I'm new on forums today.
I have had my uterus and one ovary out five years ago. I was suffering severe hot flashes, anxiety, leg cramps that kept me from sleeping, insomnia, mood swings, severe depression, low energy,loss of libido and vaginal dryness. I have tried everything ( faithfully and for the length of time I should) except the saliva testing for the bioidenticals because I have friends who have tried that route and have tinkered for five months to nearly a year before they had relief. Two months ago I was in pretty desprate shape and needed some help fast- So I went on Premarin 6 weeks ago. The hot flashes are gone, I'm sleeping, leg cramps are gone, vaginal dryness is gone and I have so much more energy. It is a tremendous relief to be able to get something done and feel sane again!
I'm having much less anxiety and depression.
So here is the problem- I HATE the thought of loosing this wonderful relief I've got with the premarin! I don't like the long term risks I'm reading about so I'd like to consider the BHRT but am afraid of what I'll have to suffer through to get to the right dosage. Friends have had months of tinkering with dosages trying to find the one that will help them feel sane again. I am frankly afraid of the anxiety and depression and low energy coming back.
*** Could someone who has been on Premarin and gone on Bioidentiacal Hormone replacement tell me their experience please. Can the pharmacist put you on bios that are comparable to the dosage of premarin that was working? How long did it take for you to see good results ( in weeks please) ? Did you have other side effects?
Is it worth going through?
I've already been going 'through the change' for 8 years and its been a very rough ride.
I tried progesterin cream, vitamins, soy, and herbs. I was faithfully using the supplements. None of those (excepting B vitamins ) helped me enough to keep on. This last month has been the first time I've felt nearly like myself again in 8 years! Hate to loose it though I've read all the concerns about premarin. So I'm weighing my options.
*** AND if BHRT won't help in a reasonable amount of time- is there another sythetic HRT that is supposed to be safer than Premarin?
Thanks ladies!

Hi there,
A warm welcome to PS.
There are many excellent ladies on this site who have done lots of research on BHRT.
I am pleased to hear that you have had success with Premarin. There is no doubt that it does the job and does it well. BHRT is much more hit and miss and can take a long time to get dosages sorted out. Many ladies feel more comfortable with the bio-identicals but I wonder if you are aware that there is no real evidence that they are any safer than the Premarin. When and if you make the switch I think that you need to be aware of this. If it makes you feel safer then I suppose there are psychological advantages. I will hand you over to those who have experience in these matters.


Take care.........


XIII

Hi, I still in Peri and supplementing with an fda approved bioidentical estradiol patch (I use vivelle but there are many other brands available). Initially I thought I had to go the compounding pharmacy route. But, as my 2 gyns said, "let's try what's available (fda) and see what works, doesn't work" before going the other (compounding pharmacy). And my insurance doesn't cover some compounded drugs. But I am willing to pay separately if needed.

My oldest SIL has been on just about every type of hrt since the age of 47 and is now in her early 60's. She started on the Prempro and did very well. As other hrt became available her doc switched her meds. She is currently taking an oral fda approved bio estradiol tablet and a separate P and doing well. A neighbor has been on Premarin for the last 25 years, is in the healthcare field, and has no interest in changing what has been working for her body.

I think the most conservative route to take now is to talk to your doc about your concerns regarding Premarin. If you're still not satisfied with his answers than get a 2nd or 3rd opinion. (I had 5 Consults) Not one doc or person has all the answers in medicine. No one knows for sure which is any safer than the other (synthetic or bio). Bottom line is doing what works for your own particular body chemistry. I've gone thru two long extremely difficult years and still "tweaking" my doses of ht. If Prempro was the only thing that worked for me then I would definitely take it. My own personal choice is to pursue a quality life worth living - not merely existing. Maybe you should consider staying on the Premarin (short term) while gathering more info. Sounds like you need a reprieve and rest after the last 8 years.

Your doc and pharmacist should also be able to give you information on other forms of estrogen that would be equivalent to the current dosage of Premarin. ie - How many oral tabs of estradiol, or patch dosage, or pumps of estradiol get, etc. Good luck with this, feel free to PM me. JZZ

Hi bib - Welcome to PS! I can definately understand your difficulty with your decision about HRT vs. BHRT. I am one of those who is still searching for the right BHRT. I've been at it for 5 months - first, started with Activella (too weak, didn't work), then went to Vivelle Dot (all the strengths - they didn't absorb through my skin), have now been on sub-lingual tablets, which I THINK may be working. I've pretty much decided that I'll give this another 4-6 weeks and if it's not working pretty good, then I'm going to ask for the Premarin. The only reason that I'd like this to work is because of the absorption through the skin, taking stress off my liver. But, I'm getting impatient and don't want to play around for too much longer. It's not Premarin that had all the bad press, it was Prempro. I don't think that Premarin has any greater risk than any of the BHRT, as far as breast cancer goes. What dose Premarin are you on? If I were you, I think I just might stick with what is working, at least for awhile.

