OK, time to mess with the mix here....need advice from estrace & testosterone experts

As bad as I hate to start messing with my HRT regimen, I have finally taken the bull by the horns, so to speak. I feel great physically (on Tri-Est compounded into capsules with micronized progesterone). BUT (don't you just hate that word) I have been experiencing, uhhhh, dryness, sometimes even feeling like a UTI is just around the corner (and have had several UTI's since my TAH/BSO for endo on 2-22-00). Also, my libido has gone AWOL the past couple of months, and I finally took pity on my DH and decided to try and remedy this situation. I have spoken with my compounding pharmacist and with my gyn.'s nurse and they are prescribing estrace cream and micronized testosterone capsules (1 mg. capsules to be taken twice daily). Anyone out there have thoughts or input? Is this dosage of testosterone going to give me acne or a beard? Geez, I'm scared of changing my HRT program! Lauren, anyone, what do you think?!!

Lisa B.

Lisa,
I am not an expert and don't know much about micronized testosterone in it's pill form. When I was taking the cream I only used .25ml per day. 1 mg sounds high to me, but it may need to be higher due to it's form, just guessing here. Hopefully, someone will be along shortly to give you a more definitive answer. Good luck and I'll be keeping my fingers crossed for you.
Hugs :-)

Thanks Kim,

I went to my local pharmacy today to pick up my Estrace cream, and after getting back in my car looked in the bag and the gyn.'s office had called in a Rx for PREMARIN cream rather than Estrace cream. Aaarrggghh!!! I've called back and left a message on the nurse's voice mail that the reason I was going the compounded Tri-Est route was to avoid Premarin and its possible side effects, so naturally I wouldn't want the Premarin cream!

Hope I have better luck when I go to the compounding pharmacy (75 miles away) to pick up my micronized testosterone capsules!

I hope all the trouble it's been getting this Estrace cream and compounded testosterone will be worth it!

Lisa B.

Lisa,
Sometimes the doctors just don't get it, do they?
I recently had a doctor's nurse tell me that he couldn't help me with my hormones because I didn't want to take synthetics. Than she calls me back 3 weeks later and say the doc WANTS to see me.
Good luck and be sure and let us know how the new hrt is working for you.
Hugs :-)

Look at it this way--that guy Sean on Survivor is a med student--argh!

Since Premarin has all these extra steroids wandering around that are still being identified, I'd say that holding out for the estrace is a good choice.

I'm wondering whether starting lower and edging the dose upward wouldn't be a good idea, since you're in such great balance otherwise. Seems like that might an easier way to hit the right amount.

I think you're the explorer of this route around here. We'll have to tag along afterward finding out how you do (handing you a machete and a canteen of raspberry tea).

I think that the conceptual approach sounds great, but that the questions the others have pointed out are good ones. I'd hold out for the estrace cream, too--even though creams aren't supposedly systemically absorbed, why borrow confusion? The testosterone sounds like a high dose, but most recommmendations start with a week or two of higher doses to replenish, and then taper down to maintenance. I suspect you'll see higher oral route losses, but don't know. Lauren may be able to clarify that for us. But it may be that you can cut that dose back soon, and I'd certainly check to clarify that. It seems that the early warning signals on testosterone are oily and zitsome responses, so I'd be alert for that and grab a quick level if anything gets off along those lines.

Be prepared for a little hormonal readjustment with the addition of the testosterone, too. That will free up some progesterone that was going to testosterone production, so that realignment will have to work its way through all the associated hormone systems and feedbacks. This isn't going to be dire, but you may notice niggling signs of imbalance till all the pushing and shoving is over. [blue]

Kim you are so write this doctors they just want to push pills an you some times I think they don't even care,I feel like they want to experiment on me or somthing.

What is the difference between etrace and estradi-
ol? Is it the same thing or is it just that the estradiol is generic.

Estradiol is the hormone. Estrace is a brand of estradiol. [blue]

Okay, both new drugs in hand. Estrace .01% cream from hometown pharmacy, and the micronized testosterone from the compounding pharmacy 75 miles away!

Only curve thrown me by the testosterone is that he went ahead and mixed it with my ProTri-Est so that the natural progesterone, Tri-Est, and testosterone are all in the same pill. Amounts of each in the capsule are 100 mg. progesterone, 2.0 of Tri-Est, and 1.0 of testosterone, and I take 2 capsules daily. Guess if I start to experience any symptoms of testosterone excess I can get him to separate them out so that I can back off on the testosterone to maybe 1 mg. per day.

I'm also trying to remember something I think I read here about being careful with the Estrace cream insofar as it can be absorbed by DH if intercourse occurs too soon after using the cream? Anyone know a time frame here?

Any input here would be appreciated. Lauren, if you read this, what are your thoughts?

Lisa B.

While we're waiting for Lauren to come by, I can throw out a few thoughts. She's said it takes half an hour for spread-out/rubbed in creams to fully penetrate the skin so you're safe to shower. Since vag creams tend to be applied in lumps, though, I think that would tend to be different. It would depend in part, I suppose, on the volume of vag cream you're using. I was using just a dab on a fingertip when I had it post-op to boost healing, and it was pretty much spread by the time I'd gotten it where it was aimed. So I would guess that the more thinly you can apply, the faster the uptake. My gut feeling would be to pick a time of day when sex is unlikely and is as separated in time as possible from those times when you normally do have sex, and try to take the cream then. [blue]