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Increased estrogen absorption with adding compounded progesterone cream? Increased estrogen absorption with adding compounded progesterone cream?

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Unread 02-08-2009, 07:17 PM
Increased estrogen absorption with adding compounded progesterone cream?


I had a BSO in May 2007. Had the hyst in Dec. 1994 at 24 yrs. old for severe adnomyosis. Since the BSO I've been on Climara patch .05 mg, but it was too low and I was miserable. So in Dec. 08 dr. increased dosage of Climara to .1 mg. I went in last month to ask for bio-identicals as I was still miserable though the increase helped slightly. So, he sent me to compounding pharmacy and here is the general plan:

They added 15 gm progesterone compounded 5% cream on Monday. I apply 0.5 ml one time a day. The pharmacist told me I would be more irritable and would start getting hot flashes because the progesterone cream would make my estrogen patch absorb better. Therefore, it would give me too much estrogen since I am on such a high dose of the patch to begin with. She said that I have to stick out they symptoms for a month before I can switch to Climara .075 and then eventually a month or two later Climara .05. The pharmacist said I have to go down on the estrogen patch so that eventually I can go on the estrogen in bio identical format. She said that the bio id format of estrogen is so low I would be miserable otherwise with a large drop. Sounds like next month they may be adding some a little bioest to the mix in the meantime.

I get severe rashes from the adhesive on the patch. Even the name brand doesn't help much. I wish I could get rid of this format and not wait months to do so. The adhesive cause a rash that takes 2 weeks to clear up. This can't be good for my skin! Also, now I am gettting hot flashes, irritability, fear / anxiety, etc. It is those symptoms that bother me the most. Ugh... According to the pharmacist, I will just have to deal with these symptoms because adding progesterone causes it. I asked for the progresterone to get rid of symptoms, not add them. If the progesterone causes the estrogen to absorb better, why not decrease it to even things out in the meantime.

I understand I may deal with some things, but why can't I go down on the estrogen to make me less miserable? Why such a drawn out way to decrease it all because she says it is easier and less symptoms? That doesn't make sense. On one hand the pharmacist says the estrogen is being absorbed better because the progesterone and yet on the other hand, she won't decrease it so the symptoms will lessen, even though she is going to eventually decrease it. I'm so confused. Any help / advice would be appreciated.

Thanks and Blessings,
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Unread 02-09-2009, 10:36 PM
Increased estrogen absorption with adding compounded progesterone cream?

Help. Anyone?? Maybe I'm not understanding this or I am giving too much info. to get a response. Basically I want to understand why I need to stay on a high level of estrogen for weeks when the progesterone cream makes the estrogen stronger, thus making it too strong.

Any light you can shed on the transferring from regular hrt to bio id hrt would be great. I just don't understand the transfer process. Also, the timeline is 5-6 months according to the pharmacist. Is this normal? Help!

Unread 02-09-2009, 11:56 PM
Increased estrogen absorption with adding compounded progesterone cream?

I know 2 things. One is that your oestrogen dose is average, not high certainly. And that progesterone is an antagonist for oestrogen and so cannot possibly increase absorption of it, the opposite is true, that if the cream crosses the blood barrier and reaches the brain it will reduce the oestrogenic effects.
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Unread 02-10-2009, 06:12 AM
Increased estrogen absorption with adding compounded progesterone cream?

I am not an expert on progesterone. In fact I do not use it now. I've used OTC and didn't like how it made me feel but perhaps I should have stayed on it longer. I have heard that it does take a while for it to build up in your system and that may be why the pharmacist wants you to wait to lower your patch strength. I have heard you may need slightly less estrogen, perhaps 10% or so. I agree with mountainwoman2 that the .1 is a pretty average dose for those of us in surgical menopause. Estradiol and progesterone can fight for the same receptor sites I think and that may add to symptoms that is why they say around here to get your estrogen dose right before adding other hormones. I also wanted to add that the Climara patch is a bio-identical.

Good luck and let us know how it goes for you!


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