My pharmacist seems to think I should be on Bi-est even though I got a migraine after 1st dose. He lowered the dose, now I'm taking .625 and 50 mg progesterone. ( both 2x/day)  Before I was on Climara patch (.05)  and I had no headaches or side effects, it just wasn't helping to relieve hot flashes.  Why do you think the pharmacist wants me to be on Bi-est...could it be because that is an income source for him? ( I prefer the transdermal route; it's better since I have hypertension and take BP meds. I do not want my liver to have to keep processing more meds. )  What do you guys think? Would a sublingual form also be gentler to my liver?  Thanks...this is all so overwhelming!Tedi

I tried bi-est/progesterone transdermal drops for a few weeks. It gave me headaches and after a couple of weeks I had mild cramps and break through bleeding.  I am now on Vivelle 0.025 dot.  No headaches, no notable side effects. They work great for me. Since I do not tolerate systemic progesterone well, I will be doing a course of progesterone vaginally in a couple of months.  Our pharmacy will compound the progesterone suppositories for me.

I don't tolerate progesterone period. I tried the vaginal route, but still felt worse.  I take a .01 Vivelle Dot  patch and cut it into quarters, which would equate to 0.025.  My gyn. said I didn't need progesterone, until I skipped periods.    Recently, she told me she doubted I was absorbing much estradiol from the patch, so could forgo the progesterone.  I tried TriEst, with progesterone, which made me feel worse than the horse pee.  I'm not comfortable taking even this mini-dose of "natural" estrogen. I noticed I had a headache last evening, changed the patch, and today the headache is gone.  I don't particularly like my snot nosed gyn, but hormones haven't been my panacea. I still get flashes, particularly around my period.   Also, I have a endocrinologist monitoring my hormones.  I'm a lost cause.lol

I haven't had a period in several months.  I think I might be done with those.  I know what you mean about not being comfortable with even a small dose of estrogen.  But I felt  absolutely terrible before I started the patch. The patch has given me my energy back and made me human again. So I'm going to stick it out for a while.  

I too am relatively new to Biest and am having a terrible time getting regulated or balanced or whatever. I just don't have any energy, have had to put my whole life of hold. Oh yes, I've had all the tests and it would appear that I am a very healthy 59 year old going thru menopause. I did get rid of the hotflashes but have acquired many other very uncomfortable symptoms....NO energy, rapid pulse, burning, stinging feet and hands, short of breath, headaches. Am I the only one that has had this experience? I've searched this board several times looking for this very thing and have found nothing like what I am going through. I really don't want to see anyone go thru this but I sure would like to hear from anyone if they have. I am so bewildered, frustrated and everything else and am beginning to feel hopeless.

Hi Susan, Our symptoms sound very similar. The burning feet and fingers is something that I deal with. It started at about the same time as my hot flashes and has gotten worse over time. My hope is that hormonal rebalancing will help to restore a sense of normalcy to my body. I do not check this board too frequently, but I wanted to let you know that I saw your post and I can relate. Best, Tedi

It's not uncommon to hear women talk about migraines from HRT. I had problems with bi-est and, actually, any of the "orally ingested" natural hormones. I developed migraines and that was an immediate red flag to me. I don't want to use anything that's going to give me headaches. I had the same thing with oral micronized (natural) progesterone (not OTC, but by Rx) which caused depression. I use 0.3 mg of transdermal estradiol cream and 150 mg. of micronized progesterone cream (in one applicator). The only reason I'm using it is for the internal shaking I haven't been able to resolve with anything else. I also use it every other day. I'm postmenopausal and don't feel the need to use it every day. I don't necessarily recommend this for other women, but it works for me. The combination of bio-identical estradiol/progesterone in one applicator is very convenient and the dose works well. I haven't had any side effects and it's helping the internal shaking. I also use my Revival soy protein every day.

I wouldn't use anything that was giving me migraines - my main concern was that it might cause elevated blood pressure and who needs that.

When your doctor prescribes naturally compounded, bio-identical hormones (Power Surge would has never endorsed synthetic hormones), you might ask him/her for a lower dose. I always think it's wiser to start off with the lowest dose possible to see how you do with it. You can always add to the dose, but over the past few years, it's become evident that women who do well on natural hormones can use 1/2 the traditional dose and feel the same beneficial effects.

