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Estradiol only or biest? Please help Estradiol only or biest? Please help

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Unread 07-10-2004, 10:02 AM
Estradiol only or biest? Please help

I have been taking biest along with progesterone and testosterone for about 2 months. The dr has upped the biest to from 2.5 to 5 since I was still having hot flashes. Today I was reading that biest is 80% estriol and 20% estradiol and that estradiol is the form of estrogen that your body makes in your youth. Estriiol is most abundant during pregnancy and is the weakest form.

Here's my question/observation - why would I want to take more of the estrogen that is the weakest and can you get just the estradiol at a compounding pharmacy? Thanks
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Unread 07-10-2004, 02:27 PM
Estradiol only or biest? Please help

Hi Yes, you can get just compounded estradiol. That would be equivalent to taking Estrace, which is also just estradiol.

Some DRs prefer to prescribe bi-est rather than just estradiol because there is some evidence that estriol is preventative or at least not as harmful as estradiol in terms of aggravating certain types of cancers and endometriosis. It's just not as effective for vasomotor symptoms, which is why it's mixed with estradiol. However, estriol by itself is wonderfully effective for vaginal dryness; I use it myself in the form of a vaginal cream.

Also keep in mind that when you take oral estrogens, what reaches your bloodstream is not what you ingested. Most of it is metabolized into smaller molecules that are either excreted or have different effects in your tissues. Have you considered using a bi-est cream rather than the oral bi-est, to avoid that 'first pass effect'?
Unread 07-10-2004, 04:33 PM
Estradiol only or biest? Please help

Thanks for the reply - I'm already taking the biest cream (5) upped from 2.5 and the progesterone(25mg) and testosterome cream(1) for 3 months now and am still having hot flashes. I am cycling the progesterone cream right now from 10-18 but starting today I'm going to take it from the 1-26. My appetitie for sweets has increased dramatically, blood pressure has gone up and I"m having difficulty breathing. Problems I wasn't having before I started the hrt. I guess I'd better call the dr monday - but I've been reading Dr Erika Swartz's book all week end and she only prescribes estradiol. I'm confused like alot of others here and was concerned about taking the extra estriol which makes up 80% of the estrogen. I don't understand why.
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Unread 07-10-2004, 04:40 PM
Estradiol only or biest? Please help

I think calling your DR is the best thing you can do right now. I wouldn't put too much stock in what one DR does... that DR isn't YOUR DR who is familiar with your particulars. Also remember that most of these books are written with women in natural menopause in mind. Is that why you are cycling the progesterone too? Most women in surgical menopause who use progesterone use it continuously rather than cycling. Mere fluctuations in hormone levels can cause hot flashes, so that is something to consider. Cycling your hormones may not give your body a chance to adjust to one level and settle down. Cycling is great imho for ladies who still have ovaries (even if they're only limping along), because they still get subtle cues as to when to cycle, whereas the rest of us don't.

Most DRs who prescribe bi-est or estriol do it to reduce cancer risk, or to try to mimic the natural distribution of estrogens in the body.

Let us know what your DR says, OK?
Unread 07-11-2004, 12:34 PM
Estradiol only or biest? Please help

Thanks again for the reply. After reading all day yesterday - I think I'm going to discontinue my biest and testosterone and only take 20mg of the progesterone cream until the 26th of the is month. Then have a saliva test done and continue with just the progesterone until I get the results back. I'm supposed to have blood work done with my dr the middle of August. The more I read I'm beginning to believe I have estrogen dominance.

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