Ladies:

Does anyone have an opinion on this or first hand experience as to what happens after stopping bhrt or hrt? I recently started bhrt and though I must say there has been some improvement it frightens me to think that producing a period every month (which is what my bhrt regimen does) is postponing the misery until I stop taking the bhrt (one does have to stop at some point no?)

My ob/gyn does not believe in giving hormones until someone is officially meno so I circumvented her and went through a nurse practioner and a compounding pharmacy. Though I believe the bhrt had some positive effect on my symptoms particularly night sweats and to some degre anxiety, I still feel uncomfortable taking these hormones. As if they are having to much of a powerful effect on my body the ultimate effect of which we really don't understand.

Don't take this wrong - If I was completely non-functioning I would go back on them in a second and do not judge anyone for whom they are like manna from heaven but for me it just feels somehow a bit scary. I have gained a good deal of weigh in a short time, my appetite is through the roof and my breasts feel tender and full. But... my skin looks much better and my hair and nails too!

So what to do? If I continue on the bhrt will I ever pass through to the otherside - meaning become officially meno. (As if that's a guarantee that things will be better ! sheeeeeeeeesh)

I'm not really sure what I am asking but can anyone add to this conversation?

Love pooks

hey Pook:

I will answer some of your questions, as I understand the answers. I believe you will still become menopausal, even using bhrt, as the hormones levels are generally not high enough to cause periods....unless you are taking very large doses! As you know, I am using the FDA approved bhrt and although it has produced one incident of the most minor spotting imaginable, it certainly hasn't produced anything like a period!

The question regarding whether you will have a return of symptoms, well yes I believe so....however you do have a little more control over it on the bhrt, as you can slowly slowly (did I mention to do it SLOWLY?) taper off the hormones and keep the symptoms to a minimum.

I don't have much fear of the hormones, I have a whole lot more fear of being without them!! The return of quality of life has been so substantial for me, that I am not particularly afraid. I wish you the best, and am glad to hear you are feeling better than you were.

I agree with Floater: I don't have much fear of the hormones, I have a whole lot more fear of being without them!! The return of quality of life has been so substantial for me, that I am not particularly afraid. I wish you the best, and am glad to hear you are feeling better than you were.


I use bhrt and hope I can have these for life. As time goes on, I'll need fewer inserts as my body gets older (eewww). I know of women in their 70's using them.

Good luck!

Welll I wish I could post like Floater & NJW... I simply can not find BHRT that helps! It's not so much that I'm afraid of them as they tend to make me worse.

I gain weight... I lack energy... I get bloated... I get moody...insatiable appetite. Without them, I have hot flashes, vaginal dryness, no libido, insomnia. I feel so much better without them yet I still have major problems so I tend to 'sample' different delivery methods and doses for a few weeks till I'm too miserable to coninue and then I quit.

I think I'm going to give up and just hope that someday the hot flashes leave and the libido returns.

Thank you floater and njw and Carol for your replies - i guess like everything about this journey our body chemistry is so delicate and each of responds so differently to adding hormones of any kind.

Like Carol I also rapidly gained weight on the bhrt and my appetite became insatiable. I do believe though that the bhrt had a positive effect on my mood and particularly my libido which sky rockets from progesterone (anyone else have this?). Carol has your bhrt been prescribed after bloods were tested for hormone levels? Mine were prescribed in direct response to almost non existent estrogen. My bloods were taken at several intervals. Have you tried different delivery systems? Some respond better to creams or gels, some to the patch, some sublingual and there are others.

I guess I'm the only one of us who has the fear of long term use

xo Pookish

Hi Pook,

After all the fanfare I created here on PS about HRT, I ended up stopping it a few weeks ago. I just could not endure the side effects. However, I still believe it is the right decision for many women. I would never have known if I had not tried.

I thought initially that the additional hormones helped my mood. But I was still getting heavy periods so it seemed that I was perhaps getting too much hormonal activity. I was bloated, crampy, consitpated, bitchy as all get out, and had tenderness in my breasts that felt just awful. It was the PMS I never had in my younger or even middle years.

Then my internist diagnosed me with subclinical hypothyroid, and I started to take a very small dose of Synthroid. My mood is even better than it was, and the hormone symptoms are gone.

I have really stopped trying to understand what it going on with my body--after years of being a militant caretaker. Just when I think I've got it figured out, all h*** breaks loose in another direction, and my theories are shot to smitherines.

