# HRT For Women



## EllisRedding (Apr 10, 2015)

I recently went on HRT, and it has made a significant improvement in my quality of life. As a dude, although there is still a stigma attached to HRT, I found that there were a lot of resources online to get information regarding, talk to others who had experience with, etc... That being said, what I found was that there was very little information for women regarding HRT. Also, I think the stigma associated with female HRT was stronger b/c it could potentially involve the dreaded "Testosterone", which evokes images of the below happening once treatment starts:










As I was digging around (looking for information for my W as I think this could potentially be an avenue worth exploring for her, especially if it could replace medication she has been placed on which does nothing more than mask issues), I did come across the below video which seemed like had some good information. I thought I would post here for anyone interested in. Also, if any female TAM'ers have experience with HRT, maybe this would be a good place to post about for others to read (similar to the TRT thread we have going on in the Dudes Dungeon).


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## minimalME (Jan 3, 2012)

Maybe I should try it. My hot flashes have come back - more like the first year. It's hard.


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## Diana7 (Apr 19, 2016)

I have been on HRT patches since my hysterectomy at age 46. Mine are oestrogen only because I have had the hysterectomy.
I have had no issues with it, and don't want to come off it many years later.


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## Ed3n (Sep 25, 2018)

There are several great sites for women and HRT, but they are typically based around surgical menopause (hysterectomy) not a natural progression of age. The issue with HRT is that it is not one size fits all, and many doctor's do no believe HRT to be necessary, and some insurances do not cover them. It really does depend on an understanding doctor, being realistic about what to expect from HRT, and LOTS of trial and error until you find what works best for you. 

It took me years after surgical menopause to be stabilized on HRT. Many times I felt like giving up, because it is a nasty, hot flash, mood swinging, weight fluctuating roller coaster ride! HysterSisters was a godsend! A very supportive group of women, who have been through much of what I had. It really helped.

I found a lot of very useful books on Amazon, so you might want to see if there is a book that has the information you seek. Go back to the olden days, and depend on a book for information :surprise:....What has this world come to! :wink2:

Good luck in your search! The information is out there, but not always easy to find. It gets a little frustrating, so put on some music, or whatever relaxes you, and start searching. I used a bunch of random terms (ie: support groups, HRT options, HRT reviews, etc.) that described what I was looking for, and after a couple of hours I finally found exactly what I needed. I wish you success in your search for answers.


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## EllisRedding (Apr 10, 2015)

Ed3n said:


> There are several great sites for women and HRT,* but they are typically based around surgical menopause (hysterectomy) not a natural progression of age*. The issue with HRT is that it is not one size fits all, and many doctor's do no believe HRT to be necessary, and some insurances do not cover them. It really does depend on an understanding doctor, being realistic about what to expect from HRT, and LOTS of trial and error until you find what works best for you.
> 
> It took me years after surgical menopause to be stabilized on HRT. Many times I felt like giving up, because it is a nasty, hot flash, mood swinging, weight fluctuating roller coaster ride! HysterSisters was a godsend! A very supportive group of women, who have been through much of what I had. It really helped.
> 
> ...


Great response. The bolded is really most of what I could see, HRT being employed after a hysterectomy or some other medical procedure. Very little out there about improving the quality of life. It just seems odd. Birth control pills can get handed out like candy and it is a form of hormone control, yet other HRT type therapies looking to increase/improve quality of life seem to be scoffed at. My W started having more noticeable PMS issues (usually week or so leading up to period) and the quick answer was to simply throw her on Zoloft. No attempt to understand why this was happening, was there a hormonal imbalance, etc... No gameplan as far as long term. Take this pill indefinitely, it should mask your symptoms. I have to believe there are better options out there, or at least feel like all options should be looked at instead of just the easy route.


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## Elizabeth001 (May 18, 2015)

EllisRedding said:


> Great response. The bolded is really most of what I could see, HRT being employed after a hysterectomy or some other medical procedure. Very little out there about improving the quality of life. It just seems odd. Birth control pills can get handed out like candy and it is a form of hormone control, yet other HRT type therapies looking to increase/improve quality of life seem to be scoffed at. My W started having more noticeable PMS issues (usually week or so leading up to period) and the quick answer was to simply throw her on Zoloft. No attempt to understand why this was happening, was there a hormonal imbalance, etc... No gameplan as far as long term. Take this pill indefinitely, it should mask your symptoms. I have to believe there are better options out there, or at least feel like all options should be looked at instead of just the easy route.




