# Women who take HRT - questions



## HipJan (Apr 9, 1999)

Those of you who have had full hysterectomies, what HRT do you take?


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## Rowe2 (Sep 26, 2002)

Hi HipJanI use a natural compound cream made by a pharmacy close to home. My gyn has to write a prescription for it, but it has sure helped with the night sweats, hot flashes, etc. It has Estrogen/Prog/Test..all the hormones a women usually produces from the ovaries. I just had those removed in April, boy did my body go whacko. Couldn't sleep, think straight, low esteem, etc. I have also tried the Climara patch. It works also, but I prefer the cream base from made naturally from plants. Of course, the patch is made from soy, but I still like the idea of just rubbing it into my skin and not fooling with a patch. Good luck on your conquest. You will probably need a hormone boost after surgery for a while.







I also take 20 mg. Prozac a day for the depression associated with chemical inbalance. I have found it has helped a lot







too.


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## Persistance (Jul 11, 1999)

Jan, I was on Estrace 1 mg., until last spring, when I switched to the tiny Vivelle Dot patch. It takes care of that swoop when you are getting low on the hormone, as the patch works 24 hours a day.You don't need progesterone when you've had a hysterectomy -- I'm sure your doctor has told you that. In fact, it can bloat you when you don't have a uterus.


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## ThisBearBites (Aug 28, 2002)

I have had a full hysterectomy (age 23) and have never taken HRTs. Neither has my mother who had her surgery at a young age (27) as well. We don't trust HRTs and would rather not take them.


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## Ks-Sunshine (Aug 23, 1999)

I just quit taking mine. Estradiol 1 mg. Not sure what all it is. I don't feel any differently. I think it has been about a month. I wanted to see if it made a difference where my weight was concerned. When I get it completely out of my system (dont know how long that takes) I am going to go see a gyn to see if I really need it. I was never tested for levels. Just given the pill when I complained of hot flashes.


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## HipJan (Apr 9, 1999)

I was given Estrace (estradiol) 1 mg, but I think it might be too strong. I can see the advantages to a patch, except that it's harder to adjust the dosage with a patch. I don't believe in the theory that it's okay to give women without their "lower parts" estrogen alone; many nowadays say that pro. should still be given at the same time (but, yes, I've been told it can make you feel a little "gassy"). It was a shock to my system to suddenly only have estrogen in it, I feel.No hormones since 23? Did you have no problems?


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## Persistance (Jul 11, 1999)

Why would you need progesterone if you no longer have a uterus? Physiologically, the purpose of progesterone is to keep the uterus from building up from excess estrogen and bleeding too much or not enough.Sunny, I envy you for not knowing the difference!


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## Persistance (Jul 11, 1999)

Sunny, the drug should be well out of your system after a month, and any amount still circulating is negligable as far as weight, I'd think (sorry!)Jan -- It is certainly "OK" to take estrogen alone -- and it is not a theory. There are no studies that show great benefits to taking progesterone after a hysterectomy. Perhaps some advocates feel that it increases the sex drive, but, again -- no evidence, and testosterone works better. I think some were saying that it could decrease the likelihood of developing breast cancer, but also, unfortunately, no studies that mainstream doctors take seriously.


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## ThisBearBites (Aug 28, 2002)

I had severe hot flashes, lack of sleep, night sweats, etc......but I think because I was so young, I put up with it better. I actually started into menapause at age 22, many months before my hysterectomy. (I'm 40 now - and now, I don't spring back so good.) Heart disease runs on both sides of my family and I was more worried about HRTs and those side effects. Plus, they were already linking HRT use and breast cancers. I figured I had enough problems, I didn't need to create any. I believe, menapause is a normal, natural passage of life. It can begin for different reasons, but I don't see the need to "fix" something that is not really "broke". I had a grandmother (menapause at 30) with severe osteo-bone loss at a young age, but she was also disabled by heart disease, rhuematiod arthritis, and asthma. My mom and I work very hard to stay active (we both have fibromyalgia and she has severe rheumatiod arthritis) We are tested for bone loss regularly and we are doing fine. Our motto is "move it or lose it" for us that is literally true. Mom is 60, and these days, in better shape than I am. (rough summer!







) My GYN is willing to work with me on this. He tests my blood hormones very specifically, but since I'm not complaining and it isn't a critical health issue, he isn't pushing me to change.


