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[Booblet]

Hi,
Can anybody suggest a bio- identical Progesterone- I can't take Ustrogestron. I suffer from Excema and my allergic level is extremely high.
From recent posts I stated that I have been taking 0.5 gel Sandrina and Progesterone cream. I also stated I had had Covid- which sent my hormones all over the place and had been spotting twice in a month..
I am at my wits end which way to go.
I am ill with Flu atm:
I need bioidentical hrt - and possibly Testosterone?
Can't get to my GP atm (Flu).
Should I stop 0.5 Sandrina gel and just take Progesterone cream?

Any advice would be so welcome.
X

[sheila99]

I think cyclogest is? I don't know of any others. How long since you had covid and do you have any symptoms of long covid? My hrt stopped working for 3 months just because of the jab, increasing oestrogen made no difference. I'm just wondering if this is something that only time will sort out, I hope not  .

[Hurdity]

Hi Booblet - sorry to hear about your issues and symptoms

You could take progesterone cream on its own - it won't do you any harm but unlikely to do you any good either and nor is it sufficient on its own to protect your uterus if you are taking oestrogen HRT.

So as sheila99 says Cyclogest is also bio-identical but it's not licensed as part of HRT. Ditto Lutigest. The ony licensed bio-identical progesterone is utrogestan.  How were you taking the utrogestan when it made your eczema flare up? Taken vaginally it might be better for you, and certainly better for eczema than rubbing a cream into the skin surely? Does the gel not affect your eczema?

If you've been spotting I do hope you've consulted a doctor because it could mean your womb lining has thickened because as above the progesterone from the cream is insufficient to protect the womb?

Sorry to hear about the flu and wishing you well for a speedy recovery.

Hurdity x

[AngelaH]

I need bioidentical hrt - and possibly Testosterone?

Any advice would be so welcome.
X

Bio identical hrt is available only privately, NHS offers only body identical.

[AngelaH]

So as sheila99 says Cyclogest is also bio-identical but it's not licensed as part of HRT. Ditto Lutigest. The ony licensed bio-identical progesterone is utrogestan

Hurdity x

Cyclogest and utrogestan are not bio identical, they are body identical.

[Petra]

I didn't know there was a "bio identical" vs "body identical". What's the difference? And can anyone explain why Utro needs to be taken in what seems to me such a high dose...i.e. why a body identical medication would need such a high dose. I realise you can't just compare mg to mg, but e.g. my Provera dose is 5 mg a day, Utro was 100 mg a day.

[AngelaH]

What's the difference?

The main difference is that body identical HRT is available from NHS, but bio identical is not available, private only.
https://www.onstella.com/the-latest/hrt/difference-between-bioidentical-hormones-and-body-identical-hormones/#:~:text=Compounded%20bioidentical%20hormone%20replacement%20therapy%20is%20not%20recommended%20as%20these,your%20own%20doctor%20on%20prescription.

[sheila99]

I didn't know there was a "bio identical" vs "body identical". What's the difference? And can anyone explain why Utro needs to be taken in what seems to me such a high dose...i.e. why a body identical medication would need such a high dose. I realise you can't just compare mg to mg, but e.g. my Provera dose is 5 mg a day, Utro was 100 mg a day.

I think the ingredients are often the same but bio is compounded so is individually tailored. The biggest drawback is they aren't tested and regulated in the way medicines are so if you use them it's important to get them from a reputable source. It's also the reason the NHS doesn't use them. That may explain the high dose too, it has to be sufficient to control the lining in all women but it might be that some need more than others. I don't think provera is body identical but perhaps the way it works is more effective than body identical.

[Hurdity]

To add to what's already been explained by sheila99.

So as sheila99 says Cyclogest is also bio-identical but it's not licensed as part of HRT. Ditto Lutigest. The ony licensed bio-identical progesterone is utrogestan

Hurdity x

Cyclogest and utrogestan are not bio identical, they are body identical.

Cyclogest and Utrogestan are indeed bio-identical! They are also body-identical. The meaning is exactly the same.

Both the terms "bio-identical"  and "body-identical" mean the hormones (in the product) are chemically identical to those your body produces.

"Bioidentical" - is the correct scientific/medical term
"Body-identical" - is more of a lay-person's, or colloquial term to explain to women who may be (understandably) confused by the terminology and the perplexing array of treatments available.

These terms refer to the hormones themselves.

So my answer to Booblet's question which was:"Can anybody suggest a bio- identical Progesterone" was completely correct.

Turning to HRT - there is much confusion about terminology with the term "bioidentical HRT" being used to describe privately (and very expensively) prescribed and unregulated COMPOUNDED bio-identical (= "body-identical") hormones, but in recent years these same "bioidentical" (="body-identical") hormones have become widely available through licensed HRT products on NHS.

