Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: Kathleen on September 05, 2019, 06:00:19 PM
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Hello ladies
I wonder if any of you can answer this question which is probably stupid but here goes.
I understand that there are different types of Oestrogen, namely Estrone, Estriol and Estradiol. From the information on BeaR's recent post about the Guardian article it seems that only Estrone is produced by post menopausal women, the other two being concerned with pregnancy and reproduction respectively. I've looked on my packet of gel and note that it supplies Estradiol ( using the alternate spelling of Oestradiol ).
Is it a silly question to ask why post menopausal women aren't offered Estrone instead of Estradiol to relieve symptoms? Surely this version of the hormone would be better tolerated. Also, could post menopausal women be struggling with Estradiol because they have lost the relevant receptors and their bodies are now being flooded with a hormone that they are unable to process. If all HRT is based on Estradiol does this mean that peri menopausal women will do better as they will they have the appropriate receptors initially, indeed a constant flow of Estradiol may be maintaining those receptors. However if they decline in number as the menopause continues then symptoms may reappear because the body is now getting the wrong hormone.?
I think that Estrone can convert to Estradiol in certain circumstances but is this what we really want when we are post menopausal? It may not be possible to deliver Estrone in any way but could phytoestrogens in food help with increasing this version of the hormone and that is why some experts insist that specific diets and supplements can help.
In summary is Estradiol the correct hormone to be giving women to treat their menopause symptoms or is Estrone more appropriate for those who are post or approaching post menopause.menopause.
It's pretty obvious that I'm not a scientist and there's likely a fundamental error in my thinking but I would be interested to hear anyone's comments on the subject.
Take care ladies.
K.
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Hi Kathleen. I believe that Estrone is the less powerful version and isn't as effective as estradiol
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Hi Kathleen,
No question is stupid, don't be daft. :)
1. Estrone is the predominant type of oestrogen in postmenopausal women, but not the only one, we still produce the other two.
2. Estradiol is the predominant oestrogen throughout the fertile years and estriol is predominant during pregnancy.
3. If estrone levels are high in postmenopausal women, I don't think there would be any reason to offer them more estrone, but...
4. Estrone has very little binding affinity to oestrogen receptors, compared to estradiol.
5. There's no evidence that postmenopausal women lose oestrogen receptors.
6. Perimenopausal women don't do better, not in my case! Estradiol levels can be quite high during perimenopause and the ups and downs cause most of the nasty effects.
7. Estrone can be converted to estradiol in peripheral tissues, but it is not accumulated in target tissues, unlike estradiol and estriol.
I think there may be a reason why estrone levels are kept high in postmenopausal women, that is a very interesting subject.
Estradiol is the most potent oestrogen, so if you want to achieve biological responses, estradiol is the 'correct' hormone.
You have raised a very interesting question though, what if estrone could be an option if given at large doses, so it could be converted to estradiol in target tissues, not only the obvious ones, breast, uterus, but also bones, brain and endothelium, so estradiol could exert its beneficial effects, without accumulating and potentially increasing the risks of breast and endometrial cancers?
BeaR.
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Hello again ladies.
MicheleMaBelle - thank you for responding.
BeaR - thanks for your very detailed reply. It would be great if sometime in the future we could have a more tailor made treatment for our hormonal woes. We live in hope I guess!
Wishing you well ladies.
K.
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Hi again Kathleen,
I have just posted this bit from Oestrogel leaflet on another thread and I thought it might be interesting to post it on this one as well. Estrone is mentioned and at least for me this is new info.
'Pharmacokinetic properties
Absorption
Pharmacokinetic studies indicate that, when applied topically to a large area of skin in a volatile solvent, approximately 10% of the oestradiol is percutaneously absorbed into the vascular system, regardless of the age of the patient.
Distribution
Daily application of 2.5 g or 5 g Oestrogel over a surface area of 400-750 cm2 results in a gradual increase in oestrogen blood levels to steady state after approximately 3-5 days and provides circulating levels of both oestradiol and estrone equivalent in absolute concentrations and in their respective ratio to those obtained during the early-mid follicular phase of the menstrual cycle.
