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Weaning off Estradiol? Weaning off Estradiol?

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Unread 10-08-2007, 06:40 PM
Weaning off Estradiol?

Hi everyone. I am a couple of years post-op and have been on HRT since surgery. My DH is a Nurse Practitioner and has asked me to reduce and eliminate my hormone therapy, based on his medical research and beliefs. I honestly have found no real benefit to the HRT, except for keeping the hot flashes to a minimum. I have ZERO sex drive, and have been that way since surgery. I take Effexor for generalized anxiety disorder (which got much worse after the surgery) and Trazodone for insomnia. I have been on the Vivelle Dot, Estratest, and Estrate and now Estradiol. I have never had blood work done to check my hormone levels. We currently are without insurance, so I can't have levels checked to see if they are beneficial anyways...I guess I am just feeling really frustrated at this point. My husband, a medical professional, is counseling me to get off hormones......any words of advice or support out there?
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Unread 10-08-2007, 07:09 PM
Weaning off Estradiol?

Kelley715 I have only been post op since June 6th. My doctor put me on premarin .3mg for about a month and then I took .45 for 2.5 month. I went off of it 2 weeks ago today and I feel so much better off of it. I do not have as many hot flashes or night sweats now. I hope one of these days I don't get slammed with nasty menopause symptoms. One thing that confuses me is the weight gain. I work out every day! I either walk 4.5 miles with my great dog Jack or I take butt kicking exercise classes! I gained 13 lbs since my surgery in my middle section! UGH!!!! I thought maybe I was getting too much estrogen? I don't know? My doctor is totally okay with me off of the estrogen. He only wanted me on it for 3 months or so . He doesn't want patients to confuse recovery with menopause symptoms.

My sister was on Premarin for 19 years! She started seeing a new doctor and he weaned her off of it. She is 59 and occasionally gets a hot flash. But she is okay otherwise.

I hope you figure out what is best for you and that it works for YOU!
Unread 10-08-2007, 07:22 PM
Weaning off Estradiol?

I too am on the "patch", just shy of two weeks from surgery and my doctor said she put me on it too so I would not have hot flashes, etc. interferring with my surgery recovery. I am concerned with the long-term cancer risk. My mother had breast cancer at 42, and my grandmother in her 60's, so I am at risk. Hoping that the doc will suggest going off when I return for check up on 29th. I'd like to not take drugs for menopause if possible!
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Unread 10-08-2007, 11:00 PM
Weaning off Estradiol?

The best advice I could give you in this situation is to see your own physician, and not consider your DH, nurse practitioner or not, a substitute for an MD who is familiar with your medical history. This is for his protection as well as your own. How would he feel if, for example, at his urging, you discontinued your HRT, and then had a heart attack or other serious medical emergency? It would be hard not to hold him responsible, and I'm sure that's not something you want in your relationship.

Interesting that you should say you found no benefit to being on HRT. Most of the things HRT helps are more or less 'silent' - for example, bone density, which doesn't really become obvious until you start breaking bones, and at that point it's too late to fix it. If you discontinue your HRT, you need to be getting regular dexa scans, and if you're not seeing a DR, that's not possible.

You mention a lack of libido since the surgery despite taking (for some period of time?) Estratest, but you also mention taking Effexor, which is known to affect libido.

You mention taking Trazodone for insomnia; yet insomnia can be caused by lack of estrogen.

Perhaps if you were to get your hormones balanced, you might not need the Effexor and Trazodone?

Since it came up on this thread, I'd also like to mention that using bio-identical estrogen (such as the patches) does not put us at increased risk for breast cancer. Careful analysis of the WHI study data showed that women on estrogen-only HRT did not experience any increased incidence of breast cancer. However, women on Prempro, a combination of Premarin (estrogens) plus Provera (a synthetic progestin), did experience a slight increase. Basically, in a population of 1000 women on a placebo, 3 of them got breast cancer during the study period; in a corresponding population of 1000 women on Prempro, 4 of those got breast cancer during the study period. It's barely even statistically significant, AND it was only the group on the combination HRT Prempro, not those on estrogen-only HRT.

Good luck with whatever you decide to do - and whatever that is, I hope you'll be able to find a way to get proper medical care: on HRT, to find the right balance; or off HRT, to make sure you're staying healthy despite the lack of hormones.

Unread 10-09-2007, 06:06 AM
Weaning off Estradiol?

I am with surferbabe on the silent benefits. A year ago I had a dexa scan and was diagnosed with osteoporosis. Previous to this during my first year after surgery I had my blood levels of hormones tested and everything was in post menopausal range. I was not absorbing my hrt and was having many symptoms.

After that dexa scan, I took many steps to fight this life threatening disease. One of them was to find an hrt my body absorbs. I switched to the Vivelle Dot patch and my levels increased dramatically. I can't say it is the perfect hrt for me and I still struggle with serious problems as a result of instant surgical menopause, but it has helped some symptoms. I have also taken supplements like calcium and vitamin D (by the way without adequate estrogen our bodies can not absorb calcium to the bones), exercised, improved my diet, etc...I have not taken any bisphosphonates like Foxamax or Actonel or Boniva due to harsh side effects and long term potential problems they cause with bone reformation.
A few weeks ago I again had a dexa scan and my scores have improved considerably in my hips and slightly in my spine. So yes the hrt has made a difference for me. Without it I am sure my scores would have been worse. For me I would rather risk the chance of cancer in the future that I may or may not get based on incomplete/inadequate studies than suffer debilitating fractures and life threatening complications from a much more common and just as deadly disease as osteoporosis.
All women in surgical menopause are automatically at risk for osteoporosis. It may not be apparent right away like mine, but it is there.

Certainly whether to remain on hrt or not is a personal decision, and I hope you make that decision based on your own personal research and needs. Good luck!
Unread 10-09-2007, 06:43 AM
Weaning off Estradiol?

Thank you, Linda and Naturebound, for saying it so well.

It's so easy to have a knee-jerk reaction to all the bad press about HRT - but in the end we have to remember that we are just not in the same category as women in natural menopause.

In fact, if one is to dig deep into the infamous WHI studies, there was a segment of the study on oopherectomized women who took estrogen only. They actually had a decline in breast cancer rates. It was statistically too small to be of much significance, but it was a decline nonetheless.

My personal stance is that I face far greater health risks from NOT trying to replace the hormones that my ovaries would be giving me if I still had them. Breast cancer is a scary beast for any woman - but for some reason we fear it more than heart disease, which will strike FAR more of us than cancer will. I can tell you from personal experience, the high blood pressure that I get when my estrogen is too low HAS to be bad for my heart and the rest of me.

Thanks again for your thoughtful replies.

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