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    Bioidentical Hormone Therapy
    MSBEHAVE posted:
    I had a full complete hysterectomy at 25 due to extreme endometriosis. i was immediatly put on HRT. It worked ok for years - as far as controlling hot flashes. At 38 my hair began falling out & thinning & my skin started to become very "thin". I begain to age in my face very rapidly. I didn't understand what was happening. I was not having hot flashes so i really did not think it was my HRT. I went to my OB - he said stress or hormone imbalance. No way to test hormones since i was on HRT. We switched from Estrace, Estrodiol, Vivell Dot patch, Premarin, etc. Nothing was helping - the only difference was i was retaining water and having Hot Flashes. I switched OB's & he said for some - Bioidentical HRT does work - he doesn't recommend but in some cases - such as mine - We had tried everything & nothing was working so he recommended a compounding pharmacist. I have been on BioHRT for about 6 months now. It does make me retain water & have put on about 10 lbs. My skin is improving, my face looks younger, my nails are growing again, my sex drive is better than it has ever been & my mood is good. I am still a bit "foggy" thinking & have trouble concentrating, I am still experiencing fatigue (i work out 3 days a week 1 hour sessions - but have done so for years), hot flashes, sleeplesness and night sweats. I am about to give up on the bioidentical hormones but i am trying to figure out which is the less of the 2 evils. My hair is still falling out & so thin, i cannot lose the 10 lbs i put on.
    Is anyone else taking bioidentical HRT & having the same problems? Do i really need progesterone? Is it finding the balalnce between the estrogen & progesterone to get your body feeling great? Do the saliva tests really accurate? Mine stated i had about a 0 level progesterone even tho i have been taking it orally for 5 months. My cortisol level was 12.9 which i was told was extremely high.
    Anyone have any suggestions or going through this? I feel all alone & need someone that understands what i am going through.
    Anon_6061 responded:
    Oh my, I'm sorry you had a hysterectomy at such a young age! I can't imagine going through that (or endo for that matter). I hope it at least gave you significant relief from the pain of endo without too many awful trade-offs!

    For me, hot flashes were nothing compared to all the other symptoms caused by my hysterectomy. The effects on my mood (suicidal depression, extreme irritability,anxiety), memory, cognition, concentration, motivation, vibrancy, complete loss of sexuality were WAY worse.

    Hair and skin changes aged me DRAMATICALLY in a matter of months post-op. My hair has never stopped falling out. And my skin sags like an old lady's because the collagen is gone.

    I have to wonder if you were getting some estrogen from endo implants left behind "cushioning the blows" of surgical menopause. And then the lower amount of estrogen in the form of HRT finally caused those endo implants to die off hence the rapid hair and skin changes. Just a theory...

    However, ovary removal or ovarian failure post-hysterectomy is a big stressor on the endocrine system. It can be very taxing on the thyroid and adrenal glands. Sometimes our bodies can compensate for this loss in the short-term but typically not in the long-term. Your high cortisol level is an indicator that your adrenals are working overtime. Your thyroid may also be operating at suboptimal levels. Have you had a complete thyroid panel (including antibodies) to check thyroid function?

    Estrogen is supposed to plump up the skin but I haven't found that to be the case. (Since vaginal E plumps things up "down there" why does it not work on the face? LOL) It's also supposed to help us keep our hair (not my experience either). That may be true of our bodies' own estrogen but doesn't appear to be the case with the estrogen in HRT's.

    When you switched to the creams, did you use estrogen, progesterone, and testosterone? Testosterone is supposed to be good for the skin at least in helping with dryness. But some say it also helps to plump it but I don't know if that's true. The 10 lb. weight gain probably helped "fill" things out too. Even though my skin and hair look like crap/old, my nails have continued to grow fast and look healthy.

    I hope you figure this out soon and start feeling (and looking) better! And if you come up with anything that helps with the hair and skin, I'd love to know.
    MSBEHAVE replied to Anon_6061's response:
    First, thank you for responding
    Well, i had a break down and called my compounding pharmacist today to "adjust" my BIO HRT again.
    I hate that you have gone through this as well.
    I took regular estrogen HRT since i had my hysterectomy.. I beleive i took 2mg of Estrace was my last prescription before switching over to the bioidentical.
    I never took any other testesterone or progesterone - just estrogen... i never had a great sex drive which i do regret my dr not doing anything about that ... but the past is the past..

