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Dr. Stoll
I am 43 years old. I had a partial hysterectomy 10 years ago. The one remaining ovary is still functioning I believe. My confusion is with which HRT drug I should be taking for my bones, to make me feel less tired, and to keep my desire for sex at a somewhat normal status. I've been on Estratest for a while. Now my doctor has prescribed Prempro. I would like to be taking an HRT drug that's natural and would give me all of the benefits I need. I still need my sex drive as well as all the other health factors. Thank you.
In Reply to: Estrogen Replacement Therapy posted by Joyce on August 04, 1999 at 09:52:09:
Hi Joyce
I'm 44 and have had excellent results with natural progesterone cream (wild yam). I also was on Prempro, but had too many side-effects. My doctor gave Combipatch and it gave me varicose veins and caused my nose to bleed! Wow, that was all I needed on top of menopause. Wild yam cream strengthens blood vessels, while estrogen dilates and could balloon veins out. Estrogen can also cause esophageal reflux. Just thought I would share my experience.
Linda J.
In Reply to: Estrogen Replacement Therapy posted by Joyce on August 04, 1999 at 09:52:09:
Joyce, see books by Jonathan Wright, MD, or Marcus Laux, ND, for detailed information on natural hormone replacement, in particular, natural progesterone cream.
I was interested to read that Estratest didn't do anything for your libido. I had heard that the testosterone it contains was very "stimulating" in that regard. I was puzzled as to why you would need Prempro since you apparently no longer have a uterus so wouldn't require protection from endometrial cancer, which the progestin in Prempro supposedly provides.
Vicki
In Reply to: Re: Estrogen Replacement Therapy posted by vickir on August 06, 1999 at 13:15:12:
I have a Q about infertility. I was a pt of yours in Jess. Co--successfully treated for Candida. (THANKS!) Nice to find you on web. I am 40 G5 P5 A0. (all conceived quickly) Would like more. Since birth of my 2 y/o I have had symptoms of low estrogen. (lo libido, mental fog, night sweats, vague stiffness, low backache, mood disturb.+ others) We have tried unsuccessfully to conceive for 1 yr. Is it possible for a low estrogen level to interfere with conception? I still cycle normally and always show LH surge. I know I'm 40, but I don't consider this impossible! My family are late menopausers. The RE are SO very negative. Could I be on the right track as long as we don't "overshoot" the estrogen? (bcp effect.) Would you go with patch or PO?
***Just an aside, maybe infert posts should be elsewhere besides estrogen archive--nearly impossible to find.
In Reply to: Estrogen Replacement Therapy posted by Joyce on August 04, 1999 at 09:52:09:
Hi, Joyce.
If even 1/4th of your remaining ovary is functioning, you do not need replacement. There are tests your doc can do to SEE if your ovary is, indeed, still functioning.
I still recommend Premarin as the most complete and natural HRT available.
Walt
In Reply to: from former pt--infertility posted by jane on August 06, 1999 at 15:26:15:
Hi, Jane.
Thanks for getting back in touch!
More and more people are having early menopause now and it seems to be because of the alteration in hypothalamic function so often mentioned on this BB due to the storage of stress-effect. Since that is the most common cause, your practicing SR right would be the most important thing for you to do.
Next, you should get a copy of Paavo Airola, ND's classic: "Every Woman's Book" and both you and your husband should start following it ASAP. It is available in every bookstore and library AND though amazon.com on the internet.
You have learned some of this stuff because of your previous experience with the C-RS problem.
By following the above, I would be surprised if your menses pattern would not return to what it was 10 years ago within 6 months. By persisting, you should be pregnant in a year & have a healthy pregnancy and baby.
Thanks for the suggestion about a catagory for infertility since it is becoming SO much more common. In MY youth, the problem was preventing pregnancy!
Let us know how you do.