The British Menopause Society distinguishes very clearly between the two different types of HRT as follows:

"Summary of key terminologies

cBHRT: Compounded Bioidentical Hormone Replacement Therapy: Precise duplicates of human hormones which are produced by specialist pharmacies and do not follow the same MHRA regulatory pathway as conventional rBHRT

rBHRT: Regulated Bioidentical Hormone Replacement Therapy: Precise duplicates of human hormones developed in a conventional way by the pharmaceutical industry and authorised by the regulators such as the MHRA in the UK"

https://thebms.org.uk/publications/consensus-statements/bioidentical-hrt/

As you can see, and as sheila99 says, in fact, the hormones in bioidentical medications may not be any different from those in traditional hormone therapy. Sometimes other oestrogens are added to cBHRT such as estriol (though this is available on NHS as a vaginal treatment).

I didn't know there was a "bio identical" vs "body identical". What's the difference?

I hope the above, along sheila99's reply, helps explain that there is no difference but that there are two different types of bio-identical HRT, though the oestrogen in both (apart from the PRE horse urine type) are bio-identical whether compounded or regulated.

Hurdity x

[Hollyboll]

Really interesting and helpful as always Hurdity!
🙏

I was told by Newson that body=good and bio=bad, that the way to remember it was bio=hazardous.
🙄🙄
Then again I was also there rapidly and excessively put up oestrogen doses that provoked tachyphylaxis and a long awful saga from which I’m still struggling to recover / undo.

Thanks for all your input
X

[orrla]

I wish I could close my eyes and wake up in 100 years from now, perhaps they would all agree on something by that time..?

When I lived in EE there was no HRT available in certain doses, so I had to cut patches, as accurately as I could..and was going crazy.
After coming to UK, same stuff was actually very different, somewhat fresher, I'd say...I felt better..
Now I read of all these bio this and that..
Well, they are called differently in US and UK...
Are they different?
F knows!
I think we are experimented on!

[dangermouse]

Really interesting and helpful as always Hurdity!
🙏

I was told by Newson that body=good and bio=bad, that the way to remember it was bio=hazardous.
🙄🙄
Then again I was also there rapidly and excessively put up oestrogen doses that provoked tachyphylaxis and a long awful saga from which I’m still struggling to recover / undo.

Thanks for all your input
X

This tickled me. What they are actually saying is that bio is hazardous, as one of the other clinics that prescribes both off the shelf and compounded might get our profits!

As stated, they are both based on the same active ingredients derived from yam.

[AngelaH]

As stated, they are both based on the same active ingredients derived from yam.

The main ingredient is the same, but bio you can get privately only, body from NHS.

[Mary G]

Angela you are right, body identical HRT is branded but bio identical HRT is bespoke hormones that are compounded in a laboratory and I have to say they are brilliant.  I used compounded progesterone for several years and it was the only way I could tolerate progesterone and get a steady dose of 50mg into my system every day.  It worked brilliantly and it very definitely did protect my womb lining 100%.

Unfortunately due to Brexit, I could no longer receive medication from the UK so now I'm using branded progesterone gel which I buy from a pharmacy in Spain and that is also very good and providing good endometrial protection even though it is not supposed to.

[Hurdity]

Hello Hurdity, 

There is no any reason for you to act like a snake in a hot frying pan, there is difference between bio and body and reasons why NHS don’t offer bio. 

How rude....

As stated, they are both based on the same active ingredients derived from yam.

The main ingredient is the same, but bio you can get privately only, body from NHS.

Angela you are right, body identical HRT is branded but bio identical HRT is bespoke hormones that are compounded in a laboratory

Please read my post again!

I don't think I need to explain again.

The British Menopause Society definition makes it very clear. Their full statement in 2020 on HRT also refers to HRT that uses bio-identical hormones as regulated bio-identical HRT.

Regulated bio-identical HRT - ie bio-dentical HRT available on NHS is branded yes but also sometimes generic and unbranded.

In my view the term "body-identical" as a word to use for a type of HRT is totally confusing and I don't know who is pushing the use of this term - certainly not the BMS. The whole concept (of compounded bio-dentical HRT) is a big thing in US where they have a different healthcare system and has gained popularity here in recent years.

I think colloquially the idea of giving a different definition to bio-identical HRT available on NHS, is so that women don't feel they have to pay a lot of money for private treatments (ie cBHRT) when you can get the same hormones on NHS, but actually I think it serves to maintain the misconception that they are different hormones, when they are not (though as I said cBHRT sometimes adds in extra hormones ).

Personally I think calling them by the same correct term but qualified by the descriptive term "regulated" or "compounded" is better (as per BMS) so that women know they can get the same hormones prescribed on NHS.

Hurdity x