HRT for women

[patrice]

Hallo irishgenes ,
one more question ( and one more an one more ...) how much estrone do you take and at what concentration is it compounded ,
My god if these things should happen to men I can imagine it would be concidered far more important and they should not have to ' dokter ' it out by themselves !
I am feeling so bad , my new treatment ( for seb derm ) does'nt seem to work , my skin is worse than ever , papels all over , big ones coming and going without any reason it feels uncomfortable and itchy and my moral is below zero .
I believe the Pytival ( la roche posay ) I have to puton my face has no effect on these papels and it is drying and the sporanox should do something after one complete box no ?
I try to go on for four more weeks but i don't know if it gets worse if I can take it without antibiotics like I promised the new derm , if it keeps getting worse I will try to see him sooner ,
Hope some of you have a nice day
Patrice
hope my english doesn't make you go mad

[irishgenes]

Patrice, your English is quite good. I take 2 mg. of estrone twice a day. That's about equivalent in strength to adding another .2 mg. of estradiol, so that my total daily dose is still under the normal 2 mg. a day of estradiol. (It's important to take it twice a day, not once.) If you use a compounding pharmacist, estrone can be made up in any strength you need. Usually it is recommended that you take the same amount of estrone as estradiol, but I am taking the estrone mainly to keep my appetite down, and I have a BIG appetite! As I reported on another thread, estrone (changed into an unnatural, patentable form, of course) is currently being investigated by a drug company for obesity and showed great results in rats. Don't despair if you can't get estrone there, as the estradiol might work perfectly well alone for you.

Thanks for that info on the strength of the French estrogen gel that Masters Marketing sells for $7. But is it in a pre-measured pump or can you just squeeze it out as needed?

Before I discovered that it was my hormones causing my rosacea problem, I took a tiny dose of doxycycline--25 mg. twice a day. I quartered a 100 mg. tablet in order to save money, but it is also available as a 20 mg. dose, mainly for periodontal disease. At that dose, it does not act as an antibiotic, and yet it was extremely helpful for my p&p. If I flushed hard for hours, I would still get p&p, but it made them go away within a day. I would recommend that to any woman (who isn't taking Accutane) until she can get her hormones straightened out to stop the flushing. You won't get yeast infections at that dose.

Hi, Gina! I tried the phytoestrogens, but they never worked for me. I guess my estrogen level was just too low, and phytoestrogens are very weak. Dr. Elizabeth Vliet writes that they can cause problems in women whose estrogen is really low because they act as drug-like SERMs (selective estrogen response modulators, I think). They look enough like your own hormone to fool the body into accepting them into the estrogen receptors, where they perform some, but not all, of the activities that your own estrogen does. In other words, they might stop some symptoms, but not others.

I have been reading the book I mentioned earlier called "The Hormonally Vulnerable Woman" by Geoffrey Redmond, M.D. On page 8 & 9, he lists "Common Symptoms Caused by Hormones", and guess what? Rosacea is listed! That is the first medical corroboration I have seen about my "theory"! He is an endocrinologist who runs the Hormone Center of New York and has had over 10,000 female patients with skin problems, which makes him the world's leading authority. His basic advice is Yasmin birth control pill for the pre-menopausal (it has a built-in testosterone blocker) and bioidentical estradiol for the menopausal, often adding spironolactone to block testosterone. He says any woman past the teenage years who still has a problem with acne has a genetic vulnerability to her own (usually normal) levels of testosterone. I also have discovered that lack of estrogen can cause your own testosterone to become dominant, resulting in acne, scalp hair loss, and the dreaded chin hairs!

I wish Dr. Redmond was not in New York City, as I am afraid to go there. He is very sympathetic to women's hormone problems and admits that gynecologists, dermatologists, and endocrinologists have little to no interest in women's "appearance problems". He says it is almost impossible to find a doctor who knows enough to treat skin problems with hormones. He says they will always use topicals and antibiotics, and you will keep on having the same problem forever. I can attest to that. I had skin problems from the age of 12 and was on Accutane at least 4 times. I would say that this book, and the one by Dr. Uzzi Reiss, are MUST-HAVES for women with our problem. After reading these two books, you'll know more than most doctors about what you need and you can then ask for it.

