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HRT for women

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  • #16
    For months and months i have been saying yto my husband I can't understand why I get so hot and flushy nearly every day between 4.30pm and 6.00pm now i know. This site is so fantastic and so full of great people with answers.I have known for ages that my rosacea is hormone driven and have thought about going to see a Dr Bond here in the uk as I don't want conventional HRT now I really will.Thankyou all so much


    • #17
      Glad to help. Yes, the estogen levels that dip at 3-4 PM usually start to climb back in the comfort zone around 6 PM. I just want to emphasize for anyone who may ever read this, the difference between no symptoms and "too much" or "too little" is incredibly tiny----.05 mg. estradiol! For example, Estrace pills come in .5 mg. and 1 mg. sizes. If your doctor raises you from .5 mg. to 1 mg. because you are still having hot flushes, you may get extremely painful breasts and bloat at 1 mg. and give up. He has raised you by .5 mg., which is 10 X the jump I recommend. Your best dose may be .55, .6 or .75 mg.

      My best dose now happens to be .75 mg, but it changes. The dosage you need may stay the same for a long time, or it can change on a week to week or even daily basis depending on diet, exercise, stress, etc. The only way you can get these tiny dose differences that I know of is gel or cream. Gel or cream also acts more like your own body by releasing more steadily and as you need it. The rings and patches also release steadily, but the dose can't be adjusted except in large increments. If you are stuck with pills, you could try quartering the .5 mg. pills into .125 mg. per quarter, but even that might be too much or too little. Most likely, though, you could get by with raising and lowering by that much.

      Another thing is that the dose does not have to be raised or lowered over long time periods. I have had doctors in the past tell me to "give it time", like several months, to "adjust" to a dose. My symptoms of deficiency can be so severe that there is no way I can endure a long wait trying to "adjust" to some doctor's idea of what my body needs. There is also no way he can know sitting in his office how I am feeling on a day to day basis. A really good doctor like Uzzi Reiss understands this. Get his book "Natural Hormone Balance for Women"--it is a step-by-step explanation of exactly what, why, when, where, and how! While getting to my current dose, I tried a dose for a day, and if it didn't work, I would increase by .05 mg. the very next day. With estrone, I increased by .5 mg. at a time, since it is weaker and much less likely to cause breast pain.


      • #18
        It sounds very complicated but i guess you get the hang of it after a while, It will be a life saver for me. Have you heard of DR bond at all?


        • #19
          No, I live in the US, not the UK. Does he write books? It's really not that complicated, but while you are figuring out your dose, you just need to keep records. Then you usually won't need to change by more than .05 mg. at a time. You can tell if you need a little more by the start of your deficiency symptoms, and if you need a little less by breast soreness and water weight gain. It's sort of the same thing that diabetics learn to do with insulin. I would just give anything if someone would invent an estrogen meter. I suppose the diabetic glucometer machines would work if there were just some kind of estrogen strips that could be inserted into the machines instead of glucose strips. I won't hold my breath for that, though!


          • #20
            Hi Irishgenes,

            Wow! Just found this thread, haven't been on this forum in so long! Thank you for posting in such detail. I've been using LifeFlo Progesterone cream for several years now for PMS but it's not really enough now, can tell that my other hormones are a little out, I'm 41, never had children and really starting to see changes.

            What blood tests did you have done in order to get the prescription? I have a packet from the Women's Intl'l you mentioned and was just saying to a friend yesterday that I've got to dig it out and contact them. How helpful was your local doctor or did you go to someone recommened by them? I can get free blood tests at a local clinic but only for the hormones related to fertility, progesterone & the LH's, but can pay a very reasonable fee for additional hormones such as estrogen, but arent' there more than one estrogens that need to be tested? It's been over a year since I read the last book, which was by Suzanne Sommers, but she recommend oral and I still hadn't felt completely comfortable w/that route having read that it's hard on the liver and doesn't stay in the blood stream as long as transdermal application. About 6 years ago read the "What your Dr Wont Tell you about Menoupause" and the "Perimenopause" which directs just to progesterone cream. They state that it could help w/rosacea, but it never did for me, however, your info on the estrogen is very exciting. I typically flush around 2-3pm and often in the evening if I have beer or wine, so maybe my estrogen is overall getting so low it can't recoupe by the evening enough to combat a trigger.

            Did you have redness & flushing? I remember your posts about occular. Just wondered if the estrogen helps w/redness or flushing from triggers.

            Thank you again, so much, for posting all your info and giving me the boost to get going w/this program. So glad to hear you've achieved remission too!!! All the best,



            • #21
              Oh, yes, I definitely flushed at menopause, almost all the time! I actually ran a 2 degree fever before I started on estrogen at age 50 and doctors did a spinal tap on me. Ouchie! When I gained a lot of weight and then started on estrogen, all menopausal symptoms stopped. But when I lost a lot of weight (and estrone-making fat) at 58, I got rosacea. I only flushed sometimes, so I didn't relate it to estrogen deficiency because, after all, I was on estrogen. So I thought that I had triggers, and it seemed like I did--the sun, certain foods, strong emotion. However, once I got the right dose & type of estrogen, the flushing from "triggers" stopped. Except, like I said, once in a while at that 3 PM dip period.