I'm on 0.3mg of the Premarin a day. I still have no libido and I am anxious though not as bad as I was before Premarin. But-All the other symptoms cleared right up. I even lost the vaginal dryness. I have so much energy now.
I have an appointment with my dr. this week. I think she's going to want to up my dosage to see if it helps with the other symptoms. I have been considering the Vivelle Dot or Climara- but my doctor says that she's found that most of her patients don't seem to absorb the meds' through their skin as wel- she recommends oral meds.
Is it sub lingual Vivelle you're taking? Has it helped at all? Caused any problems?
Thanks ! ; }

Thanks JZZ. I do appreciate the encouragement. It's good to be reminded not to be overly concerned about the hrt. I'd like to know what you're experience has been with the Vivelle - are you on the sublingual or the dot? I'm looking at that and Climara as an alternative and I'd appreciate knowing if and how it helped you. I have to say though the Premarin hasn't helped with all of my symptoms ,the vaginal dryness , and my energy levels have improved dramatically!


Thank you for the encouragement! I really do need it right now. I find myself feeling overwhelmed even starting to think about changing meds again. This one has been a sucess for the most part. ; } You ladies are helping me believe that I CAN work through this with my doctor! Blessings.

I'm on the vivelle.1 patch and my blood work has shown (twice) that I'm not absorbing optimally. Also using the Estrace (bio ident/fda) vaginal cream and that IS systemically absorbed. - great results from that. ie - more blood flow to the vag areas, generate more natural lubrication, and also sleep great! Seeing my other gyn in June and will be discussing some options from the patch. (maybe another brand or might try the e gel.) I've been told by many women who have been on hrt for years that even when you arrive at an optimal dosage, you will still periodically need to ajust it. Hang in there, it does get better. Regards, JZZ

Hi again Bib - I was on the Vivelle Dot (.75, then .1 which is the highest dose). After 10 weeks, my blood level estradiol was still less than 20, which is pretty low. Obviously, I wasn't absorbing it. So, now, I'm doing the sublingual estradiol (estradiol is also what is in the Vivelle Dot). Just had my dose increased a few days ago, and I THINK it's starting to work. I get it from Bellevue Pharmacy, advertised here on PS. I have been happy with their consultations and service. Like I told you before, I'm losing patience and am prepared to go to Premarin if this doesn't get me feeling pretty normal in the next 4-6 weeks. I've felt lousy for almost the past 2 years, and owe it to my family, my students (I am a teacher) and myself to get back to my old self. I tried to tough it out for a year and a half thinking it would improve, but all it did was get worse. Your Premarin dose (.3) is low, If I were you I would try upping the dose a bit before I switch medications, since it's working for you. This is such a long haul with the trial/error/ wait and see...... Don't give up, you'll get there.

Just wanted to throw in my two cents about the HRT/BHRT. I have a friend who was on BHRT for two years and felt no relief. She then switched to Prempro and withing ten days she was feeling much better. She had been suffering with anxiety and depression along with all of the other stuff and this really worked for her. If I don't find some relief soon from this BHRT I am considering the Prempro myself. Quality of life is soooo important.
Bev

Dear'sciencelady'
How are you?
It has been awhile since you posted but have often wondered how you are doing
I think the fact that I too was struck down by the malicious Menopause bug while still trying to teach made me remember how bad it all was.
I do hope your increased dosage of BHRT will help you feel a lot better
And yes you do owe it to yourself to feel well and enjoy life and teaching to the full
Am still on my HRT!
So all the Best
God Bless
Elizabeth

Hi
I just wanted to add a few things. My mother who is 76 has been on premarin, since her hysterectomy when she was 40. They tried to take her off of it when the hormone scare hit. So she tried and she felt so bad she is back on them. She is young looking and energetic. So I am wondering why I don't try it. I am on BHRT and am not happy at all with it..They put me just on Progesterone by mouth 200mg and cream in the day..and no estrogen. Well my estrogen tested at 44 which I think is low but they don't want to give me any till later...I dont understand any of it...But I think a talk with my dr might be the next thing. I have been trying to give this Bhrt a chance but I am getting a little impatient..
If I was you if something is working why mess with it. Any relief is good. Stick with it. This is a rough time. I hope you have found your answer. I hope my answer will be found soon.
Sishaircut

