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[pepperminty]

Hi ladies, just thinking- Wouldn't it be great if the drug companies supplied all the progesterones on patch/ tablet form  and all the estrogens in gel/ tablet/ patch form and then we could mix and match ( with expert advice) to find a regime that suits us. The choice is actually quite limited as to what it could be.  No doubt it is a cost issue. We are all living longer and this really needs to be addressed.

Pepperminty xx

[weathergirl]

I so agree.  Progesterone and me do not agree and taking the Utrogesten gels when I have to is awful.  All I have access to in patch form would be the Combipatch in the U.S.  And it's the synthetic form.   Compounded prescription progesterone cream can be prescribed by doctors here, but I am wary of it because the testing of quality and potency is not as rigorous as with FDA approved HRT.   I do wish there were more options for all of us.

[Dancinggirl]

Hopefully there will be a day when all hormones will come in a good variety of measured doses, in all the different delivery forms with clear guidelines for all doctors and patients. Unfortunately there is unlikely to be any profit for the pharmaceutical companies in doing this but if the NHS came up with their own range of hormone treatments it could save a lot of money. We can dream!  DG x

[dangermouse]

Compounded pharmacies will do this for you but you would have to pay private prices.

I suppose if we want a true health service we have to pay for it. The NHS etc. only appears to be able to afford to follow a disease model but will throw us a few crumbs for contraception, obstetrics and oestrogen therapy.

I'd love not to have to pay for my progesterone therapy but, with all the horror stories I've read here, our nearest equivalent Utrogestan would be like taking heroin for a paper cut!

[pepperminty]

Perhaps we could petition the house of commons? Or is that a crazy idea. 

[dangermouse]

I so agree.  Progesterone and me do not agree and taking the Utrogesten gels when I have to is awful.  All I have access to in patch form would be the Combipatch in the U.S.  And it's the synthetic form.   Compounded prescription progesterone cream can be prescribed by doctors here, but I am wary of it because the testing of quality and potency is not as rigorous as with FDA approved HRT.   I do wish there were more options for all of us.

Mine comes with a list of ingredients like when you buy food or medicine normally. It's the same stuff they use as the drug companies, just in different ratios and by chemists on-site like in the olden days with the scales, pestle and mortar!

I can understand why you'd be frightened off though with all the headlines but I suspect there's more suspect additives in most of the food we consume.

[weathergirl]

dangermouse, I tried a compounded form of testosterone for 6 months and it did not work at all.  Reputable pharmacy, had been doing compounding for years.  When I queried more in depth, I found out that the compounding pharmacy is only required to submit one sample (a single sample!) every 3 months for testing for potency, etc.  So there is no 'guarantee' that all the batches in between are of appropriate strength, etc.  I was fortunate my doctor let me try it, as most are reluctant to prescribe compounded and it's very expensive here in the U.S. (not covered by insurance at all).  I may look into another pharmacy that does compounding somewhere down the line.  I'm glad yours seems top notch!

[dangermouse]

Yes I think it's a bit stricter in the U.K. but, to be fair, I have no idea what gets tested, I just tried it and it worked! I had tried online creams but you had to use shedloads where my one is very concentrated.

The carrier ingredient is also key and our pharmacy have a much better one now, so I suspect cheaper carriers will equal less absorbency. My cream can stop periods so it's probably strong enough for womb protection but would be too expensive to be made into a protective drug (as opposed to an active drug) so I suspect the BMA and FDA will stick with Utrogestan and synthetics as they got there first. Although I don't see why they can't have smaller doses of the Utrogestan rather than having to knock people out cold with it!

[weathergirl]

dangermouse, you're speaking my language (re: the knock out dose)!!  I'm only on a 0.025 microgram patch - it's the lowest dose patch available in the U.S. to treat menopausal symptoms, and comparable to the Estradot 25 (I'm guessing) and I still need to do 200mg progesterone 10-12 days every other month.  I dread those progesterone days.   I try to alternate between oral and vaginal throughout the 10 days stretch but still get lots of symptoms regardless.  I know that progesterone topically needs some form of oil-based or fat based delivery mechanism and from my understanding, this is why no suitable  bioidentical progesterone patch has been created.  My doctor is not on board with using it vaginally and I have to just do it on my own as I know many women do and it works just fine.