Walt
In Reply to: Re: Estrogen Replacement Therapy (Ovarian remnant still functioning?) posted by Walt Stoll on August 06, 1999 at 15:49:03:
Walt,
I ran out of Premarin (which I had been taking continuously for 2 1/2 years) a few months ago. I started taking herbals while pondering whether I wanted to do something different long term. During this time, I read a dozen or so books promoting a variety of approaches to HRT. Some were written by MDs who support "conventional" HRT (e.g., Premarin + Provera), some by MDs and NDs (e.g., Jonathan Wright and Marcus Laux) who support use of natural progesterone with or without supplemental natural, plant-derived estrogen (primarily estriol), and one by an MD pushing raloxifene, aka Evista. (The latter, by the way, was employed by the manufacturer of Evista to design the drug trials, so he might not be considered completely impartial.) This area is filled with an incredible amount of misinformation and disinformation. Often one author would flatly contradict another author, leaving me bemused and bewildered and wondering what could be believed. What IS the truth about stroke and the participants in the Nurses Study, for example? Did the nurses who took Premarin have a 50% higher rate of stroke than the ones who didn't, or NOT??? But then an article in the December issue of "Arteriosclerosis, Throbosis and Vascular Biology" states that HRT was found to decrease levels of fibrinogen and reduce blood stickiness....
What else did I learn? There are "over 300 different estrogen fractions" (per the raloxifene doc); there are 16 estrogen fractions in Premarin (until very, very recently, the only conjugated estrogen available), only 3 of which are found in humans (the rest are natural--but apparently only to horses); Tri-Est, the formula of plant-based estrogens developed by Dr Wright, contains estriol, estrone, and estradiol, with estriol being by far the dominant component.
I came to this bulletin board looking for some clarification and got even more confused. Walt, I see that you are not a proponent of progesterone and consider it a "fad." It isn't clear to me when you talk about "progesterone" whether you are referring to the "natural progesterone" (a la Dr Wright and Dr Lee), or whether you mean "progestin" as in Provera. Or both. I didn't find in the archives an explanation of what you consider to be the fallacy in Dr Lee's and Dr Wright's (and many others') perception of its efficacy (vs that of estrogen). And why do you prefer Premarin to plant-based estrogens (Estrace, for example) which, like Premarin, are also predominantly estradiol? I noticed your reference to the apparently widespread use of Premarin among female gynecologists; I had read of one survey that reported 50% of menopausal gynecologists use Premarin. There was nothing said about what the other 50% do.
The herbals (black cohosh, chasteberry, dong quai, mexican yam extract, and red clover, plus eating lots of soy) did NOT work for me. Hot flashes returned with a vengeance, making a good night's sleep impossible. After a month or so, I began using Estraderm patches because I thought estrogen in that form might be easier on my liver and gall bladder, while still relieving the hot flashes. I'm interested in trying the progesterone cream, either alone or in conjunction with an estrogen supplement, but I'd really like to hear more about why you feel so strongly about Premarin as opposed to other forms of HRT.
Namaste,
Vicki R
In Reply to: Re: Estrogen Replacement Therapy (Ovarian remnant still functioning?) posted by vickir on August 09, 1999 at 16:00:39:
Hi, vickir.
I am no more comfortable with MY position than the world seems to be with its. I am used to using premarin----indeed, my wife is on it. Perhaps we will know what form of HRT is best (for every specific individual) in 50-100 years. The problem right now is that everyone's physiology is unique and we are still trying to force everyone into the same keyhole.
If you want to read the most coherent, and most up to date, research in the area, you need to subscribe to a year of "Functional Medicine Update". I have subscribed to this world wide service for more than 18 years (as a charter member). Call (800) 873-9660 or go to their website at healthcomm.com When you subscribe, ask them for a copy of the index for the past 5 years.
We will know in a few (20) years if vegetable based estrogen works as well as Premarin. I cannot fault Dr Wright's thinking since he is one of the foremost researchers in this area. HOWEVER, my experience tells me that ALL of the estrogen fractions humans make have not yet been discovered. Twenty years from now professionals will look back and laugh at our insistance that there are only 3 fractions. Why would a horse need a "dozen" and humans need only three?
Those who recommend only progesterone (either plant of substituted androgen [animal]) are ignorant of the unique functions of estrogen vs progesterone.
Personally, I think it reasonable for any postmenopausal person to try different combinations, for long enough to actually see what their bodymind laboratory tells them, and find out what works best for THEM.
The research you will see from the world literature will soon tell you that we all handle different hormones VERY differently. The allopathic paradigm is MUCH too primitive to handle questions of such complexity. Out paradigm of research is that we take the mean as the "truth" and throw out all the rest. Remember, that means that 99% of everyone will be on the wrong thing. Some of us will be close to what we need and a very significant number of us will be on entirely the wrong thing. This is similar to the thyroid dosage example described in my book.
