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Synthetic or plant-based hrt? Synthetic or plant-based hrt?

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Unread 08-12-2010, 08:56 PM
Synthetic or plant-based hrt?

I'm looking to get some insight on either of these and how others have responded to them.

I've been on Premarin for almost 4 years, and if I knew then what I know now, I
never would have started on it. But, I don't want to get in to that right now.

I did read that there could be more side effects with plant-based or synthetics and I'm ok with that. But, I would like to know what they are and just how severe they can be. Has anyone else made the switch from the PMU line to something else?

I will be taking HRT for at least the next 10 years (I'm 32) then my doc will discuss how to go about mimicking a natural transition to menopause. I have a follow up appt with her next month and would like to have *some* insight to other options available.
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Unread 08-13-2010, 06:12 PM
Re: Synthetic or plant-based hrt?

Seems that there would be more side effects from HORSE ESTROGEN, rather than plant-based bio-identical (converted in lab) estrogen. With the premarin, you will get the best estrogen replacement if you were equine.

I don't understand doctors who want you to "mimick a natural transition to menopause" at some point... as those women who transition naturally (non-surgical menopause) still produce UP TO 40% of their hormones after menopause. With surgical menopause you aren't making any of your own (other than the tiny amount your adrenals try to produce).

I'm 44, and NEVER plan to stop using bio-identical hormones. They will have to cancel my prescription only after I die.

Wonder what side effects you've read of with plant-based hormones? There could be more with synthetic versions definitely, but that's the beauty of the bio-identical plant based ones - they're created to match your own (human) hormones.

That being said, some women do better with one over the other. We're all different and it takes trial and error to find what works best for you.
Unread 08-13-2010, 06:18 PM
Re: Synthetic or plant-based hrt?

Thanks for the reponse Claypso! I did a bit more digging today on things and spoke to my pharmacist as well. TO be honest I'll have to go back and find the info I read to see what the side effects were. I was tired and a bit scatter-brained while reading it last night. Something along the lines of headaches, nausea, and that it isn't as strong as what I'm on now?

After speaking to my pharmacist I feel more at ease about going to a bio-identical hrt. I really can't wait to see my doctor and make the switch now.
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Unread 08-14-2010, 07:21 AM
Re: Synthetic or plant-based hrt?


I think you are definitely making the right choice switching over to bioidentical hormones. I'm 34 and have been on them for almost a year now. Calypso was right in that they mimic the way that your body would have naturally processed your estrogen because the molecular structure is "identical". Premarin and the other drugs have a piece of the structure tweaked so that they can patent the drug and therefore that's why they can be so dangerous.

I've gotten my hormones through a compounding pharmacist and have had NO SIDE EFFECTS. I feel great! A good book (easy to read) to check out before you see your doctor next month is Hormones, Health, and Happiness by Steven Hotze. I found it to be really helpful and it helped clarify what I wanted.

Hope that helps!
Unread 08-14-2010, 07:51 AM
Re: Synthetic or plant-based hrt?

Thanks Bree, I'll order that this weekend. (I'm seeing my doc next month) Good to hear you don't have any side effects. Do you use a cream? My pharmacist said what they get in is a cream. I was hoping for an oral as that's what I'm comfy with, but that's really not a big deal.

My biggest side effect right now is if I forget to take it in the morning. By that night I'm nauseated and dizzy. Usually by the time that kicks in its too close to my next dose to take it. Then I'll get another waves of nausea/dry heaving after taking it in the morning. It takes about 20-40 minutes for it to pass completely.
Unread 08-14-2010, 08:09 AM
Re: Synthetic or plant-based hrt?

Vega, if you're having trouble remembering it, why not consider a patch (changed twice/weekly) or Femring (changed every 3 months). There is also an oral version of bio-identical estradiol that's cheap ($4-8/month) too. Compounded creams (check if your insurance covers them) are just one option as are sprays, gels, etc...

The book I'd recommend is: Hormonal Connections Women Suspect but Doctors Still Ignore by Elizabeth Viet. You could check your library for a copy.
Unread 08-14-2010, 08:40 AM
Re: Synthetic or plant-based hrt?

I was on premarin for 16 yrs and then switched to bio-idents and have been trying different ones for the past six years.
Patches, estrogel, bi-est and tri-est and each time they did not stop the hot flashes at all.
For the last six months I have been on estriol vaginal cream and ended up at my GP's office last week. My vaginal walls and outer area are paper thin and very sore and irritated. She isn't the dr I see for the bio-ident hrt but she did say that it isn't working. I kinda knew that too since I am still having hot flashes, no energy. So she gave me an RX for Premarin cream and I filled it and am using it. After two and a half days on it I am noticing a big difference in how I feel down below and physically.
Maybe the dose of bio-idents isn't strong enough, but even on the strongest patches my hot flashes didn't stop. I have noticed that being on this low dose of cream my hot flashes are abating and aren't as strong as they are while on bio-idents.
As they say "If it ain't broke...." If you aren't having any problems being on the premarin, except that you don't like what it's made of, think long and hard about switching. Some women do very well on Premarin and it bothers me when others put it down cause it comes from horse urine. I know you didn't make any comments about it. Yes, that isn't very pleasant to think about, but when we've tried bio-idents and they aren't working and Premarin does, should we feel ashamed?
I'm just giving you my experience with bio-idents and how they haven't worked for me and I'm going back to what does. I never had any vaginal problems while on premarin like I have with bio-idents.
In the end, only you can decide what you want, and I hope you find something that works for you.
I hope my experience shows that bio-idents aren't always the magic potion they are claimed to be.
Unread 08-14-2010, 09:15 AM
Re: Synthetic or plant-based hrt?


I do use a cream. I'm on a skin cream with testosterone and progesterone, a vaginal cream with estrodiol and testosterone, and a estrogen patch.

One thing (and you'll read this in any book) is that you'll want to make sure you take progesterone too. It works in combination with estrogen and they balance things out together. Women who just take estrogen end up with estrogen dominance and that's where a lot of the side effects come in.

Unread 08-14-2010, 09:17 AM
Re: Synthetic or plant-based hrt?

Marcatbak thank you for your post. I was started on premarin right after surgery and I feel the same as before my Hyst. I have been waiting for the "change" but I am relieved so far to find none. But I have been wondering if I should ask about switching to bio idents at my next appt. It's all so confusing but I do like your if it ain't broke line. Just trying to find my best solution.
Unread 08-14-2010, 09:55 AM
Re: Synthetic or plant-based hrt?

From everything I've read, it doesn't matter if it's "plant based" or not, I know other people here disagree, but I don't think "natural" automatically means "better." What we need is something that mimics the female human hormone (ie not horse based).

Cutler's book (Hormones & Your Heath) is the best I've read so far about comparing the different hormones and delving into what studies actually tell us.

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