First of all, thank you so much for your work, knowledge and thoughtfulness in sharing. I'm so grateful to have found you. Perhaps you've shared this previously, so happy to be redirected if so - do you have recommendations about how to evaluate providers? I am not happy with my obgyn and need to start the process of finding a better fit. Thank you!
Thank you!!!!!! I reached out to my gynecologist last week with all the research I had done on MHT not being a contraindication to migraines with aura -- and she still refused. So I'm switching to a new one and hope I can show her this at my appointment in two days.
What about weight gain with HRT? I’ve been on the patch and pill for about a month and a half and my weight has crept up by 4 pounds. I’m not beating myself up over it, because from what I read there might be a slight increase the first few months. Not sure on the logic behind this or if there is any so I would love to hear your thoughts on the matter. I do strength training and HIIT 5-6 days a week, and I feel good and strong in my body right now, but wondering if I need to tweak my programming and nutrition.
I would love to know more about hormone therapy and mood. I have been taking the pill for 30 years, and it makes me feel emotionally stable. When I have gone off it, my PMS is horrific. In your book you briefly mention that for some women the pill does have this mood effect. I wonder what I should be thinking about as I get closer to menopause. I am 50, with irregular periods, still on the pill. I tried a lower dosage pill byw and after 2 months my mood became very bad. Also when can I stop contraception?
As of today the 25,50 and 37.5 patches Estradot as well as the Sandoz (generic) and Climera patches are not available at all here. 100 patches are which means cutting them in half as they are matrixed. Vagifem or premarin cream can be obtained by prescription.
When my reproductive endo started me out on HRT a few years ago - we tried the patch, then oral and now we've gone to injectable to get my estrogren levels to where he wants them. I have PCOS, so "normal" cycles were never a thing - I had really bad cramps from age 15 on (like in bed for 3 days bad); was on oral BCP from 17-40 before coming off after my marriage. A few years after my marriage, started having breakthrough bleeding - like high school all over again, my gyno (at the time) kept upping my progesterone (bio-identical cream that he compounded in house). I finally opted for an ablation - and the surgeon found a fibroid, so we cut that out, did the ablation and I have't bled a day since. Was diagnosed w PCOS and sub-clinical hypothyroidism (75 mg NDT for treatment) about 6 years ago, and have been on estradiol injections, 3mg every 5 days. You often talk about oral and patch options, how common is injectable estradiol for HRT used? Anything I should be extra aware of?
Many thanks for this article. Pls I thought of using this opportunity of asking this question here. Is there anyone here attending the AAGL (Gynaecology) virtual conference in November. I thought we could pair up cos it’s cheaper if we do. 👍
Estradot 50 is not available here nor in the UK or Australia. The 25 patch issue is now resolved. 100 patches are available here. I read that Bayer will be stopping the production of the estrogen only patch next year. In regards to thyroid requirements, I can not use any form of estrogen without a dose increase of levothyroxine, at least I have that figured out and have an idea what dose I will require. Women on a replacement like myself perhaps have more issues with medications. I also would like to ask (and certainly you do not have to answer) you are presently using estrogen are you intending to stop using it after 5-7 years knowing that any osteo issues, dryness etc will start once you stop?
Thank you for the information on thyroid and use of MHT . There is a significant amount of conflicting information in recent journals/studies which makes all of it confusing. I am not trying to initiate transdermal estrogen in my 60's I am trying to restart it based on symptoms (hot flashes for sure which are not related to another illness, had every test known to man). I have read that a low dose (25mg) for 2-6 weeks then increase it up to only 50mg patch is advised is this correct? There is a world wide shortage of patches presently is the estrogen gel the best alternative? Thanks
Thanks for this info! On the migraine topic, when contraceptives are contraindicated... Is transdermal estrogen at all effective for helping control menstrual mayhem?
OK, so how worried should I be that I've been on norethindrone/ethinyl estradiol birth control for a couple of decades and I have migraines?? (which I definitely reported to my docs) Gah!
Hi Dr Jen, off topic but having so much trouble! Asked my doc to do a culture for yeast sensitivity and they said the only culture they know of is for diflucan sensitivity. I wanted to see If you had the name of one that tested for sensitivity to all yeast medications. Thank you
Gynecological Potpourri
Definitely would love a post on migraines and menopause with therapies that can work.
