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Dr. Visit re Hormones/Migraines Dr. Visit re Hormones/Migraines

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Unread 08-28-2000, 11:17 PM
Dr. Visit re Hormones/Migraines

Hi All,

Well,last Friday was my appt with my ob-gyn to work on the hormone aspect of my migraines. I came back both encouraged and discouraged. As many of you know, for the last 6 months since my tah/bso, I've been having nearly daily migraines and have felt like my life was hell...nothing seemed to help and even the miracle med I had used for migraines(Imitrex) for over 5 years quit working for me. My regular doc and I concluded that hormones were definitely the problem for me, but she wanted the ob-gyn who did my surgery to adjust the hormones for me. During the 3 weeks it took to get into an appointment with him, I doubled my estradiol dose from .05 to .10 vivelle dot with his ok til I got in to see him.

During that time, the migraines decreased from 4-5 days week to 2-3 days week. Towards the end of that 3 weeks I noticed that the headaches seemed to hit on either the day of, day after or day before my patch change was due(twice a week). The rest of the weeks I was feeling fairly decent in comparison.

So what we have settled on for now, is we changed from a twice a week patch to Climara .10 which is changed only once a week in the hopes that the headache might only hit once weekly instead of several times weekly. The discouraging part is that he indicated we may not be able to eliminate these headaches and I may just have to live with them. I do have the ok to play with dropping to changing patches every 6 days if I am getting the headaches at the weekly change. So far, I'm not overly impressed with the Climara as the headache I had the day I went to see him took 3 full days to get rid of and I have also noticed more hot flashes than before, and my dreams have gone wild again the last couple nights which hadn't been happening for quite a while with the vivelle(only been on Climara since Friday night).

As far as the saliva testing I had done in July. He was aware of saliva testing - but only from the aspect that its used in some test during pregnancy. He indicated to me that the journals he subscribes to haven't had information on saliva testing of hormone levels - that it wasn't necessarily that it wasn't a good way to test, it just was an unfamiliar method of testing - and even agreed that in 10 years it may be the standard way of testing where today its serum testing thats done. Sounds to me like the Dr. Zava's of the world need to get to doing some publishing in medical journals!

We have had some discussions over previous weeks about adequate estrogen levels. My dr. indicated to me that he has seen normal levels range from 30 to 800 in women. Again, each woman is different, and what is normal for one, may not be normal for another. So my sisters, we each have our own path to follow to find out what level is going to be where we feel decent and that level will be what is normal for us.

As far as my low levels of cortisol/dheas, he doesn't want to do anything with them at this time. The cortisol testing done 10 years ago included challenge testing at the time and most adrenal problems either show up as a child or if they are tested for as an adult, and then don't come back positive at that time, aren't likely to become a problem later on for most people since most of the problems are genetic.

He does not want me to make too many med changes too quickly - were he to give me two different hormones at one time and I developed some kind of reaction which one caused it??? Or was it this hormone that corrected the problem or the other one, or a combination of both. So, I get to try the climara patch for a while, see how I do, possibly play with adjusting the days I change it for a while. Then if I'm still not doing much better with the headaches, we may try a pill format or a combination of pill/patch, or maybe even go the compounded formula route.

So thats where I am for now. And at least the headaches are 2-3 days instead of 4-5 days for now so I am feeling more hopeful than before.

Oh yes, the day I saw him was the 6 month anniversary of my surgery...I pointed that out to him - he said, it sure doesn't seem like six months ago. I said, with these headaches I've had, Yes it does!!!

And Sisters, Thanks again so much for being here for me. You have given me encouragement which has helped me to deal with all of this when I've been so frustrated and down that all I wanted to do was cry and go to bed and stay there. I am forever grateful to all of you!

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Unread 08-29-2000, 06:26 AM
Dr. Visit re Hormones/Migraines

It does sound like your doctor is willing to work with you on this, so that is a good sign.
Thank you for sharing all that info, I'm sure it will be of help to many here in this place we call the jungle.
I hope you find some relief soon. I know all too well how awful those hormone headaches can be.
Hugs :-)
Unread 08-29-2000, 06:39 AM
Dr. Visit re Hormones/Migraines

Your doctor sounds as if he listens to you and is willing to work with you. From the hyster sisters' experiences, we know these doctors are hard to find. Just yesterday, I had a woman in my store that I had written a brief letter for her to give to her doctor that explained her desire to be on natural hormones. She said the doctor chuckled as he read it. And I chuckle, too, because it's just the beginning of his bombardment of women demanding bio-identical hormones.

Please consider adding the progesterone to your hormone therapy. The symptoms you describe sound estrogen dominant (i.e. migraines, dreams). I realize not every woman does well on progesterone but it is worth giving it a try.
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Unread 08-29-2000, 10:33 PM
Dr. Visit re Hormones/Migraines

Lauren, I will consider using progesterone after a few weeks. My dr. specifically doesn't want me to change to much too quickly in trying to find out what works for me. You mentioned concern that I'm estrogen dominant - well, in most women, that may be, however, the lowered levels of estrogen needed by my body appear to be what is causing the migraines to hit me. When my estrogen levels drop the headaches begin for me. I only just switched from vivelle to the climara and its too soon to tell if its made a difference for me regarding the migraines, but I do know I'm having more hot flashes than on vivelle, and as I mentioned, the dreams have been more vivid. But taking estrogen is what relieved the vivid wild dreams for me early on in my recovery.

I do finally feel like my ob-gyn is going to work with me. Before going into see him my communication with him has been thru his nurse since my 6 wk visit. I felt like the things I wanted him to know about he was ignoring, but after seeing him last Friday, I do feel better about working with him. Its amazing what sitting down with someone and talking things out can do!

Unread 08-29-2000, 11:22 PM
Dr. Visit re Hormones/Migraines

I too suffer from migraines and I'm still trying out different types of estrogen. Currently I am on a compounded cream. I read that you were taking Imitrex and it's no longer working for you. I tried Imitrex and it didn't work at all for me. I've been using a nasal spray called Migranal and it has made a big difference. Where other drugs wouldn't touch the headache, this takes it completely away. So you might want to give that a try. Good luck!

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