Unwanted side effects from bio identical HRT after 7 months of use

Thanks for your response, Valerie. I am applying a pump of Estriadol (Estrogel) gel topically (arm) once a day. The testosterone is a compounded cream. The progesterone is taken orally. I did not mention but should here, that I do Vagifem tabs twice weekly intravaginally for localized estrogenization of the vagina. This doctor prefers morning serum testing of the hormones--I have asked about salivary testing and he said there are too many variables with how the saliva is collected to make it accurate enough. I just had my hormones levels checked. The estrogen, progesterone and testosterone are showing 'higher than normal levels', but one has to remember, it's comparing my results to other 61 year old women and usually a woman of my age ordinarily has low estrogen, progesterone and testosterone levels. You mentioned 'charts' so I'm assuming this means some sort of formula or equation that is used to figure out the 'right balance'. If there is such a formula, could you give me the name of it or refer me to where I could find it? thanks

Clarification, the testosterone compounded cream is applied to the skin.

Hi there.. I’ve began the HRT bio identical implant... it’s amazing.. I’ve nvr felt better.. not creams.. I get it changed every 4 yo 5 months..release of testosterone and estrogen.. nighttime I take progesterone orally.. nvr felt better.. I highly recommend 

I had my ovaries removed around 3 years ago b/c of a mass on one of them--the GYN wanted to remove my uterus at the same time (just because he was in there already), I told him 'no way', knowing that it could potentially take away from the intensity of an orgasm, as well as eliminate the support for other pelvic organs. Now I regret having both ovaries removed (when only one had a mass), Never realized how much this would further reduce my hormone production even though I was 6 years menopausal at that time.

Meant to ask, did you mean PMS (premenstrual syndrome) instead of PMT?

I have been reading that many people apply the T-cream directly to the labia, however my doctor instructed me to rotate applications to arms, thigh, legs etc, The prescription says Testosterone 6mg/Gm and I use two 'clicks' on a dispenser (it's a one month rx and it says the container contains 30Gm so I interpret the daily two-click dose each to contain 6 mgs of transdermal Testosterone). The bloating, abdominal cramping, abdominal distension and fluid retention seems (to me) to be more suggestive of an imbalance between the estrogen and progesterone or too much of one of them. I'm not sure why my (new) doctor, who appeared to be quite progressive and proactive with BHRT in the beginning, doesn't seem to think these extremely bothersome symptoms are of any importance when they are highly suggestive of a great imbalance in some or all of my BHRT hormones. AT LEAST make some suggestions on what could be done to alleviate the constant abdominal cramps and bloating! I normally have a nearly flat abdomen and right now, I kid you not, I look 5 months pregnant. Very worrisome and I'm not sure if my doctor has 'written me off' in some way or maybe he doesn't know what to correct or how...? He has been doing BHRT for more than 15 years and has an excellent reputation. Honestly, I've been in tears since my appt 3 days ago. I feel so lost in all this and expected my doctor to work with me so I could get the hormones I needed to regain my sexuality--but now I'm having these unexpected side effects and he says nothing. I don't usually have a problem communicating with my doctors or expressing concerns or asking questions about my treatment, but right now, I'm speechless, taken back and at a loss in how to approach him now. Not even sure what to ask him about these abnormal symptoms since he appears to act like its not a big deal. Really need encouragement here. I don't want to impulsively just leave and find another practitioner, but I'm certainly thinking about it. He should be be the one with answers, not me. What questions would you be asking if you were in my shoes? thanks everyone.

Hi,

I understand the rotating your creams on arms etc. Where are you applying them? Suppose to be to high capillary areas such as the inside of arms, backs of knees, soles of feet, palms of hands, neck,, face. Of course you don't want to apply your testosterone cream to your face. Putting any of these creams on your thighs seems the fattiest area to absorb. I'm not sure why doctors say to put it on thighs at all. The natural route ideally is through the vaginal route. The hormones are taken in where they are typically made, and the body takes them to all the proper receptors where they are put to use. You can get all your creams for labia application. Just a thought. If you are figuring your Testosterone mg right that is a pretty high mg to start with but still might not be enough. My doc increases in increments of 2mg about every 3-4 months depending on lab numbers and how I feel. Your bloating issue may still be as you say hormone imbalance issues of estrogen and progesterone. I couldn't tolerate the 100mg progesterone. Tried it once and knocked me on my butt. So you could possibly try a smaller dosage on that and see if things level out. I would still try to get your testosterone in labia application though. Can be made for women at a compounding pharmacy too. I believe I got better results from that application. 

I think PMT and PMS are the same thing, just different terminology.