Dearest

Thanks dear Dearest, for your helpful and encouraging response. It's great to receive your strong, supportive answer! I, too have internal shaking...especially bad today. That symptom is so disconcerting. Please feel free to offer any additional thoughts that you have, since I am still struggling with this problem and it makes my anxiety go way up. With much appreciation, Tedi

Dearest, You mentioned...applicator..is that the patch? Also, I know what perimenopause is but what is post menopausal..what is the critirior for for that? Thanks for the post and encouragement.

Susan, you are generally considered to be "officially" menopausal when you have gone a whole year without a period. So postmenopausal would be considered any time after that.

I think that the applicator comes with some kinds of progesterone creams.

Dearest, I am currently using .1 mg Viville Dot and I think I need to increase it due to fatigue, burning feet, terrible brain fog and major anxiety with internal shaking. I noticed you use .3 mg Nat. Estradiol Cream. Does that equate to 3X what I am using in the Vivelle Dot? ( My doc is reluctant to increase my dose, since .1 is the highest Dot available; however I have no negative side effects of too much estrogen) I was interested to read that your dose is higher and obviously some of us need a higher dose to feel normal again. I hope you will see this note and let me know if I am correctly interpreting what I read. Thanks. Tedi

I don't know whether Dearest answers individual questions, but I wanted to interject something, if you don't mind. You mention that you have no side effects with that high dose of estrogen (.1 Vivelle is very high--twice the normal dose), but I have read that anxiety is a side effect of too much estrogen. Sometimes the side effects of too much are the same as too little estrogen. Anyway, I was wondering if you had tried the regular dose (.05)--who knows, your body may have changed and needs less? I used to use the naturally compounded estrogen gel and I remember the numbers were completely different. Now I'm using the .025 Vivelle dot (and actually cut it in half!). Good luck.

I thought .01 was the standard. estradiol dosage. I cut a .01mg patch in quarters,using .025mg. Hmmm, you find even half of that useful. More estrogen was not better in my case. Then again, except for controlling flashes, I've found it virtually useless. I am however a hormonally challenged exception. Taking the lowest possible dosage, just during perimenopause, seems to be current medical consensus on HRT.

Thanks for your helpful intentions. All of my symptoms were here WELL BEFORE I started on estradiol and my doc has gradually increased it because my blood levels are rock bottom. We are all so individual and what is too much for one, is possibly not enough for another. Fortunately, my new doc uses blood work, but is willing to treat for symptomatic relief...I'm just not there yet. Hopefully......... Thanks for your reponse and I 'm glad you are feeling well on your dose. I have also written to Alice directly and I am hoping she will be able to respond. If not, I will ask my compounding pharmacist and my doc next week. Tedi

In peri the hormones oscillate. When my progesterone was low, I continued to have side effects from natural progesterone. Good luck. Estrogen rather scares me, however.

Hey, By the time we're done experimenting, perhaps this will be over. I thought more estrogen at one point, as well. I shook more extenally and internally on the higher dose of Estradiol. Whatever works for the individual is a wonderful motto!!

Tedi, I hope you'll let us know how you are doing. You're so right about our all being so different when it comes to treatments. chriscarol, my dr. said .05 was the "average" dose for the Vivelle dot, and doesn't normally prescribe any higher. Maybe she's wrong, I don't know. Anyway, no, I don't get results from cutting the .025 in half, lol! But honestly it doesn't seem to make any difference in how I feel whatever I use. I've tried two-.025's, one-.025, and 1/2 of a .025, without good results. Maybe they are really just placeboes, I don't know. Then again, I get *bad* results from the .05, so maybe I'm a lower-end estrogen-needer. I'm really at a low point in my life right now, symptom-wise. It seems every month I have a brand new symptom that is either physically upsetting or emotionally upsetting (or worrisome). It's been bad headaches for some time and this week I've developed intestinal problems (again) that are worse than I've ever had. I was able to control most all my peri symptoms for several years (had bad symptoms by about 43) with Progest cream, but now, at 49, my hormones are too wacked out for it to help (I now use Prometrium, which is the only time of the month I feel almost human). I also changed my diet and went all-out with the healthy foods, which has also done nothing (I have an R.D. and don't try anything weird, just really healthy stuff). I'm beginning to think you just have to hang on and ride it out. I'm really thinking that nothing will override what the body wants to do and it's a waste of time trying.

