Thyroid UK
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Not thyroid-related, but would really appreciate some advice on HRT!

Lately, I have been having terrible hot flushes followed by intense sweating, and it has been affecting the quality of my sleep. The Hertoghe doctors only work with transdermal estrogen and natural progesterone (Utrogestan). Transdermal estrogen is described as safer than oral estrogen, but I cannot figure out if that only applies to synthetic estrogen or to all oral estrogen, including natural estrogen in pills such as Femoston and Angeliq...? The latter is incredibly expensive (almost 400€ for three months' supply), and it would be tempting to assume that means it's better than other drugs, but it is only supposed to be used if you have not had a period for at least a year. I recently went four months without a period and assumed I had had my last period, but it recently came back. I will turn 50 in December.

Any advice on how to get through this stage of life would be much appreciated, and I'd also welcome advice on natural methods (supplements, acupuncture...). For those of you who have used HRT successfully, what worked best for you and how much did you need? And for how long?

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Some women found Black Cohosh and Evening Primrose Oil effective and perhaps safer.

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Thanks, it's great to have a few alternatives!

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I took high dose sage (1 tablet of 2000 mg a day) which worked beautifully for me and stopped my hot flushes within a week.

Clemmie

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Interesting, thanks a lot!

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Clemmie- once your hot flushes stopped, were you able to stop the sage tablets too or do you take a maintenance dose?

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I carried on taking the sage until I’d finished the pack then stopped. I think that once or twice the flushes started again although greatLy reduced, so I bought some more but I didn’t finish the pack the second time and passed them on to a friend who was suffering and she found that they worked for her too. I have to say, that I didn’t suffer terribly through menopause ( mine started when I was about 40 and I really only had the hot flushes - my periods becme extremely light and only came once every three months for 2 days and then had stopped completely by the age of 48). I bought the high dose sage online from Healthspan and it costs £12.99 for 120 tablets ( one a day).

Clemmie

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I have decided to give sage a try. The online reviews are great and it cannot hurt...it may even help! It would be nice to find something to help with the terrible sweating. I find myself becoming more and more of a recluse because I don't want to be around other people when that happens...which made me realise I have to find a long-term solution. After all, there must be a way to solve this...I have been on Oestrogel for a few years (prescribed by Hertoghe doctor as part of treatment for adrenal fatigue) but it no longer seems to be helping. When my periods seemed to have stopped, back in January, my doctor told me to use Oestrogel every day instead of day 5-25 of cycle. However, since starting to use it daily, it feels like I'm sweating more profusely than when I only used it 20 days a month...but could that be possible?! After all, at my age, you are supposed to be estrogen deficient, right...but I have started to wonder if I could actually be estrogen dominant at age 49...?! I have been using Utrogestan 200 mg along with Oestrogel, day 15-25 of cycle.

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Anna- my nutritionist reckoned I am oestrogen dominant. I haven't got round to trying natural progesterone cream yet (as getting thyroid sorted first without introducing too many variables) but Wellsprings Serenity cream has been mentioned a number of times. Good luck x

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Good luck, I hope that it works for you.

Clemmie

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You can be estrogen dominant at any age as it is the ratio of estrogen and progesterone that determines the dominance. If you have little estrogen but even less progesterone you will get ED and it may happen anytime depending on the general hormonal health and certainly during the peri- or menopause. I got ED when I first started BHRT and we needed to adjust the dosage so monitoring is vital.

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Interesting! I am seeing my hormone doctor in three weeks and will be going to the lab before that. I look forward to discussing my lab results with doc and adjusting the meds as needed.

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Hi Clemmie

Thanks so much for all that info! I've been on Vogels sage tablets for about a month and found they helped with hot flushes from day 1. Previously I was getting 4-5 a day. I don't think it's such a high strength as yours so thanks for that link. It's really helpful to hear you stopped them as I wasn't sure if I'd need to be taking them long term. Thank you and v pleased you've found relief.

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Hope it works as well for you as the one you’ve already been using.

Clemmie

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That's great to hear as that is the brand I've ordered (Vogel)! It's been getting great online reviews plus it's a reputable company. I am keeping my fingers crossed it will work as well for me...if not, I can always try Clemmie's product!

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Great!

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I took the HRT drug Zumenon for 22 years as I had a hysterectomy at 40. No side effects and was sad to come of it.

Di

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I believe the HRT patches I’m on have helped me with my thyroid problems.

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Why do you believe the patches helped your thyroid?

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I’m not getting as many health symptoms as others get with Hyperthyroidism. Although the hair on my arms and legs and brows are mostly gone my head hair is very thick although fine. Eyes and skin and energy all good. But I get anxious but manage.

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I’ve been on HRT for 14 yrs and I have no intention of coming off yet despite dire warnings and grumbling from my doctors. Tried all the natural remedies at the beginning but sadly none worked for me. Had some success with a prescribed tablet that helped with sweating in the begging but it failed after 2 years. Hope you find something to help you.

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Can I ask which type of HRT you are currently using?

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Elleste duet conti. 2 mg estradiol 1 mg norethisterone per tablet

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I have sublingual lozenges for my bioHRT as creams didn't work for me at all. Wonderful - changed my life - but expensive - about £50 a month plus the £240 appointment fee plus private bloods at London prices every 9 months or so. I tried every herbal remedy for at least 3 months (usually six) over a period of 7 years and found none of them effective, although agnus castus helped a bit.

