I feel like Henny Youngman:

A woman walks into her ob/gyn...

No really just got back my bloods - don't have the full info but my estradiol is gone along with my sanity. Doc says throw away the bc pills I just gave you but... I want you to wait two months before we try hormones to see if you feel better in a "steady state" - STEADY STATE!!!!!!!!!!!!!!!! Steady state of cr*p.

I say to her - can I pleeeeeeeeeeease have some hormones and she say - hmmmmmmmm but your Mom had breast cancer (survivor) and I say I can't live like this. She says lets wait two months and see if you feel better. Then after 3 minutes she said she had to go because she had a patient waiting.

Is anyone on bhrt who has any family history of breast cancer?
Should I get another Doc?

Feeling neglected by this one.

Love Pookish

Sheesh Pook!! At least now you KNOW it is low estrogen that is making you feel like crap! I know that feeling all to well. I think you know, I needed hormones to function....but I have no breast cancer in my family, and my mammo was perfect. I imagine your doctor is concerned about increasing your risk of getting the B cancer and doesn't want to start you on hormones immediately. Perhaps you will feel better in two months?? I know it is so difficult waiting.... I did it too. Tried anti depressants first....they only partly helped. But it is different for all of us...what worked for me may not for you.

I hope you can get through the next couple of months! Hang in there. Probably every doctor you see is going to be concerned regarding giving you hormones because of your mother's history...so if you like this doctor, you might as well stick with her, rather than starting from square one with a new one.

Pookish,
Do I have this straight--your gyn was willing to give you oral contraceptives but not BHRT? OC's have a much higher risk of causing breast cancer than low-dose bioidentical hormones. I think I'd seek another opinion if I were you. You deserve to feel good. My maternal aunt died of breast cancer at 46 (diagnosed at 42) so my breast cancer history isn't that great either. I am 47 and am taking bioidentical hormones and plan to keep taking them for a long, long time. If you are otherwise healthy I think you should be able to take the hormones for awhile anyway. I think your doctor at least should have discussed some other options with you (anti-depressants, etc.). I agree that you were neglected.

Yes skiergirl can you believe it ?- the primary ingredient in Loestrin is estradiol - what is she thinking? You are absolutely correct and thanks for reality checking me - xoxoxoxoxox I am, however, on anti-depressants - just restarted lexapro after trying it once but with some unwanted side effect - tinitus - yuck - tried several others that didn't do it for me so keepin' my fingers and toes crossed that the lex does it this time w/o the ringing.

Floater - thank you so much for all your sincere and helpful responses - I think Dr. Vliet says you need at least 100 mcg/ml (or whatever) of estradiol to feel at least "well" - 32 per s*cks big-time as you know- last year at this time I was at 64 per so I'm deteriorating rapidly - at least though, as you say , we know the culprit.

much ,much love - pookish

Hi Pook, I just got my FSH levels back and it was 90.5. This post meno level even though I have only missed 2 going on 3 periods. Fell horrible with flashes and anxiety. My mom and Aunt are BC survivors and were on HRT. They were diagnosed at 56 and are fine today. My Dr. prescribed me combination estriodal and progestin LOW dose HRT. It is called Activella. My Doc is VERY conservative and he has me on this for 6 months. I will start the pills next week. I am a little worried and wonder about bios.
Louisa

By the way this is a synthetic and I wonder if Bio's are any less risky?

Hi Skiergirl,
My Dr gave me a very, very low dose HRT-Activella. Synthetic. My Mom and Aunt had BC but are survivors. Are Bios really that much less a risk??

Louisa:

the jury is still out on whether the bio's are less risky than the synthetics, insofar as they haven't done a lot of testing on them in the US. It is a case of do you want to put substances in your body that aren't natural to the human body? Bio's have been available since the 70's but in the US they were shelved in favour of synthetics which the Big Pharm's could make more money on. Europe has used bio's for decades. I feel more comfortable using bio's than synthetics for that reason, and they are working for me.

Provobabe:

I'm as confused as you are. Good luck with the Activella... if you feel your doc is very conservative then your probably in good hands given that he knows your family history.

I will ask about this drug but my ob/gyn doesnt give me the time to get my q's out! On the bios vs synthetics question I too am stumped - it would stand to reason that if something is natural to your body to begin with it would be safer to take but in fact I'm not really sure.

All the best to you my friend and keep us posted next week when you begin of the wonderful progress I'm sure you will make!

Love Pookish

Louisa,
I've done lots of reading and research (but I'm no doctor) and I've come to the conclusion that the bios are safer than the synthetics for the simple reason that they are chemically identical to the hormones our bodies produce. Having said that, though, before peri, I was on bcp's for years and had no problems. I tried them for awhile too when my periods went crazy, but they didn't work for me and made me feel depressed. However I know that some women (my sister is one of them) do better on the synthetic hormones. I think everyone has to make the best choice they can--quality of life is important too!

