Very very bad – both HRT and women’s health services
After undergoing pre-menopausal hysterectomy+BSO (at 46), I would have loved to have had a successful HRT regime. However, it was absolutely awful, and had I known how bad it would be I wouldn’t have agreed to the surgery. These are just some of the problems I had
Absorption problems
- rapid peaks and troughs on oestrogel (caused bad symptoms)
- patches did not provide stable levels (day 1 to 3) (caused bad symptoms)
- patch absorption temperature dependent – didn’t work properly 7 months of the year and causes daily fluctuations eg when going to/from a warm room to outside
Short Half-life (bio-identical oestrogen)
– caused inter-dose withdrawal symptoms, necessitating multiple gel doses per day and night to prevent
I didn’t get these problems with the old synthetic BCPs
Lack of consideration to individual variation when prescribing – in particular, totally inadequate oestrogen doses
Equivalences – are not actually equivalent, which matters if you’re sensitive to levels
Eg from the “Pharmacokinetic Properties” on emc
Evorel 50 – estradiol CMAX 316 pmol/L (86 pg/mL)
Evorel Conti – estradiol CMAX 121 pmol/L (33 pg/mL)
Elleste Duet Conti Tablets - estradiol CMAX 61.6 (0.4) pg/ml
Lack of transparency on steroid withdrawal symptoms –
I did a trial of HRT for the physical symptoms of low hormones several years post-op. I didn’t have any neurological symptoms pre-HRT (hot flashes, headaches, palpitations, mood swings……) but after stopping HRT I went through a horrific withdrawal lasting 3 months, way worse than after the operation and I am still suffering severe, chronic insomnia as a direct result of trying HRT.
There’s much more, but it’s long enough already.