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Fear of hormones Fear of hormones

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Unread 05-11-2002, 06:01 AM

I'm scared about this too! I'm going to try and enjoy the next week as the "me" that I know now because the old ovaries are going on the 17th. I just cycled and it was horrible so that made me feel better about having this done! Tell me sisters..is it important to have a base hormone level check done before hand? My doctor said it was not needed. She said we just wanted to start on the lowest dose of estrogen to control the hot flashes and symptoms. What's the scoop on this?
I'm so glad for this site and that we are not alone on this HRT issue. I'm only(LOL) 41 and hate to start this now. Best of wishes to all of you "In Waiting". I hope to be ing soon !!!
s to you all. Braswell
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Unread 05-11-2002, 06:23 AM
Fear of hormones

My doctor told me the same thing regarding base levels. I had done a lot of reading and asked about it, but he said that he believes the lowest levels that make you comfortable is the way to go, so trying to match a presurgical level doesn't really help. Besides, if you are in perimenopause as I was, your levels tend to fluctuate wildy...so there'd be little sense in trying approximate what "normal" for me would be!

That made sense to me. If your doctor doesn't think it's necessary, then I'd trust him/her. And besides...one less test to take and worry about, right?

Hang in there!

Unread 05-11-2002, 06:33 AM
Low dose LONG!

Hi Braswell,

Your doc seems to be in line with at least one opinion I've found on the low dose issue...

This is from the introduction to a CME (Continuing Medical Education) document that I found at www.medscape.com called _Individualizing Hormone Therapy: Principles and Practice_ by Morris Notelovitz, MD, PhD:

"The clinical message is that although all menopausal women experience the same physiologic change as they transition from pre- to postmenopause, their biologic response -- and therefore their need for hormone therapy -- varies. Further, standardized dosing may be appropriate to the needs of "groups of women," but not necessarily to the individual woman. The current practice of generic "hormone replacement therapy" for menopausal women -- irrespective of their true needs or response -- is inappropriate and should be replaced by "low-dose adjustive hormone therapy." The latter practice is based on 3 principles: an appreciation of the biologic variables associated with postmenopausal sex-hormone biosynthesis and function; the clinical recognition of the potential pathologic consequences of hormone deficiency; and the application of the pharmacodynamics of various hormone regimens to meet specific needs of the individual. The lowest effective dose is prescribed and titrated upwards until the desired therapeutic effect is achieved."

ANother important point this document makes is, "the lower the dose, the longer it takes for significant improvement and the less likely that symptoms will be elimenated"... but he also says it's important to"differentiate relief from eliminaton of symptoms"

So I guess one possible bottom line is that this will take time, our mileage may vary, and we are going to have to work with our doctors. At this point I'm making a rather detailed question list for the doctor that is doing my surgery (he's an gyn oncologist) and the first one I'm going to ask is: Are YOU going to **work** with me on HRT?

There *is* going to be an adjustment period and I want to know that he will consider me as an individual and LISTEN to my concerns. I'm going to do my best to be an informed patient and to clearly communicate what my body is doing. One suggestion that I read was that is is very useful to keep a daily log of doses, and any symptoms so that you can say to your doctor, "On day X I did Y and felt Z"

I'm fairly young (35) and my feeling is I want to do the best to protect my bones, heart, and overall health. My doc(s) must be my partners in this, or I'm on to the next doc!

Happy traveling!
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Unread 05-11-2002, 07:20 AM

Thanks Chris and Karen..That's one test I may just pass on.
I'm with you Chris,I need a doctor that's in it with me for the long haul on the HRT issue. I'm allergic to just about everything but Tylenol and am worried about finding the right Hrt. My plan is this: My surgeon which happens to be a gyn/ongologist will treat me with Hrt until I'm done with surgery and recovery time. As soon as I get the green light from her I'm planning to go to another gyn that is really up on this hormone thing for my long term care. My pharmacist(which does compounding also)suggested a good gyn in my area . I do hope that my current doctor will be "workable" until that time! She said I would be put on a low dose of Estrace after surgery if there's no cancer and/or massive endo. Seems like her main issue is the surgery and findings there of....will deal with the Hrt afterwards. I'm just trusting that all will work out after surgery. Chris, thanks for theCME document info and for reminding me to keep a log of daily symptoms . I need all the help I can get!!! LOL . Karen, thanks for reminding me that I'm most likely in perimenopause. I do tend to be in "denial" like the ads say. My mind is so young....but my body is....UGH!!! Say...do the gray hairs get worse after surgery or do they fall out ?! Thanks Sisters s to you..Braswell
Unread 05-11-2002, 07:38 AM
You're welcome

Braswell, I see you're a fellow Tar Heel (I'm a transplant, but after almost 5 years I'm really starting to sound like one!!)

Sounds like we're on the right track! There are a couple of compounding pharmacists in this area, I'm going to check that out-- I'm really sensitive to stuff as well. (I ended up with a nasty rash from the tape they used to bandage my gall bladder incision sites)

I hate to admit this, but I'm actually looking forward to a little gray hair-- might stop me from getting carded-- I've got the baby face!

Unread 05-11-2002, 07:42 AM
Fear of hormones

Hi everyone,

I have to second Karen. The best thing you can do is BELIEVE that you will be one of those whose first type and dosage of HRT is going to be the correct one!

The second best thing you can do is talk to your DR about HRT. What is s/he planning to put you on, how successful have most of his/her patients been on that type, and is s/he going to work with you in case it needs to be adjusted or changed.