Oestrogel was administered to 17 postmenopausal women once daily on the posterior surface of one arm from wrist to shoulder for 14 consecutive days.
Maximum serum concentrations (Cmax) of oestradiol and estrone on Day 12 were 117 pg/ml and 128 pg/ml, respectively.
The time-averaged serum oestradiol and estrone concentrations (Caverage) over the 24hour dose interval after administration of 2.5 g of Oestrogel on Day 12 were 76.8 pg/ml and 95.7 pg/ml, respectively.
Biotransformation
Metabolism of oestradiol takes place mainly in the liver under oestriol, estrone and their conjugated metabolites (glucuronides, sulphates). These metabolites also undergo enterohepatic recirculation.
When treatment is stopped, oestradiol and urinary conjugated oestradiol concentrations return to baseline in about 76 hours.
Elimination
Oestriol is the major urinary oestradiol metabolite. However, glucuronide and sulphate metabolites of oestradiol and oestrone are also found in urine and bile. Metabolites excreted in bile undergo enterohepatic recirculation or are excreted in the faeces.'
Pay attention that both estrone and oestrone are used ;)
BeaR.
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Thank you, BeaR. Very informative. Especially the absorption of Oestrogel. Do you know of any research regarding the absorption of transdermal
patches?
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Hi Alicess,
There are many studies regarding the absorption of estradiol patches, most of them were published in the 80-90's and some comparing them to estradiol gel after 2000. I have chosen some interesting ones for you. Many are pay-per-view, I do have access to some of them if you're interested.
https://link.springer.com/article/10.2165/00003495-199040040-00006
https://www.sciencedirect.com/science/article/abs/pii/S0002937801531658
https://www.ncbi.nlm.nih.gov/pubmed/11306208
https://www.dovepress.com/clinical-efficacy-of-estradiol-transdermal-system-in-the-treatment-of--peer-reviewed-fulltext-article-RRTD
https://journals.sagepub.com/doi/full/10.2217/whe.15.64
https://www.degruyter.com/view/j/hmbci.2019.37.issue-2/hmbci-2018-0033/hmbci-2018-0033.xml
https://journals.viamedica.pl/ginekologia_polska/article/view/GP.a2017.0018/37562
https://patents.google.com/patent/US9314470B2/en
https://www.tandfonline.com/doi/abs/10.3109/13697139909038084
https://accp1.onlinelibrary.wiley.com/doi/abs/10.1177/00912709922008470
https://journals.lww.com/drug-monitoring/Abstract/1997/02000/Comparative_Serum_Estradiol_Profiles_from_a_New.6.aspx
https://link.springer.com/article/10.2165/00002512-199202060-00005
https://www.sciencedirect.com/science/article/abs/pii/S0378512203001890
BeaR.
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Thank you! I don't have much time to read them at the moment but, for now, I really appreciate your effort 🌷
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Thanks BeaR, I've been searching for research papers relating to oestogel and couldn't find much at all so thank you for these x
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Hi Alicess,
There are many studies regarding the absorption of estradiol patches, most of them were published in the 80-90's and some comparing them to estradiol gel after 2000. I have chosen some interesting ones for you. Many are pay-per-view, I do have access to some of them if you're interested.
Wow bear that's a humongously impressive compilation of refs! Most of us don't have the time to trawl through and subscribing to journals on the offchance of a juicy ref is v expensive so if you are able to distill the essence and can extract any brief salient pertinent or relevant juicy nuggets which doesn't involve us wading through nor pasting reams of extraneous guff and would help to answer Kathleen's point we would all be grateful!
Hurdity x
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Do you know of any research regarding the absorption of transdermal patches?
I don't have much time to read them at the moment
Alicess I tend to have one or two “go to†review papers that I refer to when I want to look up stuff which doesn't involve so much time! What is it that you are specifically wanting to know or are interested in? I may be able to point you in the right direction without having to do the trawl (however interesting!)....(can't promise though!).