I too am wonderfing if I will continue to get periods now that I have stopped the HRT. I will certainly let you know. At 56, I cannot wait for the bleeding to end!

Hugs and smiles,
Marcy

That's why I like the pellets. Your body takes only what it needs. And they bypass the liver.

I found I had a hard time with the creams. I got too much, not enough, didn't rub it in the right place, or didn't rub it in good enough. I haven't spoken to any women that has good luck with the sublingual types. Although, I am sure there are some happy with it.

Regards,
Nancy

Marcy:

I believe every word of your post but i will never ever believe that you could be bitchy!

Love and kisses pooks


ps i get the wicked breast tenderness too from bhrt and now that i have stopped am having the mother of all periods.

Hello ladies-

I'm a bit disheartened to read that BHRT had these negative effects on some of you. I am soon to see a doctor in London who hopefully will prescribe BHRT -- I can't help thinking that I'm just going to make things worse in the long term, especially when I read posts like this --- BUT it's okay--- I think it's great to get a balanced view of any drug, good or bad--

I just want to ask a couple of questions if I may ---

Did any of you have your hormones tested on a regular basis so the HRT could be adjusted? Anyone have compounded hormones? -and how many of you are menopausal as opposed to peri-menopausal? I guess these things make a difference as to how we react whilst taking HRT -- Just thoughts --



Thanks --

Yes, I've been tested on a 3 month basis. My estrogen levels are non-existent so are my DHEA. I had my latest results about 2 weeks ago.

I've tried, creams, gels, patch and sublinguals and all but the patch was compounded. They do increase my libido, and stop the hot flashes but I'm happier without it. I'm post so I wasn't taking enough to start my periods and when I'm off, I still don't have them. I'm 49 so very surprised that at 56 you are still bleeding. I think I'd be bonkers if I had to deal with that for the next 7 years.

I have wondered if I had taken a pill like premarin if I would have had the same problems. I guess I'll go goole up on the pellet and see what my chances are with that.

Hello sweet EP,

My GYN does not believe in testing hormones. She calls it merely a snapshop in time, and one that can change at a moment's notice. She treats based on symptoms and excellent instincts.

As you know--because I have harped on it ad nauseum-- I am still peri. My last period was on April 5--a delightful 4 days of bleeding, cramping, and general misery that had me screaming into the night.

My doctor said that if my mood got bad again she would put me on the patch. But so far so good. The thyroid medicine seems to be doing the trick.

Hugs,
Marcy

Hi Carol,

Please do not be discouraged. Every woman is different, and I am certainly on the outside of the curve. I have adjusted more or less to having periods again (I went for 18 months without; my body spontaneously started producing estrogen again, long before I started the HRT). My GYN says that her oldest menstruating patient was 60. At this point, I don't know whether to hope the periods stop, or hope they don't so I can break the office record.

Take good care.

Best,
Marcy

I am using Estrogel & Prometrium and I've had excellent results! I could not function without them and I have no intention of ever stopping them...maybe when I'm very old and ready for the nursing home. I waited to start using hormones until after my one year date had passed.


Yes, you will still become meno regardless of hormone use, you just won't know for sure when it happened. It is not unusual to have "withdrawal bleeds" after meno, especially those first few years, if you are using hormones cyclically. The replacement hormones cause you to build up a lining and when you cycle progesterone the lining will shed when you stop the progesterone. Conversly, it is also possible to stop having periods even if you are not meno yet, by using continuous hormones. After 3 to 8 months of continuous progesterone use, the lining of the uterus stabilizes and does not shed as long as you continue the progesterone. These are the effects of the hormones, if you stopped them for several months...you might begin or end periods...depending on which your body does on it's own hormones. But unless you've gone at least 12 full months without any bleeding AND without using any hormones, you can't be certain whether you are meno or not.


These all sound like too much progesterone in relation to the amount of estradiol you are getting. I had much difficulty with progesterone side effects until I got my estradiol level up. Once the E to P ratio was improved I was able to tolerate the Prometrium better. Switching from oral to a vaginal route helped reduce the progesterone side effects also.

