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Author Topic: BioIdentical HRT vs Natural Supplementation  (Read 7428 times)

LadyCC

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Re: BioIdentical HRT vs Natural Supplementation
« Reply #15 on: June 15, 2021, 10:00:30 PM »

LadyCC - I am interested in what you discover. When I lived in the USA there were a number of women who only took progesterone (as a cream) in perimenopause. Now I KNOW this is highly controversial over here, but I wonder if we are missing something for some women?

Before anyone asks, I am not thinking of using unlicensed progesterone cream but I do find I am happier during the second half of my cycle when progesterone is on the up, so wonder if it is more about progesterone diminishing first. I am certain the oestrogen effects will kick in at some point too!

I am also on the not-so-skinny side so wonder if my body produces more oestrogen.

Ah, questions and more questions...

Hey TrustandHope

Yes I had heard that this was the case and that in the U.S they do administer progesterone alone.   What is your regime currently if you dont mind me asking?  Do yo think it is helping overall?
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TrustandHope

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Re: BioIdentical HRT vs Natural Supplementation
« Reply #16 on: June 19, 2021, 05:59:15 PM »

Hi LadyCC - I am at the early stages of sussing all this out. Had peri symptoms for around 4 years (starting age 46) but not enough to bother substantially,  then a major hormonal meltdown earlier this year. Specialist is pretty convinced I had COVID and it sent my endocrine system bonkers. I have made a slow recovery and am now left with 'enhanced' perimenopause. Delightful. Maybe it was on the cards in any case.

Tried Evorel Sequi for a couple of months but the timing was all wrong because I was still dealing with what we think was long COVID. So decided to stop that and try and establish some kind of normality.

Have been tracking my cycle for 3 months - happiest days are those when I know progesterone is that bit higher. This is completely different from the past, when they were days when my husband would keep a safe distance. I am now miserable on days I was previously ok. So almost a reversal. I am normally very calm, laid back and happy so all this anxiety and other stuff has been a shock.

I have just started on Evorel again - low 25mcg this time - and so far so good but am speaking to menopause specialist this week to change to Oestrogel and probably Utrogestan because I want flexibility as estrogen drops further. I am not good with Norethisterone.

I also want to discuss progesterone cream with her. In the States I had friends who did:
- no HRT but used progesterone cream most days (which I guess is mild HRT), which they say calmed anxiety and shakes;
- low dose HRT (estrogen and progesterone) and the progesterone cream when they felt they needed it;
- average dose HRT plus the cream.

It seemed to be an acceptable add on. Perhaps because doctors felt its dosage was negligible. Some also used a very low dose estrogen/progesterone mix cream. The problem is that none of this is licensed here.  Also, it is so readily available in the USA that you could run into problems if not given good advice.

But maybe it could smooth the way for some who have lesser symptoms and don't want to use 'full fat' HRT? I am guessing that UK GPs may have progesterone cream at their disposal but the evidence base for use in perimenopause probably just isn't there.

I will let you know what the specialist says when I ask! I am just curious about all the options. This time last year I had never heard the words oestrogel, utrogestan or evorel!!
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LadyCC

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Re: BioIdentical HRT vs Natural Supplementation
« Reply #17 on: June 19, 2021, 08:03:59 PM »

Hi LadyCC - I am at the early stages of sussing all this out. Had peri symptoms for around 4 years (starting age 46) but not enough to bother substantially,  then a major hormonal meltdown earlier this year. Specialist is pretty convinced I had COVID and it sent my endocrine system bonkers. I have made a slow recovery and am now left with 'enhanced' perimenopause. Delightful. Maybe it was on the cards in any case.

Tried Evorel Sequi for a couple of months but the timing was all wrong because I was still dealing with what we think was long COVID. So decided to stop that and try and establish some kind of normality.

Have been tracking my cycle for 3 months - happiest days are those when I know progesterone is that bit higher. This is completely different from the past, when they were days when my husband would keep a safe distance. I am now miserable on days I was previously ok. So almost a reversal. I am normally very calm, laid back and happy so all this anxiety and other stuff has been a shock.

I have just started on Evorel again - low 25mcg this time - and so far so good but am speaking to menopause specialist this week to change to Oestrogel and probably Utrogestan because I want flexibility as estrogen drops further. I am not good with Norethisterone.