              I found a doctor by looking in the yellow pages of the nearest big city phone book for physician ads which mentioned "bioidentical hormones". Often you do better to look for an anti-aging doctor instead of a gynecologist/obstetrician. Gynecologists are basically surgically trained and don't usually know much about natural hormones, though some are learning due to the demand Suzanne Somers' book created. (Although I read her book and didn't think it was very good. It was mostly about how beautiful & sexy she thinks she is, with very little to none of the "how to".) I did get an estradiol blood test, but I consider the blood tests pretty much useless. Your hormones can be up one hour, down the next; up one day, down the next--same as with glucose for a diabetic. If you get an estradiol test, I'd time it for a few days before your period and around 3 PM if possible, so you'll be at your lowest. I wouldn't bother to check the estrone.

              I am not a fan of progesterone cream. I own all of Dr. John Lee's book in which he says it is a cure-all. However, he has no proof and one expert, Dr. Elizabeth Vliet, says that when she tests women with PMS, they are deficient in estrogen, not progesterone. I tried progesterone suppositories 20 years ago for my PMS and felt much worse. I only use progesterone cream now every 2 or 3 months because I have to since I still have my uterus. It makes me depressed, crampy, headachey--all the usual PMS symptoms. I've lowered my dose to the bare minimum, but I have to take a certain amount in order to get withdrawal bleeding. That's the one thing I don't like--the idea of having periods the rest of my life. Some doctors give progesterone every day to eliminate periods, but I hate the hormone too much to ever take it daily. Every woman is different, though, and some may like progesterone's effects.


              • #22
                So what tests did you use to get a correct rx for the bioidenticals? Saliva, or do you think those are accurate? You right about the fluctuations and that's great advice to go in around 3pm. The dr. advised day 14 of my cycle but is that more for checking fertility or do you think that would be good time. I usually start the progesterone cream at day 12 but will of course hold off 'til after the tests. When I read in the Dr Lee book all the cure claims, that stuff you have to take w/a grain of salt. It seems like body chemistry is so diverse for each individual that's why the same things don't work for everyone. One of my best friends hates the progest. cream too, made her extremely tense, anxious and acne but it was so helpful to me - until recently. Ditto on the Suzanne Sommers book, but it helps having someone famous recommend alterntives and for some people that's inspiring. What books have you found most helpful?

                There's a doctor out here that several of my friends have gone to for compounded hormones but for different reasons than rosacea. One who'd previously had surgerey for severe endometriosis and cysts and the results for her have been amazing but her blood work cost $2,000.00 and I don't have that to spend. So that's why getting the tests at the free clinic were such a boon.

                Thanks again for any imput!


                • #23
                  Hallo irishgenes
                  tried to pm you but i don't know if it worked
                  can I ask you a few things ?
                  I am going to start with oestrogel again
                  The gel is 0,6mg /g -gel (estradiolum ) one flacondose is 60mg my gynocologist told me to use 2 doses in the morning and 2 in the evening
                  I only took 2 in the evening but gaied 2,5 kilos in one week and a half ( ware -retaining I guess .
                  I had to stop because i had a severe allergic reaktion to something and because the oestrogel was one of the new products I was using ( the others were Sporanox and Eucerin lotion ) I had to stop all 3 and can now begin again with one at the time
                  But if I understand you my 120mg is a very large dose Am I correct or do I mix things up
                  Thanks for your time !


                  • #24
                    Patrice, I saw that French Oestrogel for $7 a tube from Masters Marketing (a British mail-order firm) and was trying to figure out the dose, because that is cheap. I even emailed the pharmacist there asking how many mg. of estradiol per gram of gel. She gave me a reply that did not answer my question. I am sure that your dose of 120 mg. is not the actual dose of estradiol, but a measure of volume of gel, because nobody would give a woman that much estradiol! Is that an over the counter product in Belgium, by the way? It does sound like you got too much, as bloat and breast pain are the main signs of overdose. Try to find out from your gynecologist how many mg. estradiol per gm of gel. Also, I am not sure that estradiol by itself will work for you. Probably, but it didn't for me. I have to take estrone, too. Estrone acts as a storage supply of estrogen which can be converted to estradiol as needed, but which doesn't cause bloat and breast pain. It is too weak to use by itself, but if I don't add it to the estradiol, I get symptoms.

                    Karla, I had only my estradiol level checked a long time ago, but that was just for the doctor's records. The only "test" you really need is your own body's symptoms. Learn to believe your body instead of a medical test or a doctor. Your body will ask for the exact right amount of estrogen that you need. When you feel good and have no symptoms, THAT is the right amount of estrogen for you. When you are a little low, you will get one or two symptoms. Like in my late 30's, I started with the rosacea eyelid symptoms, so that is the first symptom that appears when my estrogen is just a smidgen below normal. That means my skin needs more or steadier levels of estrogen than any other organ. As my estrogen dips further and further below normal, more and more symptoms appear until I feel like I am going to have a heart attack and take to bed with fever, shakes, and heart pounding in my ears. You don't need to worry about taking "too much", either. Your body will stop you by getting bloat and sore breasts.

