going to dr today need advice quick!

Hi after alot of consideration, I am going to a new dr. today. I am 34 surgically menopausal. Have currently been using triest but have no energy or libido and have been quite depressed. I want to ask about using a compounded testosterone gel and hopefully get a perscription for it. Dr's around here aren't big into perscribing testosterone, so I am anticipating a bit of resistance. I have had dry hair and skin, vaginal atrophy that is not entirely responsive to the estrogen's that I have been taking. I am taking about 1.8 of my triest. I am so afraid that the testosterone will cause hairloss and hairiness where I don't want it but am also worried about my overall condition if I don't. My appointment is in a few hours and I am confused about the dose that I should request. I need to be able to be asertive when I go or I know that I'll never get anywhere. Also, does testosterone conversion to estrogen cause hairloss? I am having a hard time understanding this whole testosterone thing. Can someone who has a little knowledge on this subject please respond, cause I definately need a better quality of life.


shellynn

is requesting a full hormone panel and using that information to do the prescribing. It would help if you had the names of some local compounding pharmacists you could suggest to the doc as well. If they don't know the resources, they might just rely on the proprietory HRT's out there and not consider a custom blend.

Surferbabe is very familiar with the dosage of testosterone and likely will post soon. She is darn good on this issue and so are other sisters here. She is right on about the ability to tweak dosages using compounded drugs.

In preparation for my HRT second opinion later this month, I am compiling a list of symptoms for the doc. And I am being very specific about things like energy levels (rating it on a scale of 1-10) , frequency of night sweats and hot flashes. Doing it in a diary format and noting improvement I have experienced since upping my vivelle dot and doing 2 percent progesterone cream. The data might be of value. It may sound obsessive to some, but I think it is appropriate. With an appointment so soon, you might not have a chance to do something like this, so maybe if you just list the major problems, it will be a start until you get labs back.

One of the advertising links to College pharmacy has a questionaire of symptoms that might be of use to you. The compounding pharmacist I found asked extensive questions about my symptoms during our brief interview last week and we will do this more in depth once I consult with the new doc.

This is probably coming to late to help you today, but from my personal experience, my compounding pharmacist wants me to try tri-est and progesterone first and then add testosterone if I need a jump start to my libido. He is cautious about adding the testosterone because many of the side effects it can cause can't be reversed. That's potent stuff! My compounding pharmacist is one who insists that progesterone is a very necessary component to women who have had a hysterectomy. He explained why in depth - just wish I didn't have such brain fog so I could share what I was told. It made a lot of sense and I'm looking forward to trying it.

It's so confusing - hard to know where to begin and what questions to ask. I completed a very lengthy survey before meeting with my pharmacist. We reviewed it at my consult. I hope you are lucky enough to find someone you can work with. Let us know how you're doing!

Hi,
I have a different question for you....Have you ever just been on estrogen alone, as a patch or pill? Tri-est generally contains weak amounts of estradiol; maybe not even to relieve your symptoms, and you are young and might need more.

The bioidenticals are generally very well tolerated by women.

I would avoid progesterone if you are depressed or lethargic; it might make you feel worse.

good luck!

Thanks for your input girls. Cmcm is right about the thethatgic and depression. Every time I try and supplement my estrogen with Natural compounded progesterone I go into and immediate depression. I am not sure why it effects my this way as it is supposed to stabalize the mood. I am also worried that compounded testosterone will do the same thing. What is a girl to do. I tried using just estrogel for about a year before I switched to the triest. It worked okay except for causing a water in the left ear type feeling which set me off balance. It got progressively worse until I tried the triest. With triest alone, this feeling left me and I did quite well for a few weeks until the crashing fatigue hit me. The type where I couldn't even motivate myself to get out of bed. And then depression and aggitation. What works one day doesn't seem to work the next. This is all so scientific, and thus far I have had horrible luck in finding a dr. that will work with, me. The reponse I get is take your medication things will be okay. But it never is. I am so frusterated. My appointment is over an hour away and I feel so overwelmed that I can't even bring myself to drive there. Almost like a panic feeling when I think about getting behind the wheel. My dh took the afternoon off to go with me. I have put him through so much lately. I feel so angry one minute and cry the next. This hormonal stuff is awful. I don't even want to see the doctor on my own because I'm scared that he won't help me. I'm supposed to be a "Big girl" now but I just can't cope. I truly feel on the verge of a breakdown. Also of course I worry about the hairloss issue. In the past month since being on triest, I feel like I've lost more. Would this mean that it isn't strong enough or too strong. It is so awful to have to deal with such major decisions when you feel like this.

shellynn

take a deep breath! You have a lot of power and input into your health, really you do. You have the power of observation on a daily basis your doc doesn't and you can provide that information to the doc so he can help you.