I also want to discuss progesterone cream with her. In the States I had friends who did:
- no HRT but used progesterone cream most days (which I guess is mild HRT), which they say calmed anxiety and shakes;
- low dose HRT (estrogen and progesterone) and the progesterone cream when they felt they needed it;
- average dose HRT plus the cream.

It seemed to be an acceptable add on. Perhaps because doctors felt its dosage was negligible. Some also used a very low dose estrogen/progesterone mix cream. The problem is that none of this is licensed here.  Also, it is so readily available in the USA that you could run into problems if not given good advice.

But maybe it could smooth the way for some who have lesser symptoms and don't want to use 'full fat' HRT? I am guessing that UK GPs may have progesterone cream at their disposal but the evidence base for use in perimenopause probably just isn't there.

I will let you know what the specialist says when I ask! I am just curious about all the options. This time last year I had never heard the words oestrogel, utrogestan or evorel!!

Hey TrustandHope

Sorry to hear that you have been unwell.  I too notice that I feel 'better' when progesterone is higher, particularly when I was on Utrogestan and Oestrogel. 

It would be great if you could share what you find out from your menopause specialist.  Can I ask, is it a menopause clinic you are attending or have you found an independent specialist that you are working with? 

Someone told me about Prof Jerilyn Prior ( https://www.cemcor.ubc.ca/media/prior_bio ) who also advocates a progesterone only approach.  It seems that there is quite a way to go before this is accepted more widely without controversy though  :-\
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Hurdity

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Re: BioIdentical HRT vs Natural Supplementation
« Reply #18 on: June 21, 2021, 05:25:20 PM »

The thing about progesterone is that it does deplete during peri-menopause in that this is when anovulatory cycles occur. Oestrogen then allows the uterus lining to build up leading to heavy and sporadic bleeding, so progesterone alone can be given in order to regulate periods and protect the womb from build up. As women get further towards menopause then oestrogen declines overall even while still fluctuating so oestrogen replacement prevents that crash which can occur either just after mid cycle (if ovulation occurs) but especially towards the latter part of the cycle and first part of the next cycle ie provides a buffer against the fluctuations when oestrogen falls very low.

I haven't looked at the research papers recently but I am sure studies into symptoms have looked at oestrogen and progesterone replacement both during peri-menopause and post-menopause.

It is acknowledged by some specialists that a small minority of women may benefit from progesterone replacement to alleviate symptoms but this is a minority. Studies show that most of us benefit overall from oestrogen repalcement along with progesterone to protect the womb lining.

Progesterone cream is not licensed as part of HRT because it does not provide sufficient progesterone to protect the womb and compounded progesterone because it is non-standard and unregulated so it is not possible to determine what dose you are getting whereas the approved stuff is regulated. GPs do not have progesterone cream at their disposal because there is no licensed product. I doubt you will find BMS approved menopause specialists recommending it either for the same reasons.


Someone told me about Prof Jerilyn Prior ( https://www.cemcor.ubc.ca/media/prior_bio ) who also advocates a progesterone only approach.  It seems that there is quite a way to go before this is accepted more widely without controversy though  :-\


It's not a controversy as such - as I said - just lacks a regulated product and as far as I know, insufficient evidence base to warrant investment maybe? Obviously all sorts of weak products can be purchased privately at great expense and at your own risk or off the shelf - even weaker and anyone who wants to try them is welcome.

Me - I prefer to use something that is tried and tested properly with regulated trials as a starting point - even if one then deviates from the licensed regime to some extent as I do ( under medical supervision).

There is also nothing to stop anyone from cutting patches to give a very small oestrogen dose and eg taking progesterone every couple of days to protect the womb - if doc approves....

Hurdity x
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TrustandHope

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Re: BioIdentical HRT vs Natural Supplementation
« Reply #19 on: June 24, 2021, 03:59:25 PM »

OK, so I had a chat with the menopause specialist (she works for the NHS and privately). Her response was along the lines of what Hurdity has said (thank you Hurdity!).

She would not recommend using OTC progesterone cream, though acknowledged it might be useful to some women in the early stages of perimenopause (which I am well past!). But she could not recommend it. I did clarify it was more curiosity on my part than anything because so many USA women I know rave about it. And I know it won't protect my uterus, but that was not what I was curious about.

