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lots of hrt ?'s - can anyone help? lots of hrt ?'s - can anyone help?

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Unread 09-14-2006, 06:14 AM
lots of hrt ?'s - can anyone help?

I had a TAH/BSO on the 5th. I was put on the Estrasorb cream right away after surgery. (we were worried about the adhesive in the patch so thought we would try the cream first). (I have had an adhesive allergy in the past) -
about 2 days on the cream I began having hot flashes and sweats. I was using a package on each thigh at the same time each morning so two packages a day total.
yesterday I had a doc's appt - follow up - 8 days past surgery and told him of the horrid sweating at night and hot flashes.
We decided to give the patch (Vivelle) a try along with the estrasorb. So I now have a patch and am suppose to use one package of cream at night and if I need to go back to 2 packages to try that.
I go back in 3 weeks. Here are my questions. My doc never did any blood work to check any kind of hormone levels. Is this normal?
He also said eventually he will put me on oral HRT. Why would he say that? What is the difference and what is the benefits or Oral?
Can anyone help. Last night I had bad sweats again. Does it take the patch a while to work?
Thanks so much for your help
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Unread 09-14-2006, 06:18 AM
oh by the way the Vivelle dose I am on is .1

thanks again for the help
Unread 09-14-2006, 10:04 AM
lots of hrt ?'s - can anyone help?


I'm sorry that you're having those miserable symptoms. Early in recovery that's not unusual. Your body is depleting the stores of hormones made by your ovaries while recovering from major surgery and adapting to a new source of estrogen. Any one of those things is enough to cause imbalance. It's going to take some time for things to settle down so now is a time to try to be patient. I know that's not always easy to do.

If you prefer to use transdermal hormones and you find as time goes on that you're doing well on them, I think it's fair to request that you continue to have them prescribed. Not all women do well on transdermals, but then not all do well on the oral therapies, either. What you don't want to do is feel settled on one and then have it changed for no other reason than your doctor wants to prescribe an oral method of delivery. Here in the Jungle we say "If it's not broken, don't fix it."

Transdermal hormone therapy is absorbed through the skin and bypasses the digestive system. The oral hormones, if swallowed, versus taken sublingually (under the tongue) or transbuccally (between the cheek and gums) go through the entire digestive process and much of it is lost. To compensate, the amount of hormone in the pill is greater than what is in the transdermal delivery methods. My personal preference is to use the lowest dose possible to keep my symptoms under control and also to use transdermal.

It's not at all unusual not to have hormone levels checked, especially so early post-op. Those levels fluctuate and what they are now may be way different than what they would be in another day, week, or month. Prescribing hormones isn't an exact science anyway and many of us find it's much more accurate to have our hormones prescribed based on our symptoms.

For now I would suggest keeping a journal of your symptoms. Jot down what they are, when you have them, how severe they are and note what hormones you are using, the time they are taken, along with mentioning any other medications or supplements you take. Share the journal with your doctor at appointments so that tweaks can be made, if needed. You might want to print the Too Much/Too Little symptom list so you can refer to it while working to find balance.

It takes time for any hormone therapy to reach full effectiveness so try not to make changes too frequently. In the long run it can make getting balanced harder than it needs to be. Usually it's a good idea to give each change a good couple of weeks to work before considering another change.

I hope this helps you!


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