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  1. #1
    Join Date
    Jul. 21, 2006
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    South Carolina
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    Default Bioidentical hormones for HRT?

    Does anyone know anything about them? Anyone use them?

    New OB-GYN prescribed a topical cream for me - you rub a tiny amount on your forearm before bedtime - containing "bioidentical" estrogen/progesterone.

    The idea is that because the hormones are plant-derived (from soy/yams, respectively) and identical in molecular structure to the hormones in the human body, they are safer than those derived from pregnant mare's urine - which it is said have an extra molecular chain added on to make the hormone replacement patentable.

    I've read some criticism that says, at worst, it is not known whether or not plant-derived progesterone can be absorbed by the human body - dangerous because unopposed estrogen is a known health risk. I've also read that, at best, a hormone is a hormone, so the bioidenticals are no safer than any other hormone supplement.

    My mother and my maternal grandmother both had post-menopausal breast cancer (both survived and eventually died of something else) so I've always thought I couldn't take hormones. But my new OB says that the bioidenticals may actually protect against breast cancer!

    Anyway, I gave it a try for two whole days and was hateful, overly-emotional, and scared of my own shadow. So I stopped using them. But since then, I've been noticing TV advertisements for clinics that prescribe bioidentical hormones. I hear Oprah is on them.

    Which makes me wonder - are bioidentical hormones for real? Or are they the snake oil of the moment? If the latter, I don't really want to keep seeing the dr. who prescribed them for me!

    What says the collective COTH wisdom?
    Last edited by pAin't_Misbehavin'; Aug. 30, 2013 at 02:40 PM.



  2. #2
    Join Date
    Jul. 12, 2010
    Location
    Oklahoma
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    191

    Default

    So, I don't want to get into a debate about it, so I will just give you something to read. This is from the North American Menopause Society, which is a very well respected organization that a lot of ob/gyns and endocrinologists are involved with. It also mentions the FDA stance on bioidentical hormones. See what you think.

    http://www.menopause.org/publication...ormone-therapy



  3. #3
    Join Date
    Jul. 21, 2006
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    South Carolina
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    Default

    I see from your link that one reason NAMS warns women about potential harm from bioidentical hormones is that they are custom mixed at a compounding pharmacy. As your link explains, compounding pharmacies aren't subject to FDA inspection.

    I'd just watched the 60 Minutes program about all those people getting meningitis from medicine from a compounding pharmacy when the dr. prescribed the bioidenticals to me. So I mentioned that, but my doctor said not to worry because the topical cream wasn't for internal use (meningitis was caused by mold contaminating medicine used in spinal injections) so it would be unlikely I'd catch anything from them.

    Of course, as your link points out
    Concern arises with the bioidentical hormone medications that are “custom-compounded” (custom-mixed) recipes prepared by a pharmacist following an individual prescriber’s order for a specific patient. These medications do not have FDA approval because individually mixed recipes have not been tested to prove that the active ingredients are absorbed appropriately or provide predictable levels in blood and tissue. Further, there is no scientific evidence about the effects of these compounded medications on the body—both good and bad.



  4. #4
    Join Date
    Oct. 20, 2008
    Location
    Florida, USA
    Posts
    779

    Default

    Hi,
    Separate issue... stopped having a period at 24 here, shortly after quitting 7 straight years of BC. Gyno put me back on BC (different one) and still nothing. FINALLY went to an endocrinologist and was put on a thyroid support (Hypo here) and bio identical progesterone... That is, after about 14 vials of blood analysis. In my case, I have less progesterone than what most post menopausal women have...
    Basically went 2 years without a period and after first trying 25mg of progesterone twice a day for 90 days with zero result, bumped it up to 35 twice per day and got my first period- TODAY!
    Success on that front... But now need to figure out if I can come off, if I have to stay on these things, etc...

    Definitely custom compounded- SCARY link.. appt on the 19th, will bring it up!

    Had tried EVERY possible natural thing on the market before going to this.. which is probably why it took me so long but I didn't want to just jump in the most drastic thing either!