[patrice]

Hi irischgenes
Mine is pre-measured : 1 flacon dose is 1,25 mg of gel ( = 0,75mg of oestradiol ) but you can also get it in a 'tube where you can take out what you want.
I hope to start again soon with it .
Have a nice day
Patrice

[Susan Ches]

My mother made me promise years ago never to take hormone therapy for hot flashes. She had three good friends die from breast cancer after taking hormones for hot flashes. Well, I never got the chance to even try it, because I got breast cancer before menopause. I don't know about horse urine - but my breast cancer was estrogen positive. One of the risk factors was that I never had children. When you are pregnant your body gets a break from estrogen production. I am currently taking tamoxifen which affects estrogen production.

[irishgenes]

I am very sorry that you have gotten breast cancer, Susan. Did your mother also have it? Women who get it before menopause usually have a genetic factor involved. I'm afraid that your idea that the body "takes a break" from estrogen during pregnancy is erroneous. Estriol (a type of estrogen) rises from 38 ng/mL in the first trimester to 460 ng/mL in the final trimester (from Web MD). Pregnancy and lactation reduces your chances of breast cancer, but not by decreasing your estrogen. The opposite is true.

I am aware that some breast cancers are estrogen-positive, but this does not mean that estrogen caused the cancer. Most doctors will say that "estrogen" is forbidden to breast cancer patients because that is the "conventional wisdom". However, in the May 15, 2001 Journal of the National Cancer Institute, a study called "Hormone Replacement Therapy After a Diagnosis of Breast Cancer in Relation to Recurrence and Mortality", it was reported that: "The rate of breast cancer recurrence was 17 per 1000 person-years in women who used HRT after diagnosis and 30 per 1000 person-years in non-users. Breast cancer mortality rates were 5 per 1000 person-years in HRT users and 15 per 1000 person-years in non-users." In other words, over the long run, the non-HRT users had twice the recurrence rate and three times the death rate. And that is with the bad stuff---Premarin or horse urine. How much better would they have done with topical estradiol?

In another study from Journal of the National Cancer Institute called "Effect of Long-Term Estrogen Deprivation on Apoptotic Reponses of Breast Cancer Cells to 17-beta Estradiol", it was found that high concentrations of natural estradiol in vitro resulted in a 60% reduction in the growth of breast cancer cells and a sevenfold increase in cell death. This study was done at NIH. They know what really works with no side effects, but they want to push drugs and make money.

Women who take tamoxifen start to get cancers of the uterus, liver, and digestive tract after a few years, so it is not harmless. It also causes all those horrible menopause symptoms like memory loss, hot flushes, osteoporosis, insomnia, and on and on. Here is an interesting article on tamoxifen:
http://www.lef.org/magazine/mag99/may99-cover.html

[irishgenes]

Just an update to say that the increased estrogen dose has continued to keep me free from flushing and rosacea for 6 months now. Also, for those who may be interested, the French Oestrogel from Masters Marketing has 60 mg. estradiol added per 100 gm. of gel, and the tube is 80 gm. of gel for $7 a tube. They supply a funny little ruler and you are supposed to squeeze out a length of 1.25 gm. of gel, which contains .75 mg. of estradiol. That just happens to be my "best dose" of estradiol, which I rub on my skin twice a day.

However, trying to squeeze the tube evenly along the ruler just isn't very accurate, as it tends to come out in dollops. So I use a plastic "gm gel" spoon from Women's International Pharmacy, which happens to be equal to 1/4 tsp. This gm gel spoon supplies .6 mg. estradiol of the French gel. Then I add more gel from one of my "pinch" measuring spoons (from ebay). It measures 1/16 tsp., giving me another .15 mg. estradiol. Thus I get my .75 mg. dose. If I ever need to add a little bit more, I have figured out that using one of my "smidgen" measuring spoons (1/32 tsp.) adds .075 mg. estradiol with this particular gel. That is as accurate as you need to get for going up or down to find your best dose. Masters lets you order up to 12 tubes at a time.

