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Need advice on Bi-Est & Progesterone Troches Need advice on Bi-Est & Progesterone Troches

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  #1  
Unread 01-17-2001, 04:01 PM
Need advice on Bi-Est & Progesterone Troches

Hi all - I am new here, trying to figure out this hormone madness on my own for too long, so thought I would check in here. I just switched from oral Bi-Est 2.5 2Xday and 100 mg. progesterone 2X day - - and started last night on troches, same Bi-Est and Progesterone doses as above. I am having what I think are symptoms of low absorption - black depression, fighting back tears, and the terrible bloating is back - clothes I could wear a few days ago are impossible today. These are the symptoms I always get when I am not getting enough hormones. I had these same symptoms on Bi-Est 1.25 2Xday & Progesterone 50mg 2X day, so increased to 2.5 Bi-Est & 100mg Progesterone 2Xday a few weeks ago, and it helped ALOT at first - for about a week - then the symptoms started coming back. I thought maybe I was not getting enough absorption with the oral route so that is why I asked my Dr. to switch to the troches. But since I started them last night, there is no difference, it's like I am not taking anything at all, the symptoms are so bad today.

Does anyone know - is there a waiting period for the troches to get the hormone levels back up? I keep trying to take charge of my own health care and go the most natural route,and I have a really nice doc who is willing to let me try different things, but am not having much luck. Last summer I tried the patch. At first it seemed perfect, I felt better than I had in a long time. But then after about three days I hit a low that was pretty bad - a lot like the one I am having today, as a matter of fact! Sorry this is so long and thanks for any info you can offer.

Cath
  #2  
Unread 01-19-2001, 12:58 PM
Good ? for Lauren...

I have no experience with Troches, but perhaps LaurenRPH will be by shortly. Yo might want to consider emailing her by clicking on her name above if she doesn't swing in a little later.
  #3  
Unread 01-19-2001, 01:20 PM
Need advice on Bi-Est & Progesterone Troches

hmm. I had the opposite thing happen, but share it with you just in case it can be a clue of any sort. I recently switched from oral estrace, oral compounded progesterone (like Prometrium, only weaker) to progesterone troche and letting the estrace dissolve by my gum. I found I had to cut the troche into l/4th the size because I was absorbing 4x the amount compared to the pill! I went estrogen dominant immediately, and cut the pill in half. I still had swollen boobies, nervousness, etc. Since I couldnt' cut it any smaller, the doc switched me to the patch.

In general, most women absorb much more into their bodies through the dissolving method than they do the swallowing method. The liver takes a bunch of it out when we swallow it. When it dissolves, it goes into the blood stream directly rather than going through the liver as a peak load.

hmm. Did you try letting the troche dissolve slowly by placing it between the gum and the lip near the back? It takes around 10-20 minutes for mine to dissolve. If you suck on it, or have a ton of saliva so it dissolves quickly, that's the same as swallowing it. Its supposed to get absorbed through the mucosa.

Its always possible that your mucosa don't absorb well, but that doesn't seem likely.

If I had to guess, I'd wonder if you weren't getting a huge dose of prometrium -- that can certainly cause the black depression, weepiness, and even the bloating. (It can also help bloating - depends on the individual and the dosage amount.) For example, in my body -- switching to troche would have increased the prometrium from l00 mg to 400 mg, just by changing from swallowing.

Prometrium/progesterone can build up in the body -- It can feel wonderful at first, for a week or two, and then start causing the above symptoms. It all has to do with the balance between progesterone and estrogen too. I could be completely off in all this. I hope I haven't confused you even more.

When you tried the patch,and it felt good at first, what were you doing with the progesterone?

Also, is it possible that the compounder could have made an error?
  #4  
Unread 01-19-2001, 08:57 PM
Need advice on Bi-Est & Progesterone Troches

I take almost the exact dosages you describe for progesterone troches, but take half that dosage for my bi-est.

Troches are an immediate dump into the system. I have no idea how old you are, but I know that I was in the meno stages when I had my hyst. I've switched from HRT to HRT until I found this particular dosage for me...and its working the best. I've been on it for a year and a half...

Do you have any energy? Depression always makes me think of too much progesterone....and too much estrogen makes me anxious and revved up.

It takes enough estrogen...and then enough progesterone to balance that estrogen for me.

I wonder if you are getting too much progesterone? Bi-est is mostly the estriol....which is very mild estrogen. Maybe you are tilting the balance too heavy on the progesterone side?

I do know this: We are all so different. What makes me go off the charts is perfect for another gal. What makes her slink off into the jungle babbling to herself may be perfect for me.

Hang in there....you are on the right track and in the right place. We don't have all the answers but we like to cheerlead and offer raspberry tea and chocolate to make your journey through the jungle easier just by being here.

  #5  
Unread 01-20-2001, 12:28 PM
Need advice on Bi-Est & Progesterone Troches

Thank you for all the incredibly helpful information! I think you are both right, Bethany and Kathy, about the progesterone causing the depression because I am not balancing the Bi-est properly. The bloating seems to happen if I don't get enough estrogen, but also of course if I get too much I swell up. I also get those jittery and high-anxiety symptoms on too much estrogen - it's such a fine line. I get panic attacks and want to crawl out of my skin, and it can also cause me to hyperventilate if I take too much estrogen. I wonder if this is because of my natural metabolism always having been kind of hyperactive?

Anyway, here is what I think I will try at this point - cutting my doses down, while at the same time dissolving the troches along the gumline for better absorption. I had not known about the matter of the excessive saliva reducing the effectiveness of the dose, but it makes perfect sense, and when I tried the transbucal (?) method yesterday after reading Bethany's post I found it much easier to control and I also didn't have all that saliva collecting under my tongue like I did with the sublingual method. Maybe my doses have been too high and also too inconsistent due to the method of delivery. Starting today I am taking 1/2 of the 2.5 Bi-est troche (1.25) morning and night, and will try only one 50 mg. progesterone troche at night. So far this morning I feel better than I have all week, after taking this morning's reduced Bi-est dose and no progesterone. I feel more cheerful and much less bloated.

