Bioidentical progesterone/estrogen/testosterone

[Riverside1]

Anyone here taking this kind of combination of bioidentical creams? I am not menopausal and still have regular periods (45) but have been prescribed these by the Marion Gluck clinic as I had low levels of all of them (despite low LH and FSH). I react to just about everything and have a lot of health issues (chronic headache and migraines, fatigue, muscle problems) that have as yet not got a clear diagnosis, so giving this a try. At this point the potential benefits outweigh the risks

Anyway would be interested to hear from anyone with experience of them and how they made you feel.

thanks

[Pinkfrocks]

Are you using bioidentical HRT or HRT that is tailor made in a lab, just for you, for your hormone levels as a result of blood tests?


The NHS can prescribe bio identical HRT. what this means is HRT that is formulated so it is identical to what we would produce naturally.

Some HRT is made from conjugated oestrogen - mares urine is used. Bio identical is made from plants and is estrodiol.

There is a lot of confusion over this partly because of what they offer in the US where 'bioidentical' has come to mean 'compounded': compounded means you are not using the usual prescribed amount daily, as in 1 tablet, a patch, or gel, but you are using the amount that has been made for you in a pharmacy.

One of the best gynaes/ former president of the British Menopause Society - the UK- Nick Panay- has done research on this and poo-poos it.

The reason is that your hormones vary daily. It is IMPOSSIBLE to prescribe an amount that will be right for you one day and 10 days later, during peri.
You would need blood tests daily to find the perfect amount.

What follows here is an extract from the Daily Mail on this. Have a read!



_

Women are usually given a blood test first to check their hormone levels. This information is used to make up an individualised prescription, often in the form of a cream (as with regular HRT, bio-identical hormones come in a variety of forms, including pills, patches, pessaries and lozenges) to build up the levels of hormones that are low.

It's a personalised service that's not cheap - it costs several hundred pounds for a detailed consultation plus the cream.

And it does not make medical sense, explains Dr Nick Panay, consultant gynaecologist at Queen Charlotte's and Chelsea Hospital in London. 'It is not possible to work out the level of hormones to give, based on a blood test,' he says.

'First, because your levels fluctuate-all the time and second because you can't predict what a person needs from the test result.'

He is also concerned about making up creams for individuals. 'These are unregulated products that haven't been tested for safety or effectiveness.'

However, Dr Panay does support the use of licensed forms of bio-identical hormones. And as he points out, you can get these on the NHS.

There are patches or creams containing a standard amount (not tailor-made) of the hormone oestrogen and progesterone. 'That's the most effective route,' explains Dr Panay. 'It gets directly into the blood stream, so you need much less of it.'

Brands include Estrogel, Estraderm and Hormonin. He believes that these approved bio-identical hormones 'should be regarded as part of HRT'.

The problem is, few doctors know about these treatments. 'The crisis of confidence in HRT after the study showing the cancer risk has meant there has been a lack of promotion and education. But these licensed bio-identicals should be one of the options available,' says Dr Panay.

Read more: www.dailymail.co.uk/femail/article-1197933/Should-middle-aged-women-taking-natural-HRT.html#ixzz38NvSgdua

[Riverside1]

Thank you Pinkfrocks. I totally agree - for me this was partly about advice and knowledge which my GP doesn't have - though she was happy to run blood tests for me to take to the clinic. I totally get the point about balancing isolated blood tests - i think the issue is here that i have also had testosterone added in which isn't standard as my level was on the floor. It is put together in a compounding pharmacy and i was told to vary the prog cream dosage according to stage in cycle, but the biest and testosterone are combined in one cream.

I have no idea if this is going to help at all but i am desperate (tried everything over the last year or so without results).

From what i understand though, I might get headache (constant) worsening initially due to the change in estrogen level? Anyone experienced this? Just about everything gives me a headache so it's hard to isolate cause and effect and to know when to carry on and when to quit :-(

So any experiences much appreciated.

[Pinkfrocks]

Personally, I'd use my money to have a private appt with Nick Panay (or another very eminent gynae who works in the same way.)

The problem you have is that 2 hormones are mixed in one product- that's silly really because how do you know which is to blame if you get side effects/

If you use something like bio identical gel you can alter the dose daily to see what you need and you can use bioidentical progesterone in different strengths too.

[Pinkfrocks]

The products I mention are available on the NHS or from a gynae if you are seeing them privately - cost around £15 a month - and you can control the amount you use/need.

There is no need to pay £££ to someone like Gluck- who is not actually a gynaecologist.

[Riverside1]

thanks Pinkfrocks. IF this has any beneficial effect on me then I will look at the NHS options, but at this time I just needed to see someone quickly and easily (and wasn't aware of Nick Panay and will read up).

I read very mixed reports about people with headaches using any form of HRT . Some say it works wonders in levelling fluctuations and others say it makes everything worse.

[Pinkfrocks]

I've had a quick look at her website and am shocked at her fees! I pay less than that for my Harley St gynae who is far more experienced and is a surgeon too. Been seeing them for 7 years.