Hurdity x
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Hello again ladies
Bear - thank you so much for your heroic efforts! You have uncovered a lot of information there.
Maybe science does have the answers we are looking for, but it's a mission to find them. Still, it gives me hope that 'the truth is out there'.
Wishing you well.
K.
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Hello ladies
I wonder if any of you can answer this question which is probably stupid but here goes.
I understand that there are different types of Oestrogen, namely Estrone, Estriol and Estradiol. From the information on BeaR's recent post about the Guardian article it seems that only Estrone is produced by post menopausal women, the other two being concerned with pregnancy and reproduction respectively. I've looked on my packet of gel and note that it supplies Estradiol ( using the alternate spelling of Oestradiol ).
Is it a silly question to ask why post menopausal women aren't offered Estrone instead of Estradiol to relieve symptoms? Surely this version of the hormone would be better tolerated. Also, could post menopausal women be struggling with Estradiol because they have lost the relevant receptors and their bodies are now being flooded with a hormone that they are unable to process. If all HRT is based on Estradiol does this mean that peri menopausal women will do better as they will they have the appropriate receptors initially, indeed a constant flow of Estradiol may be maintaining those receptors. However if they decline in number as the menopause continues then symptoms may reappear because the body is now getting the wrong hormone.?
I think that Estrone can convert to Estradiol in certain circumstances but is this what we really want when we are post menopausal? It may not be possible to deliver Estrone in any way but could phytoestrogens in food help with increasing this version of the hormone and that is why some experts insist that specific diets and supplements can help.
In summary is Estradiol the correct hormone to be giving women to treat their menopause symptoms or is Estrone more appropriate for those who are post or approaching post menopause.menopause.
It's pretty obvious that I'm not a scientist and there's likely a fundamental error in my thinking but I would be interested to hear anyone's comments on the subject.
Take care ladies.
K.
Kathleen - it is sad that you feel your questions might be stupid! The best discoveries can be made by people who look at things with fresh eyes! That is a fair question and one that has been raised before.
My GP gynae specialist told me that there are over 30 different oestrogens – and she was in favour of replacing others – although they are not widely known about nor occur in sufficient quantities. Estradiol is the major one with receptors all over the body and although it is a crude way of mimicking our pre-menopausal hormonal mix – it is probably the best we can do at the moment. Estriol is a strange one as it can't be reconverted to estradiol but nevertheless as you know is used widely for vaginal preparations where it binds preferentially to one of the estrogen receptors (either alpha or beta can't remember!).
This is not answering your questions directly but in fact there used to be a hormonal preparation containing a mix of those three oestrogens called Hormonin but was discontinued. I never looked into this particularly but there will be a reason it is not more widely used. I suspect it is not the norm for HRT because in fact estrone is an integral part of estradiol metabolism (this is not big news!) so no need to replace it – and there are interconvertible ( by this I mean the body converts one to the other depending on various factors and in different tissues). Estradiol taken as HRT is partly metabolised to estrone and this is notable for oral preparations, where it is metabolised extensively in the liver to estrone ( ?and estrone sulphate) and then reconverted to estradiol elsewhere in the body (not sure which tissues). From what I understand with oral HRT due to the liver “first pass effect†(the hormone has to go through the liver before entering the bloodstream) the proportion of estrone to estradiol is way greater than occurs naturally which is apparently not ideal whereas transdermally the ratio is closer to that which occurs normally. This is from memory so can't remember what the disadvantage of having excess estrone is – but my main point is – you don't need to replace it because it is made in the body!
As far as I understand the hormones exist in the body in some sort of dynamic equilibirum ( ie re estrone/estradiol) and would not be confined to peripheral tissues (eg fat etc) as it will be transported around the body where it will exert its effects. The details are hazy so this garbled reply is off the top of my head - I've read odd bits but not enough to remember and don't have the time to spend my days researching hormones!!!
Estradiol seems to do a pretty good job for most women - provided you get the right dose of the right product and delivery method - and most important - the right progestogen which doesn't give such dreadful side effects!
