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perimenopausal, should I start highest dose HRT? perimenopausal, should I start highest dose HRT?

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Unread 07-10-2010, 05:33 PM
perimenopausal, should I start highest dose HRT?

My doctor wants to start me on .10 estrogen patch right after TAH/BSO surgery. Reading all the threads about "feels better to use the lowest dose possible" and HRT associated weight gain makes me wonder: should I ask about starting with a lower dose instead?

Thanks to all you ladies who have shared your HRT experiences, I think surgical menopause is a bigger fear for me than the TAH/BSO and recovery....
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Unread 07-10-2010, 05:49 PM
Re: perimenopausal, should I start highest dose HRT?

My doctor wanted me to start with the average dose (Vivelle dot .05) and then see at my 8 week appointment if I needed more or less. My appointment is this Tuesday (in three days) and all I can complain about is occasional night sweats. I'll take that instead of 10 days of period per month and won't ask for a higher dose. If more symptoms show up in the next month I will call the doctor and see if I need another dose. Before this surgery I had hot flashes in 2007/2008. Did you have any symptoms already? Maybe your age has something to do with it?
Unread 07-10-2010, 05:51 PM
Re: perimenopausal, should I start highest dose HRT?

I don't think there is one right answer to that question. I was started out on the .10 Climara patch and still had symptoms. So much is going on during the early weeks/months post op that no matter your doseage you may still have symptoms.

One thing that I found is that in the beginning my body did seem to crave more estrogen. I was eventually able to tweak my dose down, but in the beginning I did need more.

Best wishes on your surgery.

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Unread 07-10-2010, 09:16 PM
Re: perimenopausal, should I start highest dose HRT?

Thank you both for your replies...I have experienced a few night sweats but not many other symptoms yet. So maybe it is an age thing. It also makes sense about craving estrogen after the shock of BSO (or any surgery). Never expected to deal with surgical menopause and hoping to avoid the worst of it, if it can be done safely.

I had no idea this was so much an "art" and not a science. It's been impossible to find reliable information , and on top of that there are so many individual factors! It's amazing anyone figures out how to get it right. Trial and error I guess...
Unread 07-15-2010, 05:32 PM
Re: perimenopausal, should I start highest dose HRT?

Pagro by no means am I an expert, I am wandering through all this too, what i did might have been pretty stupid for a woman that had been on the vivelle patch .05 for about 4 years, but I didn't get my HRT lab work checked as often as I should have been. When my dr suggested a higher dose a few years ago because I felt like things were not working right, I tried it, didn't give it enough time, and went back to the lower dose...but I am 53, and it seems that my body is wanting more estrogen than that patch gave me....I am trying to wade through a lot of this since I have gone on thyroid meds for low thyroid, and such severe fatigue I can hardly leave my home...this has been going on about 2 months now....I have had other labs taken all coming back normal, so far, no one can connect this fatigue to anything other than a possible link with low estrogen, not enough in the 05 patch to even cover bone loss according to the doctors office....and the thyroid..which some doctors don't feel needs to be treated at that level...
What I am trying to get at is this....I am wondering if I had gone along and upped the patch dosage to stay within a normal estradiol range at least by getting labs done often, would that have kept the thyroid from getting out of hand, and preventing this severe depletion I now feel...something I will only know as time passes.....
I just went off of Prometrium (progesterone) after 1 week and started on a 0.75 patch to see how this will help me.....if at all....
the thought of going through life with depleted glands and hormones isn't going to be good if the fatigue I am feeling is coming from that....hopefully, you won't do what I did and ignore the need for regular lab checks....I think it would have been helpful to me anyway
Unread 07-15-2010, 06:11 PM
Re: perimenopausal, should I start highest dose HRT?

I am 44 and had my lavh/bso on June 28th. My doctor put a .1 vivelle dot on me right after surgery, and that is what I am still on at this point, bearing in mind that it has only been 2 1/2 weeks since surgery. So far, so good for me, but we'll see.
Unread 07-15-2010, 06:39 PM
Re: perimenopausal, should I start highest dose HRT?

Just another post from me.... At this week's post op appointment I mentioned the occasional nightsweats. He offered a higher dose of Vivelle (.075 instead of .05) but I told him I would prefer not to get a higher dose since I don't have any other complaints (and worry about other side effects). He suggested I leave the old patch on when I put the new patch on. That would give me just a tad more estrogen. I usually change patches Sun/Thurs and just put a new one on today. We'll see what happens. Will keep you updated !

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