alibeau, for another perspective, go to YouTube and search for Dr Felice Gersh and what she has to say about HRT regimes.
She is strongly in favour of trying to mimic a natural cycle as far as possible. There is evidence to suggest that taking continuous P down-regulates the E receptors and counters some of the benefits of taking E in the first place as a result.
She is a HRT prescriber in her 60s herself, and on sequential HRT.
There are members of this forum who choose to stay on sequential HRT because they just prefer it or do better with it. We really don't have enough research into sequential vs continuous and cancer risk since the only research we have used synthetic progestins and also since dosages of P are all over the place - especially in the UK. It is not possible to compare apples and oranges, for eg. One woman taking 200mg of oral P is not going to have a serum P level the same as another woman who is also taking 200mg. We all absorb it differently, just the same as transdermal E products.
For more info, take a look at this wiki article - especially the graphs further down the page comparing P levels with oral, vaginal and rectal P:
https://en.wikipedia.org/wiki/Pharmacokinetics_of_progesteroneYou'll see that far more is absorbed (on average) with vaginal and rectal P than with oral. Furthermore, in the UK it is impossible to test serum P levels with the tests we have available if you take oral P. This is because if you take it orally, it is processed by the liver and that creates a lot of P metabolites which the test registers as useable P - when they are not, they are useless and excreted. IF you take vaginal or rectal P, on the other hand, the tests we have available ARE relevant and you CAN test your P levels reliably. (In the US they have a test called the LC MS P test, which gives a reliable result even if you take oral P - but we don't have that in the UK. So the only way to test here, is to take it vaginally and rectally.)
My experience has shown WHY we need to test P: I am on a high E dose. So I wanted to be sure I had sufficient P to oppose my E. I was taking 300mg P vaginally at night (sequentially), which is already a higher dose than most women - and vaginally usually sees a higher level than orally. My result was only 5ng, which is barely inside the minimum recommended amount. So I have now increased my P and am taking another 200mg vaginally in the AM. P has a short half life, so many women take it twice a day (in the US, anyways....).
In short, just like there are bazillions of women, walking around and thinking they are 'taking HRT' - and therefore protected from dementia, cardiovascular disease, osteoporosis etc due to the estrogen - except they are wrong, because their E levels are incredibly low and were never tested.... So there are bazillions of women thinking they are protecting their endometriums with their P dose - except they are not, because they are not absorbing enough of it to get their serum P levels high enough to do that.
So to then throw research in there about sequential vs continuous P is just a huge load of misleading codswallop really. Because how many women in either group were on enough P (full stop)? Was this controlled for? Were their serum P levels tested or was this just about dosage administered? (The latter.) And so on.
HRT is still an evolving field. We are all biohackers. The women are ahead of the doctors, many times. (Except for the enlightened few doctors.)
I plan to continue to take sequential P, for all the reasons Dr Gersh gives. I am also on a very decent E dose (as she advises). And I take my P vaginally (again, as she recommends) - because it is not natural to take such high doses orally and cause such high GABA levels which effectively is functioning like a sedative. There has been no research into whether or not that increases the risk of dementia, for eg....
Sorry, I am going on a bit - but you get the picture.
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Topic: GP appointment - seq vs continuous (Read 1256 times)