Over the past few weeks, I have talked to different doctors, read varying books, including Dr. Vliet's and talked to her office, read transcripts on this site, read other doctor's site and literature, read messages on this board, talked to pharmacists, etc.  What I'm getting is some say Estriol with progesterone is sufficient and we should not take Estradiol unless absolutely.  It sounds to me like Dr. Vliet is saying Estriol is NOT sufficient for meeting long term needs and that we need Estradiol.  I also do not find where she thinks we need Estriol at all but just Estradiol and progesterone although others say we need Estriol for health of the vaginal tissues which Estradiol does not provide.  Anybody got any answers???

I answered your PM with a lot of background on this, Greataunt. (If anybody else wants my mini-essay on the phyiology of estrogens, let me know and I'll post it here.) But the key element is that we can convert estradiol and estrone back and forth into each other as needed. It's not as though what we take controls what we have actually circulating in our bodies. Estriol is simply a metabolite of the other two, so if you have them, you have estriol. To me, then, it has always seemed a little irrelevant what we put in (estradiol vs estrone) except that obviously we have to adjust whatever we take to fulfill our body's needs. That said, however, there are certainly women who do better on one blend as opposed to another--which must speak to their ability to juggle their needs.

Greataunt,

I added estriol to my progesterone and it made my hot flashes go away but not the anxiety.   When I added estradiol, it made the anxiety go away completely.    So for me it seems they each do different things in my body.   Thought it interesting and was hoping the estriol alone would be enough but apparently not.    I still have cyclic depression but not have figured out that however...

Framboise,

I have a question for you....what do you think?

When I added compounded  estradiol, my depression which is cyclic got worse those days 4-7 in my cycle.  My doctor said that is when estrogen is rising.  Do you think adding estrogen made it rise too much and too much a fluctuation up....or would it be too little at that time?  He also said that it  the problem is not the level itself perhaps but the change....And do you know about the change in hormones on serotonin levels?...

He told me yesterday to keep the level of estradiol I am at but add the 5-HTP.   Took my first pill of that and will see.

I use .5 mg of estradiol and 2 mg of estriol; also 20 mg of progesterone all compounded creams.

I thought about halving it again...but will do what he says for now..

My next cycle will coincide with my class reunion....want to feel good for that...

Just wondering your take on this....thanks!

Hi NancyV,

About the 5-HTP.....did your doctor prescribe this? At Dr. Shipko's PDI site, he has an interesting FAQ about 5-HTP. You might want to read it.  I was considering 5-HTP until I read about it. Maybe your doctor knows all about it, though.  I've also read (can't remember where though....i' m always surfing) that really low doses of Prozac ( 2/12---5 mgs) help a lot of people, without all the side effects.  My main problem is anxiety but sometimes, because of this, depression creeps in.

Just thought you'd be interested.

Kari,

My doctor did prescribe it....will look at the site you mentioned.  

NancyV  :)

Looking here for answers, but I guess we don;t have too many. I started with estriol cream, too, and used it close to a year. Then decided on a wild hair to try adding estradiol. My mental clarity seemed to improve greatly, which is very important to me, as my Mom had Alzheimer's.  But, during my 5 days off hormones, I began getting terrible headaches. Dr. just decided now that I can go with no off cycle. I guess she thinks I'm menopausal enough. I don't feel officially menopausal mentally, but physically I do.  Now I noticed on some stuff on PowerSurge that some people have progesterone days 1-14 and some have it 14-25.  My doc has the cream now for everyday now that I am not cycling and am going on every-day hormones. But, I am wondering it half a month of progesterone would be better - certainly lower $!   Where to get other experience and answers is a question - know any other good websites?

I just started taking naturally compounded hormones after using a phytoestrogen supplement and prog. cream (OTC). I thought I needed the change as I've been battling fatigue all year. (I've also tried all kinds of synthetic HRT and my reaction to them is complete exhaustion...can't get out of bed). Well I followed directions and applied 1/4 tsp of the compound (estradiol and progesterone) on Monday afternoon. The next morning I did the same (supposed to apply twice a day)...about an hour later I had to crawl into bed and could not keep my eyes open. I slept several hours. Today I was still tired but applied a teensy amount late in the afternoon and noticed that I feel slight tremors in my legs and arms. I read Snowbird?'s post in which she said she cannot take any hormones and maybe that's the case with me (other than the phytoestrogen supplements and OTC prog cream). My new gynecologist says she doesn't do blood or saliva tests to read estrogen levels...says that's not an exact science yet (it took forever to get an appt with her...she's one of the few in my area who work with natural HRT).  I know I've only been on this a few days but it's reminding me of that debilitating fatigue I've gotten from synthetic HRT plus the new weird tremors. Anyone else had these symptoms or have any advice?