                    If your doctor wants you to come in on the 14th, he is probably going to order an FSH test. That is the standard test for menopause, but it is not all that useful. There is apparently an FSH urine test available OTC in the US. I would rather use that than get my arm poked just for an FSH test. Dr. Vliet and some others say that the saliva tests are not accurate. They cost about the same, so probably the blood tests are better. Here is an interesting article about the FSH test:
                    But if your doctor won't prescribe the compounded bioidentical estrogen cream or gel, you will be stuck with some kind of pre-measured "one-size-fits-all" dose, most likely a pill or patch. That is like a shoe salesman who sells only size 5 and size 10 shoes. If you happen to be an 8, you will be out of luck. That is why women quit HRT. They are not getting any relief, or they are suffering overdose symptoms, so they say "HRT didn't work for me" and give up.

                    As for books, anything by Dr. Elizabeth Vliet. She'll have a new book on estrogen in August of this year. She doesn't believe in Tri-est and tends to use the patch or oral pills, but she does believe in natural bioidentical estrogen and is suspicious of the progesterone cure-all theories because they don't coincide with research. Her books are a bit technical, but very good because they show how strongly estrogen affects every system in the body. The Bible of HRT, which will answer your every question, is Uzzi Reiss' book "Natural Hormone Balance for Women". He believes in Tri-est gel and also in taking small doses of progesterone all the time, which avoids periods for most women. However, he admits that some women do not tolerate progesterone well due to their own body's handling of it. Here is an interview with him on CBS:
                    Isn't he a sweetie pie? I wish I had him for my doctor!


                    • #25
                      Hi, Irishgenes
                      Thanks a lot for sharing your hormones experience with us. I am 42 so last month I tried estradiol transdermal patch Climara. The result was beyond any expectations. It helped my rosacea tremendously. But within 3 weeks I gained 7 lb. Is weight gain the inevitable side effect of HRT?


                      • #26
                        Sounds like water weight gain. You are probably taking a little bit too much estrogen, if you are having a bloated feeling in the belly and breasts. Unless you have had a total hysterectomy, you are still producing your own estrogen at 42, so maybe you only need the extra estrogen for a week or two each month. Actually, studies show that women on HRT gain less actual fat than woman not on HRT.

                        Are you also on progesterone? I develop a ravenous appetite on progesterone and not only eat more but retain water. This makes sense, because progesterone is the pregnancy hormone, and pregnancy is the time when nature wants us to eat more to nourish the fetus. This increase in appetite is one reason I limit my progesterone to every 2-3 months. I can kiss my diet good-bye on the 12 days I am on progesterone.


                        • #27
                          Hi irishgenes ,
                          it was my gynecologist who gave me a prescription for the oestrogel
                          it only costs me 1,80euro ! I tried to get hold of him to ask him how much in mg a dose is but he is gone for another two weeks .
                          On the flacon it says : Formula : Estradiol 60mg (0,06% ) -Carbomerum-Trolaminum-Aethanol-Aqua purificata
                          Here in Belgium i believe you need a prescription
                          Can you tell me a brandname fot the estrone , is it also a gel ? I will ask mu gynecologist to help me to get it ( if he wants ! )
                          Thanks again for heloing


                          • #28
                            Ask how many mg. estradiol per gm of gel instead of how many mg. per "dose", which is too vague. (And then tell me what he says, because I might buy it myself!) Usually 1 gm. of gel equals 1/4 tsp., but "dose" could be anything. I should be able to figure it out from the .06%, but I am not that good at metric. I didn't learn that stuff in school (eons ago!), and have a hard time thinking in those terms. Do you even use teaspoons as measurements over there any more? Bioidentical estrone is compounded individually by pharmacists and not available as a drug company product in the US. I have no idea if or where you could get it in Europe. Does your government allow individual compounding of drugs?


                            • #29
                              Well I didn't wait but ( I am a dentist that helps to get the information ) asked the firm that brings it on the market here in belgium. 1,25 g of gel (= one flacon dose ) contains 0,75mg of oestradiol
                              They say you need to use 2,5 mg of gel daily ( that means 1,5mg oestradiol )
                              So I think I will start again with one dose ( max ) and ask the pharmacist abouth the estrone
                              I cannot answer your other questions yet but I wil try to get answers from people who are familiar with this
                              I stop now because since this morning I have one red eye ( several little vessels bursted ) gues my eyes are the next step in my R problem !
                              It is not very painfull but annoying and light and the pc are irritating
                              Thanks again and hope to talk to you again soon
                              Have a nice weekend


                              • #30
                                How timely that I find this discussion!

                                I was diagnosed with prematurely high FSH several years back and it certainly does coincide with when my skin went completly off the charts!

                                I take a few phytoestrogenic herbs: cohosh, red raspberry root, wheat grass and if I add soy that really seems to help level me out a LOT (that combo also helped me conceive my son, and he is the reason I met with the herbalists in the first place!).

                                My dermatologist will go as far as to say that my skin condition IS hormonal - but nothing he's done or prescribed has helped a whole lot either.

                                Very interesting topic!