Hormone Replacement therapy (HRT) - PBC Foundation

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Hormone Replacement therapy (HRT)

JaneIng profile image
28 Replies

My functional doctor recommended HRT for me and she thinks it helps with bone strength, joint pain, vascular disease, etc. She also said the bio-identical hormone in trans dermal form will not hurt the liver.

Does anyone take HRT? Does your liver doctor approve it? I won't see my liver specialist for a while.

Thanks,

Jane

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JaneIng profile image
JaneIng
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28 Replies
Pamela4475 profile image
Pamela4475

I don’t take it but would be interested in what liver md says because I can ask in March when I see mine 😊

LisaC22 profile image
LisaC22

I asked my specialist about this last week - he said not a problem.

JaneIng profile image
JaneIng in reply to LisaC22

Thank you.

--Jane

gwillistexas profile image
gwillistexas

If you’re referring to the hrt patch, I used one for 12 years. My ob/gyn preferred the patch because the hormones do not go through the liver as the pill does. I finally weaned off it, my choice, due to history of breast cancer in my family. Felt better while I was on it though.

JaneIng profile image
JaneIng in reply to gwillistexas

Thank you.

gwillistexas profile image
gwillistexas in reply to JaneIng

Welcome 😊

JaneIng profile image
JaneIng in reply to gwillistexas

I told my doctor that my mom died of ovarian cancer. She said that synthetic hormone may cause cancer but the bio-identical hormone won't. She also mentioned that study showed the bio-identical hormone reduces polyps in the colon.

DoreenD profile image
DoreenD

I have been on the HRT patches as it does not go through the liver, I was put on the patch when diagnosed with PBC in 1988. My specialist wants me to stay on them to help with bones etc.

dianekjs profile image
dianekjs

Yes, the estradiol patch is safe, I am on the Vivelle-Dot brand and it’s been great. My hepatologist approved it, it largely bypasses the liver. It should generally be balanced/opposed with bioidentical progesterone (NOT a synthetic progestin).

Mirimaur profile image
Mirimaur in reply to dianekjs

The thing is if you have not had a hysterectomy then we need oestrogen and progestetone

JaneIng profile image
JaneIng in reply to Mirimaur

My lab showed I have a little bit of progesterone but no estrogen and testosterone. So she's going to do some compound prescription with mixture of estrogen, progesterone. and testosterone.

hi i took hrt for 19yrs 8of them while on urso my liver dr did nt mention it being a prob had a bone scan for liver reasons and my bones were above average in strenght for my age not sure if genetic or hrt because the only calcium intake i have is milk in coffee so if there offering them in my case i would say yes good luck x

JaneIng profile image
JaneIng in reply to

Wow, excellent. I have osteopenia so I sure definitely give it a try.

iagra profile image
iagra

pharmpress.com/files/docs/d...

"The use of HRT is generally cautioned in liver disease because of concern

over its potential to provoke or worsen cholestasis. This is based

on early experience with oral contraceptive pills that contained higher

doses of the less degradable synthetic oestrogen ethinylestradiol.

However, several studies have demonstrated the safety and efficacy of

HRT in patients with chronic liver disease, in particular those with PBC

and viral hepatitis. HRT may be particularly beneficial in patients with

PBC owing to the high prevalence of osteoporosis in this population.

Consensus guidelines for the management of osteoporosis in patients

with chronic liver disease recommend transdermal HRT (containing

258 Putting the theory into practice

Drugs&Liver chap-12 19/9/07 8:37 am Page 258

oestradiol 50 µg/day plus progestogen in women with an intact uterus)

in combination with oral calcium and vitamin D supplementation, as

first-line therapy. "

I've been taking premarin for 25 years after a full hysterectomy, at age of 39. First on higher dosage, but, in the last 15 years on .625mg. I feel, I still need it. I have osteoponia, so, it is advisable to remain on it, plus of course to take calcium supplement and vit D. My gastro says that she has female patients in their 80s who still take HRT pills and swear by them. PBC affects bones, so, HRT could be helping in this sense.

June9961 profile image
June9961

Yes I am on hormone patches. Both gynae and gastro consultants agree that it does no harm in fact it can help. Last winter I decided to slowly come off the patches and fell really ill. Even my blood nos worsened. I was put back on the patches and everything has returned to normal. I am in the process of reducing to a low mg patch and will stay on that. Hope this helps.

Wocket profile image
Wocket

I’ve been on HRT trans dermal patch and my hepatologist is ok with that.