Compounded estrogens (Biest & Triest) & synthetic estrogens (Premarin & Prempro) do not have enough estradiol in them to raise the blood level to where you will gain the most benefit with the least side effects. In order to get the amount of estradiol you need out of a compounded cream you would have to use so much that you would get side effects from the estriol &/or estrone overload. The synthetics do not contain much estradiol either and you end up with side effects from all the nonbioidentical estrogens that cannot lock into the cell's receptor sites correctly. Estrogel 3mg daily raised my serum estradiol level from 37pg/ml to 152pg/ml in 2 months. Each dose of Estrogel is 0.75mg of estradiol so you will probably need at least 2 doses, maybe 3 doses daily, to get from 35pg/ml to over 100pg/ml. Time your serum blood level for 2-3 hours after using a dose to measure the peak. I have since cut back from 4 doses to 3 doses daily - one dose every 8 hours and still feel great. Give it a try before you throw in the towel!

Unfortunately, many of the docs out there do not understand what a woman's body needs in hormone therapy treatment...so it is going to be up to us to educate ourselves so we can help them learn!

Pookish,
This thinking made me go off BHRT and the fact, that my body hates progesterone too. After reading all the books written by respectful doctor, I came to conclusion:
1) BHRT should be given in manner that mimics reproductive years, meaning I would have a period for the rest of my life and PMS to go with
2) in oder to produce results and make me feel like when i was younger, the dose has to be high enough ( to produce withdrawal bleeding) of both E and P, which takes me to next point.
3) if I had to take it for the rest of my life, I would be in constant anxiety over getting female reproductive cancer, as the risk increases, so it includes ultrasounds, mammograms, and constant worries over every ache and pain.
I also had to consider financial aspect, would I be able to afford the BHRT when I am older, not all insurance cover bioidenticals.
If I eventually, will have to get off HRT, I would go through the same misery again, only in my 60s and beyond, then I would rather do it now not later.
I see as long term commitment, not short term solution, could be the reason women still take hormones even well in their 80s and beyond.
I also ask myself, as thing will get better while I am over the hill, and I think positive, as they gotten better over the past few years, so I am looking forward to be post-meno, but I never expect to feel as I did in my 20s and 30s, even if I take hormones.
Consider bad I was on BHRT, I don't even think about it anymore, just treat my anxiety with Xanax and live almost normal life, once I figured how to deal with the symptoms.
I felt like hormones too overpowered my body and I could not control anxiety/depression, so I think my body knows better, and I need to patient and wait, things are looking up.
HTH,
Lots of love,
I.

Thanks Nightowl, I know you and others have mentioned estrogel and estrace before. I have an appointment set for the 22nd of May and had planned to ask her about those then but I've also considered calling her and requesting she presribe them prior to my appointment so we can talk about the results on the 22nd. Is there a certain delivery method that is best? She doesn't like to prescribe anything that has to be filtered through the liver first.

My latest results from 3/27 are as follows : Estrodial =5, DHEA =40, TSH=0.953, Progesterone =1.2, Triiodothyronina Free=2.5, T4 Free=1.16, LH=40, FSH=57.3, Vit D=14, Vit b12=570.

Iradan, very nice post. I went through the same kind of thought process and felt I had to think beyond just how I felt today. The other question I asked myself, "if I did get a cancer which was caused by the use of bhrt, would that decision still be okay with me?" ie. not that I want cancer, but am I ready to accept that risk if it really happens? My answer was an emphatic "no"..... and for me that's because it is an avoidable risk and I actively try to avoid those risks in every other area of my life.

I also understand the choice of bhrt. I think the decision rests with how each individual prioritizes the benefits and risks, and that is different for everyone and a very personal decision.

Hi

I have no idea when I'll advance to meno from peri, as I've been using BHRT for a while now

It took quite a while to get the right level of estrogen. Estrogen-progesterone therapy never completely ended the discomfort, but the addition of testosterone has. As some one else wrote, tests just show a snapshot in time. The bottom line is experience over theory. Start with a lowish dose, and if you don't get relief, ask for a higher dose. Be prepared to have to wait 60 to 90 days before asking for an alteration. My last bleed was January, but it was brought on by altering the level of prometrium.

If you have enough prometrium in your system and use it on a daily basis, you can quit having periods, or you can take a double dose with estrogen for a fortnight, then estrogen only for a fortnight and you will bleed, because the prometrium either maintains the blood-lining of the womb in a steady state, or it builds it up to mimic a regular cycle during the time you're not taking the stuff.

Doctors are now suggesting younger women who are still fertile can do the same thing, and not have a period for extended ah... periods of time.

There are a number of forms of estrogen available, some are bio-identical, some are not. of the later group, most are derived from plants. I've posted a list of them somewhere on the boards, but you could do a google search and find another.

There is no evidence that for the average woman with no history of cancer, and all her bits and bobs, are suddenly at a greater risk for cancer.

