To make a long story short, I had a very minor knee surgery on 12/7 that has turned into a nightmare. I developed blood clots behind the knee and in my calf, and I've now been in bed for 10 days with no end in sight. Injecting Lovenox and taking warfarin until my levels are OK.
When I went in for my blood test yesterday, my GP, who was not my surgeon, was looking at my chart and asked if I was still taking the compounded progesterone and testosterone and I said I hadn't for about 2 weeks because of the surgery.
He said, "Well, we're stopping it right now and I won't prescribe it anymore." I suppose because of the blood clots. I was too distraught yesterday to argue. Ended up having 90 CC of blood drained from my knee, excruciating pain, out of it from morphine.
Will NHRT compounded specifically cause blood clots? I'm on a very very low dose of T and I think 1 mg of P on days 12-26.
Anyone else have problems with clots? I know it's nothing to take lightly. I'm a redhead too, so I'm a bleeder.
Full Version: Blood Clot After Surgery
Michele,
I think you need to find a new doctor. My progesterone and testosterone cream helps me way too much to just be taken off of it without even a simple explanation. Maybe your doctor is confusing progesterone with progestin. Dr. Reiss in Natural Hormone Balance for Women has an entire chapter describing the side effects of progestins which are not caused by natural progesterone. On page 119 Dr. Reiss states that natural progesterone does not cause thrombophlebitis. I have never read that blood clots are a possible side effect of testosterone. Maybe you can find out more information from your surgeon as to why you got the blood clots. It may be that the doctors are trying to cover themselves in the event of a lawsuit and may not want to tell you anything.
Is 1 mg of P a typo? The usual dose would be much higher (up to 100-200 mg).
Kathy
I think you need to find a new doctor. My progesterone and testosterone cream helps me way too much to just be taken off of it without even a simple explanation. Maybe your doctor is confusing progesterone with progestin. Dr. Reiss in Natural Hormone Balance for Women has an entire chapter describing the side effects of progestins which are not caused by natural progesterone. On page 119 Dr. Reiss states that natural progesterone does not cause thrombophlebitis. I have never read that blood clots are a possible side effect of testosterone. Maybe you can find out more information from your surgeon as to why you got the blood clots. It may be that the doctors are trying to cover themselves in the event of a lawsuit and may not want to tell you anything.
Is 1 mg of P a typo? The usual dose would be much higher (up to 100-200 mg).
Kathy
Sorry, 100 mg of P.
I will do some research, and I also need to talk to my hormone consultant. Maybe she can talk some sense into the doc. He's old school. They did not give a reason for the clots, just being female and never having surgery before. I honestly think I had them before surgery, as I had the same pain after a long run back in September.
We've got the clotting under control, but now my bone is bleeding into my leg and because of the thinners, it is bleeding too fast to absorb naturally. I'm in a vicious cycle!
I will do some research, and I also need to talk to my hormone consultant. Maybe she can talk some sense into the doc. He's old school. They did not give a reason for the clots, just being female and never having surgery before. I honestly think I had them before surgery, as I had the same pain after a long run back in September.
We've got the clotting under control, but now my bone is bleeding into my leg and because of the thinners, it is bleeding too fast to absorb naturally. I'm in a vicious cycle!
QUOTE (Michele1 @ Dec 18 2006, 03:38 PM) 
Sorry, 100 mg of P.
We've got the clotting under control, but now my bone is bleeding into my leg and because of the thinners, it is bleeding too fast to absorb naturally. I'm in a vicious cycle!
We've got the clotting under control, but now my bone is bleeding into my leg and because of the thinners, it is bleeding too fast to absorb naturally. I'm in a vicious cycle!
Oh my gosh! The best of luck to you, I hope this all works out ok.
Kathy
QUOTE (Michele1 @ Dec 18 2006, 06:38 PM)
Sorry, 100 mg of P.
I will do some research, and I also need to talk to my hormone consultant. Maybe she can talk some sense into the doc. He's old school. They did not give a reason for the clots, just being female and never having surgery before. I honestly think I had them before surgery, as I had the same pain after a long run back in September.
We've got the clotting under control, but now my bone is bleeding into my leg and because of the thinners, it is bleeding too fast to absorb naturally. I'm in a vicious cycle!
I will do some research, and I also need to talk to my hormone consultant. Maybe she can talk some sense into the doc. He's old school. They did not give a reason for the clots, just being female and never having surgery before. I honestly think I had them before surgery, as I had the same pain after a long run back in September.
We've got the clotting under control, but now my bone is bleeding into my leg and because of the thinners, it is bleeding too fast to absorb naturally. I'm in a vicious cycle!
Sorry to hear about your orderal, but natural (bioidentical progesterone) causes blood clots too. I am not sure if you use the sublingual or oral P, but this is quote from Prometirum (bioidentical micronized progesterone) label, I quote:
QUOTE
Most important fact about this drug
Prometrium increases the risk of blood clots, which can lead to phlebitis, breathing problems, vision problems, or stroke. If you experience any symptoms that might suggest the onset of a clot-related disorder--pain with swelling, warmth, and redness in a leg vein, coughing or shortness of breath, loss of vision or double vision, migraine, or weakness or numbness in an arm or leg--stop taking Prometrium and see your doctor immediately.
