Print

Please login or register.
1 Hour 1 Day 1 Week 1 Month Forever
Login with username, password and session length

[GeordieGirl]

Hi Greenfields,
Whenever anyone mentions bio-identical hormones, it's always followed by a lot of arm waving about how natural doctors are trying to cheat us with made up preparations to make a lot of money...etc etc...etc

Bio-identical hormones are basically hormones that have the exact same molecular structure to our own hormones. They're what our bodies are used to. Unless you were brought up in a stable, it's unlikely you ever had horse hormone in your body so to call some HRT "replacement therapy" is completely incorrect. Hormones made from pregnant mares has never been made by our own bodies, and I guess it's no great surprise that these are then seen as carcinogenic.

I am a great proponent of sticking with nature and using products natural to our bodies. Unfortunately compounded hormones (which are not any witch doctor's magic but simply generic hormones tailored to our needs) aren't available within the standard NHS doc's offering so instead I've gone with branded varieties. I'm currently on Oestrogel and Utrogestan - both are bio identical.  These are the first hormones I've ever taken and I'm pretty impressed with the results.

Bio identical hormones are used widely throughout Europe and have a greater safety record than non bios, with some good overall benefits to our bodies too such as protection against oesteoporosis, cardio vascular issues and also colon issues (one I've fallen foul of).

GG x

[GeordieGirl]

There are a lot of reasons for this. The one very big reason is that there still isn't any evidence that progesterone used externally (ie as a cream) is strong enough to oppose estrogen.

A lot of HRT is taken via the skin or as a pessary - this is actually better for the body as it avoids "first pass", where the liver breaks down the hormone, with only a lower amount reaching the blood. A higher dose is thus required for any hormone taken by mouth.

the fact that there have been cases where doctors have been found to get kickbacks from the pharmacists for prescribing the compounded hormones, or the doctors have actually had a conflict of interest by owning the compounding pharmacy.

...totally unlike the big pharmaceutical companies of course who make over 5 billion dollars a year from branded HRT, ahem (and use a large percentage of that wooing the local GPs).

Generic drugs cost a lot less than a boxed product, look at aspirin for example. The issue is because generic hormones aren't within the NICE guidelines our GPs have little option but to prescribe some expensive brand name. Fortunately there are a number of bio-identical hormones available with a name, but not in the same proportions are our bodies have previously been used to (eg with a mix of estradiol, estrone, estriol).

GG x

[Suzyq]

Prometrium is ultrogestan in canada. It can be used vaginally

[Dana]

A lot of HRT is taken via the skin or as a pessary - this is actually better for the body as it avoids "first pass", where the liver breaks down the hormone, with only a lower amount reaching the blood. A higher dose is thus required for any hormone taken by mouth.

Please note that I said “there still isn't any evidence that progesterone used externally (ie as a cream) is strong enough to oppose estrogen”. I said nothing about taking estrogen externally, and using a progesterone pessary is not “external”.

...totally unlike the big pharmaceutical companies of course who make over 5 billion dollars a year from branded HRT, ahem (and use a large percentage of that wooing the local GPs).

Generic drugs cost a lot less than a boxed product, look at aspirin for example. The issue is because generic hormones aren't within the NICE guidelines our GPs have little option but to prescribe some expensive brand name. Fortunately there are a number of bio-identical hormones available with a name, but not in the same proportions are our bodies have previously been used to (eg with a mix of estradiol, estrone, estriol).
 

I'm not going to get into a discussion about generic vs branded or anyone's personal opinion about the actions of pharma companies, because what is relevant in one country is not relevant in another.

Regarding compounded hormones, I'll just refer you back to the links I posted from respected and reputable menopause information sites (not pharma companies). I have nothing more to add.

[Dana]

Prometrium is ultrogestan in canada. It can be used vaginally

Yes, Prometrium and Utrogestan are the same thing - just different names.

[GeordieGirl]

I'm not going to get into a discussion about generic vs branded or anyone's personal opinion about the actions of pharma companies, because what is relevant in one country is not relevant in another.

