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[Sallyyy]

I think one of the challenges for the wider menopause discussion is that there will always be people who don’t fit within the ‘normal’ experience - and if this is you it can feel quite isolating. So with something like vagifem the vast majority of people are helped by it without any problems, and articles by the high profile consultants understandably celebrate that. It just would be helpful I think if it was acknowledged more that some people WILL get side effects.

[AngelaH]

My periods from age 11 were heavy, very painful ...... although I have no idea which hormones were involved at any time of the month.  It was 'normal' for me but I dreaded each 1.  Eventually I went onto The Pill which helped a lot. 

It looks like estrogen dominance. I started having my periods from the age of 10.5 (very early) and all my life they were heavy and long.

[AngelaH]

I think one of the challenges for the wider menopause discussion is that there will always be people who don’t fit within the ‘normal’ experience - and if this is you it can feel quite isolating. So with something like vagifem the vast majority of people are helped by it without any problems, and articles by the high profile consultants understandably celebrate that. It just would be helpful I think if it was acknowledged more that some people WILL get side effects.

Exactly.
But I would not call it “side effects”, it is just something which is not studied yet. So nobody can explain why it happens to some people.

[dangermouse]

Interestingly, I could always tolerate the synthetic Ethinylestradiol in the pill, but bio-identical oestrogen acts like poison to my body. Saying that my own oestrogen surges also made me very unwell in peri, so must be to do with oestrogen dominance and the higher ratio to progesterone.

[AngelaH]

Interestingly, I could always tolerate the synthetic Ethinylestradiol in the pill, but bio-identical oestrogen acts like poison to my body. Saying that my own oestrogen surges also made me very unwell in peri, so must be to do with oestrogen dominance and the higher ratio to progesterone.

I have never tried synthetic estrogen, but my meno specialist suggested it may work for me better, so I will ask GP about Tibolone. It is possible that my body can not tolerate bio indentical hormones.

 My peri was the worst part of my life, progesterone level dropped to the bottom and estrogen was still too high, that imbalance made me mentally and physically ill.

[Jules]

The only thing I had was some stomach cramps and breast soreness near the start and after about 3 months of episode of blood spotting.  After checks and all clear I tried again and after 17 months have been fine. Now on alternative nights and ovestin every night. I was under the impression topical estrogen was safer as less entered the blood stream.

[CLKD]

Good points Sallyyy 

Jules - that was my take on VA treatments.  Especially as I had breast disease in the 1990s. 

[dangermouse]

Interestingly, I could always tolerate the synthetic Ethinylestradiol in the pill, but bio-identical oestrogen acts like poison to my body. Saying that my own oestrogen surges also made me very unwell in peri, so must be to do with oestrogen dominance and the higher ratio to progesterone.

I have never tried synthetic estrogen, but my meno specialist suggested it may work for me better, so I will ask GP about Tibolone. It is possible that my body can not tolerate bio indentical hormones.

 My peri was the worst part of my life, progesterone level dropped to the bottom and estrogen was still too high, that imbalance made me mentally and physically ill.

You sound like me!

Tibolone is also bioidentical from yams, it sounds like a bioidentical form of DHEA so may cause similar issues if too much goes down the oestrogen pathway.

The vaginal oestrogen is much safer of course due to the small amount but when you’re sensitive, you’re sensitive to the slightest amount. There are some anecdotal reviews on that site that Vagifem gave them a dangerous womb lining but it doesn’t make much logical sense.

[AngelaH]

You sound like me!

Tibolone is also bioidentical from yams, it sounds like a bioidentical form of DHEA so may cause similar issues if too much goes down the oestrogen pathway.

The vaginal oestrogen is much safer of course due to the small amount but when you’re sensitive, you’re sensitive to the slightest amount. There are some anecdotal reviews on that site that Vagifem gave them a dangerous womb lining but it doesn’t make much logical sense.

Tibolone is synthetic, this is probably why it isn’t the first choice of treatment for GPs.

