Hysterectomy 2 years ago, bioidentical HRT or patch? (also have fibro)

[Karen333]

Hi everyone,

I had a full hyst 2 years ago due to endo. Also have adhesions, femoral nerve pain and mobility probs. This then developed into joint pain, fatigue etc. Was diagnosed with fibro 2 years ago.

I was on estrogel originally but found it messy and it didn't help joint pain etc which I though could be hormonal. Changed to Livial as had been on that when having prostap injections for endo treatment.

I have got to the point where livial is making me feel worse so keep stopping and starting it which isn't a good idea (its difficult for me to tell how many of my symptoms are menopause and how many are fibro)

I want to try a new HRT to see if I improve. I'm considering bioidentical hormones but also wondering if people use a patch which they have found helps and at which dosage, my GP seems clueless!

Also have asked about DEXA scan but told not necessary, any views? Including the time on prostap I have been menopausal for 5 years which I when the Rheumatologist said I would need a scan but he didn't include this on his letter to the GP. Have also had vit D deficiency in the past, don't eat much dairy and in bed most of the time due to fibro so no weight bearing exercise.

Thanks.

[PollyPerky]

Hi there
Sorry you've been through the mill a bit. Did they remove your ovaries too?
Livial is not 'usual' HRT ( assume you know that :) ) - it's a synthetic mix of 3 hormones including androgens. Was it chosen for you for the androgenic / testosterone effects?

When you say 'bio identical' HRt what are you meaning? All oestrogen in the UK is 'bio identical' ( the same biological structure as our own) except for the sort using conjugated equine oestrogens ( Prempak and Premarin.)

Maybe you mean compounded HRT which is sometimes called bio identical? Compounded HRT is made in private labs, is not licensed within the NHS and isn't recommended by UK consultants as the ingredients and doses are not regulated / quality controlled.

You might benefit from a DEXA scan if you had your ovaries removed under the age of 50. Your GP should sort this - just ask or get the consultant to write to your GP. I paid for a dexa scan in my late 40s, privately - purely for preventative reasons- and jolly good job I did as I almost had osteoporosis.

Can you not get on with the gel? I split the dose morning and evening, apply to upper arms and it dries while I'm cleaning my teeth. But some women do prefer patches- personal choice.
Would your GP not refer you to a gynae for some advice? Worth asking.

[Karen333]

Thanks for the reply. I didn't realise what Livial was really until today, I knew it wasn't normal HRT but that was it really. It is the usual one used with Prostap injections which put you into a false menopause to control pain etc. When I asked to go back onto it I wasn't offered anything else. I have never even heard of androgens! Just googled, am I right in thinking this could be causing the facial hair/acne? I also have a really smelly discharge and all swabs are clear.

I did mean compounded HRT rather than bio identical but I'm thinking more now of a normal bio identical HRT from the GP instead. He really has no idea about HRT, when I asked for anyone except for the one made with horses bits he said he didn't know which that was and prescribed Premarin! I had to ask the pharmacist to check and I never took it.

I did try Elleste solo and didn't get on well with it, again GP didn't explain that trans dermal is better than it going through your stomach I have just read that.
I used the gel for quite a while and maybe that's the best thing to go back to. I think because I have been in such poor health I was trying to think of anything that might be affecting me badly so I changed it. I was concerned about not washing it off properly and ending up with too much of it in my system if thats even possible lol (fibro symptoms are very close to low/high estrogen symptoms in some ways).

Which dose of Estrogel did you find useful? I think I was told to use 1 pump a day.

For DEXA scan the last time I asked I was told no because my Vit D & calcium levels are now fine (can't ask consultant, have been discharged) I am thinking of going privately, did you need a letter from you GP for that?

Thanks x

[PollyPerky]

Livial could certainly be causing the facial hair and acne! It's not HRT per se, it's a type of steroid combination which doesn't cause the womb lining to thicken which is why it's often used in women with endo.

All you need now is oestrogen on its own. There is absolutely no point paying a fortune to see someone for compounded products; they are really not worth the money and are sold on a bit of a false premise: you can get the right dose for your symptoms by adjusting a licensed body-identical oestrogen such as Oestrogel. One pump for someone with no ovaries (is that right?) is far too low. The prescribed dose is 2 pumps for women in peri or post menopause (I use 2 and am in my 60s). You can use anything from 1 to 4 pumps a day and it's best to start with 2 , keep going for about a month then increase if you still aren't getting any better.

You should be able to get a DEXA scan privately with no referral letter- it depends on where you live and what the options are. Don't go for one of the 'heel scans' some places offer- they aren't the right thing!

[NK346f2849X127d8bca260]

I need 3 pumps of Estrogel and I am 18 months post meno.

[Deux]

I use Estradot patches and they're fab. They are small and I've not had any problems with adhesion or allergic reactions. I also have Sandrina gel sachets to top up if I feel I need it