I'd have thought an English woman was pretty damn similar to an American, an Australian, a French woman....and many other different varieties. Unfortunately the pharmaceutical companies must think differently, hence the reason they've petitioned the FDA to ban some natural hormones in the USA whilst actively advertising these in Europe (one such example is Wyeth, bio-identical estriol). When cash is king, ethics and the patient are rarely at the forefront....     

GG x

[Greenfields]

Hi Greenfields I use estradot 50 here in UK, and it is equivalent to Evorel 50. The number after the patch is the number of mcg per day the patch is designed to deliver into the system. Most patches come in several doses - from 25 mcg to 100 mcg. It shouldn't make a lot of difference although I find Estradot, being very small and more convenient, don't leave such big marks and stick very well (I used Evorel when I first started HRT)! So - no worries there that you can't get the equivalent. I'm not sure of the formulation of Prometrium but I am sure there are one or two other overseas members who may use it and can tell you. Not sure if it can be used in the same way as utrogestan ie vaginally but I guess so if it is also used as a fertility product.

Hurdity x

Thanks Hurdity x

[Greenfields]

Just been reading through the discussion between GG and Dana - and I wondered is Oestrogel the same as what's in Evorel?

The reason I ask is that I'm still getting side effects from the HRT I'm on (Evorel and Utrogestan) and I'm wondering whether there is anything else that might be a bit easier on my body? N.B. I'm still only into the second cycle of these medications though.

[GeordieGirl]

I've just done a quick google - Estrogel is trans dermal oestradiol (in a gel format to be rubbed in), Evorel is a patch but appears to be bio identical oestradiol too? 

I haven't used a patch but am tempted, however I want to make sure my dosage is right first. I've only been taking the Estrogel for 6-7 weeks and I've halved the dose the doc suggested as it gave me heavy breasts. I'm taking one pump per day and it seems to be working for me.  I'm not sure you'd have quite the same flexibility with patches, though I guess you can cut them in half? They're probably less messy too...

I would have preferred an oestradiol / oestriol mix but don't think there's a (branded ) option that offers this in cream / pessary or patch form.  I noticed on the forum someone had had oestriol prescribed as a generic drug, I'll chat to my meno doc next time I have an appointment.

If you're only in the second cycle it may be worth waiting a little longer to see it if settles? Or perhaps tweak the dose slightly if that's at all possible?  I've tried a higher dose, a lower dose and no dose and it's become clear that I definitely need the oestrogen but there's a fine line for me between the right dose and too much.

GG x

[Greenfields]

Thanks GG.  I'm seeing my Dr Wednesday.  The side effects I've had this second cycle so far (I'm in Day 13 at the moment) have been quite different from the first cycle so I guess I should wait and see how I am by the middle of July when I will have completed 3 cycles.  I guess I'm just desperate to get fully well again 

I was talking to a really nice therapist this morning who I'm going to see for the next little while even thought its private and its going to cost more money - I was talking about going to Canada for a week in July - but by the time I'd driven home from the therapy session I was exhausted - I took an antihistamine last night for the hives I currently have and because I'm so sensitive to medication, I still wasn't 100% this morning so I'm hoping that is the reason why I was so tired. 

So I spent part of this afternoon lying down resting for an hour ... and although I try to stay positive, part of me was thinking, who am I kidding in terms of being able to be well enough to make a trip to Canada in July?  But I really need to try and sort things out before my flat tenancy is up in mid-September (and the landlord will want to know whether I'm renewing by mid-August) otherwise I will be stuck in the UK for another 6 months and drain even more of my savings.  It's hard to stay positive sometimes 

[Greenfields]

Just to update on this thread, I heard back from the health unit in the city in Canada that I want to move back to and they have told me where I can get Estradot and Prometrium prescribed for me!  Which is great.  It will cost though - don't know how much but hopefully less than what the Dr in Toronto was quoting me.

All I need to do now is just get really really well so I can make a trip out for a week and see how I manage things - but it needs to happen before August ideally.