Tibolone has four features which make it different from conventional hormone replacement therapy. These are: (1) it is a synthetic molecule, (2) it has different activities at different tissues, (3) it is a non-bleeding hormone replacement therapy, (4) it has androgenic activity.

Tibolone is a synthetic steroid that is structurally related to the 19 norethisterone derivatives, such as norethynodrel and norethisterone
https://www.sciencedirect.com/science/article/abs/pii/S1471769702000175#:~:text=Tibolone%20has%20four%20features%20which,4)%20it%20has%20androgenic%20activity.

It’s not about amount of estrogen in vaginal treatment, it is about ingredients. I tried patches and gel, in different doses and had the same result. The same time I don’t have any problems with synthetic Mirena, so why not to try synthetic estrogen? If my theory is not right and it’s not bio identical hormone causing the problems for me, then just estrogen (any) will be blamed.

[dangermouse]

Ah right, as it was made from yams I thought that equalled bio-identical.

Give it a go!

[AngelaH]

Ah right, as it was made from yams I thought that equalled bio-identical.

Give it a go!

It’s not made from yams, it’s synthetic and it has all the risks like other synthetic HRT.

[dangermouse]

If you Google it, it’s says ‘Tibolone is a type of synthetic hormone replacement therapy (HRT) drug. It is derived from the Mexican yam. It is metabolized in the body by the liver. Some of the tibolone metabolites act at the estrogen receptor exerting estrogen effects, especially at the alpha receptor.’

Perhaps this is incorrect but it’s repeated on lots of sites.

[AngelaH]

If you Google it, it’s says ‘Tibolone is a type of synthetic hormone replacement therapy (HRT) drug. It is derived from the Mexican yam. It is metabolized in the body by the liver. Some of the tibolone metabolites act at the estrogen receptor exerting estrogen effects, especially at the alpha receptor.’

Perhaps this is incorrect but it’s repeated on lots of sites.

I am talking about this, it calls Livial and it is synthetic. Or you can redirect me on the site with info, which you found, so I can read as well.
https://patient.info/medicine/tibolone-tablets-livial

Tibolone has four features which make it different from conventional hormone replacement therapy. These are: (1) it is a synthetic molecule, (2) it has different activities at different tissues, (3) it is a non-bleeding hormone replacement therapy, (4) it has androgenic activity.

Tibolone is a synthetic steroid that is structurally related to the 19 norethisterone derivatives, such as norethynodrel and norethisterone
https://www.sciencedirect.com/science/article/abs/pii/S1471769702000175#:~:text=Tibolone%20has%20four%20features%20which,4)%20it%20has%20androgenic%20activity.

[dangermouse]

https://www.menopausefacts.org/tibolone/

https://www.menopause.org.au/images/stories/infosheets/docs/AMS_Tibolone_for_post-menopausal_women_April_2015.pdf

Here are a couple. I wonder what makes other HRT bio-identical, yet this is termed synthetic? Hopefully you will not have the same effects as the BI oestrogen.

[AngelaH]

https://www.menopausefacts.org/tibolone/

https://www.menopause.org.au/images/stories/infosheets/docs/AMS_Tibolone_for_post-menopausal_women_April_2015.pdf

Here are a couple. I wonder what makes other HRT bio-identical, yet this is termed synthetic? Hopefully you will not have the same effects as the BI oestrogen.

Thank you very much, I can see now. One resource is Australian and another one Malaysian. Well I don’t have any reasons not to believe them, but I am trying to find the same info on western, UK or US sites and even wiki does not mention it.  UK NHS call Tibolone simply “artificial”. So, yes, it is interesting, wild yam itself doesn’t contain any hormones, it only contains chemicals that chemists can use as a starting point to manufacture them. It should be difference in production which makes one product body indentical and another synthetic.

I don’t have any choice but to try, when it possible. I am over 50 and it looks like the only one synthetic product available in the UK for my age is Tabolone. I still have Mirena coil, which should be removed in spring hopefully, and then I can try.