Specifically, what happens when you do the progesterone? Write that down. What were the bad side effect to each of the estrogen preparations you used in the past? Write that down too. Valuable info in your observations here and you doc can use that to eliminate things that don't help and find you what does help. Can you list the reasons you think progesterone is wrong for you and testosterone might help? What is the down side to testosterone for you?

You mentioned side effects like hair loss. Can you describe when that started occuring and what med you were taking? How severe is it? Helping by quantifying these events also helps the doc.

Taking your dh with you is a grand idea. I know when I am upset, sometimes I don't retain information really well and it helps to have a second set of ears there. It also helps to have a concerned person with me for moral support.

You don't have to address all these questions to the board, but your doc. You are going to be listened to at this appointment. If you aren't, enlist your dh to help guide the convo back to the problem. And if your doc isn't willing to help, find another doc if you have to. I did just this and feel better about it already even tho I haven't had my second opinion consult yet. It's perfectly normal to feel anger when you expect help and get your impressions discounted. Docs can be a bad fit sometimes and docs can be wrong. Doesn't mean you aren't in charge of your own health.

Well, It is another day now. I did take husband with me yesterday, and found him to be quite and asset. We went through the process of giving my history. I quite liked this dr. and felt like he was concerned and listened to my feelings and difficulties. He didn't feel like progesterone was a good thing for me, except perhaps in the form of birth control pills. I explained my reactions to them in the past and we both decided not to go there. I was dissapointed that he would not give me a perscription for testosterone even after I explained why I wanted it and how I thought it would benefit my problems. He doesn't like giving testosterone to women or men for that matter because of the long term effects that haven't been studied yet. I happen to think that I would like to take my chances because quality of life to me is more important then quantity. Anyways we ended with a referal to a dr. that lives a few hours from me. He is a hormon specialist and maybe can run some proper tests on me to see where things are at. The only problem is it'll be a long wait. I told them I'd be glad to take cancellations. The waiting game begins again, i'm expecting it'll be feb. or march. I do feel a bit better today, mostly because of the helpful advice from this board and the care of others.


Shellynn

Shellynn,
Have you had your thyroid tested? Hair loss and fatigue can be a sign of a thyroid imbalance. Alot of symptoms cross over and sometimes it is difficult to determine what is causing what. I think it would be worthwhile to at least have it checked. If your thyroid is out of whack it can make finding hormonal balance very difficult.

Have you read the pull down menus at www.hormonejungle.com ? There's some good information there about hormones, symptoms of imbalance, necessary supplements to take and some very good articles about some of the issues confronting those of us in surgical menopause.

I'm sorry you have to wait so long for your appt with the specialist. I will say a er that the specialist will be able to help you find that place called hormonal balance.

What's vaginal atrophy??

certain tissues in our bodies are hormone sensitive and when our levels are off, the tissues can be less dense and flexible than they were in our menstrual prime. Proper hormone levels being maintained prevent this from happening. This situation is not limited to surgically menopausal women either. Women who progress thru natural menopause can have this occur. It isn't as prevalent as other menopausal symptoms like hot flashes.

To give you an example, as I age, my breasts which are hormonally influenced, lose their fight with gravity and become less dense. So does my facial skin. Wish this didn't happen but unless we have widespread insurance reform and plastic surgery is approved for cosmetic reasons, I am just sunk. Women who are menopausal also have to use sexual lubricants to make up for the lack of moisture in the vaginal tissues. Hormones provided that before. Lots of remedies to the problem and nothing to really worry about. Just an inconvenience.

Even if I hadn't elected for bilateral salphingo-oopherectomy, I have no way to avoid the risks since I can't make my ovaries work forever. Well, I could, but I intend to live to a ripe old age and the alternative isn't worth discussing. At least we have options with HRT that weren't available to older generations of women.