Of course, I am 60 and have essentially no estrogen of my own. Those in perimenopause can try using just a small amount (maybe a pinch to start) during those days you tend to flush, like pre-menstrually when estrogen drops. Your body will tell you by symptoms like breast fullness/pain and abdominal bloat if you are taking too much. Then just drop back a little. No harm done, as it disappears within 24 hours. The French product is identical to your own estrogen and is made by Besins International Pharmaceutical.

[Bonnie]

Hi Irishgenes,

Is this something that you will do for the rest of your life or will you eventually have to stop the hormones?

I read the book you suggested "Natural Hormone Replacement" and decided that I probably could use a little my estrogen in my body. Then I thougt about what my body would go through if I had to quite the hormones for some reason. I sure don't want to have to go through the hot flashes and night sweats again.

I haven't had a chance to talk with my doctor about this book but will my on my next appointment.

Also do you still have less headaches?

[irishgenes]

Yes, I am going to take it the rest of my life because I get so extremely ill that I become bedridden when I have no estrogen. I haven't had any migraines since upping my dose and using the dermal route. Rosacea appears when I have almost but not quite enough estrogen, so I guess my skin needs more or a steadier supply. Or perhaps it is just that I get hot flushes now and then when I don't have quite enough estrogen, and that sets off my rosacea. If I am REALLY low in estrogen, I run a 2 degree fever all the time, which is why I didn't originally recognize that I was having hormonal hot flushes when I developed rosacea.

I get just a wee bit of eyelid itching and dry eyes occasionally when it is has been 12 hours since my last dose of estrogen, which always goes away within an hour of applying the estrogen gel. I remember once going to a dermatologist with bright red crusted and swollen lids (upper and lower) which I had had for several weeks. It was so embarrassing to go out looking like that, and it felt like I had sand in my eyes all the time. She thought it must be an allergic reaction instead of rosacea and gave me a tube of cortisone, of course. I am so happy I will never have to have ocular rosacea again now that I know the cause.

If you no longer have hot flushes, then your body has adjusted to not having estrogen any longer, and I would be hesitant to stir things up again. But are you sure that your rosacea flushes are not menopausal hot flushes? I thought I had rosacea triggers to certain foods, the sun, & strong emotions. Those things did always bring on a flush, but now that I'm on the right dose of estrogen, I am not flushing to any of those "triggers" any more. Estrogen does so many good things in all parts of the body, that I am much more afraid NOT to take it than to take it forever. The studies showing bad effects have all been done with Premarin (and Provera), and horse hormones set up an immune response in the body because it is a different species.

[pinkcheeks]

What a great thread. Such a big help to me. I can't wait to get my hands on the recommended books.

It's silly that medical gurus and drug companies don't explore these issues. I have hope that the BabyBoom generation of women will change their apathy. There are lots of them, they know how to get things done, and they're entering the age when rosacea "typically" hits.

I had a baby in April. During pregnancy my rosacea symptoms all but disappeared. Now, a few months later, I'm starting up again with the perioral dermatitis. Based on this thread I'm wondering if my plunge in estrogen isn't the culprit (I'm breastfeeding and my midwife says it takes a real dive during nursing). No bioidentical hormones in the house but maybe some soy rich foods from the local health food store.

You all are wonderful. Thanks especially to Irishgenes for all her conscientious posts.

SF

[irishgenes]

Unfortunately, the phytoestrogens like soy are about 1000 times weaker than estradiol. However, you wouldn't want to take estradiol while nursing. Nursing for as long as possible is very good to help prevent breast cancer, by the way.

[Carol in NY]

Thank you! I just discovered this forum and realize that I'm coming in very late on this thread. I'm 49 and its not fun. My rosacea has gotten much worse in the last 6 months and nothing seems to be working that worked before. Antibiotics aren't touching it.

Meanwhile with my face aglow and pussing, my breast are swelling with cysts and very uncomfortable. This weekend I had one become infected and ended up getting an IV antibiotic. Still have pain but no fever.

So, now I'm wondering what the connection is to fibrocystic breast disease and rosacea is? IrishGenes, you seem to be the resident expert on all things hormonal. Any thoughts?