The third best thing you can do is give it a chance, don't immediately assume every bad mood, warm spell, or dry skin is because of your HRT. You need to give your body a month or two to adjust to HRT, switching frequently just confuses the body more.

I am 46, apparently I don't age, people think I'm in my early 30's. My surgery was 13-1/2 weeks ago, and I have been on Estrace 1mg/day since 2 weeks after surgery. The only change I or my family has noticed is how even tempered I've been. I haven't lost any hair or grown a mustache. In the winter my skin and hair get dry anyway, I use cream rinse and body lotion and it doesn't seem to be any drier than normal. Oh yeah, one change - my face used to break out - haven't had a zit in 3 months!

Presurgery testing for hormone levels: seems kind of pointless in most cases. A lot of ladies have been on some type of hormones or bcps, or their systems are way out of wack anyway and that's what has been aggravationg their symptoms, so the results of any test would be meaningless.

Good luck and try to relax!
Unread 05-11-2002, 08:37 AM
Fear of hormones

Pellice, considering the same possible problems myself. I'm 48, gonna do the BSO, then HRT. Thanks to all who posted. Very helpful!

Unread 05-11-2002, 09:07 AM
Fear of hormones

Hi All,
I just wanted to say that I too am on HRT and having no problems. My doctor started me on the 1mg. Vivelle Dot (estradiol patch). I felt it was too much and quickly went down to .5mg and it has been working great. I have no symptoms, no problems, no weight gain. And my face is still nice and oily. Quite an advantage. I am about to turn 51 and I have no wrinkles!
My mom also had a hysterectomy at 37 or 39. She has been on Premarin all these years and is 78. She lives alone and is very independent. She could go bear hunting with a switch! And I think she does when I am not looking.
Personally, I would not consider not taking HRT. I think with all the new studies and all the new types of HRT, and more coming all the time, that the benefits far out weigh the risks. But I do understand not everyone can take it or wants to. Like everything it is a personal decision.
Unread 05-11-2002, 09:08 AM
Fear of hormones

I hate pills also! After my TAH/BSO on June 6, 2001, I had the Climera patch for a week and have been on 1 mg. of Estrace since. I worry daily about the effects, but so far have only seen positive ones from my ordeal of a year ago! I have more sex drive, don't get zits anymore, have no more heart palpitations which I had for years (I just noticed this last week!), have tons of energy, and fewer bowel problems. My hair is a bit drier and I use lubrication during sex which I never did before, but otherwise I feel the same! I too thought my personality would change. I think I got better, more even tempered. I still get slight indigestion and tummy problems from severe stress(my principal, jury duty, and life) but this is all part of living in NJ and being a 6th grade teacher!!! Have a great summer and take it easy; take it as it comes!
Unread 05-11-2002, 09:16 AM
Fear of hormones

hi sisters...

have stayed away for a few days (almost a week, I think), but it's Saturday, and I figured I'd just drop in and read a bit. Had my xrays & CT (cat) scan on Monday evening...haven't heard from the dr yet. I saw the xrays, didn't see anything that looked "not normal", and the cat scan tech said she'd gotten "great pictures" (hope they got my 'good side' ) so doesn't it seem like I should have heard from doc by now, I mean at least to schedule an office visit or something, discuss those results, discuss the surgery, etc. I haven't seen him since April 19 when he examined me and suggested (told me) that hysterectomy would be best and I said that I couldn't just agree "just like that", I needed a some time. I called and made the surgery appt the following week, but haven't spoken to him since then. The surgery's been approved by my insurance (I'm looking at my referral now; it's right on top of my computer) I've begun the process of letting my job know, and I actually have paperwork that the dr needs to fill out for that. I've got my list of questions to ask all written out in my "journal"...but seems to me like this waiting to talk to him is nearly as bad as waiting for the surgery date! The referral actually has TAH/BSO on it...I wasn't even sure of the procedure until I saw it on there. So am I nuts or what?! (anyway, called and made appt to speak with him the other day, and May 31 is the soonest available date ) Believe it or not, I've gotten more/most of my knowledge from this site, but am still learning...

re: HRT, how long does that last? is it for the rest of one's life, or till "normal" menopause would be over. My ovaries will be taken, so I already know I'll need that. Anybody else see the ads that Patti LaBelle's been doing for Premarin? I was watching my one vice - All My Children - a few days ago and saw the commercial.

re: hormones and skin breakouts...whoa! I'm 36, had no acne problems as a teen but now'days feel like I'm in delayed puberty or something! My forehead keeps these mini-bumps on it...And don't let me eat chocolate!! Up until about 3 maybe 4 years ago, I suffered no repercussions from eating as much chocolate as I could stand! Now, if I so much as eat ONE little bite-size reese cup, I've got a zit the size of a small island popping up on my cheek or my forehead within minutes! (that may be one science project I'll work on for myself right around Labor Day weekend... see if I can eat a mini-chunk of my mom's German Choc cake - should be almost 3 mos post-op by then!!!)

as for hair :hair: ...got plenty of gray streaks already! Have also been surprised to see a couple of "loners" under my chin and on my neck, didn't think too much of it until I saw it mentioned here. Don't think there's any more over the upper lip than normal...is that a hormone thing? Woke up about 3 nites ago, only had the top sheet over me, but was drenched in sweat from neck to mid-back...scared me and I couldn't go back to sleep!

I've made notes of these little things, but since I've got access to this web of "sisters", some of who have already "been there, lived it, here to tell about it!"...well, you know!!

Trying my hand at these static smiley thingies, hoping it works!


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