Look for a natural hormone therapy. I was on progesterone cream for years. It did miracles for my PMS. Seek out compounding pharmacies or natural HRT clinics. They’re popping up everywhere these days. 


Sent from my iPhone using Tapatalk


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## EllisRedding (Apr 10, 2015)

Elizabeth001 said:


> Look for a natural hormone therapy. I was on progesterone cream for years. It did miracles for my PMS. Seek out compounding pharmacies or natural HRT clinics. They’re popping up everywhere these days.
> 
> 
> Sent from my iPhone using Tapatalk


Thanks. The HRT doctor/clinic I go to specializes in both men and women, so at a minimum that would be an option for her. Really, I would just like to see her have a comprehensive bloodwork / hormone panel done. Maybe there is nothing there, maybe it will help better understand why she is experiencing these changes. Right now the zoloft has made a big improvement, so it is kind of a "if it ain't broke don't fix it approach" in her mind. Short term I am perfectly ok with. I don't like that it just masks the symptoms though, and seems to be an open prescription to take as long as needed with no sort of game plan (aside from consciously weening yourself off, how would you even know if you needed it anymore). Although I have noticed anything yet, I don't like the fact that she is taking something that she potentially doesn't have to, where the risk of sexual side effects only increase (especially if there are better options).


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## Elizabeth001 (May 18, 2015)

EllisRedding said:


> Thanks. The HRT doctor/clinic I go to specializes in both men and women, so at a minimum that would be an option for her. Really, I would just like to see her have a comprehensive bloodwork / hormone panel done. Maybe there is nothing there, maybe it will help better understand why she is experiencing these changes. Right now the zoloft has made a big improvement, so it is kind of a "if it ain't broke don't fix it approach" in her mind. Short term I am perfectly ok with. I don't like that it just masks the symptoms though, and seems to be an open prescription to take as long as needed with no sort of game plan (aside from consciously weening yourself off, how would you even know if you needed it anymore). Although I have noticed anything yet, I don't like the fact that she is taking something that she potentially doesn't have to, where the risk of sexual side effects only increase (especially if there are better options).




2 words:
Big Pharma



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## minimalME (Jan 3, 2012)

On average, how much does it cost? Cause I'd have to pay.

My transition is natural - not from surgery. I think my hot flashes started around 2013/14. 

Initially, I knew something was off, so I went to my doctor and asked if I could be starting perimenopause. They tested my hormone levels and said everything was normal and fine. For whatever reason, the tests were inaccurate, and I was having hot flashes and my periods were tapering off.

I guess my hesitation about starting on hormones is that:

1. I can go months without a hot flash. The past couple of weeks have been intense, but I never know what the day will be like. So, how do the hormone replacement methods work? If I'm having a rough period, can I put on the patch or use the cream and have relief within a few hours? Or is this something that takes days to start working? If it takes a long period of time, I don't really want to do that, because they could be over by the time the hormones kick in.

2. We go through menopause for a reason - probably in ways we're totally clueless about. Like having a fever that doesn't get too high, it has a purpose. So my concern is that I'd be tempering a naturally occuring function, and I'd be getting temporary relief without really knowing definitively what the long term effects would be.


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## EllisRedding (Apr 10, 2015)

Obviously my protocol would be different, but for me everything is out of pocket. I am spending approx $300-$400 every 10 weeks (at the end of the 10 weeks, before a reorder is done, I speak with the doctor and we re evaluate everything). I have an HSA account, so I at least get some tax benefits as I use that to cover the costs. Of course i don't know how close this would be for females @minimalME , but I would guess it would be less.


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## minimalME (Jan 3, 2012)

EllisRedding said:


> Obviously my protocol would be different, but for me everything is out of pocket. I am spending *approx $300-$400 every 10 weeks* (at the end of the 10 weeks, before a reorder is done, I speak with the doctor and we re evaluate everything). I have an HSA account, so I at least get some tax benefits as I use that to cover the costs. Of course i don't know how close this would be for females @minimalME , but I would guess it would be less.


Thanks. I think I'll continue to talk myself through them for now. I'd rather go to Europe.


