hrt

[Orchid40]

Hi folks,

I wonder if anyone can help. I know HRT is a moot point for many of us but hopefully some of you will have more knowledge/experience than I do. I'm shooting in the dark.

I'm on Premarin and my doc says he can't measure my hormone levels to see if I have the right amount because it's purified horse pee. Well, he didn't actually say it like that but it's a nice thought, isn't it?
To be honest, I have no idea how much HRT and what sort I should be on. I've tried the combined pill when I was young, then nothing (naughty I know but bones are OK) now Premarin. Most of the time I'm on what a GP prescribes which is invariably what a woman after hysterectomy would have.

My hair is noticeably thin and weak but then I am not a 20 year old now. Even so, not much energy either. Any ideas what's normal for PAIS or are we all different?

[Aseras]

Premarin is crap. why not ask him to put you on bioidentical hormones so he can check them for normal reference ranges.

The idea is to use bioidenitcal hormones and have them in the normal female or male ranges.

It's not just one hormones it's all of them it's a balance. There are 3 kinds of estrogen ( estrone, estradiol and estriol ). premarins ia equine estrone. it's not the same as estradiol. estradiol is the normal primary estrogon in pre menopausal women. estriol is only seen in pregnancy.

estradiol is the strongest. estrone is 12 times weaker. estriol is 40-100 times weaker.

the idea is to test all of them E1, E2 and E3 ( fractionated estrogens test ) and get them all in the correct female ranges. then it's just maintenance.

[Orchid40]

Ah, I thought someone would say something like Premarin is crap. I've been on it for about 10-15 years! I don't like the fact it can't be tested for easily or that it comes from pregnant mares.

I have a doctor who's reluctant to do anything without a specialist's instruction...who delegates the job to an understudy... who says take what your GP recommends. Argh!

I think I'll ask for the 'natural' stuff which can be monitored cos I suspect us AIS girls need more HRT than regular girls cos we're used to high hormones before gonadectomy.

Thanks Aseras.

[fraulein_Maria]

Ah, I thought someone would say something like Premarin is crap.

>>> You do know that its BANNED in canada? the market then got flooded with lots of it, so it wouldn't surprise me if the UK gov. bought a ton of it cheap. it is now being pushed heavily in this country aswell for the same reason. thankfully, most americans aren't buying it. <<<

I've been on it for about 10-15 years!

>>> and causes nasty side effects. <<<


I have a doctor who's reluctant to do anything without a specialist's instruction...who delegates the job to an understudy... who says take what your GP recommends. Argh!

>>> in america, it would be simple enough to just switch doctors. i realize that's harder where you are, but i have an idea.....

you really should be seeing a gynecologist, or a reproductive endo, NOT a GP anyway ... unless yours is as "cooperative" as mine. ;) If he's got a problem with that, sick the AIS-UK support group on them. Talk to Miriam if you haven't heard of them. <<<

I think I'll ask for the 'natural' stuff which can be monitored cos I suspect us AIS girls need more HRT than regular girls cos we're used to high hormones before gonadectomy.

>>>> most AIS'ers i know are indeed on higher doses, but they did NOT start that high. Avoid the nausea and vomiting, by just upping it gradually. <<<

Thanks Aseras.

>>> good egg, he is. :) <<<

[miriam]

I suspect us AIS girls need more HRT than regular girls cos we're used to high hormones before gonadectomy.

When you say 'high hormones' I assume you are talking about high testosterone levels. With AIS the natural levels of estrogen are rather low.

Groeten, Miriam

[Orchid40]

Yes, Miriam, well something like that. At least for most CAIS girls but I'm PAIS and my testosterone was high but not as high as most CAISers. My oestrogen levels were high (for XY but not sure about XX comparison). I get the impression we're hormonally overflowing to begin with then, snip-snip, here's some HRT pills and we're in the doldrums.
I would like a bit more oomph in me, a bit more sparkle, like I used to have and I don't think it's just age!

I see Endos at UCLH, London every few months but a different one each time :sad_smile. My GP doesn't want to tread on their toes but I will ask to go on natural oestrogens so I can get a reading and try to get it into the normal range. I don't want to try testosterone treatment as several people have had neutral or bad responses to it.

[Aseras]

You'll have to forgive my typing in my earlier post. I did it on my phone and it just plain sucks for this.

First, you are going to see a lot of doctors not wanting to treat you right, or deferring to other "smarter" doctors ( who actually know jack, or worse think they know but don't and sell you down the road ). I've been through this dozens of times.

Hormones are a delicate balance. It's not all about replacing E or T, it's replacing both especially if you have been "snipped" or been on HRT so long everything has atrophied to nothing.

Your lack of energy may be in fact too low of T ( if you are PAIS some minuscule amount of T was working ). You may need to add T as well as E. For you, since the T is largely ineffective it will have to be dosed to what you feel is right. An added bonus is that the T will drive SHBG down ( regardless of AIS ) and thus your E levels will be more effective since T binds to SHBG permanently ( thus making is useless ) and E is only weakly bound.

It's all a very delicate balanace. Most people take things like this for granted, unfortunately for us, we have to live with whatever is wrong with us, and many of us are unique, and that's too much for 99.99% of the doctors out there who are unable to service those of us who have such rare conditions. The few who are willing, don't really know what they are doing.

My only suggestion is to first, find a good doctor who will work with you, and is willing to learn and then learn everything you can yourself about hormones and your condition and then treat it. It may mean trying things, more tests and seeing if you can find what works for you. It'll take years, maybe longer.

[nicolerocknroll]

There is no such thing as bio identical hormones . They my have the same molecture weight but not the same molecture sturcture.

[Aseras]

There are bioidentical hormones. It is the same molecule or one slightly modified, such as an addition of a ester molecule to enhance absorption and slow the release of the hormone into the body. Once it enters the bloodstream however the liver removes that molecule and then it is the same molecule that the body would make. Thus it shows up on normal bloodtests ( synthetic or non natural hormones such as birth control or premarin or other synthetic hormones do not ) and you can titrate and adjust your dosages to be in the normal range.

Great site here, same thing applies to both estrogen and testosterone. Just substitute the words. The same esters and delivery methods are used, just different dosages ( since estrogen is 10 times stronger than testosterone ). It goes into far more detail than I can.

http://www.ftmguide.org/ttypes.html