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[Menomale]

Hi dangermouse,

I stopped it for 2 reasons. First, I had itching and redness since the first day and when I phoned the pharmacy asking which were the other components in the formula they said that was a secret formula etc. I thought that was not professional to say the least. Second, I have to confess I was fed up with that nightly routine of spreading the cream, I just don't like the sensation, guess it's an Asperger's trait, I rarely use creams, gels these days, even water sometimes gives me some weird feeling and I have to dry it right away. That's why I didn't even considered the oestrogel option. I simply can't doi it every night. The patch is just twice a week (according to Dana's experiment on another thread even once a week could do) which suits me better.

Talking about costs... in Brazil it´s the opposite, compounded drugs have become so popular that the prices have skyrocketed. Last time I checked, Estradot plus Utrogestan and the compounded cream had basically the same cost per month.
It's still early days on the patch so nothing is impossible, I am opened to try any options available to make me feel functional again. Even go back to the componded formulas, I'm sure I can find a pharmacy that will provide me the info I need.

Thank you very much for the encouragement, I really need this!

XXX

[Hurdity]

My word! Really interesting thread. I'm about 4 months into trialling hrt and reacted really badly to progesterone tablet form but same (norethisterone) in patch I feel actually really good after a few days on the prog/oestrogen but after finishing and back to oestrogen only around day 3-4 get really anxious and feel slightly mad! Then day 5 start feeling okay. Had terrible mood swings pre hrt but finally starting to feel much more balanced and happier on hrt. Not sure I've got it right yet as no joint pains on tablets but with patches has returned noticeably worse on prog phase. Also missed a couple of periods but had light bleeding from day 3/4 off prog and has carried on all through oestrogen which I'm changing back tomorrow to prog/oestro phase (on Everol sequi). Is it okay to have light bleed/brown discharge (sorry for details) this long? Have had to post as this appears to be the experts post ☺ x

Probably the reason you feel a bit twitchy after going back on to the oestrogen only part of your HRT - is due to normal pms symptoms - similar to what you would feel when fertile, just before your period. it is due to progesterone withdrawal and the body has to reverse the physiological changes which take place in the presence of progesterone. Once these have reversed,  and you are stable on the oestrogen only the feelings subside - hence your feeling normal.

Yes fine only to have a light bleed - according to this website 15% of women actually don't get a bleed on sequential HRT.

Menomale/dangermouse - compounded oestrogen/progesterone creams are not recommended/licensed in UK - we've had lots of discussions about these before!

Hurdity x

[Menomale]

I'm aware that it is not recommended/licensed in the UK (yet) but I think it should be ok to talk about it, not advocating its use, after all no one here has the expertise and legal right to do such thing not only regarding compounded products but the licensed ones as well. Just my humble opinion.

[Hurdity]

Of course it's OK to talk about it!!! I am just aware of other women reading this forum in UK and thinking to go down this expensive route not recommended by the medical profession! In fact there has been a recent article in the magazine about it which Emma promoted on this forum a few days ago:
http://www.menopausematters.co.uk/pdf/article%20Bio%20identicals%202017.pdf

Whenever I see reference to compounded hormones - I always post what the current view is of this - for women who just chance upon a thread .

Hurdity x

[Menomale]

Ok, whenever I type the word "compounded" I'll make sure to add in sequence "NOT recommended/licensed in UK" (thanks copy/paste inventor!!!) for the benefit of all ladies here who deserve the best information available. 

[murphydurf]

I think compounded sounds wonderful and I know Marion Gluck in London prescribes these. Sadly I can't afford to go down that route as I've already spent quite a bit on prof studd. It's about time we in the U.K. Had a more tailored approach vs. the try it and see what happens method which can result in a fair bit of misery. My understanding is that all the compounded HRT is also BHRT. The prob in the U.K. is obviously that the NHS could never support these formulas nor the testing to determine prescriptions.

Hopefully they'll start to become more commonplace and we can all benefit from another option.

Mx

[murphydurf]

Dangermouse - are you prescribed through Marion Gluck?

Mx

[Tempest]

There is a LOT of talk about this over at Hystersisters! I smell a rat - 'Big Pharma'  is NOT getting a slice of the compounding 'pie" so is going at it hammer and tongs. Why aren't I surprised.

[murphydurf]

Nail on the head Tempest!

Mx

[Menomale]

There are many issues concerning drug's regulation all over the globe. An island is still a part of the globe, no matter how much water surronds it.

I think the big problem of drug's regulation is that technology develops faster then science for many reasons (tech needs less bulk of accumulated knowledge, is opened to innovations, creativity, etc, and most of all is not hindered by buraeucratic public investiments and the scientific method steps).

Compounded pharmacy (NOT recommended/licensed in UK) is becoming very popular because it is based on technology rather than science. Most countries cannot afford to test all available products and new ones keep coming every day. Add to that a massive marketing structure that rules the world now, then you have the perfect nightmare for TRUE scientists that want to study all possibilities but are tied by money/power interests.

[Menomale]

Patents = money/power. This is an interesting discussion and progesterone itself is a good example of how patenting natural substances can be done by sideways. Utrogestan and Prometrium are identical to the natural progesterone produced by humans, but they could be patented under the name "micronized progesterone" because they are processed in a formulation that can be delivered in small amounts (sustained release and increased half-life). The progesterone used in compounded products (NOT recommended/licensed in UK) is exactly the same molecule extracted from plants (soybeans and Mexican yam) but cannot be patented because it is natural and is not processed in a formulation that can be patented (yet, because this is only a matter of how much money/power and time you have to develop a new delivery route, such as a patch).

I would appreciate if all pharmaceuticals (big and small) were interested in developing a progesterone patch!

[murphydurf]

Wonderful idea Menomale - perhaps you should look into it?

Mx

[Menomale]

I'm not sure how... 

[dangermouse]

Dangermouse - are you prescribed through Marion Gluck?

Mx

It's through Jan Toledano who now has her own practice but I did initially see her at Marion Gluck several years ago when she said she didn't think she could help me as I reacted so badly to the creams, so we assumed it wasn't my hormones. I returned to her as my symptoms had become stronger and more apparent (and clearly linked to my cycle) and she realised I'd been having migraines triggered by high oestrogen so now just on progesterone, which reacted badly to during first cycle but now doing great and best I've been in years these last few weeks! She's great as really tries to get to the bottom of your issue and doesn't just fob you off with the same as everyone else. I also couldn't afford to see her for follow up (and wanted to try the higher dose before reporting back) so I emailed her assistant and I only had to pay for the prescription.

My GPs have no issue with me using compounded products - they aren't against them, they just can't prescribe them because they can't be bulk made and affordable by the NHS and, as Menomale points out, patented. The BMA have no warnings about them (as far as I know) as they are the same ingredients in the stronger formulations of estradiol patches, gels and Utrogestan. I believe they differ in formulation in terms of the carrier, so the possible 'magic' ingredient that helps absorption, hence the pharmacy may have their own formulation they don't want others to copy!

If women do well with what they can get on prescription (as I'm sure many do) then yes always try those first of course. However, if another poster hadn't mentioned seeing Jan and doing well with the compounded HRT, I probably wouldn't have thought to give them another try so I'm very glad they were mentioned!

[murphydurf]

That's really interesting dangermouse and also that you discovered it was prog you needed and not E. I'm sure that would've been difficult to uncover in conventional treatment. Great that it's working for you and you've found your solution. Hopefully one day that option will be available to more women.

Mx