I have no exprience with Premarin only with BHRT, which did not work for me, but if I did not need progesterone ( I have my parts intact), I would try premarin now, based on how my experience with Bios.
I have started reading about premarin out of curiousity fisrt, perhaps, I am a rebel, and also because I am interested in science and wonder why they need to use horse urine when they can really syntesize any chemical in the lab nowdays, as they do with Bioidentical hormones.
I alsodon't believe that BHRt is much safer and more effective than premarin, neither I believe that natural progesterone has less side effetc or poses less health risk that MPA, but it is just my opinon.
I have read many articles on premarin, the more I have read, the more i think it works better than identical estradiol because of the unique properties of equinine, part of the CEE, which is estrogen and equinine. Equnine is indeed SERM, and prevents bone less without stimulating breast and uterine cells.
In any case, here is very interesting article on premarin, pros and cons, see for yourself. I understand your concern, but why switch if you feel just fine, no one has proof that BHRT is safer than conventional HRT, until then I think odds are the same, even better, as premarin been on market for long time, much longer than bios.
http://www.project-aware.org/Managing/Hrt/...s_Opinion.shtml
HTH,
I.

Irandan

That link you posted is very interesting!
I hope no-one minds me going slightly off subject because I wonder if maybe one of the knowledgable ladies on this thread could help please?
I was given a low dose estradiol patch a few weeks ago but I had to remove it as even cut up very small it made me feel terribly ill.
I was given estriol cream 18 months ago for vaginal dryness and I have nearly a full tube because I absorb it systemically and I can't use it either.
My doctor prescribed me some Premarin cream ages ago but I have been too scared to try it as I understand it is stronger than the bios. However reading the link it suggests that premarin is actually more estrone than estradiol and may not have such a strong punch to it. I wonder if there is any point in trying it? I really could not tolerate a tiny dot of estriol-it made me depressed and tearful. I have only just got the estradiol out of my system and I am now almost out of options!
That unopened tube of Premarin is beckoning me. I almost threw it away with the horrid patches the other day but I didn't. I am terrified of being really ill again. Oh dear what should I do?
I like how well I feel now but I could just do with a bit of help "down south"
janet c

Janet,
I understand your concerns, and my heart goes out to you as a cancer survivor. Before I have learned about BHRT, my undertsnading was that Premarin is the most potent ( horse power ) estrogen like substance, and if I used it or syntetic progesterone, I will drop dead on the spot. I too thought BHRT is God sent, best thing since sliced bread, etc.

After trying BHRT, I have changed my mind and opened my horizone to thinking: if premarin is soo bad, how come it is the mostly used HRT on the market for 50 years, give or take. Millions of women used and continue to use it, so there has to be something that makes this product soo appealing to women all over the world.

Since I did more reading on Pubmed, I have figured, that Premarin while still can be "charged" with increasing risk of Breast, uterine, and ovarian cancers, is actually less potent that pure bioidetical estradiol and estriol while marketed as a weak estrogen, can be quite stimulating, given right quantity. I can attest that I hated Bi-est and progesterone, even they were Rx compounded hormones identical to my endogenous, they made me very sick and plain nuts.

In your situation, the proof is in the pudding, you never know, until you try it. If you try premarin and it works better, then you can apply it sparingly and once you replenish the tissue, you wont need much of it, as I have read.

I agree that over time, lower but constant level of hormones may feel better than hormonal peaks and valleys, I still remember agonizing migranes from high estrogen since my teen years and all the way until early 40s, when my estrogen started to drop. I surely don't miss them.
I hope this helps, if premarin will make you sick as well, why not to try Vitamin E vaginally, I have read it helps even if it is messy, you would need a tampon to keep it from staining your undies, but it can be very helpful.
Good luck,
I.

Thank you Iradan. I did read it right then that actually Premarin is less potent. How strange because I have always understood it is stronger than the bios! I am interested that the bios made you sick too.I have read of a few women who cannot use them!

I must be very sensitive to something in them if a pinprick of estriol makes me feel so terrible so you can see why I am a little wary?
If I pluck up the courage to try the Premarin cream I will do it when I have no pressures or events looming
I got the estradiol out of my system just in time for a wedding last weekend and I actually did still feel quite unwell

janet c

I am not sure where the notion that premarin is too potent came from, perhaps, becasue it is oral, and it stays in the system longer, I am very confused on the subject, and just decided to stay away from HRT of any kind, not saying "never", no one knows how things may progress.
I udnerstand your hesitation, I would be in the same shoes, given the situation. Do it as you feel like, I think sometimes the pinprick works more as placebo, as our mind is very potent, but you haven't had much estrogen in your system for some times, even this tiny bit can make you sick, I have heard it from other ladies.
Good luck.
I.

Iradan - I'm pretty sure that you can still take Premarin, even though you still have all your parts. You just have to take Prometrium along with it, just like you do with taking estradiol.

I am not trying to try HRT again, sciencelady, Prometrium and all forms of progesterone was the reason I had to quit the BHRT in the first place.