Just a few random thoughts but do keep asking questions!
Hurdity x
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Hello again ladies
Bear - thank you so much for your heroic efforts! You have uncovered a lot of information there.
Maybe science does have the answers we are looking for, but it's a mission to find them. Still, it gives me hope that 'the truth is out there'.
Wishing you well.
K.
Hello Kathleen,
You're welcome. Absolutely, many current articles are about recovering the overwhelming amount of data available online and trying to make sense of them.
Most of those links are from summaries, so you really don't need much time to read them. I personally think it's very important to know as much as I can about everything, not just hormones, but they are a fascinating subject, not to mention they rule my life!
BeaR.
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Hi Hurdity, I wish I had your GP!x
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Hi Hurdity,
I would really like to know if patches have a better absorption then Oestrogel. I went up to 8 pumps and still my symptoms got worse and even adding more symptoms.No difference what so ever when I increased dosage. I've also tried patches and went up to 400 mg (4x100 patches) I only felt a little relief a few days around ovulation then things got worse again. Maybe some women need more because FSH is to low?
I also wonder if ethinylestradiol, which is also a oral estrogen, would be mainly converted to estrone too?
Alicess X
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Hi everyone
Can someone answer a question for me which is does estrogel cause thinning scalp hair ?
Some websites say it does other say it dosent some say the frequency is unknown and others say at least 1 percent of people taking it , it does and then the leaflet dosent mention hairloss ?
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Hello again ladies.
Hurdity - many thanks for your interesting response. I have some favourite science sites that I go to and though I'm fascinated by the information I despair at the complexity!
BeaR - When I was diagnosed with an autoimmune disease I began doing a lot of research. One site referred to all users as ' citizen scientists' because although not trained, we had the tenacity and motivation to examine every aspect of our condition. Who knows where the next big idea will come from?
Many thanks for your efforts ladies and I wish you well.
K
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Hello Kathleen,
Brilliant, thank you. Tenacity and motivation. When we or our loved ones are suffering terribly and common medical care cannot help us, it's up to us to become 'citizen scientists'. I love people who are always having ideas, thinking is our gift isn't it?
BeaR.
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Hi Hurdity,
I would really like to know if patches have a better absorption then Oestrogel. I went up to 8 pumps and still my symptoms got worse and even adding more symptoms.No difference what so ever when I increased dosage. I've also tried patches and went up to 400 mg (4x100 patches) I only felt a little relief a few days around ovulation then things got worse again. Maybe some women need more because FSH is to low?
I also wonder if ethinylestradiol, which is also a oral estrogen, would be mainly converted to estrone too?
Alicess X
This is a bit off Kathleen's topic about the different types of oestrogen and estrone but the answer to your question is how long is a piece of string?! It is really a question of how your body absorbs estradiol best from the different modes of delivery. The dosage is always given as eg low medium and high and based on a group of individual women whose serum levels are measured over a period of time and then an average arrived at. The doses are set based on these averages - and that has led to the approx equivalents which are always quoted. These approx equivalents provide a good starting point but you may not achieve the level given by the dose. There is a huge variation between how much of the estradiol from a given dose is absorbed into the bloodstream and within a particular individual - how much she will absorb from patches vs gel or tablets.
Ostensibly - 6 pumps is a very high dose (although it probably wouldn't be if you had experienced surgical menopause). Also 400 mcg is a very high dose. Have you ever had serum estradiol levels measured and where are you in menopause, do you have a womb/ovaries etc? Estradiol suppresses FSH so not this does not mean you need more oestrogen! There is a condition resulting from supra-physiological levels of estradiol (or some drugs) known as tachyphylaxis (might be spelt wrongly!) so that higher doses have a reverse effect. Also very high doses of oestrogen normally suppress ovulation so if this is not happening for you then maybe you're not absorbing it?
I hadn't ever looked into ethinylestradiol which I understood to be a stronger synthetic oestrogen used in many BCPs - it is much stronger than estradiol and as far as I can make out from my fave reference about this - it is not converted to estrone.