Yes, even though I was already menopausal, the removal of either my ovaries or my uterus seemed stop production of some some hormones.  My consultant said that female hormones is an under-researched area - they're still a bit of a mystery!

Regarding HRT, different women react in different ways to the same hormones.  My progesterone sensitivity meant unbearable PMT-like effects - bloating, headaches, depression, nausea, joint pain etc.

I've heard some women say they've reacted badly to progesterone HRT, even though they rarely experienced PMT when they actually had periods.

I have one friend who was prescribed HRT by a GP who 'specialised' in HRT at her local surgery.  She was having bad side effects and got referred to a specialist menopause clinic. The clinic changed her prescription completely - the GP, who supposedly specialised in HRT, had prescribed incorrectly.

Have you asked your doctor WHY he doesn't consider the possibility that it's the hormones in some way causing the bloating etc?

If, ultimately, your present doctor isn't willing to seriously consider your thoughts about the hormone treatment, I'd say go to one who will listen to you.

 

I was instructed to apply the Estrogel gel consistently to the same arm daily. The T-cream, I apply in rotation, to the areas BEHIND my knees and thighs, the non-estrogen arm, flanks. I'm relatively lean in my thighs (although lately that has been changing rapidly), so applying to my lateral thighs I've included in the rotation. He NEVER suggested that the T could be applied to the labia. The 6mg of T is a recent increase from 4mg daily. Unfortunately, I can't take a smaller dose of progesterone since it is a round capsule.  I do wonder if he would be open to lowering the dose of progesterone since he has already said my symptoms are not a result of a hormonal imbalance. I don't know how it is that he is so sure of this! Fluid retention, increasing abdominal distension and fluid filled thighs don't usually happen because of something that could be found on an ultrasound. To me, this 'sounds' like he's convinced that all my symptoms are something OTHER than hormones (maybe even somatic). Other than the possibility that something unexpected is going on inside my body, (i.e. a pelvic tumor, cancer), my symptoms came on within one month and I doubt they are a result of some disease process going on internally. If they were, they would  be symptoms happening at late stages of a disease process. So one must first look at the 'most likely' and 'most logical' source of my symptoms and that would be hormonal. This doc is a board certified GYN and surgeon. He does not do OB. His practice is both preventative GYN medicine and holistic care which includes BHRT. I'm confused at best with his response. The only thing I can attribute his stubborn stance on is what happened recently, A couple weeks ago, I believed I had a rapidly worsening UTI (I've had MANY throughout the years). I had a fever, malaise, frequency, bladder pressure etc. It was over the weekend and I've had a history of sepsis, so I started the antibiotics. I'm an RN and believe I have a respectful knowledge base... I already had an rx for antibiotics that he ordered, which I take (one) post intercourse to prevent UTIs. When we traveled to Europe in May, he said that if I felt I was getting a UTI, to take the antibiotics 4x/day. Being a weekend and me feeling uncomfortably worse by the hour, I started the antibiotics and notified him through the patient message board that night. The next day he admonished me, saying I shouldn't have 'self-treated', that I should have gone into an urgent care to have a culture done first, etc.(uh, not at 8pm on a Sunday night). As if I didn't have a brain cell in my head. I know it sounds crazy, but I've worked with enough doctors who were just plain tired and cranky and it doesn't care how logical, kind, respectful a patient is to them, they get p*ssy about certain things and blow them out of proportion. Maybe this doc (as I said, he's new to me) just needs a vacation. Perhaps he easily gets his panties in a bunch. I don't know, but I certainly do not feel that he's taking my complaints seriously or is even attempting to 'work' with me, the patient. This is concerning. thanks for reading all this.

Hi catbee,

Might want to consider finding a doctor that understands hormone treatment and has more understanding and patience with you. My holistic dr practiced general medicine as a MD for 22 years prior to going holistic and he is very patient and understanding. He listens and listens intently to everything. Your concerns are not blown off they are addressed until a fix comes. Sounds like your dr has a understanding of BHRT but maybe not fully and still carries the bedside manners of the general docs out there that don't like you to self treat or read anything that might show you know something. After all they are the doctor right and they usually let us know that. hehe. As far as your UTI's and continuing to treat with antibiotics which you know are not good for us at all. I know they are necessary for treating occasional things in life but a regular basis not good. Have you ever heard of D-Mannose for treating and preventing urinary tract infections? Look into it. It is natural and if done right could help you keep these nasty UTI's at bay. I think its the lack of estrogen causing thinning in your vaginal walls and leaving you open for these to happen. It takes some time for hormones to work and hopefully that estrogen will start healing your delicate tissues downstairs. This is another reason why I think getting your creams for labia application is the best. Gets everything right to that area right where you need it most. Good Luck in your upcoming decisions.