Hi Izetta
The first thing to say is that the "bio-identical" hormone therapy regime you are using which you rightly say are expensive - is not approved by Governments in either UK or US ( nor Aus) - depending where you're from!
The main hormones taken as part of HRT - as in estradiol and progesterone - are available in UK through NHS and in US/Aus through your regular health-care practitioner. They are more commonly referred to by the medical profession now as BODY-identical hormones ie structurally identical to the hormones our own bodies make. The only hormone not easily available on NHS in UK is testosterone, but in Aus there is a licensed cream Androfeme (sp?). Not sure about US.
After 3 weeks you most certainly should have noticed some difference - depending on what symptoms you want to treat, Hot flushes often diminish within days using transdermal HRT ( not creams - but gel or patches) and tablets work often within a couple of weeks.
Unfortunately the BHRT and compounding pharmacies are just a big commercial con designed to make a lot of money out of women at this time of their lives! Your oestrogen dose is extremely low - and even if it was high enough to make a difference to your moods (which it isn't likely to be as quite high oestrogen doses are needed) then the progesterone dose is insufficient to protect your womb from thickening therefore increasing your risk of endometrial cancer
Please ditch this treatment asap and find a proper one that has a chance of working. You certainly don't need to wait 3-4 months for HRT to work on physical symptoms - some mood effects may take longer than the physical symptoms but important to persevere (as it sounds like you are prepared to do) - and not to be tempted to take anti-depressant medication while the HRT is working its magic and the ADs may well dull your symptoms so you won't know what's what.
You need to bring your oestrogen levels up sufficiently to raise your mood and take sufficient progesterone to protect your womb. Adding testosterone can come later. Also depends where you are in menopause - if you are peri-menopausal then you need to take the progesterone cyclically to induce a withdrawal bleed like a period.
Here is an extract from the position statement of the North American Menopause Society:
http://www.menopause.org/docs/default-source/2017/nams-2017-hormone-therapy-position-statement.pdfCOMPOUNDED HORMONES
Government-approved bioidentical (similar to endogenous) HT, including estradiol, estrone, and MP, are regulated and monitored for purity and efficacy, sold with package inserts with extensive product information (based on RCTs), and may include black-box warnings for AEs. Compounded hormone therapies are prepared by a compounding pharmacist using a provider's prescription and may combine multiple hormones (estradiol, estrone, estriol, dehydroepiandrosterone [DHEA], testosterone, progesterone), use untested, unapproved combinations or formulations, or be administered in nonstandard (untested) routes such as subdermal implants, pellets, or troches.
Compounded HT has been prescribed or dosed on the basis of salivary hormone testing; however, salivary testing for HT is considered unreliable because of differences in hormone pharmacokinetics and absorption, diurnal variation, and interindividual and intraindividual variability.37-39
Prescribers should only consider compounded HT if women cannot tolerate a government-approved therapy for reasons such as allergies to ingredients or for a dose or formulation not currently available in government-approved therapies. With interim guidance on compounding safety and quality control from FDA, quality control of compounded HT may improve.
Key points
Compounded bioidentical HT presents safety concerns such as minimal government regulation and monitoring, overdosing or underdosing, presence of impurities or lack of sterility, lack of scientific efficacy and safety data, and lack of a label outlining risks.
Salivary hormone testing to determine dosing is unreliable.
Prescribers of compounded bioidentical HT should document the medical indication for compounded HT over government-approved therapies, such as allergy or the need for dosing or a formulation not available in FDA-approved products....and a few more links about the practice of "Bioidentical Hormone Replacement Therapy" as opposed to mainstream HRT using the SAME HORMONES!
https://www.menopausematters.co.uk/pdf/article%20Bio%20identicals%202017.pdfhttps://www.menopause.org.au/hp/information-sheets/212-bioidentical-hormones-for-menopausal-symptomshttp://www.menopause.org/publications/clinical-practice-materials/bioidentical-hormone-therapy/compounded-bioidentical-hormones-what%27s-the-harm-https://www.fda.gov/ForConsumers/ConsumerUpdates/ucm049311.htmhttp://www.nhs.uk/Conditions/Hormone-replacement-therapy/Pages/Alternatives.aspx#bio-identicalIn most cases HRT at the right dose in the right formulation at the right stage of a woman's menopause is often the help it ought to be - according to evidence from trials!! You will see light at the end of the tunnel from using your HRT - but only if you take the right HRT!
Incidentally where are you in menopause - how often are your periods and how long are they? Do you skip them and are they few and far between?
This is meant to be helpful to you Izetta - so that you don't spend a lot of money and time on a treatment that is not suitable and won't do anything. - as other members ( Dana in Aus has experience of this) have done and regretted.
Hurdity x