Maybe start a new thread about your circumstances?
Hurdity x
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Thank you, Hurdity, for your explanation. I do admire you! BeaR mentioned only 10% of Oestrogel is being absorbed so I was hoping there could be research about absorption in general for patches or comparing the two. But you are right, of course, its different for everyone. I'm still on BCP's, I have to, it prevents me from having cluster headache. It's a long story and I hesitate to write it down because then it seems to become more real and it makes me feel sad. So many shattered dreams. But I do need the knowledge from all the ladies on this forum so I hope I will find the courage soon.
Alicess 🌷
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Just to clarify Alicess - the dose of each type ( patch, gel, tablet) is set to take into account how much is absorbed into the bloodstream of each on average - so really it doesn't matter that only approx 10 % is absorbed (I think some estimates are variable anyway) - it's not an important point - because that is what it's meant to do if you see what I mean? And like I said - it may well be different for you.
Hurdity x
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Yes, I see what you mean. Didn't realize. Thank you for pointing it out.
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Alicess
You say you are on bcp can I ask what that is. ?
Thanks
Are you in menopause ?
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Hi Sammiejane, I'm on Femodene but I have severe hairloss as the estrogen in it doesn't seem to work. I also have many other peri/menopausal sympthoms. I don't think BCP''s are the solution for you. Progestins can cause hairloss too in some women. I It's probably low estrogen and/or low testosterone that's causing your hairloss. Did you try upping your Oestrogel? Do you know your testosterone level and SHBG?
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Hi alicess
Yes my estrogen on 2 pumps of the gel was 195 back in march then 104 in June
Testosterone was 0.8 in March then 0.6 in June this year
My meno said I'm not obsorbing it well so don't know whether to go up to 2.5 or 3 pumps or change to estradot patch,
In my 20s I was on the combined pill microgynon 30 and never suffered hairloss so was thinking of going back on them cause I had hairloss on HRT so far and when I had low estrogen prior to taking HRT I never had hairloss which is why I was wondering if it was imbalance between estrogen and progesterone ?
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Microgynon is a more androgenic pill and and it made my shedding less. Gestodene, the progestin in Femodene has a high progestogenic and weak androgenic activity and it made my hairloss much worse so I would not recommend taking progesterone. You could increase your Estrogel as you're already on it. When your level is sufficient you could ask your GP or specialist for testosterone. I understand you want a quick fix but I don't believe progesterone is the answer.
Your hormonal system has changed a lot from when you where in your twenties. What worked well then doesn't have to work now. Microgynon 30 did wonders for me a few years ago but now it has the opposite effect.
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Something went wrong, wasn't finished yet. If I remember correctly you've had a hysterectomy? I'm personally not against BCP''S for menopause but if
you don't need progesterone or progestins I would stay clear of them as they can have a lot of side-effects.
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Hi alicess
I was only wanting to add progesterone for hairloss and to balance out the effects of estrogen which my meno said I can try but utrogestan 100mg every night.
I feel rubbish on estrogen only I cannot function !
And have been suffering 9 months now
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Sammiejane, I think you need to increase your estrogel. If you feel rubish on it it doesn't necessarily mean it's the estrogel. You probably need more pumps. Urtrogestan will probably make it worse as it increases SHBG thus lowering testosterone. I think you should discuss this with your specialist.
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Sammiejane, I think you need to increase your estrogel. If you feel rubish on it it doesn't necessarily mean it's the estrogel. You probably need more pumps. Urtrogestan will probably make it worse as it increases SHBG thus lowering testosterone. I think you should discuss this with your specialist.
Hi Alicess - Interesting re the progesterone and SHBG - I haven't come across this - do you have a reference. I know that progesterone has a depressing effect on libido but didn't know it could be via its effect on SHBG? This would be very significant and have implications for HRT regimes. I've had a quick look but can't get into the refs I found and also just about to sign off and caught your post so no time right now!