    Looking forward to hearing some other feedback on this!
    Proudly living in my "let's save the world bubble"!



  5. #5
    Join Date
    May. 24, 2007
    Location
    Monroe, WA USA
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    Default

    I had some reactions to bioidentical hormones and am now on synthetic ones (I refuse to use Premarin). I have had good luck with them and am on very low doses now. I've only taken hormones orally. I would think it would be hard to get consistent doses using the cream. I have had no problems with the hormones I've been taking and it's been about 18 years now.



  6. #6
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    Mar. 19, 2009
    Location
    Out West
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    575

    Default

    My sister has used the bio-identical hormone troches for one or two years and swears by them (for hot flashes and other menopause issues). I tried the troches but couldn't get past the bitter taste (which my sister doesn't notice... then again she likes cilantro and I can't abide it, so perhaps there's some sort of link there).

    My doctor then switched me to a compounded cream, which has not been effective for me so far even after doubling the application dose. I'm hoping to get relief from hot flashes from hell, but no luck so far...



  7. #7
    Join Date
    Nov. 11, 2010
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    Six miles from the beaten path
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    Default

    I use bio identical. I'm young (33) and require estrogen, testosterone, and progesterone, among others (cortisol, aldosterone and thyroid, if you're wondering).

    My experience has been that endocrinologists and the general medical establishment are worse than useless for hormonal balance. I had two adrenal crises in as many months, and was given solumed and no wean down.

    My sex hormones were that of an 85 year old woman...baseline or non detectable. I was offered Prozac and 'therapy' for my 'mental' issues. I saw approx a dozen MDs before I found a functional med guy that, IMO, saved my life.

    My two cents is that bio ID is the way go.
    I am not allowed to look at breeding stock.
    Or babies. Or CANTER, et al.

    ESPECIALLY not CANTER, et al.


    2 members found this post helpful.

  8. #8
    Join Date
    Feb. 18, 2013
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    41

    Default

    The problem with creams is the variable dosing. You never get the same dose two days in a row. There is a difference in uptake between oral and dermal. One solution is a estradiol patch. Of course it needs to be balanced with progesterone, which I for some reason have no issue with being synthetic. Its the same thing as was in my BC pill years ago.

    For those where breast cancer is a real risk, many docs are doing testosterone. Its off label usage, but very effective for symptoms of menopause when all else fails. I might also add that following a paleo type diet *closely* (especially the elimination of added sugar), can help with some of the milder symptoms.


    1 members found this post helpful.

  9. #9
    Join Date
    Nov. 11, 2010
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    Six miles from the beaten path
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    Default

    Quote Originally Posted by Arisperson View Post
    The problem with creams is the variable dosing. You never get the same dose two days in a row. There is a difference in uptake between oral and dermal. One solution is a estradiol patch. Of course it needs to be balanced with progesterone, which I for some reason have no issue with being synthetic. Its the same thing as was in my BC pill years ago.

    For those where breast cancer is a real risk, many docs are doing testosterone. Its off label usage, but very effective for symptoms of menopause when all else fails. I might also add that following a paleo type diet *closely* (especially the elimination of added sugar), can help with some of the milder symptoms.
    I disagree with this. I'm am extremely sensitive to testosterone due to a negative feedback mechanism involving some enzymes ad whatnot (5 alpha reductase, among others) and have ZERO trouble getting a consistent dose.

    The trick is to use a GOOD compounding pharmacy who understnds the need for the right consistency, and use the right kind of syringe.

    Pump bottles are a fail. You MUST use calibrated syringes.
    I am not allowed to look at breeding stock.
    Or babies. Or CANTER, et al.

    ESPECIALLY not CANTER, et al.



  10. #10
    Join Date
    Nov. 11, 2010
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    Six miles from the beaten path
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    Default

    Another thing that helps, sometimes dramatically, is iodine supplementation.

    People have this bizarre fear of iodine, but its what lets metabolize estrogen into the proper form...which is crucial.