    I beleive the plumping up in my face is also the weight gain so i cannot say that the HRT is making any difference in that area. I weighed 114 when i started Bio HRT & today i am at 126lbs! I cannot stand the way i look and feel...

    In my BIO HRT cream - she has DHEA, Progesterone, Estrogen and Testesterone. My Primary dr states progesterone can make you gain weight but she says it shouldn't if it is given in the natural form (which is what i am receiving). She keeps saying once we get it straight the weight will fall off, I will have energy & feel great... Well, i sure don't feel good yet and just dont' know how much longer i can wait. I am so sleep deprived !!
    Nothing FITS in my closet so that just makes me feel Worse!.
    I will keep you posted as to the changes and let you know if any progress occurrs.
    Take Care of Yourself
    Anon_6061 replied to MSBEHAVE's response:
    I'm sorry you're still feeling so awful! Many women do not absorb creams well. And combining all hormones into one cream is not a good idea. At least if they're separate, you can easily tweak the dosages of each individual hormone.

    Also, adding or removing more than one hormone at a time does not allow you to ascertain which hormone is doing what. So it's always better to optimize (get settled on) estrogen and then add other hormones as necessary.

    Compounding pharmacies seem to love progesterone but the standard says you don't need P if you don't have a uterus. I'm not clear on if your P is in the cream or oral (you said you've been taking 5 months orally but thought you said it's in your cream too). I'm clueless why your labs show your level as 0 but it's my understanding that serum (blood) testing of hormones is more accurate than saliva.

    Testosterone may or may not be helpful. Also, it can convert to DHT which can cause hair loss. But my hair falls out regardless of whether or not I'm using T.

    Which former HRT did you feel best on? Maybe you need to go back to it and try a different dose. And let your body settle into just the estrogen before adding anything else. I've personally felt fairly good on generic Estrace. And the bonus is that it's a $4 Rx! But instead of swallowing it, I let it dissolve between my cheek and gum which is more efficient than oral so you don't need as high of a dose. Of course, HRT is very individual so that doesn't mean it's a good fit for you.

    Can't think of anything else...keep me posted.
    MSBEHAVE replied to Anon_6061's response:
    I spoke with my hormone pharmacist this morning. She suggested the saliva test may have been inaccurrate (we all know not every test is 100% accurate so if it was gonna be wrong ... it would be wrong on mine! LOL ).
    My progesterone is in my cream as well as i take a 200 mg progesterone capsul at evening.
    My cream comes in a turn - by click - dipsenser. I have been using 2 clicks of the current formula for 2 months. She has suggested that it may be too much. She suggested i began only using 1 click of the hormone cream and stop taking the progesterone capsule at night & report to her at least once a week to report my progress so she can determine what needs to be done where...
    She suggested the Testesterone may be a bit high which is causing the hair issue.
    So i will attempt this and see what happens...
    The generic Estrace worked GREAT for me as well... and at $4.... i loved it. While i was taking the Estrace 2mg i began getting the thin skin, breast tenderness, hair loss & my scalp was very tender. This is my problems started... That began my search for a new hormone.. They tried Premarin, Vivelle Dot, Estriol - in all different mg - I attempted to try those for 2 years before going to the BIO HRT..
    There is something to be said about the absorbtion of creams and medicine !! You are so Right !! Everyone is different & we all absorb medicine differently.
    I will keep you posted as to the proress.. Thanks so much for listening and giving my your thoughts.
    Anon_6061 replied to MSBEHAVE's response:
    Sorry - my memory is shot! Everyone used to tell me they couldn't believe I had such a great memory. Well, it went missing with my organs!!

    I meant to mention that progesterone increases cortisol. So does any prolonged stress on the body. 200mg oral P PLUS the cream is a lot of P. And all that P will "dampen down" the effects of the estrogen. Even though P tends to be a good "sleep aid" it doesn't sound like it's even having that effect on you which may be because you aren't getting enough E. When I was on the patch, my sleep was very fragmented because I kept awakening feeling like my body was on fire (no sweats though). And then it took me forever to fall back asleep. Once I got a higher (or at least more consistent) level of E, my sleep improved greatly.