Hurdity x
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Hi alicess
I was only wanting to add progesterone for hairloss and to balance out the effects of estrogen which my meno said I can try but utrogestan 100mg every night.
I feel rubbish on estrogen only I cannot function !
And have been suffering 9 months now
Hey, I'm reading a book that had something interesting about ovaries at menopause:
‘Around the time that a woman is in her mid-forties, something very interesting happens: The inner part of the ovary develops a life of its own and produces estradiol, progesterone and androgens independent of follicles or corpus luteum cysts. In other words, the ovaries stop producing eggs but not hormones.' (Hormone Balance, Carolyn Dean)
I've never read this before (if it's accurate) and as these hormones are also produced in the adrenals it does suggest that we need all 3 for therapeutic and rebalancing reasons.
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Hi Alice's
Yes have already spoke to specialist they have left it up to me to decide whether to up the gel or add in progesterone or change to patch and add in progesterone or go on the contraceptive pill
I read though a few books from celebrities who have had ovaries and womb removed who take estrogen and testosterone and have hair loss because they are missing progesterone part ?
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Sammiejane I suggest you start a new thread related to your question with a new title so as to attract answers from the right people, as this one's about different kinds of oestrogen and Kathleen's original point - you may not get the responses you are seeking.
Hurdity x
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Hello again ladies
Dangermouse - thanks for a very interesting piece of information. It makes you wonder if HRT fails for some of us because it is actually adding to our hormone imbalance. A new book about balancing hormones will be published next year. It is likely to be science based and I'm hoping that it will have some good news for us meno ladies.
Take care.
K.
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Hi Hurdity, I found this research about Urtrogestan increasing SHBG
https://www.ncbi.nlm.nih.gov/pubmed/6538615
It would make sense as Urtrogestan doesn't have any androgenic activity while most progestins do. Progestins with high progestogenic activity
have weak androgenic activity. Levonorgestrel and Tibolone are the most androgenic progestins and can decrease SHBG. It seems the more androgenic the more decrease of SHBG
I have posted some links in this thread about SHBG and progestens
https://www.menopausematters.co.uk/forum/index.php/topic,43535.0.html
It could very well be the lack of androgenic activity in Urtrogestan that is, partly, to blame for its side-effects, as you mentioned.
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Premarin has 9 different Estrogens and one that attaches itself to oestrogen receptors in the brain.
Have considered trying it out .
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Alicess - thanks for that. The study you linked to relates to women with very severe pms and also uses progesterone at extremely high doses not used in HRT - and is a very early study. It doesn't look as though it was placebo controlled and refers to SHBG binding capacity not necessarily SHBG itself so will reserve judgement on that one for the time being! Interesting though....
Thanks for the refs to the other thread and will have a read of those another time.
Tibolone is a special case as it is not oestrogen, progesterone nor testosterone but breaks down into compounds which have activity similar to these three hormones. I know it reduces SHBG which is one of the mechanisms by which it is thought to increase libido as it increases free T, as well as the testosterone-like metabolite also binding to androgen receptors ( this is from memory!).
Interesting that about levonorgestrel. I knew that some of the testosterone derived progestogens bind to androgen recpeotrs hence for some women help with libido but didn't know about the SHBG effect as with the Tibolone metabolite.
re the last ref - yes I think it's well known that in some tissues progesterone interferes with the (beneficial) effect of oestrogen but that still doesn't explain re SHBG which is separate from the hormones' effects on receptors.
Aaagh it's all so complicated! I think we struggle because it is still not all fully understood, and because of this there is no clear summary or review with mechanistic explanations!
The whole point about utrogestan ie progesterone is that it is our own progesterone and as such is not androgenic,, and therefore has the same metabolic effect - the others are synthetic. The side effects are due to the large doses needed in HRT and high quantities of metabolites especially after oral ingestion.
Sorry Kathleen this is not about oestrogen!
Thanks for the refs Alicess...