    It's also good in about ten thousand other way, but that's another story
    I am not allowed to look at breeding stock.
    Or babies. Or CANTER, et al.

    ESPECIALLY not CANTER, et al.


    3 members found this post helpful.

  11. #11
    Join Date
    Jul. 21, 2006
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    South Carolina
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    Default

    Quote Originally Posted by lintesia View Post
    My sister has used the bio-identical hormone troches for one or two years and swears by them (for hot flashes and other menopause issues). I tried the troches but couldn't get past the bitter taste (which my sister doesn't notice... then again she likes cilantro and I can't abide it, so perhaps there's some sort of link there).

    My doctor then switched me to a compounded cream, which has not been effective for me so far even after doubling the application dose. I'm hoping to get relief from hot flashes from hell, but no luck so far...
    What's a troche? I tried googling but Google is convinced I want to know about trochee instead.

    I actually experienced a funny taste in my mouth using the cream on my forearm. I just figured maybe they use DMSO as a way to get the hormones through the skin - I always get a strange taste in my mouth when I have to put DMSO on a horse.

    I think cilantro tastes like dirty dish water. Blech.


    1 members found this post helpful.

  12. #12
    Join Date
    Feb. 14, 2010
    Posts
    2,993

    Default

    Quote Originally Posted by Eklecktika View Post
    I use bio identical. I'm young (33) and require estrogen, testosterone, and progesterone, among others (cortisol, aldosterone and thyroid, if you're wondering).

    My experience has been that endocrinologists and the general medical establishment are worse than useless for hormonal balance. I had two adrenal crises in as many months, and was given solumed and no wean down.

    My sex hormones were that of an 85 year old woman...baseline or non detectable. I was offered Prozac and 'therapy' for my 'mental' issues. I saw approx a dozen MDs before I found a functional med guy that, IMO, saved my life.

    My two cents is that bio ID is the way go.
    Amen to that, sister! I swear I'd rather use my horse vet for myself than the general medical establishment!



  13. #13
    Join Date
    Feb. 4, 2009
    Location
    NCC DE
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    2,225

    Default

    Just going to toss this out as it's a little off topic, but if your main complaint with menopause is hot flashes ask the doctor if a low dose of Clonidine might help.

    I was having hot flashes to the point where I was waking up every hour all night long. I went for at least 6 months without a decent night's sleep. I'm not a candidate for HRT as there is a strong history of stroke in my family but I was to the point I would have risked the stroke.

    I tried all the OTC stuff, evening primrose, phytoestrogens, roasted soy nuts, selenium & E, you name it, I tried it.

    So my GYN prescribed the Clonidine and although I was very skeptical, I'll be damned if it doesn't help. A lot. It's not 100% effective but I'd say my flashes are reduced 75-80%. I still take the selenium & vit E and the GNC phytoestrogen. The combination is effective for me and I can regularly get a good 5 hours uninterrupted sleep a night. And Clonidine is dirt cheap. I don't even bother running it through the insurance.

    It won't help with other symptoms but I can live with those.



  14. #14
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    Jul. 21, 2006
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    South Carolina
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    Default

    Nah. I'm so used to the hot flashes I barely even notice them anymore. They wake me up, but I just fling off the covers (cats have learned not to sleep on me ), wait for the overhead fan to dry the sweat, and go right back to sleep. During the day, I just fan a lot. It's the South, ladies of a certain age are expected to do that.

    ETA: But I'm glad you posted that, mswillie. During the years I was not so OK with my "power surges" I'd definitely have given it a try.

    I actually like the way I feel nowadays. I find my nerve is much better than it's been since I was a kid. So's my ability to focus.

    But canoeing? Sadly, no desire to go canoeing. Or even kayaking. Which is OK with me but I keep thinking DH must miss it. So that's why I decided to give the hormones a try. Unfortunately they made me so mean no one would want to canoe with me.