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## ThisBearBites (Aug 28, 2002)

FYIMy last GYN insisted I take hormones. Gave me a months worth samples to try without taking any blood tests. I went home and flushed them and never went back to that GYN.


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## HipJan (Apr 9, 1999)

Persist. - I think more mainstream docs ought to start taking seriously the possibility that estrogen (esp. in excess) can contribute to breast cancer risk. Also, just because one no longer has a uterus, or even ovaries, does not mean that person has no risk for getting a cancer down there (even my doctor was quick to tell me that). Plus, progesterone has far more than one basic purpose/function...you know that, right? I find it odd that premenopausal women especially should be put straight on estrogen alone after full hysterectomies; here they have been used to progesterone and other hormones too, then they suddenly are given only estrogen. Doesn't make a lot of sense to me.Curious: those of you who've had full hysters., how long (till what age) have you taken the estrogen treatment? Did your docs advise you how long to take the treatment? One male doc at the hospital muttered in passing that, of course, I'd take Estace "for life" (and maybe I will). However, my female doc said we could discuss my hormones after 6 weeks and see what I wanted to do. Dr. C. Northrup says in one of her books that women with no ovaries should probably take estrogen till they are at least 52, the average age of menopause.I am pretty sure I will take some type of conventional hormone treatment for at least several years.


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## HipJan (Apr 9, 1999)

TBB, yes, you have to carefully weigh the benefits and problems associated with HRT. It's an individual matter.


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## Persistance (Jul 11, 1999)

HJ -- I admire your pro-activism...but. But (a lot of "buts"). Did you have your ovaries out? And how are you feeling, anyway?My suspicion is you're missing your ovaries a lot more than you realize. Women with hysterectomies especially need testosterone to give them back libido, energy, lots and lots of things, and it's becoming more and more common to give them that. It does a lot more than progesterone for that purpose (although no good studies out as to what exactly is the ideal dosage). See, the ovaries used to make a lot more estrogen than is safe to give in hormone replacement (if you were to try and duplicate the menstruating woman's body, you would need about 5 mg. of estrogen, rather than 1 or 2mg) (I was on 2 mg. Estrace, before the patch). That is also the purpose of progesterone in HRT -- to exactly duplicate the menstruating body. Thus, it's only purpose is to regulate the periods by allowing the uterus to shed regularly (and straighten out your bleeding patterns where they are all haywire, from perimenopause) and prevent cancer that estrogen alone can cause.Mainstream docs _are_ taking seriously the possibility of breast cancer caused by estrogen since that huge study (but it's not estrogen alone that was implicated). But preventing breast cancer has nothing to do with progesterone.You say: "Also, just because one no longer has a uterus, or even ovaries, does not mean that person has no risk for getting a cancer down there(even my doctor was quick to tell me that)." and I'm quite puzzled by that. Progesterone has absolutely no role in helping any cancer "down there" (vaginal, vulvar, etc.). The _only_ cancer progesterone can help is uterine cancer. Actually, estrogen doesn't cause those cancers, either. As far as progesterone having more than one basic function -- no, I don't know that. The basic function is to oppose estrogen in the uterus. There was something about helping bones that Women's International Pharmacy and others were saying, but we have a lot of things that do better jobs for that nowadays. Ditto breast cancer -- a handful of studies, but nothing, apparantly, very convincing (darn it!). It's possible that taken in pill form it can help your sleep, just like it does before the hysterectomy, because it sits in the stomach and makes you drowsy, like a good meal. The feeling of well-being women get from progesterone is often from how it regulates the raging hormones of menopause and per-menopause, by again, opposing their raging estrogens, or not enough estrogen. You have no uterus anymore, so your body really isn't "missing" progesterone. And again, menopausal women _aren't_ necessarily just put on estrogen alone -- often testosterone is given as well. The ovaries used to put out a certain form of estrogen (estrone), that is converted in the body to testosterone, and you don't have that anymore. That you would possibly miss! I saw a coupla quotes from John Lee, the natural progesterone so-called pioneer, that, I have to say, sounded really wacked out! Something about how taking progesterone in hysterectomy could reduce estrogen by 50% and then regulate the numbers downward so you were getting 0% estrogen. It was Greek to me. He has his place in having gotten doctors to look at natural progesterone, but almost no-one takes all his theories seriously these days.Me, I'm on estrogen for life, unless I get breast cancer. I just can't do without it.