As the wise man once said about this: "The appearance of one sparrow proves the existance of birds." Think about it.
When there is so much controversy, it means that no one of us KNOWS what is right. Until we do (and controversy fades) our own personal experience will have to be our guide (our personal laboratory).
I hope this is making sense to you. More questions?
Let us know what you learn.
Namaste`
Walt
In Reply to: Re: Estrogen Replacement Therapy (ARCHIVE under estrogen))Nugget? posted by Walt Stoll on August 12, 1999 at 09:53:42:
Dear Walt,
"I am used to using premarin----indeed, my wife is on it."
My mother has been on Premarin for over 30 years and is one of the reasons I have reservations about it. She takes a blood-thinner and medication for high blood pressure and has had her gallbladder removed, all of which could possibly be related to Premarin. So far, she has not had breast cancer nor osteoporosis (respectively, an escape from possible bad consequences and a possible beneficial result of Premarin). However, she wears a pacemaker and has been afflicted with rheumatoid arthritis for the past 5 years, so Premarin hasn’t benefited her much in those areas.
"Perhaps we will know what form of HRT is best (for every specific individual) in 50-100 years. The problem right now is that everyone's physiology is unique and we are still trying to force everyone into the same keyhole."
This is an aspect of natural hormone therapy that particularly appeals to me—that it allows one (to SOME extent, at least) to tailor one’s supplemental hormones to one’s individual needs. Premarin as well as the other brand-name hormones, whether plant-derived or otherwise, are much more “one size fits all.”
"If you want to read the most coherent, and most up to date, research in the area, you need to subscribe to a year of 'Functional Medicine Update'."
From my observations, MOST of the published studies on hormone replacement used Premarin. Relatively little research seems to have been published in the major journals (for all the old, familiar reasons) that used other forms or types of replacement hormones.
"…my experience tells me that ALL of the estrogen fractions humans make have not yet been discovered. Twenty years from now professionals will look back and laugh at our insistance that there are only 3 fractions."
In fact, the doctor who wrote the book promoting Raloxifene mentioned that over 300 human estrogens have been identified. In the meantime, we apparently have a lot to learn just about the three that are currently prescribed. Dr Christiane Northrup remarked in a lecture I heard recently that she prefers estriol over estradiol because the former becomes weaker as it gets broken down in the body, while the latter becomes stronger. She didn’t say what she bases that opinion on.
"Those who recommend only progesterone … are ignorant of the unique functions of estrogen vs progesterone."
From my own perspective, the most important difference in functions that I’m aware of is their respective roles in bone building vs. bone destroying (i.e., progesterone is said to promote growth of new bone material, and estrogen is said to retard destruction of existing bone). This takes us back to the advantages of having one’s hormonal status tested prior to prescribing a supplemental hormone regimen.
"The research … will tell you that we all handle different hormones VERY differently. The allopathic paradigm is MUCH too primitive to handle questions of such complexity."
My point EXACTLY.
I appreciate your comments, Walt. If I have learned ANYTHING from the reading I’ve done so far, it is that no one has the definitive answer in this area yet. Probably won’t happen in my lifetime, so I’m going to figure out what I feel most comfortable with (mentally and physically) and go for it.
BTW, the change you reported to the Hippocratic Oath is simply appalling. Surely any organization taking such an attitude is doomed. Let's hope it happens sooner rather than later.
vickir
In Reply to: Re: Estrogen Replacement Therapy (ARCHIVE under estrogen))Nugget? posted by vickir on August 13, 1999 at 12:10:33:
Thanks, vickir!
300, eh?
How can anything less than a "natural" product have any chance?
I hope you will look at the Functional Medicine Update. The purpose of this organization is to search ALL the world literature and not exclude alternatives just because they do not follow the party line. You would be pleasantly surprised.
Walt
In Reply to: Re: Estrogen Replacement Therapy (ARCHIVE under estrogen))Nugget? posted by Walt Stoll on August 15, 1999 at 16:47:04:
Walt,
I will check out the FMU. Thanks for telling me about it. The Women's International Pharmacy very kindly sent me a thick stack of journal articles describing research using plant-derived hormones.
Vicki R.
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