Lekkerbek profile image
Lekkerbek

Been on HRT for about 6 years now and on Urso for 3 yrs. no problem at all. PBC is bad enough, but to deal with menopause at the same time....better to have some pill to help right?

in reply to Lekkerbek

been there its a nightmare i had to come off after 19yrz it was hell so wish i could still have i was taken off by a dr who thought i had a mini stroke not thru hrt i hasten to had that proved negative but becausr of age 62 they would nt put me back on

shirlwhirl profile image
shirlwhirl

I have PBC/ AIH and have been on Estradot hrt patches for last 23 years after having a full hysterectomy at 29 !

Doc stated it would do me more harm coming off them now .

I'm in the UK and as far as I know HRT in tablet form isn't recommended but the patches are apparently. I am not far off 54 and when I was 49 my cycle started going haywire. I didn't really experience any problems at all and never have with my cycle throughout life. 14months ago my cycle stopped so I think I can say that that is it for me now. I have had a few of the hot flushes/flashes but nothing that has gone on and on and not had one of those now for about 5mths either.

I know if in my cae HRT was offered I'd not take. I say this simply because I greq up in a family who only really ever took medications if they were necessary and I am not one for taking things 'just in case'. I find it bizarre to be honest. My late gran went through her life with just the odd necessary medications (ie pain killers or lozenges for sore gums, etc) but if she was still alive today (she died in the 1990s at aged 83 with no real ill health)) she'd be palmed off with allsorts of 'just in cases'. My 83yr old father-in-law takes a whopping 14 medications for this and that and he takes a lot because the one he was given gave side-effects so he got another that gave another side-effect so got another one for that and so on.

Mirimaur profile image
Mirimaur

Yes I do , my Professor has let me stay with it very low dose . Iyou need to check with your liver specialist. Please tell me which one you were recommended that was the safest for the liver. I must confess that I have taken it for many years , I have osteopenia so I think it may help although my prof has ordered blood tests for vit d and calcium levels . He also said I should be eating more calcium rich good rather than take calcium supplements for the moment

Kind wishes

Miriam xx

JaneIng profile image
JaneIng in reply to Mirimaur

My vitamin D and Calcium level are fine, but she did want me to reduce the vitamin D intake because it is too high now.

The HRT my doctor ordered is customized for me with Estrogen, Progestrogen and Testosterone (I have no testosterone left).

I can't use the patch because I have many contact allergies. I brought my allergy list to the compound pharmacy and they have to use different filler/preservatives to make it. I believe it is going to be very low dose and she said I should feel better in a month. Follow up in 3 months.

I normally don't deal with medicine very well. I am hoping this one goes well.

Thanks,

Jane

Mirimaur profile image
Mirimaur in reply to JaneIng

I have always felt so much better on it I take premique low dose. We are all different though . Good luck

Miriamxx

Jeanb47 profile image
Jeanb47

I’ve been on HRT since I had hysterectomy when I was 37. (Im 70). I’m on the patch and have been for most of that time. 75 mg change twice a week. I tried going off a few years ago and suffered heart arrhythmia. Went back on and it fixed that problem. Recently my cardiologist suggested I might need an increase as I was having some angina with exercise. apparently recent studies show that it is helpful? But chose to stay on the 75 patch

I have no problem with bone loss even though I have PBC for long time. So maybe the HRT has helped me? There is no history of breast cancer in my family so that was not a concern.

My liver specialist knows that I’m on it and has made no comment about it. So... but I shall ask my next appointment.

Jeanette

Pat_H profile image
Pat_H

I took HRT for 16 years, and then had to come off it because I had a bleed. HRT was marvellous. I felt great, I had no aches, I could do things like a 'young-un'. If it hadn't been for that bleed I would be on it now. All the time I was on it my DXA scans were good, since I came off not so good for the upper body. Legs still OK because I walk a lot.

As I've been off it now for two years I am thinking of asking my doctor if I can go back onto the same one. I don't want to go on one which has more testosterone - a friend of mine did that and her hair thinned.

JaneIng profile image
JaneIng in reply to Pat_H

Thank you.

--Jane

loriejw profile image
loriejw

Hi Jane, yes I do. I use the trans dermal esterdiol patch and bioidentical progesterone. My bone density is pretty good . Been menopausal for over 20 years and PBC for 10. Used HRT for about 10. My former liver specialist was very comfortable with it.

JaneIng profile image
JaneIng in reply to loriejw

Great to know. Thanks!!!

—Jane

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