Your question is interesting.  Too bad I don't know an answer!  I was doing the phytoestrogen and nat. progesterone also.  My doctor did hormone levels but mine were normal.  I could use some mental clarity!  I started having hot flashes again.  The phyto and n.p. were not doing anything and I stopped both and just increased my Vitamin E.  I'm have very few and very mild "warm" flashes now.  My blood test a few months ago said my levels were normal - barely, but normal.  My question is how they know when you truly menopausal.  I've only had a one mild period in about 4 to 5 months now.  So what's supposed to happen when they declare you menopausal?  Is that when the doctor insists on hormones?  I am concerned about the mental clarity and am not convinced that Estriol is sufficient for that.  That's why I believe doing the compounded route is better because you can get more Estriol, less Estradiol but still get the Estradiol.  Have you read the collegepharmacy.com web site?  But I can say this, if the hot flashes start back, I will probably do or take anything.  I've had enough of them.  They have worn me out - emotionally and physically.  I just want to be normal like other people.  I want to wear a sweater this winter.  Even though I'm not flashing right now, my body temperature is up.  I still wear t-shirts to work.  Tried a pullover sweater on a cold day - thought I would have to go home and change!  But I just don't like that wierd feeling you get inside right before I flash.  Sometimes it almost scares me.  I feel like I may suffocate.  Anyway, when I do start hormones, my plan right now is to do the compounded thing so I can get the Estradiol but less of it and get more Estriol since it's the weaker one.  Now I will just have to convince my female not very open-minded gynecologist to go that route with me!

Well I've decided to give up on the natural compound hrt and go back to my phytoestrogen supplements and OTC progesterone cream.  I've had it with my body's miserable reactions to the synthetic and natural hrt and what I buy OTC will have to get me through menopause (when does it ever end?).

I don't think menopause really does end. Maybe technically there is an end, but I see menopause as the beginning of all of the signs of old age. Many of the "symptoms" of menopause are actually old age characteristics that we just aren't used to yet, such as the drying out that causes wrinkled skin and many other effects. I wish I could stop the hormones, but I notice differences even when cutting back a little. I am wondering how long to stay on the hormones and still trying to find out about 14 days of progesterone instead of every day. I called the Dr, but they want me to go 3 months with the everyday regimen before discussing any changes. I feel very strange having no "period." I had the 25 days on, 5 days off for a while, and now everyday hormones, and I still am not sure whether I am menopausal or not and whether the lack of bleeding is OK!  I am planning to go talk to a local pharmacist who works with this a lot. My Dr. is cooperative but doesn't claim to know a lot about the natural creams.  About being sleepy, I remember at the beginning of all this, when I would skip periods, I felt I had less tiredness and more energy sometimes. When I first started the estrogen, I remember noticing a big sudden sleepiness!  Then when I was on the 25 days on, 5 off, I noticed less need for sleep during the days off. I think the hormones do induce sleep.   Some of the things that contribute to tiredness can be food sensitivities, such as wheat or sugar or dairy, and lack of exercise. A little exercise sometimes puts me to sleep but gives me more energy for later. Chocolate, of course, can help sometimes!

YOungOldMe, you are so right!  I am not taking any hormones right now and I'm not sure what to do.  The last hormone test said my levels were okay.  I do use a little progesterone cream occasionally.  Was having hot flashes regularly but upped my Vit. E which has just about done away with the completely!  I haven't had a period in several months.  But I was getting extremely w/o hormones.  I still get tired but I started drinking one of those anti-aging drinks and it has helped me and my 70+ mother a lot.  I actually feel human again when I wake up in the a.m.  I'm also trying to eat healthier.  I believe cutting down SIGNIFICANTLY on processed foods and having fresh fruits and vegetables - lots of dark green vegetables and just things with lots of color - is helping.  And drinking lots of distilled water.  It just seems common sense to me if we give our body the necessary nutrients instead of drying it up with soft drinks, caffeine and processed foods, it would help in this "transitional stage."  Not to mention being a preventative for diseases.