  15. #15
    Join Date
    Jun. 29, 2008
    Posts
    434

    Default

    I've been on a regimen of implanted bioidentical hormone pellets (estradiol, testosterone, progesterone) for about a year, and I like them quite a bit (except for the fact that my insurance refuses to pay for them). They're made by a compounding pharmacy and inserted by one of the nurse practitioners at my specialty GYN's office. I'm much less mentally foggy, have stopped crying/becoming homicidally angry at the drop of a hat, and actually have something resembling a libido again. The doc also prescribed Armour thyroid -- apparently lots of women in their thirties and forties are hypothyroid but don't realize it. (I'm about to turn 47 but have been having symptoms of perimenopause for more than 10 years.) I haven't lost as much weight as I'd have liked, but part of the problem is that my bum knee and hip have been keeping me from running. My doc's oldest client is an 85-year-old woman; until he died at age 90, the woman's husband was getting pellets as well.



  16. #16
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    Mar. 19, 2009
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    Out West
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    575

    Default

    Quote Originally Posted by pAin't_Misbehavin' View Post
    What's a troche? I tried googling but Google is convinced I want to know about trochee instead.

    I actually experienced a funny taste in my mouth using the cream on my forearm. I just figured maybe they use DMSO as a way to get the hormones through the skin - I always get a strange taste in my mouth when I have to put DMSO on a horse.

    I think cilantro tastes like dirty dish water. Blech.
    You have to manually remove the "e" that Google adds in order to get the right search results (I can't bash Google since DH works for Google and pays many of the horse bills!!!):

    http://dictionary.reference.com/browse/troche



  17. #17
    Join Date
    Oct. 20, 2008
    Location
    Florida, USA
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    779

    Default

    Quote Originally Posted by Sunnyhorse View Post
    The doc also prescribed Armour thyroid -- apparently lots of women in their thirties and forties are hypothyroid but don't realize it.
    That's what I'm on as well!! 26 here... so guess it can start earlier!
    Will say that the Progesterone troche have made a HUGE difference for me... I feel like I'm "myself" again!
    Proudly living in my "let's save the world bubble"!



  18. #18
    Join Date
    Apr. 28, 2013
    Location
    Vancouver Island
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    485

    Default

    I don't know anything about HRT specifically for women because I'm FtM transgender and taking testosterone myself, but I do want to make a brief point about where you are applying your cream. If you have a partner that you share the bed with, it's really NOT a good idea to apply the cream anywhere that is not covered by clothing all night. If it were to rub off on your partner they could suffer from adverse effects from the medication. You are better off applying it to the outside of your thigh/hip area, or your shoulder (only if you wear a t-shirt to sleep in). Topical hormone formulas (such as creams, gels, patches, etc) should be covered when on your body at all times, to prevent transfer onto other people or surfaces that other people may also come into contact with and have the medication passed onto them through third-hand contact. It's SO important, in fact, that even though I inject my testosterone deep into a muscle, I can't have children or pregnant women sit on my lap afterwards (I inject into my quadriceps) for risk of the serum potentially seeping out and harming them in some way. HRT is a very common thing these days, but it doesn't make it any less potentially harmful to others around us!

    Good luck finding the information you're looking for
    Curious about Trans* issues? Feel free to ask!

    Saving Pennies To Get My Own Canoe



  19. #19
    Join Date
    Jul. 21, 2006
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    South Carolina
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    Default

    Wow, Ceylon Star, I'd never thought of that! And neither the pharmacy nor my doctor told me anything about how to apply it or gave me any safety warnings. I had to call my neighbor to find out how to use it. I'm thinking this is yet another sign of a less-than-professional operation.



  20. #20
    Join Date
    Apr. 28, 2013
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    Vancouver Island
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    Default

    Yeah, that really seems sketchy that neither the prescribing doctor nor the pharmacy told you how to use the medication or what the possible side effects could be. My endocrinologist was SUPER thorough when discussing the testosterone and the pharmacist was as well even though I told them that the doctor had gone over it in major detail. If I were you, I'd be looking for another doctor and going in to the pharmacy and asking all the questions you can think of.
    Curious about Trans* issues? Feel free to ask!

    Saving Pennies To Get My Own Canoe



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