    Did you by any chance have your estradiol or estrogen blood level checked when you were on the 2mg generic Estrace? Did you notice any changes at all with the hair loss with those other types of HRT before switching to the creams? Hair loss seems to be impossible to figure out and I know all too well how frustrating that is. My hair is SO thin now.

    If you don't already do this, it can be helpful to keep a journal of your HRT changes and symptoms (good and bad) especially when changing things up so much. Otherwise, it's almost impossible to keep track.
    MSBEHAVE replied to Anon_6061's response:
    Hi, I actually do keep a journal of every type of hormone i have taken & the effects i received from it.... Good and Bad.
    My Dr & the Compounding Pharmacist thought it was very helpful that i had such details... Obviously not helpful Enough.

    I think the issue could be the way body absorbs the hormone. That is the only thing that makes sense at this point. The cream says to put it on your lower abdomen, inner thigh or back of arms. If i put it anywhere than my inner thighs, it feels as though i skipped the hormone for that day so that has to say something about the absorbtion rate.

    And i think I am so ready to quit the P. I don't think i need it and i think it is doing more harm than good. I am ready to go back and try the regular Estrace or whatever.
    I am having some worse effects with the BIO HRT than the regular HRT so if neither will be great - I will take the lesser of the 2 evils. And who knows... Maybe i will have better luck this time around.

    I am sick of having hot flashes for the 6-8 months, night sweats, etc. Not 1 day has gone by w/o continuous hot flashes. It is embarrassing to be at work in a meeting or talking with someone & break out into a dripping sweat. My face shows the sweat so BAD! Especially my upper lip.. So embarrassing.

    Even at being on 1 click of the cream - down from 2 & the additional "P" i am still not sleeping and still having hot flashes. I started taking Exederin PM at night so i can sleep. I called for an appointmnt with my Dr.

    Well, i called to make an appointment with my Gyno Dr to get back on regular HRT. So we will see... Hopefully i do not have to wait too long before i can get an appt.

    I will let you know what i get next
    Anon_6061 replied to MSBEHAVE's response:
    From everything you posted, it sounds like you felt best on the 2mg Estrace (or its generic). When you switched to those other HRT's and then the cream, did your hair loss lessen or stop? My hair loss lessened significantly once I'd been on the patch for 6 months or so (but by then I'd already lost over half my hair from the drastic change in hormones). But since I felt awful in every way on the patch and am so much better on generic Estrace, I guess I have to sacrifice my hair for some sense of normalcy. I'm not happy about this but don't want to try anything else at this point.

    BTW - You don't have to get compounded estrogen to get "BIO." A lot of the HRT's you get at your local retail pharmacy are considered bio-ID. The estrogen patches and Estrace are "bio" estradiol. I think the gels are too. If you want to try taking the estradiol tablets "sublingually" it has to be micronized estradiol (Estrace or the generic). Otherwise, it won't dissolve and absorb. So you can't do this with the synthetic oral estrogen tablets like Premarin and Enjuvia. Since you haven't tried a gel, that may be an option worth trying too. Some absorb gels better than creams. But then some don't absorb any of the transdermals well. It's all a crapshoot!!
    MSBEHAVE replied to Anon_6061's response:
    I got an appointment with my Dr. Friday morning to see what he thinks. I did go ahead & stop taking the Bio HRT cream a little over a week ago i had some of my Generic Estrace 2 mg left so I started taking it again. I have been on the Estrace for a little over a week. I can sleep again, I do not feel like i am in a fog. I am actually eating less and do not have any food cravings - Which i didnt even realize i was having. I have not lost any weight yet but it has only been a week so i know i must be somewhat patient.

    I'm not really against trying any other type of hormones but i think my Progesterone days are over. I don't think i will ever try that again. The more I read about it, the more i really do not see why i would need it and i was taking a lot of it. I never thought i absorbed the creams well either.

    I am just kicking myself for trying it for 8 months. that is just such a long time to not sleep, have night sweats, hot flashes all day. I know what works for one, doesn't work for another so i am head strong and will Find What Works For ME. I will not give up... I just hope i will not end up being bald and 100 extra pounds before i find it.
    Anon_6061 replied to MSBEHAVE's response:
    Well, one week back on 2mg estradiol and seeing improvement is progress! Yay! Hope your appointment with your doctor on Friday goes well and you're on your way to better days (no rhyme intended!). Keep me posted.

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