My mother was on HT for eons. Every two years, she'd take a break from it, but the symptoms kept returning. Her doctor has no problem with her continuing (she's 83).
I don't know if that's typical or atypical. I'd go overseas and buy it if my doctor suddenly quite writing the scripts.

Estrace is an oral form of bioidentical estradiol and it does make a first pass through the liver. Oral estradiol did not work well for me....that was when my serum estradiol level tested at 37pg/ml, timed for when it should have been peaking.

Your estradiol is very low, it might be the timing from when you took your dose. Compounds and orals are pretty much gone from your bloodstream in less than 24 hours. A patch and longer acting gels should keep blood levels more constant. I don't follow DHEA but I've read you can't convert DHEA without functioning ovaries...and according to your estradiol level, LH & FSH your ovaries do not appear to be functioning. If you are looking for libido, energy, &/or bone help you may want to ask for a small dose of testosterone instead. Thyroid looks good, progesterone is at follicular range, Vit B12 is good, Vit D is just below the low end of normal.

I would certainly recommend trying the Estrogel before giving up - a 0.75mg dose at least twice a day should get you up to a sufficient estradiol level to protect bones, prevent symptoms, and help you feel much better!

Good for your mom and her doc! Low estrogen is what causes our problems in meno so I think it is only natural when we stop taking hormones, and let the level drop, we are going to get low estrogen symptoms again. It would probably take a very long, slow wean to let the body gradually adapt to a lower estrogen level again to keep symptoms at bay. But if forced to choose, I would rather do that later in life...when I don't have all the demands I have now to be functional at work, home & finishing up raising the family.
It will take years & years of studies to prove but already there are signs that the risks may have more to do with starting hormones too late than how long you take them. If you've already lost too much bone density, have built up clogged arteries, etc you may do more harm than good by starting them late. If you start them sooner after meno, before the problems develop, there may be no reason to stop the protection they give.

NiteOwl,

I agree with your assessment. My mom is another who has been on hormone replacement for a long time...14 years so far, and at 64 she is the poster child of good health. She believes she has maintained her vitality and energy from the hormone replacement and has no intention of ever stopping. She is very consciencious about her health, gets all the regular checkups, mammos, USs, bloodwork, bone density tests, etc. and she is biologicially younger than her years. I am another who will take the estrogel and prometrium forever.

Hi Guys,

Am having bloods done on monday to confirm peri/menopause.
Spoke to my doctor today and she says she thinks its menopause probs, as am having meno probs and symptoms and have not had a period since dec 07, and the worst for me is the anxiety/panic.

Anyway, she has made me an appointment for next week, when blood results come back, but will not treat my symptoms, she says she wants to talk to me about HRT, I have heard a lot of BAD things about this, and when i told her, she said ONLY if your on it for longer than 4 yrs.

Please help, am a bit worried about using anything like this, and was hoping to go the natural route, with herbs etc, but i do know how bad the anxiety/panic can be.

Anjo

Anjo, nobody seems to know the answers you seek for sure. Evidence on the WHI study suggest one thing, but the study was flawed. Plus all the positives were not played up in the media, the way the negatives were. Bio Identicals have not had the same study done on them, but Europeans have had good results. It is a risk, I suppose, but so is jumping in your car in the morning. So is getting into the bathtub, or eating a ham sandwich by yourself!!

Hi Anjo - I read through your previous posts and it certainly sounds like you are getting hit with peri/meno symptoms! Since you've only gone 4 months without a period your labwork may not show meno changes yet, you have to go a full 12 months without a period before you are "officially" proclaimed menopausal...but be assured, even if the labs are 'normal' that doesn't mean your symptoms can't be hormone-related.

Don't worry, your doctor can't make you take hormones! You shouldn't take anything that you are not comfortable with...it is not an immediate life or death situation. You have plenty of time to read up on it, think about it, or try other avenues. I researched the pros & cons for about 2 years before I made my decision...I wouldn't have been comfortable without giving it a lot of serious thought first.

If you read all around this board you'll find some women notice improvement by changing their diet & exercise and some take various herbs & homeopathic remedies for their symptoms. Others are using soy products or OTC progesterone cream for symptoms. Some use therapy to help deal with anxiety, try accupuncture, take antidepressants or antianxiety medications. Many are using a combination of techniques to deal with the worst of peri/meno. I'm sure there are many other things being tried so read up and maybe you will find success with something you feel comfortable trying.