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I have an additional question in this context as I imagine I will have to resort to HRT eventually: has anyone tried both bio identical and synthetic hormones and found the latter to be more effective? The Hertoghe doctors will prescribe only bio identical hormones, and for many years I was convinced that was the best and most natural solution. Now, however, I am not so sure...it seems many are doing very well on synthetic HRT, especially synthetic progesterone...so I'd be interested in hearing from others having tried various forms of HRT: which one worked best for you?

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All forms of oral oestrogen and progesteron (synthetic and bio) are deemed to increase the risk of possible blood clots and strokes due to the fact they are metabolised through liver. However, creams or transdermal application does not work for everyone or sometimes works just to a point so everybody needs to weigh the benefits and possible risks and make this decision themselves. I am on lozenges for bioidentical oestrogen and progesteron and they certainly sorted out the hot sweats and a lot of other symptoms so I am sticking to them for as long as I will need to (last year, at least in the USA, they updated the recommendations saying it is safe to stay on HRT for 10 or even more years). I was on progestins in the past and they did not do much for me so for me yes, bio is better, especially that it does not come packed with fillers and other stuff that can affect my autoimmunity.

There is a very good hormonal health specialist called dr Anna Garrett who also runs a FB group called the Hormone Harmony Club - might be worth having a look.

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Thanks a lot:-) If the recommendations have been updated in the US they must have been in Europe as well, or at least be about to...I have always read and heard that it's only safe to stay five years on HRT. That is not nearly enough for many women, including me, so I'm very happy to hear about the updated recommendations!

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I just received this interesting newsletter (great timing!):

restartmed.com/menopause-test/

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I have another question in this context....today, I spoke to a colleague who has been having the same problems as me (mainly, hot flushes and terrible night sweats). She was put on an oral estrogen and progesterone drug called Indivina by her gynaecologist and has been feeling fabulous since. She recommended I try it, and even switch to her doctor if I cannot get anyone else to prescribe it...it all sounds great, but the Hertoghe doctors that I have been seeing in Belgium all say that oral estrogen is a big no-no, and that transdermal estrogen is the only option...I feel I have heard that so many times I have come to believe it. However, when I try to find objective information about it all, I fail to understand why estrogen cannot be taken orally, whereas it's perfectly fine to prescribe oral progesterone (even the Hertoghe doctors prescribe Utrogestan or Duphaston)...so, is there a difference in the way estrogen and progesterone respectively are metabolised by the body...?!

I admit to being completely clueless, and I never had any real reason to try to find out more until I started having terrible hot flushes and night sweats almost exactly six months before my 50th birthday...which is why I am trying to find out as much as possible, and I know there is so much expertise in this forum that it would be very foolish indeed not to benefit from it...!

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anna69, I've been using HRT cream forever it seems. 1999 Jan started with progesterone only, then by 2000 I was on half dose triestrogen and progesterone. I stopped using for a year or more because I didn't think I needed it. I was very wrong. I had hot flashes and heart palpitations like crazy. By 2005 I was on full dose. I tapered the dose down to where I don't get hot flashes. I'm 60 years old now and have no intention of ever stopping permanently.

I ran out recently and did not phone for a refill because there was another compounded drug (for Eddie the cat) and decided to call in both refills (pending no change in his prescription) after he had blood taken. I thought it would be okay to not use the cream for 14 days. Was I ever wrong! 10 days on I was waking up at night feeling like hot suffocation and sweating. Then I'd freeze. Then back to heat. It was as if super hot air was coming in through the window. I gave up at 3 a.m. and stayed awake after that. Not a great way to start the day that's for sure.

My script is Triest 1.25mg/1.25mg + Progesterone 6% (75mg/1.25mg)

It is issued for 3 months but I stretch it out to 5 months because I don't need 1/4 teaspoon twice per day to suppress symptoms.

It took 5 days at full dose to get comfortable again. I don't get any schtick from the doctor anymore and get 5 refills per presciption so that lasts 20 months.

My periods stopped completely at age 52 but I'd been using HRT 365 days of the year for years before. I was getting my periods regularly even though I was using the cream.

Endo wanted to know why I was still on Triestrogen when most HRT is now Biestrogen. I told her that if it ain't broke, don't fix it.

Hope this helps.

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Thank you, yes, that is very helpful indeed!

HRT is often described as something you should use as little as possible for the shortest time possible...lately, I have come to doubt that will be possible for me, so it's very reassuring to read about others who also need to stay on HRT long term and possibly indefinitely.

Thanks again for your input and detailed account, much appreciated:-)

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I know ladies in their late 80s who are still on HRT. That sure hasn't killed them.

There's too much fear but the WHI study was defective. They gave estrogen to post menopausal women who had never used Hrt. You can start someone on estrogen at age 70 when they never had a problem with menopause in the first place. The body is in homeostasis and adding hormones disrupts this.

That's why I started early and keep my body in balance at all times. It's used to it now and removing the HRT for the couple of weeks showed clearly that adverse symptoms will show up when it is withdrawn doesn't matter I'm 60 years old.

Recent studies indicate that women who need HRT should start before menopause. It is safest when used in this way. That's why my doctor says nothing anymore because I had to educate her.

I need to be alert at work. I make a lot of decisions and they need to be done quickly and accurately. I can't do it if I feel like a zombie.

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Again, thank you so much:-)

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