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What ERT worked for you where others didn't? What ERT worked for you where others didn't?

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  #1  
Unread 06-12-2009, 03:10 PM
What ERT worked for you where others didn't?

Just wondering if there are other women out there for which finding a suitable estrogen replacement is a real battle.

The vivelle patch was not absorbed, tested non-existent estrogen after 5 months of trying, and the Femring works excellently for me, but only for about 3-4 weeks before running out of estrogen.

Am now searching for another delivery system. My dr. will not prescribe oral estrogen so any other suggestions? What has worked great for you?
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  #2  
Unread 06-12-2009, 03:43 PM
Re: What ERT worked for you where others didn't?

Yep, I tried many things before I found something that s worked for me. Although in hindsight I think I was too quick to change things during the first year after surgical menopause.

I started on the Climara patch, than went to tri-est pills and prometrium, than to tri-est troches and progesterone troches, finally settling in on the tri-est cream and progesterone cream.

My doseage has been tweaked over the years. I started on a 20% cream for the progesterone, but now use a 5% cream. And I am using bi-est now instead of the tri-est.

I rarely did testing in the beginning. We went based solely on symptoms. I did do a saliva test at about six months post op, total waste of my money. I had my first testing done when I was about 5 years post op. Only had it done because I went to a new doctor and she and I were curious where my levels were at. I now have it done every other year just to be sure nothing is totally out of whack. I switched to the bi est because my estrone levels were extremely high.

Good luck. I hope you find something that will work long term for you.

Just thought of something, sounds like you don't absorb transdermally very well, how about a sublingual? That is not a pill, but is dissolved under the tongue.

Another thought, perhaps it's time for another doctor if the doc won't prescribe oral when that just may be the right method of delivery for you. You don't know until you try.

  #3  
Unread 06-12-2009, 06:16 PM
Re: What ERT worked for you where others didn't?

  Quote:
Originally Posted by Kim M View Post
Just thought of something, sounds like you don't absorb transdermally very well, how about a sublingual? That is not a pill, but is dissolved under the tongue.

Another thought, perhaps it's time for another doctor if the doc won't prescribe oral when that just may be the right method of delivery for you. You don't know until you try.

Hi Kim,
Thanks for your response. I know many of us change too quickly. I did give the patch 5 months try, and now on the 3rd month of Femring - and I so wanted this to be it... the Femring works so wonderfully for almost a month.

I understand about testing too soon. I have been tested a few times now, only because I was complaining of low estrogen symptoms and the drs didn't believe me.... they said it wasn't possible this soon into a 3 month regimen or no way on the highest dosage of the patch plus.. but honestly the test results have reflected how I felt so far.. usually when they're in the 30s I know something has to change soon...

My dr doesn't want to go oral because she's worried about the liver first pass, and so has recommended perhaps the Belmar compounding pharmacy as they're supposed to be able to lipidize or lipid-encapsulate the estrogen so that it bypasses the liver. This is difficult for me to believe. Perhaps that might be my next try.

As far as sublingual troches go, wouldn't you have issues with fluctuations? I mean I suppose there would be an increased dosage at first, then tapering off until the next dose? I seem quite sensitive to fluctuations which is why I loved Femring.....

Am sure I just need to try other methods at this point. Thanks for the hope, happy to hear you found your perfect match.
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  #4  
Unread 06-12-2009, 06:41 PM
Re: What ERT worked for you where others didn't?

Just wanted to throw in my about hormone fluctuations with different delivery methods. Not everyone is super sensitive to these, but some are.

There are going to be fluctuations with any delivery method. There have to be. Otherwise, you're adding more hormone when you don't need it.

The thing is, think of it this way. You can either have much larger fluctuations less often (the 3-month delivery methods), or you can have much smaller fluctuations more often (daily, twice a day methods for example). Personally, if this were an issue for me I'd rather go with something I use/take twice a day because then the size of the fluctuations could be much smaller each time.

Sublingual compounded troches are an excellent option in your situation. For that matter, some women find that regular old oral Estrace (or the generic equivalent, even cheaper!), cut into quarters and taken sublingually, works just fine and think of the cost savings!

I agree with (((Kim))) that, while I am not a fan of oral HRTs for the reasons associated with keeping my liver healthy, for a physician to refuse to prescribe them when a patient is having trouble with finding the right delivery method is awfully limiting. I'd also think about seeing another DR if you continue to have problems finding something that will work in the long term.