So, I am about to launch into an oestrogel/utrogestan regime. Will be interested to see what happens, hopefully nothing terribly eventful!! Every day is a school day on this wonderful journey of menopause...
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Suzysheep

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Re: BioIdentical HRT vs Natural Supplementation
« Reply #20 on: September 23, 2021, 03:06:09 PM »

Trustandhope, how is the new regime working for you?
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Jasmine20

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Re: BioIdentical HRT vs Natural Supplementation
« Reply #21 on: September 26, 2021, 11:48:12 AM »

TrustandHope

I'm curious about your DUTCH test results and how this has helped you? This is something I feel I would benefit from but alas it seems to require a private doctor or practitioner to order and interpret the results.

I found a company called LifecodeGX who do genetic 'genomic' testing to find out how the patient metabolises hormones, what their inherited health risks are and how diet and lifestyle would be beneficial, amongst other things.

This is all beyond the remit of the NHS and so unfortunately must be privately funded.
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LadyCC

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Re: BioIdentical HRT vs Natural Supplementation
« Reply #22 on: September 28, 2021, 12:18:46 PM »

TrustandHope

I'm curious about your DUTCH test results and how this has helped you? This is something I feel I would benefit from but alas it seems to require a private doctor or practitioner to order and interpret the results.

I found a company called LifecodeGX who do genetic 'genomic' testing to find out how the patient metabolises hormones, what their inherited health risks are and how diet and lifestyle would be beneficial, amongst other things.

This is all beyond the remit of the NHS and so unfortunately must be privately funded.

Hi Jasmine20

I have had the LifecodeGX test (really really expensive) amongst other tests.  I dont feel that the practitioner I was working with put it to great use - I am being told a load of information that my brain cannot retain due to brain fog and memory loss as part of this wonderful period of life.  Suffice to say that from a nutrition perspective, I am not seeing the benefits of this in a way to help me with weight loss.  I have been looking at alternatives and am only targeting working with people who can interpret these results and will take the fact that I have gone to such efforts on this in relation to fees for services.  I cant believe I have spent all that money and for it not to really be doing anything for me - I am disappointed but I dont want these tests to have been in vane hence my continued search for a practitioner to help me.

Are you going to do the test?  Do you have a practitioner in mind?   
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VictoryV

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Re: BioIdentical HRT vs Natural Supplementation
« Reply #23 on: September 28, 2021, 09:04:58 PM »

Hi LadyCC, it sounds very frustrating.
Apart from the weight loss plans was the practitioner helpful making you feel that the tests were of value? Will they provide the appointment discussions in writing or does this incur further charges?

I hope you find a new practitioner soon, do they have to be UK based? I’m thinking if you could do a zoom apt at least you’d be able to record it.

Either way, good luck.

Victoria.x

EDIT
This might be of interest, I don’t think I’m allowed to post links where products are sold, hope it’s ok to name her, called Pippa Campbell, a Nutrigenomics and Weight loss specialist.
« Last Edit: September 28, 2021, 09:47:17 PM by VictoryV »
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LadyCC

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Re: BioIdentical HRT vs Natural Supplementation
« Reply #24 on: September 30, 2021, 10:05:22 PM »

Hi LadyCC, it sounds very frustrating.
Apart from the weight loss plans was the practitioner helpful making you feel that the tests were of value? Will they provide the appointment discussions in writing or does this incur further charges?

I hope you find a new practitioner soon, do they have to be UK based? I’m thinking if you could do a zoom apt at least you’d be able to record it.

Either way, good luck.

Victoria.x

EDIT
This might be of interest, I don’t think I’m allowed to post links where products are sold, hope it’s ok to name her, called Pippa Campbell, a Nutrigenomics and Weight loss specialist.

Hi Victoria

Thank you so much for providing the info on this person.  I have I think found someone who will incorporate the tests already done but am intrigued as to what a nutrigenomics weight loss specialist is so will look her up.  Do you have any experience of this practitioner? For me with the current practitioner when all was said and done they werent overly keen on drafting a programme for me and it incorporates a lot of recipes from scratch with lots of ingredients and im not working at the moment so its all just becoming too expensive and most importantly, I am not seeing or feeling any benefits either.  Ive given it a while now - its time to knock it on the head  :-\
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