Hopefully this will calm things down - I'll let you know. Kathy's description of a sister slinking off into the jungle babbling to herself hit a little too close to home, I have felt like a basket case lately! Thanks again - from my heart!

Cath
  #6  
Unread 01-20-2001, 02:43 PM
Need advice on Bi-Est & Progesterone Troches

Wow. I know how important this board is . . .a place where we women can share with each other from our experience. I feel really touched by your post. Let's hope this is a good solid next step on your path. . .
  #7  
Unread 01-22-2001, 07:45 PM
Need advice on Bi-Est & Progesterone Troches

It's only been a few days, but the improvement I noted upon first lowering the doses did not continue, and I am suspecting that it is still perhaps too much progesterone. Bethany wrote that changing her progesterone from oral to troche could quadruple the dose in her body, and I have been thinking about that a lot...as my symptoms keep fluctuating. Another big clue is that I have been constipated ever since starting the troches (not completely but close enough for a lot of discomfort) and that makes me suspect the big P as well. Hmmmm...

I still have my uterus, (I only lost one tube, one ovary,and about a mile of intestine to the tumor) so I have been taking the progesterone to protect the uterus. I have only been taking the progesterone daily for about a month, because I thought it might even out my symptoms to just go continuous since I have not had a period in several months anyway. But if my body reacts anything like Bethany's and this measly 50 mg of Progesterone is equating to 200 mg. because it is taken via troche, then that is still quite a wallop of Progesterone opposing the 1.25 Bi-est twice a day.

I am tempted to try taking 50 mg transbucal progesterone only every other day, but if it is out of the system within 12 hours as I have read, then does it do any good? Is Crinone an option here?

One other symptom I find a little surprising - I have mild acne that shows up with the estrogen and calms down with the progesterone. Isn't that opposite? The only other good thing about the progesterone is that it does seem to be a powerful diuretic for me. Any comments are most welcomed.

Cath
*One tube and one ovary removed at age 25
*Three miscarriages,all during 1st trimester (low progesterone?)in early 30's
*First symptoms and beginning of HRT jungle at age 42
*Now 45 and still swinging from branch to branch!

  #8  
Unread 01-22-2001, 07:57 PM
Need advice on Bi-Est & Progesterone Troches

Dear Cath,
Bless your heart. How hard this must be for you. I know the struggles you are going through. I was not able to tolerate the progestrone troches. They dumped too much into my system too quickly. I would become so sleepy, fatigued, blue and out of it immediately - even before they finished dissolving. I do much better on Progestrone cream. I did use Tri-Est troches for a long time but kept getting headaches immediately so had to break it up over 5x a day. I've finally settled on patches but even with that have to use 2x the normal amount. Keep in mind that we are all different. Our skin absorption rate is different. I can't tolerate oral estrogen. It is absorbed too quickly for me. Don't give up the battle. You deserve to feel better!!! Hang in there - I'm sending prayers and hugs your way.
  #9  
Unread 01-22-2001, 10:37 PM
Need advice on Bi-Est & Progesterone Troches

That is interesting, Jill, that you were unable to tolerate the progesterone troche and yet had to double up on the patch. My compounding pharmacist said that, as with everything else, we are all different in terms of our skin, some are more oily, some thicker, some drier, some thinner - - all contributing to the different rates of absorption. So you are using the progesterone cream now, and the estrogen patches, correct? What are your dosages?

Also, I would be very interested to know how you determine when you have hit upon the right formula...I have changed a lot, and sometimes I feel that I should stick with this regimen or that for a longer trial run, but it is making me so crazy that I end up making a switch. I DO have to hold down a job, and sometimes that is QUITE a challenge! So can anyone tell me - how do I know when I have hit "pay dirt"? I already feel better about the Bi-est (and even Tri-est before that) along with the compounded progesterone, because even when I was taking them orally before the troches, I was able to sleep through the night, and even have dreams again, for the first time in over a year. When I was taking Estrace and Prometrium I had to take Ambien or Sonata to sleep, sometimes twice a night, once at bedtime and then another .5 dose at 2 or 3 a.m. So this tells me that my body likes the naturally compounded formulas better for some reason.

Thanks, Jill, I appreciate your kind words, and wish you all the best of luck as well (another Texas gal here.)

Cath
*One tube and one ovary removed at age 25
*Three miscarriages,all during 1st trimester (low progesterone?)in early 30's
*First symptoms and beginning of HRT jungle at age 42
*Now 45 and still swinging from branch to branch!

  #10  
Unread 01-22-2001, 10:49 PM
Need advice on Bi-Est & Progesterone Troches

Okay, here is another thought or two....

I've heard from some that there is some evidence that the body needs a rest from progesterone. That the estrogen receptors need a break from the sensitivity that progesterone creates. SOme doctors suggest cycling the progesterone (mimicing the ovaries). This doesn't work for everyone (as Adrite has suggested...with a history of endo, the consistent balance is what works for her) as in the hormone jungle we've learned what works for one, doesn't necessarily work for another. Environment, genetics, general lifestyle, etc...all play into the individual needs.

But perhaps, you might need to cycle that progesterone? Cycle it not by every other day...but get off it completely for a week....and then get back on it for 3 weeks. Let it completely leave the system and give those receptors a break.

I'm just guessing since I'm not a doctor....nor am I a pharmacist...but maybe Lauren can remember where I can't about the reasons for cycling...?

I hope you feel better soon!
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