First of all, thank you so much for your work, knowledge and thoughtfulness in sharing. I'm so grateful to have found you. Perhaps you've shared this previously, so happy to be redirected if so - do you have recommendations about how to evaluate providers? I am not happy with my obgyn and need to start the process of finding a better fit. Thank you!
Thank you!!!!!! I reached out to my gynecologist last week with all the research I had done on MHT not being a contraindication to migraines with aura -- and she still refused. So I'm switching to a new one and hope I can show her this at my appointment in two days.
What about weight gain with HRT? I’ve been on the patch and pill for about a month and a half and my weight has crept up by 4 pounds. I’m not beating myself up over it, because from what I read there might be a slight increase the first few months. Not sure on the logic behind this or if there is any so I would love to hear your thoughts on the matter. I do strength training and HIIT 5-6 days a week, and I feel good and strong in my body right now, but wondering if I need to tweak my programming and nutrition.
I would love to know more about hormone therapy and mood. I have been taking the pill for 30 years, and it makes me feel emotionally stable. When I have gone off it, my PMS is horrific. In your book you briefly mention that for some women the pill does have this mood effect. I wonder what I should be thinking about as I get closer to menopause. I am 50, with irregular periods, still on the pill. I tried a lower dosage pill byw and after 2 months my mood became very bad. Also when can I stop contraception?
As of today the 25,50 and 37.5 patches Estradot as well as the Sandoz (generic) and Climera patches are not available at all here. 100 patches are which means cutting them in half as they are matrixed. Vagifem or premarin cream can be obtained by prescription.
When my reproductive endo started me out on HRT a few years ago - we tried the patch, then oral and now we've gone to injectable to get my estrogren levels to where he wants them. I have PCOS, so "normal" cycles were never a thing - I had really bad cramps from age 15 on (like in bed for 3 days bad); was on oral BCP from 17-40 before coming off after my marriage. A few years after my marriage, started having breakthrough bleeding - like high school all over again, my gyno (at the time) kept upping my progesterone (bio-identical cream that he compounded in house). I finally opted for an ablation - and the surgeon found a fibroid, so we cut that out, did the ablation and I have't bled a day since. Was diagnosed w PCOS and sub-clinical hypothyroidism (75 mg NDT for treatment) about 6 years ago, and have been on estradiol injections, 3mg every 5 days. You often talk about oral and patch options, how common is injectable estradiol for HRT used? Anything I should be extra aware of?
Many thanks for this article. Pls I thought of using this opportunity of asking this question here. Is there anyone here attending the AAGL (Gynaecology) virtual conference in November. I thought we could pair up cos it’s cheaper if we do. 👍
Estradot 50 is not available here nor in the UK or Australia. The 25 patch issue is now resolved. 100 patches are available here. I read that Bayer will be stopping the production of the estrogen only patch next year. In regards to thyroid requirements, I can not use any form of estrogen without a dose increase of levothyroxine, at least I have that figured out and have an idea what dose I will require. Women on a replacement like myself perhaps have more issues with medications. I also would like to ask (and certainly you do not have to answer) you are presently using estrogen are you intending to stop using it after 5-7 years knowing that any osteo issues, dryness etc will start once you stop?
Would love a post on what “liver disease” as a contraindication means. Any liver issue at all? Fatty liver? Mildly elevated AST/ALT <100’s? Thanks!!
Thank you for the information on thyroid and use of MHT . There is a significant amount of conflicting information in recent journals/studies which makes all of it confusing. I am not trying to initiate transdermal estrogen in my 60's I am trying to restart it based on symptoms (hot flashes for sure which are not related to another illness, had every test known to man). I have read that a low dose (25mg) for 2-6 weeks then increase it up to only 50mg patch is advised is this correct? There is a world wide shortage of patches presently is the estrogen gel the best alternative? Thanks
Thanks for this info! On the migraine topic, when contraceptives are contraindicated... Is transdermal estrogen at all effective for helping control menstrual mayhem?
OK, so how worried should I be that I've been on norethindrone/ethinyl estradiol birth control for a couple of decades and I have migraines?? (which I definitely reported to my docs) Gah!
Thank you!
Hi Dr Jen, off topic but having so much trouble! Asked my doc to do a culture for yeast sensitivity and they said the only culture they know of is for diflucan sensitivity. I wanted to see If you had the name of one that tested for sensitivity to all yeast medications. Thank you