PM me if you want details.

[gemsis]

I visited the Marion Gluck clinic and, aside from the ridiculously high prices, was appalled at a number of aspects of their service: the doctor I saw was rushed, she got me mixed up with a other patient and when I had queries about the prescription it took three months of regular calls to get an answer to my questions and concerns. They readily take your credit card details before consultations but any other queries seem to be a low priority to them. When finally a doctor called me back she was defensive about the service and offered no apology.

Having done a lot of research I think there are other practitioners out there who are more knowledgeable and honest (eg about how worthwhile blood tests are) and who have more integrity. I would recommend Dr Shirley Bond though I am unsure whether she is taking in new patients. I found her to be knowledgeable, quick to respond to follow up questions and very reasonably priced.

[pinkfrocks]

That's a terrible experience!
I've never heard of anyone having to pay at the time of the appt for a private consultation. I'm invoiced approx 2 weeks after the appt and the letter detailing the consultation outcomes and what was discussed always comes before the invoice!
There is never any problems with emailing or phoning the consultant directly with a query- it's answered on the same day if urgent- and this is what you'd expect if you are paying.

[Tayley44]

I visited Dr gluck clinic as an absolute desperate measure to finally resolve my hormonal symptoms ....
Firstly I was told my docs results even though I had followed their advice and got the list of blood results needed off their website and taken to my very accommodating gp were of no use -I was then charged over £400 for bloods at the clinic as I had travelled over 300miles so I wasn't about to waste the trip by having insufficient results
I then had a follow up a week later by phone and was told I might need thyroxine for my thyroid and I definitely needed their bio identical hormones
...now I might have been very naive as I was desperate but thyroxine is not natural and I was adamant I want to follow a natural path to get better I thought the clinic was about more natural remedies.
I told the doctor I wanted to follow a natural / nutritional path and I felt she was so arrogant towards me and belittled me saying that "a plant will never cure me"
I complained to the clinic manager who was so cold and lacking in any compassion and when I asked for a second appointment she agreed..but WHICH THEY CHARGE ANOTHER £75 for???!! I fainted and missed the phone call they charged my card without my permission... I decided to walk away at this point
I now have a piece of paper I paid £900 for showing little more than what I already had from my own gp results
I am extremely disappointed and felt it was more about money and less about genuinely wanting to help people
I have since pursued the path of detoxing my liver and so far so good!

[pinkfrocks]

To be fair- and this is a very old thread now- if you have a problem with your thyroid then you need thyroxine- just like a diabetic may need insulin. That is a totally separate problem to menopause, and they were right to check your levels as part of the 1st appt.
It's also very common for any practice to do their own tests.
I don't understand your annoyance- if you had a follow up phone consultation but then wanted to go back for another appt face to face then yes, it's normal for any private dr to charge for that.

I hope if they diagnosed a thyroid problem that you have got some support for it from your GP perhaps?

[LaundryMum]

Sorry to hear people have had bad experiences at the Marion Gluck clinic. I would like to say my experience is the total opposite and that they gave me my health and life back. This was following a thyroidectomy and hysterectomy whilst my children where under the age of 3. If people want i will go into more depth.

Thyroxine is a synthetic replica of the hormone produced in your body and like the previous post would recommend you seek support from a doctor. I would not wish hypothyroidism on anyone it can be a debilitating chronic illness if not treated.

[sportiedoc]

I also had a fantastic experience at the MG Clinic with one of the more junior doctors.

Its definitely not just about the menopause.. they take a holistic approach to health - encorporating nutrition and lifestyle changes. I also like the co-prescribing of DHEA and testosterone in those that need.

Yes it is expensive - but after the initial consult - follow ups are £75 and only needed 3-6monthly.

[zigangie]

Hi riverside, I am using oestradiol Utrogestan and testosterone and it really has changed my life.
I'm post meno and this has improved libido depression anxiety confidence sleep raging heat and hot flushes odd aches and pains dry vagina. Been on it only 8 weeks so things could still get better so in told.

[Menonomore]

I'm on the same regime as zinangie and echo all she said. Been on it for 12 weeks and has been life transforming. And if I'm to expect further improvements then I await with eager anticipation!

[0070nicky]

Hi, I've just caught up with this discussion. I've been trawling the internet looking for an alternative to the Marion Gluck Clinic as I refuse to go back there. I had a very unsatisfactory experience. The doctor was rushed, indifferent and arrogant and my 45 appointment which was mega expensive (around £300) was cut short by 15 minutes. I didn't realise this until I got out. The suggested follow up appointment wasn't for 6 months despite their advertising that you would have regular follow ups to track your progress and 'fine tune' the prescription. I had horrible side effects initially and felt completely unsupported. I wrote and complained and they didn't even acknowledge my letter. If anyone can recommend an alternative clinic or doctor specialising in Bio identical hormones, I would be grateful.