Prometrium increases the risk of blood clots, which can lead to phlebitis, breathing problems, vision problems, or stroke. If you experience any symptoms that might suggest the onset of a clot-related disorder--pain with swelling, warmth, and redness in a leg vein, coughing or shortness of breath, loss of vision or double vision, migraine, or weakness or numbness in an arm or leg--stop taking Prometrium and see your doctor immediately.
I have used both sublingual and oral P, and had nocturnal leg cramps as I had when I was pregnant. I think that Progesterone is working to sort of "hold the blood" and assure healthy pregnancy, so it does increase body's thrombotic acitivities, especially if one prediposed to thsi condition. I doubt testosterone to blame, more likely it is progesterone. hence the higher blod clots possibility with late age pregnancies.
I hope you feel better soon, but, I would go with your doctor suggestions and abstain from hormones for now.
Speedy recovery!
Iradan:
Thanks for the informative post. I have always wondered about the link between bcp/hrt and blood clots. You always read that such a link exists, but you never get an explanation as to why. From what you're saying here, it seems progesterone is the culprit rather than estrogen -- or can the estrogen play a role as well? Do we try to minimize estrogen intake primarily because of the role that it can play in breast cancer, or can it too cause blood clots, and if so why? Sorry to throw so many questions at you, but you always seem to be so knowledgable about these things.
Thanks for the informative post. I have always wondered about the link between bcp/hrt and blood clots. You always read that such a link exists, but you never get an explanation as to why. From what you're saying here, it seems progesterone is the culprit rather than estrogen -- or can the estrogen play a role as well? Do we try to minimize estrogen intake primarily because of the role that it can play in breast cancer, or can it too cause blood clots, and if so why? Sorry to throw so many questions at you, but you always seem to be so knowledgable about these things.
Hey Michele:
You may want to do some investigating on "Factor V Leiden". See below. Before I considered HRT, I asked my gyno to do this test..it came back negative. Suffice it to say that a negative test is no guarantee that you will not develop clots on HRT, but a positive test is definitely an indicator that you will want to stay away. Hope this helps.
Avi
Women with Factor V Leiden (FVL) have a substantially increased risk of clotting in pregnancy (and on estrogen containing birth control pills or hormone replacement) in the form of DVT (deep vein thrombosis, sometimes known as "milk leg") and pulmonary embolism. They also have an increased risk of preeclampsia, as well as miscarriage and stillbirth due to clotting in the placenta, umbilical cord, or the fetus (fetal clotting may depend on whether the baby has inherited the gene). Note that many of these women go through one or more pregnancies with no difficulties, while others may miscarry over and over again, and still others may develop clots within weeks of becoming pregnant.
[edit] Diagnosis
Suspicion of factor V Leiden being the cause for any thrombotic event should be considered in any white patient below the age of 45, or in any person with a family history of venous thrombosis.
This disease can be diagnosed by watching the aPTT (the time it takes for blood to clot) as activated protein C is added. With a normal patient, adding aPC increases the APTT. In patients with factor V Leiden, adding aPC will barely affect the time it takes for blood to clot.
There is also a simple genetic test that can be done for this disorder. The mutation (a 1691G→A substitution) removes a cleavage site of the restriction endonuclease MnlI, so simple PCR, treatment with MnlI, and then DNA electrophoresis will give a quick diagnosis.
You may want to do some investigating on "Factor V Leiden". See below. Before I considered HRT, I asked my gyno to do this test..it came back negative. Suffice it to say that a negative test is no guarantee that you will not develop clots on HRT, but a positive test is definitely an indicator that you will want to stay away. Hope this helps.
Avi
Women with Factor V Leiden (FVL) have a substantially increased risk of clotting in pregnancy (and on estrogen containing birth control pills or hormone replacement) in the form of DVT (deep vein thrombosis, sometimes known as "milk leg") and pulmonary embolism. They also have an increased risk of preeclampsia, as well as miscarriage and stillbirth due to clotting in the placenta, umbilical cord, or the fetus (fetal clotting may depend on whether the baby has inherited the gene). Note that many of these women go through one or more pregnancies with no difficulties, while others may miscarry over and over again, and still others may develop clots within weeks of becoming pregnant.
[edit] Diagnosis
Suspicion of factor V Leiden being the cause for any thrombotic event should be considered in any white patient below the age of 45, or in any person with a family history of venous thrombosis.
This disease can be diagnosed by watching the aPTT (the time it takes for blood to clot) as activated protein C is added. With a normal patient, adding aPC increases the APTT. In patients with factor V Leiden, adding aPC will barely affect the time it takes for blood to clot.
There is also a simple genetic test that can be done for this disorder. The mutation (a 1691G→A substitution) removes a cleavage site of the restriction endonuclease MnlI, so simple PCR, treatment with MnlI, and then DNA electrophoresis will give a quick diagnosis.
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