-Linda
  #5  
Unread 06-12-2009, 07:11 PM
Re: What ERT worked for you where others didn't?

  Quote:
Originally Posted by surferbabe View Post
I agree with (((Kim))) that, while I am not a fan of oral HRTs for the reasons associated with keeping my liver healthy, for a physician to refuse to prescribe them when a patient is having trouble with finding the right delivery method is awfully limiting. I'd also think about seeing another DR if you continue to have problems finding something that will work in the long term.
-Linda
Hi Linda,
Thanks! I did previously ask about using Estrace sublingually and was told it had been tried by other patients of this dr and was not effective for any of them. Would be curious to hear how many women out there use it this way successfully! I'd be willing to try about anything that works at this point.
I did read in Dr. Vliet's book that this is an effective solution but usually only works with the name brand, not the generic (which I don't understand if they're the same ingredients!!!)

I am ready for long term relief! I think my dh and kids are regretting this surgery as they have to deal with these estrogen fluctuations as well! Will ask my dr to reconsider this option. THANKS!
  #6  
Unread 06-15-2009, 07:30 AM
Re: What ERT worked for you where others didn't?

I just replied to another thread of yours so sorry that I am saying this twice but just thought I would add to this...

I am still so new to the compounded HRT but have been using it now for 3 weeks. I did not think I would respond to it at all simply bc it's method is thru the skin and into the bloodstream. I did NOT respond to vivelle dot and I assumed I would not respond to this either.

So far, so good though. I have had a few days that were harder yet still manageable but I also realize that on those days I applied the gel to my arms rather than my inner thighs. It works great on the inner thighs for me but I have noticed I feel much lower in mood overall if I use the arms. I'm sticking with thighs only now! Hope this helps some.
  #7  
Unread 06-15-2009, 09:49 AM
Re: What ERT worked for you where others didn't?

Hi

I used compounded troches, dissolved between my gums and cheek, quite successfully for a while. I switched to a patch because of the convenience of bi-weekly changes and insurance coverage. However, my Dr has come to the conclusion that I need the benefits that a compounded troche can provide, so I am about to make that change back to troches. I was using them twice a day to avoid the large fluctuations, and plan to do so this time too.


I also agree with (((Kim))) and (((Linda))). I have had Doctors who tend to think that what works for one, or several patients, should work for all. Those Doctors were not very helpful for me. I called my local compounding pharmacist and asked for a referal to a Doctor who prescribes HRT for each individual woman's need. I have not regretted that decision.


Kay
  #8  
Unread 06-15-2009, 02:02 PM
Re: What ERT worked for you where others didn't?

Thanks for your input. I am going to try Estrace generic sublingually... the nurse reluctantly agreed to let me try it ("though we're very skeptical it will work...")!!!! However, she insists on a very low dose - 0.5mg/day which I think will be too low but trying to be optimistic... Was on 0.1 femring and 0.1+0.0375 patch and they were never enough... I might just call a compounding pharmacy and ask them who they recommend.
Thanks for the advice!
  #9  
Unread 06-15-2009, 02:04 PM
Re: What ERT worked for you where others didn't?

  Quote:
Originally Posted by kay m View Post

However, my Dr has come to the conclusion that I need the benefits that a compounded troche can provide, so I am about to make that change back to troches. I was using them twice a day to avoid the large fluctuations, and plan to do so this time too.

Kay

What benefits do you refer to? And while using troches, did you also need vaginal estrogen too? Thanks.
  #10  
Unread 06-15-2009, 03:01 PM
Re: What ERT worked for you where others didn't?

Remember that when you take oral estradiol sublingually, the dosing is like the patches, not as if you were swallowing the pills. When you take it orally, 95% of it is lost in the first pass through the liver. Sublingually, that won't happen. So, for example, 1mg oral estrace would be equivalent to 0.05 (not 0.5) mg transdermally or sublingually. So, 0.5mg oral estrace, if you successfully absorb it sublingually, would be roughly ten TIMES the amount many of us would need.

I've heard of members being successful using an Estrace tablet cut into quarters, one quarter once or twice a day, sublingually. I think a whole tablet would be way too much.

s,
-Linda
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