[mylaptopismylapdog]

After an early menopause I was on conventional hrt but recently found that my hormones levels were still post menopausal so now on same as Menominee et al. and my mood, energy sleep and pain levels much improved.

[PollyPerky]

0070Nicky
Hi- it depends what you are looking for. 'Compounded' HRT where the HRT is made up for you based on saliva and blood tests is not recommended by top UK gynaes. The reason for this is that blood tests only test on that day and our hormones vary daily during peri meno. There is also not the same level of quality control over the products.

There are previous posts on this thread about using them and experts' opinions.

You can get 'body identical' HRT on the NHS from any GP or consultant. Most of the oestrogen used in the UK now is body / bio identical. I think you will find enough on this if you read through the previous posts on this thread.

[ljb12]

How have the ladies on testosterone managed to be prescribed it? I had my ovaries removed last year and I'm on Elleste and a mirena coil. Libido gone, lacking motivation or drive and I would like to try testosterone but my gp and gynaecologist will not prescribe it.
Any ideas about how to convince them?

[PollyPerky]

I think the latest on this is that it is not prescribable on the NHS. I don't know if this is a cost issue or safety. I do know of other women using it who obtained it privately by seeing gynaecologists who work both privately and NHS. It's sad you can't get it when you have a genuine need. have you asked the gynae why it can't be prescribed?

[PollyPerky]

Update-Testosterone for women was discontinued in the NHS in 2012 due to incidents of serious side effects. You can still be prescribed it by private consultants.

[Menonomore]

The only testosterone specifically for women was removed from the market in 2012 because of costs versus profits. The only available alternative is one for men but I, along with others, use this but in much smaller quantities - a tube lasts around 10 days. The benefits are incredibly positive. I intend to go back to my GP when my current prescription obtained from private gynae (who, interestingly, has written to my GP recommending that my HRT could be prescribed on the NHS) runs out. I won't hold my breath, particularly based on ljb12's experience.
I found an article on this subject, which included this interesting extract;
‘Any gynaecologist with a serious interest in menopause today advocates the inclusion of testosterone in HRT,’ says Charles Kingsland, a consultant gynaecologist at Liverpool Women’s Hospital and a spokesperson for the Royal College of Obstetricians and Gynaecologists.

[ljb12]

Hi Menonomore

I seriously feel that I'm bashing my head against a brick wall. I spoke to my GP who said she'd ask my consultant gynae who did the oophorectomy. He is the one who said no because you can't measure the dose for women and it's hit and miss. Worries me that if booked an apt with Nick Panay I'd likely walk away with it immediately.
Can I ask which private gynae you used?
My husband tells me off for 'self-prescribing' but I'm just using evidence from people who have had positive impact from testosterone.
I have lost 3 hormones with my ovaries: oestrogen, progesterone and testosterone.
My oestrogen must be fine because I have not had one single hot flush.
My progesterone is OK with just the Mirena coil because when I tried tibolone (the past 3 weeks) I've got increasingly irritated and anxious and snappy. Women with severe PMS are often intolerant of progesterone - though I did have the pill for years without trouble (I thought, in fact it controlled my PMDD)
What I do have is a loss of motivation, sense of wellbeing, get up and go, energy and oomph - and that is all related to testosterone. All I want is to be able to replace the hormones I've lost and need. Oestrogen and progesterone are fine!
So when my consultant gynae wants to refer to me to a general menopause clinic, or a sexual dysfunction clinic I just worry that it's not going to get me what I need. My husband kept saying "there are lots of HRT's available to try" - yes but none with testosterone!
I feel really alone and frustrated about this (if you can't tell) so great to meet people in a similar boat.

I'm going to ask my GP to refer me to Nick Panay's NHS clinic and we will see what happens.

[Menonomore]

Hi ljb12
I understand your frustrations re GP and went down the same investigative /self diagnosis path which took me to Professor John Studd in early December. Nick Panay, according to all I've read, and trust me iit's been extensive, also recognises the benefits of testosterone, For the amount I use, a tube lasts for more than a week, but the benefits are so positive even with such a small amount. Finding a person who is knowledgable on the subject will fill you with confidence and in my experience it won't be long until you've got your mojo back!
I'll be interested to hear how you get on. It's exhausting fighting a system that is so random, some GP's are obviously more interested/better informed than others, but don't be deterred.

[PollyPerky]

There is an 'interesting' account on the Testogel thread here about a nurse prescribing testosterone willy-nilly it appears to female patients. She looks like your best bet! (I think she's breaking medical prescribing rules but that's for the poster to mention to her friend.)

You will face a long wait for an NHS appt with Panay- no chance you could pay for the appt? Though I've heard he has a 3 month wait for those too.

[Menonomore]

I feel quite confident that the practice nurse in question is prescribing with the full knowledge of the doctors she works with and not selling it from the back door!!!
A forward thinking Drs practice that recognises the benefit of testosterone is great for their female patients but unfortunately not commonplace. If you look hard enough there is contradictory evidence for many aspects of healthcare and a
lengthy wait to see the right person is worth the trade off, IMO.