Louisa,
I've done lots of reading and research (but I'm no doctor) and I've come to the conclusion that the bios are safer than the synthetics for the simple reason that they are chemically identical to the hormones our bodies produce. Having said that, though, before peri, I was on bcp's for years and had no problems. I tried them for awhile too when my periods went crazy, but they didn't work for me and made me feel depressed. However I know that some women (my sister is one of them) do better on the synthetic hormones. I think everyone has to make the best choice they can--quality of life is important too!

If anyone has anything helpful to ad, I just got the full copy of the results of my hormone panel from Thursday - here are the #'s

TSH with free t4 RFX
TSH 3rd generation 2.10 reference range .4 - 4.50 miu/l

FSH 38.1 reference range post menopausal 23.0 - 116.3

LH 19.1 reference range post menopausal 5.0 - 52.3

Estradiol <32 reference range post menopausal < 32 pg/ml

so here you have it -

funny thing is I had a full blown period 2 weeks ago right after a family tragedy - perhaps brought on by the stress - maybe my last.

Anyway if anyone can add any info re interpreting the #'s - I'd much appreciate -

much love Linda (pookish)

My younger sister had breast cancer and my doc did not raise any qualms when I decided to go on BHRT. I do not feel the fact she had cancer raises my risk any more than I feel the fact my older sister, mother and grandmother haven't had breast cancer lowers my risk. If I had multiple family members with breast cancer I might test for the BRCA genes to see if I had a higher genetic risk, otherwise I feel it is just 'one of those things in life' that she had it....a fluke, bad luck, different lifestyle....who knows?!? The majority of women with breast cancer have no previous family history of breast cancer. Other than discovering an association in some families with the gene, I don't think scientists are any closer to identifying what causes breast cancer today than when they first started research....lots of theories and possibles, no proof.

I have not read anything in scientific studies that bioidentical estradiol (whether produced by our bodies or supplemented in hormone therapy) causes breast cancer. If that were true I would think we would see most cases in younger women, when estrogen production is strong. We should see a jump in incidence following childbirth, because more estrogen is produced during a pregnancy than during a woman's entire lifetime. Risk would increase with each pregnancy as the body is bombarded again and again with high level hormones. Yet statistics show just the opposite. Breast cancer is rare in women under 35-40 and pregnancy lowers your risk. Instead, the incidence is more common after 50 and the risk continually increases the older we get...despite the fact that estradiol is long gone.

I agree that estrogens can fuel growth of some types of breast cancer cells, but I'm betting those cancer cells are already present from a currently unknown cause. It generally takes 10 years for a breast cancer cell to grow large enough to be detectable. So when we use hormones for 7-8 years and our yearly mammogram suddenly finds a lump, it doesn't mean hormones caused the breast cancer, it's more likely that the cells grew faster so it was found sooner, instead of several more years down the roads.

With or without hormone therapy, everyone has a risk of developing breast cancer. The key is catching it early before it spreads and regular mammograms are meant to help with that. Your doctor should inform you of possible risks and help guide you but should be willing to work with you as a partner and respect your right to make decisions. If she doesn't feel she can support your choices you may have to find someone else that can. I'd be tempted to call back and inform the office that you really can't hold out any longer for treatment and does she wants to see you or would she prefer that you see someone else.

Good answer!

NiteOwl: I agree with Louisa...EXCELLENT ANSWER!! And I agree with you whole heartedly!!

As I posted before I have this appointment w/ another DR. He is a specialist in hormones, bio and otherwise. Treats many women related issues. I aslo found out that he treats some of the guys at the gym with HGH. ( Human growth hormones) I wonder ... The fee is 250.00 first visit, 100.00 each follow up. Will file Health insurance but is not associated with any plan. There is a compounding shop next door to his office. The fee seems very high and I worry a bit about the HGH factor. Does this guy sound ok to you guys? I know I have not given you much info but he is well known around here for helping with the bio factor. I think I willl ask around some more. Maybe I should try another GYN? This guy is a mediacl doctor. I do not know why the HGH bothrs me . They are legal but isn't there some controversy about that??

Louisa,

Isn't there controversy around everything?? I mean seriously!! There are two sides on every issue, every drug, every treatment!!! Hormones or not! Bio's or synthetics!! T for women, no T for women!! HGH is good, HGH is bad! Aspartame is poison, aspartame is safe! We can find research to prove whatever side we want to prove or not prove.