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## HipJan (Apr 9, 1999)

P - Thanks for all the info. I agree with, or understand, much of the info. However, I do not think you are correct about everything. Pro. *is* supposed to help lower the risk of ovarian cancer too, for instance. A recent study showed that, and we talked about it here on this BB. I can't myself, of course, prove that pro. is beneficial to other areas of the body besides the uterus alone; however, I do suspect there is more to it than conventional medicine is able to currently claim. Isn't it supposed to play a role with corticosteroids and the nervous system, for example? (I don't want to go looking all this up right now: not up to it.)A little anecdotal info.... My mother uses just a bit of natural pro. For a while earlier (maybe for a few years), she was having a terrible time with bruising all over her body. After she began using the pro., she noticed the excess bruising ended. That seemed very odd indeed to us, but that's what she told me.After my surgery, I said to my doctor, Well, at least I won't get ovarian [and other pelvic] cancer now. She was quick to say, No, that's not necessarily true; there's still a slight chance for ovarian cancer [even without ovaries], though it would be rare. Just the other day, I also read - somewhere - something to that affect. At any rate, I don't feel like arguing any more right now about the pros and cons of natural pro., but I am interested in hearing about how posters have fared in regard to hormonal treatments after surgical menopause.Yes, I may ask about estrone/testosterone cream sometime. I am curious if other women, esp. those without ovaries, here have used it - and what were the results? P.S. Don't worry: I by no means agree with everything John Lee says. He's seems to be too fanatic and black and white about some of his theories. But something to think about nonetheless.


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## HipJan (Apr 9, 1999)

On a different note, if anybody sees my post here, do any of you know why nearly two weeks after my surgery I'd be having headaches and leg aches? Would that have just as much to do with my anemia as to my Estrace use? (They scare you in their literature, saying you might have an estrogen-induced blood clot, of course, but I would think that would be more likely after large doses of estrogen for a more prolonged period of time.)I'll ask the doc on Monday, but she prob. won't know what to tell me.


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## BrendaGayle (Feb 14, 2001)

I had a full hysterectomy, I'm in my 30's. I started out on Cenestin and now I've been on the Vivelle Dot (.025). I haven't been able to make sense out of any study or any doctor of what is safe and what isn't. I had severe hot flashes within a day after surgery and still get them every now and then. I also have developed headaches, joint aches, and the list goes on. I personally am so fed up with the medical field and how they contradict everything. I would love to go off the ERT but then again you know the studies, they claim I'll be at a higher risk for bone loss, sexual disfunction, and colon cancer. I don't regret the hysterectomy but all these studies and contradictions just blow my mind. I have read every book from natural to ERT's like I'm on and they still contradict each other. I gave up searching for the right answer.


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## HipJan (Apr 9, 1999)

BG - Yup, hard to find the "right answer." I don't know about your joint pains and headaches. If they continue, maybe you should see an internist (or neurologist)?I've had a lot of headaches too, following my surgery.


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## Persistance (Jul 11, 1999)

HJ -- give your body a chance to heal. So many things are impacted in surgery. Perhaps you are slightly bloated from the estrogen. It can do that at first until your body adjusts and can cause headaches. So very doubtful you are experiencing a blood clot. Please don't read the tiny words in the packaging!! I hope you had good results from talking with your doctor today (I do recommend the Vivelle Dot or any patch for more even absorption of the estrogen throughout the day).


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## Persistance (Jul 11, 1999)

Brenda -- just read your post. Menopause itself or estrogen deficit - can cause so many ill-defined symptoms -- including nausea and joint aches and a general feeling of not being well. Surgical menopause even more dramatically affects this, and it's even more dramatic at a young age, because you were making so much estrogen before --that the body finds it hard to adjust in this new state. At 0.25, it doesn't seem like the patch is addressing this. At least the .5 patch would seem more helpful. This is all barring the discussion about estrogen in and of itself being risky. IF you are committed to estrogen anyway for now, you might want to raise your dosage.