Rothchild, I think you must be right about just hanging on. It DOES seem that no matter what one does, just wait 'cause another nasty symptom is going to bite you/us. I had such severe hotflashes and was desparate to find relief....got that w/Biest but now I have an entire host of other symptoms that have pulled the rug out from under me...I've had to put my life, my activities on hold. I can make no plans. Geeze, I understand the concept of hormone imbalance but I do not understand the depth of it......nothing fits, nothing is consistant. I have never been knocked down like this in my entire life.

Sla and Des, Riding it out seems to work best for me. I was an avid reader, but these days I have the attention span of a gnat. I'm about to get my period and I'm a miserable witch. I've given up the chase for the miracle cure, as most were useless. This hormone imbalance business. How do you balance hormones in perimenopause, since they fluctuate constantly. It makes no sense to me!! Sells books and products though.

slalinh, no, the applicator is not for the patch. I'm using naturally compounded estradiol and micronized progesterone that come with an application -- from Pete Hueseman's, Bellevue Pharmacy Solutions. Pete has been Power Surge's Pharamceutical consultant for 8 years

The two hormones are absorbed transdermally (through the skin).

As for your question about what is postmenopausal, joyous answered you perfectly -- you're "techically" considered menopausal, aka postmenopausal, when you've been without a period for 12 consecutive months. That doesn't necessarily mean that ALL SYMPTOMS will suddenly stop once the 12 months are up. Many women continue experiencing residual side effects - sometimes for years, but the worst symptoms of perimenopause generally decrease as time passes.

Patience - that's the key word.

Dearest

Tedi, I've been offering thoughts on internal shaking all over these and previous boards for the past ten years - the ones before this recent upgrade. You'll find many of my responses in the "Internal Shaking," "Anxiety," "Palpitations" forums. Sometimes, you have to look in the earlier topics. I don't post in every new topic that opens when I've posted about something so many times. Besides, too many new topics are started by people when there are already so many existing topics on the same subject - and it becomes confusing - AND confusion is the last thing hormonally-challenged women need! I found that information on the topic of internal shaking was scarce. I never found references to it in my searches back in the early days of perimenopause. Nobody seemed to be discussing it and I was sure it was related to my perimenopause. That's another reason I created Power Surge -- when I first started looking, my questions weren't being answered. I'd even put the question to guests I've had in Power Surge chats over the years and the answer was almost always a resounding, "Anxiety." That didn't satisfy me because it seemed more than something caused by anxiety. The internal shaking can be quite severe, like an earthquake - tremors inside one's body, and anyone looking at you can't see them because there are no overt symptoms. My hands would always be still, never shaking. I wouldn't appear outwardly anxious, but all the while my insides were in complete turmoil. This has been my nemesis since entering perimenopause and, since I started talking about it in Power Surge, droves of women have crept out of the woodwork saying they experience the same thing. There are days when it's been so intolerable, I've had to climb into bed and just rest until it passed. Sometimes it can last for days and then disappear for a week. I would always recommend, though, a complete examination by your physician or health care provider. There could be other reasons for the shaking, although when it begins during perimenopause, the imbalanced hormones, coupled with anxiety are usually the reasons. However:

• Have your thyroid checked. That can cause tremor-like feelings, too.
• Have your hormone levels checked: Estrogen, Estadiol, Progesterone, DHEA, Testosterone
• Anxiety can cause internal shaking in some women
• Some medications have "tremors" as a side effect - some of them being the popular SSRI's, tranquilizers and other Rx's
• Have an echocardiogram to be certain you're heart-healthy
• Avoid processed foods, SUGAR, caffeine, alcohol, nicotine and spicy foods
• Learn to medidate, do yoga - anything to feel calmer
• Learn to relax - in any possible way you can, using any means you can! [/list] For a great deal of information on how to cope with the many symptoms of the menopausal years, Read Power Surge's Menopause Survival Tips and read everything you can in the Educate Your Body and the Recommendations areas of the site. There's a wealth of information there. As I said in my original post in this thread, I don't use the transdermal cream every day. I prefer using as little as possible. I don't recommend this for other women, but it's my way of using the transdermal estradiol and micronized progesterone - AND when I've pointed this out to Dr. Erika, natural compounding pharmacist, Pete Hueseman, R.Ph, P.D., and other experts in this area, I was told - if it works for you, that's fine (not that I would do any differently even if they didn't agree) Best, Dearest