I don't know anything about this doctor, but wow, $250 for the first consultation seems high...I mean what if you don't like him or what he has to say...you still have to put out that money?? I don't know what to tell you...get more information if you can. I think in the proper amounts some extra HGH isn't bad for you, it is just another one of the MANY hormones we lose as we get older.....

I do recall hearing about a women who died from taking too many supplements...and a serious overload of DHEA. Although these hormones can help us feel better and improve our lives, they have to be taken seriously as they can be dangerous if misused.

Did you ever record the numbers of your blood tests? You should have the results by now.....

Thanks Nite Owl - beautifully said and absolutely true! The idfference in my situation is that my mom is an only child, i have no sisters, and we don't know exactly what her mom died from. But thre is a serious quality of life issue we could take nothing, suffer each day and still wind up with B cancer of some more immediately deadly form of cancer. Also I've been told many times by many docs and breast specialists that post meopausal breast cancer is less of an inheritance risk than bc at a younger age. I don't think anyone really knows.

Provobabe: You may want to call Pete at Bellevue pharmacy for a consult. I did this last year before i was willing to take BHRT but never filled the script. I was still cycling fairly regularly and thought it might get better over time. It didn't. So yesterday I called him, we spoke for a long time and he hooked me up with an ob/gyn in my area who uses bhrt (I belive he knows her quite well!) luckily she is in my insurance plan (guardian health-net) so that's a major added plus. Am going to see her friday morning - Provo - whay don't you call Pete? - you can find his number by clicking through the experts list - make sure to ask for him not the others at his shop - you might have to fill out a questionairre but it's worth it. Perhaps then he can refer you to someone inyour area who he knows and may trust. He has been a ps expert in BHRT for over 10 years. It's worth a phone call.

Floater: The suggestions that you made to your doc - where did you come up with them? For instance why estrogel vs. biest or something like that?

thanks all - good discussion

pookish

Pook,

I did a lot of research, a lot of reading before I decided which way I wanted to go. I chose Estrogel as it is FDA approved, it is bio-identical and it is transdermal. I wasn't comfortable bringing in compounded hormones from the US, and then there is the question of how reliable the compounded hormones are which were available to me in Canada. I chose prometrium as the reading I did said the progesterone taken orally gives more bone loss protection than transdermal....and again it is FDA approved and bio-identical.

I am not suggesting that the Bellvue Pharmacy isn't great, I am sure that it is! But being in a different country made me feel uncomfortable using them, plus I wasn't sure if my doctors here would support me if I was using a product they hadn't prescribed. Then there was the issue of cost....in Canada our prescription drugs are much much cheaper than in the US. So to buy American hormones and add the cost of shipping, makes it cost prohibitive.

I think you should give Bellvue a try!! Pete is known to be very supportive and knowledgable...if I lived in the US, I would have given them a try for sure. Let us know how it goes!!

floater

Pookish,
Just a quick add-on. My gyn quizzed me about "when" my mom had breast cancer (she was well into her 60's) and gave me BHRT. She feels the big concern is family history of breast cancer in women younger than 40. For me (as others have mentioned) it is a huge quality of life issue. Also - I don't have other risk factors: no smoking, drinking, weight is good, etc. I hope you're able to get this resolved. Hang in there girl - we're all pulling for you.
Adair

YES - my mom had breast cancer (survivor) and I am taking a low dose estradiol gel called Divigel (.25mg). I was dying anyway (felt like it) before I started the estradiol so the thought of me possibly raising my breast cancer risk didn't bother me because I couldn't live like I was living either! I have 4 children to raise and I felt like jumping off a cliff so I opted for the bio estradiol gel. I am taking 2000mg of Vitamin D a day which is supposed to cut the breast cancer risk down in half, plus annual mammograms, etc.

Your doctor sounds ridiculous. Even my doctor said that my choice of low dose estradiol gel and OTC progesterone cream (Progest) was pretty much the safest route for me (as opposed to the birth control pill). You need a new doc!!

My estradiol level was at 21 and my doctor says that even THAT, as low as it is, is still within the "normal" PRE menopausal range. I told her that I thought 21 was very low but she said if the blood test is taken on day 1-3 of your period, the levels are SUPPOSED to be that low. Sheesh - confusing as ever...

I think the docs don't know - period. I could not convince her that I thought I was perimenopausal. My estradiol was at 21, my testosterone at 13, and FSH at 10. She said NO - you are not premenopausal.

Sounds high, but I know how frustrating it is for the typical OB/GYN to be absolutely clueless about this stuff. In my opinion, I would gather as much info that you can, and go to a regular OB/GYN doc, and TELL HIM/HER this is what you are going to do (provide backup documentation). The doctor can give you his or her opinion, but ultimately it is you who is supposed to make the final choice/decision.