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[Garnet161]

Hi again all,
I am currently using Emerita topical BiEstro cream which suits me very well. It's 1mg estriol and 0.25mg estradiol on the skin each day (I think that is the correct measurement) with the corresponding ProGest progesterone cream.
Now, on the tube it says to use 3 weeks of the month and then have 1 week off.  I have never been able to do that - 24 hours without the BiEstro and the hot flushes and palpitations return. So, I have been doing a routine of 6 days on, 1 day off on the weekend to have a break.  In the book written by the doctor who made these creams, he says to have a break to give the body's cells a rest.
On doctor prescribed estrogen, gel, tablets, patches, I get the impression that those are a daily thing for most? - I'm talking post menopause. 
I just seem to suffer on the day I don't have the estrogen cream so I thought I would ask what other's administering routines are with systemic estrogen.
Thanks for any info.

[Hurdity]

Hi

It seems you are talking about compounded bio-identical HRT which is not recommended in UK, nor I think US - and obtained by private prescription only at great expense!

However you are quite right - the principle remains the same as with regular (regulated) HRT available on NHS - that the oestrogen component is given daily because it is oestrogen replacement that is the reason for taking hRT in the first place. The idea of giving "body's cells a rest" is nonsense!

In addition the formulation you are taking firstly does not have much of the  recommended type of oestrogen, (which is estradiol) and secondly is not the best route to get oestrogen into the body. I don't have data in front of me but if you want to use it transdermally there are other ways - estradiol spray, patch or gel.

Also if you are getting oestrogen into the body in sufficient quantity to give symptom relief then progesterone cream is not recommended to protect the uterus as it is not regulated nor guaranteed to be strong enough.

All in all I would suggest you save your money and go to a regular doctor and try perhpas a low dose regular (bio-identcial) HRT - if you are in UK - which is available on NHS. Lists are available on this website of the recommended different types ( other countries will have similar if you're not in UK).

Hope this helps and that you sort out a regime that makes you feel better.

In a nutshell - take oestrogen every day!

Hurdity x

[bombsh3ll]

I agree with the above.

No medication works as well if it is only used 75% of the time.

This practice dates back to the 1960s when it was believed that if women didn't have a week off birth control every month for an artificial withdrawal bleed, they would think they were pregnant.

It was misguidedly adopted by some clinicians prescribing menopause hormone therapy, where a hormone free interval is particularly undesirable due to the return of symptoms during this time.

[Garnet161]

Thank you both!  As I suspected.
I have an appointment with my GP (who is wonderful) to discuss swapping onto the combined patch.

[CrispyChick]

Whoa.

Hold it right there Garnet. I can see from your newer post about HRT patches u are in Australia.

Plenty of countries support the use of BHRT creams. They are supported here in the UK by private clinics like Marion Gluck and the London Hormone Clinic. They work for many. I've tried them and they can be quite potent.

The problem, in the UK, is they are not supported by the NHS or British Menopause Society - not because they don't work or are unsafe but because they've had no testing via big pharma.

I urge you not to listen to the opinion of one person on a UK forum. You opened your post with "which suits me very well".

Why swap?? I've lived through 7 years of hell with this peri and still going. If I find something that suits me very well, irrespective of the opinion of others, I'd be sticking with it.

Your question was about taking breaks. I believe that's to do with receptor sevsitivity. True or not, I don't know. But if it's causing you issue, stop taking the breaks. Mainstream hrt does not give breaks, so there should be no difference with your creams.

Please do what is right for you. Xx

[Garnet161]

Thanks Crispy - I am open to all options, and I did a great deal of research around bio-identical estrogen.  I started getting hot flushes again recently and I was toying with the idea of trying something stronger, hence the question surrounding patches.  Not sure if I will go down that road yet.  My main issue is VA - the rest is annoying but not debilitating.  I'm unfortunately just going through an uncomfortable patch at the moment with my VA (there might be an underlying infection or possibly the batch of Ovestin I have been using may have degraded).  It has happened once before - I couldn't work out why my VA was back and it turned out the Ovestin cream had gotten too warm in the Australian summer.
Anyway, thanks for the reply.  I am throwing a few ideas around at the moment.

[CrispyChick]

Great. Weigh it all up.

I just didn't want you to stop something that was working on the back of a rigid UK response. Towing the line with the BMS and then NHS over here, makes for no flexibility.

There are many woman using bhrt creams and other preparations. You can also buy many of them online - Onas, Biovea, Serenity. And lots have great success. But this forum isn't very supportive of them.

I hope you can make an informed decision of what is right for you. X

[Garnet161]

I'm in Australia and it's even less supportive here.  I have to order my creams from the USA.
Fortunately, my GP is excellent. She says to go with what works but she insists on 6 monthly uterine ultrasounds to check things.  Which is fair.
Thanks for the replies.  I appreciate it 

[CrispyChick]

Your GP sounds amazing. That's exactly what you need.

Woman really do need support to go with what works, with uterine scans to check. Brilliant.

That's why there's only support for conventional HRT here, because the NHS can't do regular scans.

If you use compounded BHRT there's actually less risk as the clinics insist on yearly scans. Which you obviously pay for. Folks that haven't used this system get quite hung up on the BMS and NHS. There's more than one route to menopause treatment.