Hurdity x
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Hi awesome ladies: My GP has me on ESTRAGYN which is estrone. She said that this product is excellent and pharmacist concured. I use Vagifem internally and Estragyn externally. I can say that it certainly helped with the vulva atrophy. Estrone converts into estroidol in the post menopausal phase and that's why estrone is now being recommended.
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That's interesting Whatsupwiththis. What country do you live in? That's not available here although there are different oestrogens and other substances used for VA - here in UK for VA we have estradiol (the conventional one) as Vagifem, estriol as generic 0.01 % or Ovestin 0.1 %, and recently there has been licensed a DHEA pessary - Prasterone (Intrarosa) which also converts to estradiol. The estriol binds directly to the oestrogen receptors whereas DHEA and estrone need to be converted to estradiol in local tissues first. I think in US they have ( or used to have ) a conjugated equine oestrogen cream for VA (the horse pee one!).
Hurdity x
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Hello again ladies.
Yet more excellent comments.
Hurdity - don't worry about posts not being about oestrogen specifically. The more the merrier!
Whatsupwiththis - your estrone experience sounds very interesting and I'm sure ladies will want to know if it's available here in the UK.
As you say Hurdity, it is all so complicated and the mechanisms are not fully understood. More's the pity.
Take care everyone.
K.
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Hi all: I live in Canada where Estragyn is widely used. Not sure if available in U.K. We have limited options with respect to topical hormone..Premarin (pregnant mares urine - Very cruel), Vagifem and Estragyn. I believe the U.S. has one called NeoEstrone which is quite popular. U.S. has a number of estrone pills available. Estragyn is estrified estrogens made from plant derivatives (yam).
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Hi Whatsupwiththis,
Canada 8)
BeaR.
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It's my understanding that oral oestradiol hrt is converted into high levels of estrone and lower levels of E2. There's some conversion to estrone with transdermal but nowhere near as high as oral.
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BeaR.....yup....Kanuck all the way....(except in winter YUK).
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KiltedCupid...I believe that is the case. The U.S. have 2 or 3 oral estrone pills. In Canada I think we have just the 1. As I am not eligible for HRT (other than topical), I'm not familar with the benefits of oral or transdermal. Interesting topic....
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KiltedCupid...I believe that is the case. The U.S. have 2 or 3 oral estrone pills. In Canada I think we have just the 1. As I am not eligible for HRT (other than topical), I'm not familar with the benefits of oral or transdermal. Interesting topic....
Yes, it's really interesting and I know you ladies over the pond have the option of bi-est and tri-est compounded creams which some do very well on.
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It's my understanding that oral oestradiol hrt is converted into high levels of estrone and lower levels of E2. There's some conversion to estrone with transdermal but nowhere near as high as oral.
This is correct and FYI was highlighted in more detail at the beginning and ealrier on in this thread, which you might not have seen as you are new!
KiltedCupid...I believe that is the case. The U.S. have 2 or 3 oral estrone pills. In Canada I think we have just the 1. As I am not eligible for HRT (other than topical), I'm not familar with the benefits of oral or transdermal. Interesting topic....
Yes, it's really interesting and I know you ladies over the pond have the option of bi-est and tri-est compounded creams which some do very well on.
As explained earlier on in this thread (do please have a read) and what I was referring to above - we do not need to have estrone tablets because the metabolism of estrone and estradiol is interrelated and anyway estrone is much weaker. As far as I understand it interconversion between the two continues post-menopause in target tissues - and estradiol can continue to exert its beneficial effects where there are receptors.
Compounded creams are not approved in UK nor in US by the medical authorities nor academic menopause societies. There is an enormous amount of info on this on this forum, and elswhere through position statements - although is the subject of another thread (you will find several if you search!).
Hurdity x
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Thank you Hurdity. I'm aware. Just chatting re.product differences and user experiences with our Canadian friend.
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Hi Kathleen, if you are still interested, I found this information on Wiki about not only absorption of different kinds of administration of estradiol but also conversions to estrone etc.
https://en.m.wikipedia.org/wiki/Pharmacokinetics_of_estradiol#