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## HipJan (Apr 9, 1999)

my doc just attributed the leg pain to surgery and, when I specifically asked, possibly also to anemia. I'm getting better, little by little, each day. my doc seemed amused when I told her I was cutting up my Estrace into quarter pieces (because, right now, 3/4 of a tablet seems right for me, based on how I feel at least). she told me I could either eventually up it to a full tablet or decrease it to half a tablet. how do you know what is best for you? just base the amount on your symptoms alone?I was sleeping tons earlier. now, I can barely make it through the night with a good, solid sleep. I wonder if that has to do with hormonal levels?


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## HipJan (Apr 9, 1999)

by the way, my incision itself apparently is doing very well (just looks like a scratch).


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## Rowe2 (Sep 26, 2002)

HipJan, if your hormones are out of balance, it will cause your sleep pattern to be disrupted. I had my ovaries removed in April this year, and my sleep almost diminished. I was like a zombie trying to work. I am on a natural hormore cream compounded by a pharmacy my gyn has prescribed me, and I am resting much better. Those hormones can do crazy things to a gal! Also, if you prefer a natural patch with estrogen only, Climara is based on soy products. Good luck with the sleep, I know how you must feel.


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## Persistance (Jul 11, 1999)

HP, glad you are feeling better.Yes, it's all in how you feel.Most women (yes, I know you were asking others, not necessarily me), but I think you will find that most women just take one of the prescribed dosages, and if it's not enough, they up the dose. The standard starting dose is .625 Premarin as I was, and if you are losing sleep (as I was) and still feeling hot (as I was), or not up to par -- they go up to .9 mg (which I did), or to 1.25 mg. I switched to Estrace, which I liked better because it seemed stronger. It only comes in 1 mg. or 2 mg. The .5 patch is about equivalent.I have known one or two women who can get by on .3 mg. of Premarin (which is probably equivalent to 1/2 your Estrace), but that's usually because they have migraines, and estrogen makes those worse. Women who have been through surgical menopause are experiencing a sudden drop in their estrogen levels which is far more drastic than natural menopause, and thus are usually started out, as you are, on 1 mg. of Estrace or .625 of Premarin. The .5 patch is equivalent to both of those.


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## Persistance (Jul 11, 1999)

Glad you are feeling better, HJ.Yes, women adjust their dosages based solely on how they feel.Sleeplessness is a big symptom caused by not enough estrogen -- and seems to be the major reason -- except for feelings of being hot -- many women up their dosage. Women are usually started on .625, as I was, and if that is not enough and they are losing sleep (as I was), often they go up to .9 (this is Premarin, which I did), and finally, to 1.25. If you are on Estrace, which I liked better because I think it absorbs better (you can even put it under your tongue), they start on 1 mg. and if you need more and are still sleepless or hot or irritable, you ask for 2 mg. I have spoken to one or two women who can get by on .3 mg. of Premarin (which is probably equivalent to 1/2 your Estrace), but that's usually because they had migraines, and estrogen made it worse. We women who have been through surgical menopause are experiencing a sudden drop in our estrogen levels which is far more drastic than with the slow drop with natural menopause, and thus we are usually started out, as you are, on 1 mg. or even 2 mg. of Estrace or .625 of Premarin (on up). The .5 patch is equivalent to both of those. Just like with pills, you can adjust the dose.


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## Persistance (Jul 11, 1999)

Oops! (sort of) duplicate posts! The second one has the one about sleep! (which I'd just seen).Jeff PROMISED us the editing function back on Dec. 25 in our "stockings!" I will wait for the holidays to be over and ride him then!


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## HipJan (Apr 9, 1999)

thanks, yes, I was started out on the 1 mg, but I felt it was too strong. I've only reduced it to .75 so far - because I feel my body went thru such shock lately that it might need a bit more estrogen for a while. maybe later I'll reduce it to .5. I wish there was some scientific test, though, that would tell me exactly how much I need and for how long.


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## Persistance (Jul 11, 1999)

There is no scientific test, because unfortunately, symptoms stay with most women a long time -- years. The pill is there to help your symptoms. It used to be given for bone loss and heart problems, but the jury is out on the latter (as you know). Anyway, if it was just for bone loss -- you could take something else.Before that big study, women were put on hormones for life. Now, I imagine things are in a bit of a quandary. There may come a time when you feel you can get along without it, like Sunny did -- so it's all up to you. It helps if you have a bit of weight on you. I couldn't get along with less than I'm taking. I'll take the risk. Maybe post this on the MP and see if you can get more of a survey as to what women are on and for how long?


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