HRT

[ameliedoo123]

Does any ladies on here take "Prempak" HRT medication, I would be grateful for any advice on this medication, does it make you put on weight? how long does it take to work? After having between 20 and 30 hot flushes per night, I have decided to take this pill, I am scared as there is so much conflicting information on the internet about the dangers of HRT. Hdlp please, Thankyou in advance

Personally I would not use Prempak as HRT - but depends where you are in menopause? It is an old fashioned type of HRT (and the cheapest) made from the urine of pregnant horses and contains a mix of oestrogens not all of which are the same as our own.

Weight tends to increase around the time of menopause anyway so weight gain cannot necessarily be attributed to HRT. Metabolism slows down so you need to eat less and exercise more just to stay the same weight. Oestrogen tends to plump up the boobs a little though - especially if they've shrunk during menopause!

Femoston is one that is better tolerated (fewer side effects) and contains bio-identical oestrogen, and the progestogen is the closest to progesterone of all the synthetic progestogens. It comes in two strengths 1/10 and 2/10 of the cyclical types (that give a monthly withdrawal bleed - to tie in with your cycle). You could try 1/10 to start with and see if that helps.
Listed here: www.menopausematters.co.uk/perimeno.php

Some women find HRT works within a few days but I think transdermal ( ie patches or gel) seem to work quicker. You should notice the sweats lessening in a couple of weeks - for some women it is only days...

The dangers of HRT are overplayed and depends on the type of HRT, your age, your general health and age since menopause. The absolute risk is very small and no greater than being overweight, sedentary and drinking more than the recommended amount of alcohol.

Thankyou so much for your reply Bellaciao, I have been going through the menopause for approx 4yrs now, I had a vaginal hysterectomy 17yrs ago, however my ovaries were left in, not sure if this makes a difference to me taking prempak? I would be grateful for anymore information you might have, its day 5 now taking these pills I have had no change whatsoever yet but I am aware its early days and can take much longer for them to hopefully start working. Thanks again in advance!

You should not have been given Prempak! Another example of an ignorant doctor! This is a cyclical combined HRT type containing oestrogen (the horse ones) and a synthetic progestogen and designed to be taken by women who still have their womb!! Women taking this get a withdrawal bleed every 4 weeks to shed the uterus lining built up from stimulation by oestrogen.

You need to go back to the doc and ask for an oestrogen only HRT - and I would take the opportunity to change the type you have too. If you definitely want to take a pill then the pure bio-identical oestrogens are: Elleste Solo or Zumenon. If you are happy with a transdermal route then you could ask for a patch or oestrogel. Patches are changed either twice weekly or weekly depending on the type ( Estradot are very small) and gel is applied usually daily.

The different types are listed on Menopause Matters here:
www.menopausematters.co.uk/treatafter.php

You haven't said how old you are...

Hi Bellaciao, Thankyou for your reply, looks like I will have to make an appointment with my doctor, I think she gave me Prempak as I still have my ovaries, it was only my womb that was taken away,you asked my age, I am 51yrs old! Do you also know if I will come to any harm having taking these pills for the last 10 days? Thankyou for all your advice, itds really helpful to me!

Get some Phyto Soya by Arkopharma. Boots do three packs for the price of two.

Quite honestly, I don't think she gave you that type for HRT because you still have your ovaries; she doesn't seem to know what she is doing!
Having your ovaries is not a reason to give HRT that is meant to give a bleed- for women with a uterus.
The reason for taking a progestogen is to protect the uterine lining; no uterus = no progestogen needed (ovaries are irrelevant.)
You are unlikely to have come to any harm with taking them for a few days.

Hi Pinkrosa yes the pills are definitely "Prempak-C 0.625mg/0.15mg coated tablets, conjugated Estrogens and Norgestrel" this is exacly what is written on the front of the box, I will also look out for that book, thanbkyou for your help and advice, very much appreciated.

Thankyou I will also get this soya supplement!

With respect, before spending any money, I wouldn't just go out and buy a soya supplement on the recommendation of someone randomly posting without knowing why or what it was for! I mean what has this got to do with the thread anyway?

Bellaciao I was open to trying anything that might help my symptoms, anyway I have been back to my Doctors, she made a bit of a stink saying I hadn't informed her that I didn't have a womb only my ovaries, I am 100% positive that I did tell her, I have now been given Premarin, so fingers crossed this one helps!

My blood test came back and I have been informed I also have an under active thyroid, maybe this his caused my weight gain too, anyone else no anything about this please?

If your blood tests show you have an underactive thyroid then yes this definitely causes weight gain! What was your TSH reading and are you being treated? You might like to post a Q on the general health boards as there are other women like yourself.

Oral oestrogen interacts with thyroid medication so ideally you would be better of using transdermal oestrogen (gel or patch) rather than Premarin, if you are taking thyroxine.

Hi again, I am new to this so I am just going to put on here what is on my results they printed out for me, hope you understand it better than me -: Serum TSH level (XaELV) = 17.97 miu/L ( 0.27 - 4.2) Above high reference limit. I have been given "Levothyroxine 50 micrograms". Looks like I am gonna have to go back to the docs and change my HRT, to transdermal oestrogen, whatever that is, will look it up. I appreciate your help Bellaciao.

Wow that is quite high. Presumably you have other symptoms eg extreme tiredness, weight gain, feeling cold etc? It may be OK re the oral oestrogen. As far as I remember it mainly apples to women who have been on thyroid medication for some time and are stable, and then start taking HRT - as it alters the amount of thyroid hormone available.

For example this is what it says under the product info for Climesse (a type of HRT): "Thyroid function should be monitored regularly in patients who require thyroid hormone replacement therapy and who are also taking oestrogen in order to ensure that thyroid hormone levels remain within an acceptable range". I wouldn't worry now - it's not going to do you any harm - but if you were going to change at some point perhaps better to start now on the ideal HRT at the same time as you start the thyroid meds. Transdermal oestrogen is one that goes through the skin ie is a patch or a gel.

If you think you're going to be on HRT for some time then I would use a bio-identical HRT (estradiol) rather than one consisting of a mix of horse oestrogens. See my first reply in this thread. it is an old-fashioned type of HRT and happens to be the cheapest so docs will often try women with this first! All the risk data currently quoted, were obtained from a large study of women using this oestrogen ( however absolute risk of adverse events from using HRT is very small).

Hopefully you're going to feel a lot better really soon!

Thankyou again Bellaciao, yes I did put on a lot of weight over 3 stone in about a year, I was very very tired had no energy at all, I put it all down to the menopause, only thing I have not experienced was being cold, as I had that many hot flushes I was always hot, I am pleased I had the blood test or I probably wouldn't have found out about my thyroid, my daughters friend is a nutritionist and very good at planning diets for the individual person, she has had loads of success stories, she is going to help me, however she has told me I cannot go on a slimming diet, I have to just eat certain foods which will help keep me healthy and hopefully lose some of this weight, fingers crossed, once again Thankyou for your advice you were better than my Doctor!