! Sounds like he (I think you said he) is a believer in the bioidentical hormones, though. So, that is a good start.

My point is...if you decide you want to go the Vivelle and progesterone cream route, the health food stores and stores like Whole Foods sell a cream that is a 2% strength. Directions are included. I use it every day since I have had a hysterectomy. I have used the over the counter stuff when my script has run low and I needed to reorder. For me, the 2% strength was not strong enough even though that is the strength I was getting from the compounding pharmacy (difference was it was micronized for better absorbtion and insurance paid a part of it) but it was helpful none the less.

Till next time, Mary
Avatar universal
Hi there, yes it made sense.  You were on the same strength but it worked better in the compounded form.  Didn't you say you

recently dosed up to 10% though?  The combipatch says it delivers 0.25mg per day of progesterone, so what would the percentage be?  I don't understand that part of it.  Yes, I am in the United States, are you?  My name is actually Egyptian, Merytre is the ancient goddess of the sun in their mythology.  My father was really into studying that stuff at one time, henceforth how I got a really different name. LOL, but its okay, I am probably the only one in the world with that name. The main trouble is that NOONE can pronounce it, they add letters, leave letters off, make up whole new names, trying to make sense of it. I usually tell them to call me Mary, so much easier. :)  

I have recently ordered a book off half ebay, thats an excellent place to get books cheap, have you tried it?  Let me check to see what book it was, brb.  Okay, its "Hormones, Health and Happiness" by Kathy Griffin and Steven Hotze, I don't know anything about it, I just ordered it because I liked the name. (stupid I know) I have not received it yet.  I will look for the ones you mentioned too, thank you.

I know what you mean about names, Caitlin is very pretty, I heard it a lot for a while, but I don't hear it much anymore. We named my daughter Tatiana, thinking it was so different, then I found out in Russia, it is sooo common, just like Mary is here!!!!  Anyway, I guess I will get some over the counter progest. for now, and will put in a call to my doctor about seeing what percentage I need and see if he can call it in to a pharmacy that does compounding.  I wonder if most of them do it?  Hopefully he will go along with it, because if not I will find another doctor.  I tell you, these doctors are wearing on my nerves lately.  I am starting back to work in a little over a week so I need to get it straigtened out before then.  You take care and once again, I appreciate your help!!  Merytre
Avatar universal
Oppss, I didn't realize you had written the post about the name, I addressed the response to Mary (the other one,hee hee, wow this gets confusing huh?) Anyway, Caitlin is pretty, my daughter's name is Tatiana, we thought it was soooo different, and I knew it had Russian roots.  My daugthers school had some Russian teachers convention come through and most of thier names were Tatiana!  Talking with them I discovered that that is the most popular name for girls in Russia.  Anway, my name is from ancient Egypt when they had gods and goddesses for everything. (earth, sun, moon, wind,rain, etc. etc.)  Merytre was actually the LOVER of the god of the sun, so I am actually named after a floosie I suppose.  My father liked the name so I am probably the only one in the world with it. I do go by Mary since NOONE can pronounce my name. Go figure.... :)  Merytre
167426 tn?1254089835
You gals are so smart   You know I am doing this for my daughter  so now I find another thing she should be aware of  Her surgery was 4 months ago  OVCA3  everything went  I have some questions  I know now what you call surgical menopause  I asked her last week if she is having any sweats  and so forth  she is having them  When did you start the replacement therapy?  she has 1 more chemo to go  They seem to have a patch for everything nowdays  Should she be on proges  now?   She goes to an onocologist weekly now for blood work etc  Should she be asking for and getting  a follow up schedule?  I think I understand that it takes around 3 months for it to leave the body and about 3 months for it to return with the patch. she is having alot of joint and bone pain , memory loss, fatigue.  Do homones slow down the process of chemo?  I am so sorry to be anxious about this, but until this happened I knew nothing. Now I want to learn and help. Back when I was nursing the patients I took care of came into die.  That is not the way now, they come into live.  My daughters name is Leslee she is 49 and a brand new gramma.  Ran out of ink on my printer, I copy alot of what you say and take to her, hoping she will have the right questions for the doctors.
106886 tn?1281295172
Hi to all...

Merytre...cool info about the name. I love names and the stories about how people came to be named the way they were. Oh, read on to see about the progesterone (Pharmacy, over the counter issue).

Ok...I googled the book you mentioned and found a nice review  about it on Amazon.com. Looks like it will be interesting and helpful. I see the doctor covers thyroid...and, thyriod problems seem to go hand in hand with menopause, surgical or otherwise. And, I am glad you are considering the Northrup book too. I still use that as my main resource and then branch out from there to other books such as when I first read "The Wisdom of Menopause"...from there I read a book with a title something like, Progesterone, the New Estrogen....it was excellent.

Simply star, I would suggest that you pick up Northrup's book as the best guide during this journey...and, how lucky Leslee (I always loved that name) is to have your help and support.

It sounds like she is definitely having menopausal symptoms what with the joint aches and memory loss and fatigue. And, it is so hard to know what her doctor will say about her wanting to get relief from these symptoms by taking bioidentical hormones. My oncologist started me on the Vivelle patch, but it took me months to discover why I was still feeling awful....and, then I learned about the Progesterone. Luckily my doc was willing to let me go on it and is pleased that I have had relief.

For years I was on the 2% strength progesterone and I used either the one from the pharmacy or the one from the store...over the counter. I preferred the pharmacy's because even though I needed a script for that, it is made so that it is absorbed more redily into the body. And, insurance covers a part of the cost. I am now on a 10% strength and it has been great for me. I also eat healthfully, exercise, take vit. D and magnesium. The progesterone has helped with bone strength ...was heading towards osteoporosis...but, the weight training, magnesium has also helped. I fault my not starting the progesterone for almost a year after my surgery for the decline in my bone health. I have worked out since 1980...

There have been women on this forum who have been allowed to take hormones, some have even been on the synthetic hormones. Others have been told "no way" ...but to that I often wonder if the doctor is aware of what the women are asking for. I am thinking that often the doctors are thinking of the synthetic hormones...the ones that were studied for a longitudinal study but was abruptly stopped when it was felt that the hormones were causing many problems. Now even the results from this study are constantly debated...but to be clear, bioidentical hormones were not studied in this report. And, there is so much information out there that is false and/or confusing.

Women will go to the doc and ask for progesterone such as we have been talking about and they get this blank stare. It has even happened to me. "No, I am not talking about "Progestins"...(the synthetic stuff to protect the uterus if one is taking sythetic estrogen)...I am talking about the hormone that even men produce called progesterone. People mix up the terms progesterone and progestins allllll the timeeeee.....

When a hormone is made to be identical to what the body is used to when it made it's own progesterone, it cannot be patented. So, the drug companies pretty much ignore it and there are not thousands of studies on this, particularly in the Medical journals that doctors would read. Sometimes you have to find a specialist in this area. Read my post to Vicki and the others to Mertre to get more suggestions.

Well, I know this is a lot to absorb. And, remember, I have been doing this for six years...my sister has been doing it for about 15 years...

But, you will get your answers....I hope. Let us know how things are going for Leslee.

Kind of swamped today, but I will check the posts over the next few days. More time later this week.

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