[irishgenes]

Hi, Carol. I don't read or post to the forum much any more since I have "cured" my rosacea with estrogen gel, but I do occasionally get an email if someone posts to a thread I am "watching". It has been one year now since I have had any problems with rosacea, other than that occasional eyelid problem that I mentioned previously, and which always disappears within 15-30 minutes of my estradiol gel application. I started using the French Oestrogel, which is .6 mg. estradiol per 1/4 tsp. I use about 2 mg. per day total, divided into two doses since estrogen gel lasts about 12 hours. I found I no longer needed the expensive compounded estrogens like Tri-est, which is good because I think the FDA is going to outlaw compounded drugs soon, thanks to the publicity of Suzanne Somers new book "Ageless" and the AMA's and Wyeth's reaction to it.

Peri-menopause is harder than menopause, I think. You still have fluctuating levels of endogenous hormones. I don't think there is necessarily any direct relationship between rosacea and fibrocystic breasts, other than that they both have a hormonal basis. A woman can have one without the other, however. I did have some problem with fibrocystic breasts in my younger days and remember that taking lots of Vitamin E helped me. Today, I would use the Gamma E. Also, I think evening primrose oil is supposed to help.

I have recently been reading about the link between lack of iodine and fibrocystic breasts. I have no personal knowledge of this treatment, but some women are painting their breasts with iodine and swearing that it works. You might want to google it and make up your own mind whether to try it or not. I don't think I would do it myself since large iodine doses, at least internally, can cause acne, and I had such a time with acne from ages 12 to 50.

One thing I sure wouldn't do is believe the "estrogen dominance" theories espoused by Dr. John Lee and his followers and start using progesterone cream. Transdermal progesterone cream builds up over time in the tissues because it has a half-life of 6 months. It won't show up on blood tests, though saliva tests can show the excess. I think only oral progesterone should be used in HRT. Even with oral progesterone, I always felt breast swelling & pain, abdominal bloat, migraines, hunger, and greasy skin on my progesterone days. I limit progesterone to 12 days every 2 or 3 months and also increase my estrogen about .15 mg. (1/16 tsp.) twice a day, which helps alleviate the symptoms progesterone causes in me, since it is an estrogen blocker. Many of the symptoms that Dr. Lee and his followers list as due to lack of progesterone are actually due to lack of estrogen.

[redhotoz]

Thought I would make this thread a "Sticky", as it is referred to so often.

Thanks IrishGenes for your posts on this topic! Oh and of course to everyone else who has posted in this thread!

Jen

[texascacti]

I have been reading the book I mentioned earlier called "The Hormonally Vulnerable Woman" by Geoffrey Redmond, M.D. On page 8 & 9, he lists "Common Symptoms Caused by Hormones", and guess what? Rosacea is listed! That is the first medical corroboration I have seen about my "theory"! He is an endocrinologist who runs the Hormone Center of New York and has had over 10,000 female patients with skin problems, which makes him the world's leading authority. His basic advice is Yasmin birth control pill for the pre-menopausal (it has a built-in testosterone blocker) and bioidentical estradiol for the menopausal, often adding spironolactone to block testosterone. He says any woman past the teenage years who still has a problem with acne has a genetic vulnerability to her own (usually normal) levels of testosterone. I also have discovered that lack of estrogen can cause your own testosterone to become dominant, resulting in acne, scalp hair loss, and the dreaded chin hairs!

Yasmin? You're kidding me! I may have to get myself a copy of this book and start reading it. When I think back to when I first started noticing the red cheeks, it was in 2001 after I moved to Houston. I was on a bc at the time, but stopped because I did not have insurance. I was off of any bcs for 2001 and part of 2002 before being put on Yasmin. The other bcs only lasted about 4 months with me before I couldn't take them anymore. I am still on yasmin without any complaints. But reading this has me wondering now. I also am taking additional spiro per gyn's orders. he said there's not enough in Yasmin. I also think it has been since this time that the side of my face went red, so perhaps I'm still dealing with a hormonal imbalance that isn't apparent in blood tests. Thankfully, the last blood test showed that my testosterone levels are in the normal range. All tests prior to that showed free testosterone to be high. I wonder what hormonal changes could impact my rosacea... maybe it's time I email my accupuncturist and see what he says about herbal treatments...hmmm

If i'm 19 and have rosacea, is it possible mine could be hormone related and using one of these drugs might help?