I'm glad your compounded works so well!  That's really nice to hear and there are likely differences in the way compounded are regulated and monitored between the UK and the US.  And you're right!  I could use an OTC progesterone cream but would probably need 3 or 4 times the recommended dose (covering nearly half my body!) to get the amount in me each day that the single gel cap would provide! 

[weathergirl]

pepperminty, the choice for estradiol is so much wider than for progesterone options.  At least in the UK, I actually think you may have more choice for estradiol products (covered by NHS) than we do here in the US.  I know at one point I wanted to try Divigel (Sandrena) and it was not covered at all by insurance, but the patches were, even if somewhat expensive. 

[pepperminty]

Hi Weather girl, yes the estrogen has more choice, It is the progesterone I agree, shame they don't go dydrogesterone separately as it is not so testosterone related and might be an alternative for some. 

[rosie17]

Weathergirl, I'm also in the U.S. - have you looked at Women's International Pharmacy or Skip's Pharmacy in Florida? Both have websites you could google. I used Women's International once for hormone creams, but didn't like the base...too slimy just like the OTC creams. Plus it was too expensive with the shipping costs. I used Skip's once for something other than hormones, but they were very helpful when I called for information.

According to Dr. Elizabeth Vliet, creams should be 1/10 the strength of oral doses, so if you're using 200 mg oral progesterone - I'm assuming Prometrium - could you possibly use a 20 mg compounded cream every other month? This might be a gentler way to use it, though I am no expert by any means. The OTC creams are usually 20 mg strength, too.

[weathergirl]

rosie, it's interesting you bring that up!  I HAVE read in two other places that on such a very small dose of estradiol, I could probably make do with using the OTC progesterone creams but perhaps every day, consistently, since they do deliver the 20mg per topical dose (equivalent to the 200mg Prometrium).   I would love it if my GYN would agree to that, but we know that's not going to happen!  Are you using or were you using the bioidentical compounded creams?  I haven't heard of either of those pharmacies but thank you for the names.  If I ever did go compounded again, I would probably want to use a pharmacy I could drive to (I'm not in FL) so I could easily pick up the scrip and talk to the pharmacist. 

What's really frustrating too is there used to be a vaginal option for progesterone that was frequently used in women who were pregnant and needed additional progesterone to sustain the pregnancy in the early stages.  I asked my GYN about this - Crinone - but she says they don't prescribe it for HRT use and even in pregnant women nowadays, they opt for the oral Prometrium instead.  sigh....there has to be a better way! 

[weathergirl]

Pepperminty, yes it would be could to have that option for a gestagen  - as many options as possible since so many women have issues with that part of HRT.

[rosie17]

Weathergirl, I've been seeing a naturopath for years as I've been 'mishandled' by allopathic medicine too many times, and she is very open to me trying whatever I want, even at my advanced age of 62, and especially since I have osteoporosis. I started very low-dose compounded estrogen, progesterone and testosterone just a month ago and haven't had any problems whatsoever, though I haven't had blood tests yet so don't know what my levels are or if I'm absorbing the creams like I should, will be doing that soon. I'm lucky to have a compounding pharmacy in my area and I pay about $30 per prescription ($90 total). I might switch over to a bioidentical patch or gel form of estrogen to cut part of the cost.

I started all 3 hormones at the same time and about 3.5 weeks in, I suddenly got a glimpse of the old me that I thought had disappeared forever. I found myself interested and curious about some things I didn't have the energy or motivation to even think about in a long, long time. It was delicious! I attribute this to the testosterone - I've dabbled with estrogen and progesterone a few times in the past and never experienced this benefit. I have the click-top dispensers, but think I will ask the pharmacist to put the creams in syringes so the dose is more accurate, at least as far as the amount I'm using.

If you can, I would suggest seeing an integrative/naturopathic doctor. My insurance covers it, maybe yours would, too. Also shop around for a compounding pharmacy as they can set their own prices.