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## Rowan (Apr 3, 2012)

minimalME said:


> On average, how much does it cost? Cause I'd have to pay.
> 
> My transition is natural - not from surgery. I think my hot flashes started around 2013/14.
> 
> ...



Interestingly, the "normal" range of just about anything can be quite abnormal for a certain number of people. I have "normal range" thyroid numbers, yet also have every symptom of hypothyroid and a family history of it. For me, normal really isn't all that normal. So, it might be that your numbers were in the normal range, but that they were low/high for your particular body. If you never had a hormone panel done before middle age, then you'd never be able to tell if those "normal" numbers were actually sharply different from whatever was normal for you beforehand.

Yes, HRT would be a long-term thing. It can take a while for your hormones to stabilize once you start treatment, and you may have to do some trial and error to find the right combinations and dosages to best control your symptoms. The process can take anywhere from days to months, and then may need to be tweaked periodically as your body continues to change with time. So it's not something you'd be able to take only when symptoms arise for immediate relief, then stop as soon as your symptoms do.

If you want something over the counter and generally considered very safe, Estoven or Amberin might be good options. They have both seemed to help a good bit with my hot flashes. Again, though, they can take a few days to work, so it's not an instant fix.


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## Elizabeth001 (May 18, 2015)

Rowan said:


> Interestingly, the "normal" range of just about anything can be quite abnormal for a certain number of people. I have "normal range" thyroid numbers, yet also have every symptom of hypothyroid and a family history of it. For me, normal really isn't all that normal. So, it might be that your numbers were in the normal range, but that they were low/high for your particular body. If you never had a hormone panel done before middle age, then you'd never be able to tell if those "normal" numbers were actually sharply different from whatever was normal for you beforehand.
> 
> Yes, HRT would be a long-term thing. It can take a while for your hormones to stabilize once you start treatment, and you may have to do some trial and error to find the right combinations and dosages to best control your symptoms. The process can take anywhere from days to months, and then may need to be tweaked periodically as your body continues to change with time. So it's not something you'd be able to take only when symptoms arise for immediate relief, then stop as soon as your symptoms do.
> 
> If you want something over the counter and generally considered very safe, Estoven or Amberin might be good options. They have both seemed to help a good bit with my hot flashes. Again, though, they can take a few days to work, so it's not an instant fix.




Bingo. All of my ranges were “normal” but the compounding pharmacist showed me that my estrogen was higher and my progesterone was a little low so that essentially made me “estrogen dominant”, even though everything fell in the “normal” range. 

As far as cost, it was expensive getting through the initial consultations...maybe around 300-400 but then my monthly supply of cream was $50/month. 

And you have to get your regular doc to get on board to approve the prescriptions. Mine resisted somewhat in the beginning but finally agreed to play and I think he was surprised at the outcome. He’s much more open to it now. 

I have since stopped the progesterone cream because after getting laid off from my well-paying job, I needed the $50/month and I’m almost 50 so I was hoping it would kick my meno in. That hasn’t happened yet but my periods are a little different now. 

If anyone is interested in the pharmacy I used (Virginia), send me a pm. 


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## minimalME (Jan 3, 2012)

Thank you! I'll look for both of those.

Everything my body is doing is all mixed up.

It's not even the hot flashes that are hard - it's the trigger that occurs right before. I don't know what it is - a spike or a drop, but it's emotionally very uncomfortable. Like a split second of despair or a panic attack. But as soon as I recognized it, it's gone and the hot flash starts.

Even that's not consistent though. I haven't had days like these since they first started, and I often have very mild hot flashes with no uneasiness at the beginning.

Sometimes I'll even have cold flashes.



Rowan said:


> If you want something over the counter and generally considered very safe, Estoven or Amberin might be good options. They have both seemed to help a good bit with my hot flashes. Again, though, they can take a few days to work, so it's not an instant fix.


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## Ed3n (Sep 25, 2018)

minimalME said:


> Thank you! I'll look for both of those.
> 
> Everything my body is doing is all mixed up.
> 
> ...



If you are not consistently having hot flashes, or other issues, I would suggest something like Estroven or other OTC menopause symptom reducer. Dialing in hormones takes time, and can be costly.

On a side note:

I know a lot of people have great things to say about compounding pharmacies, but I do not. I went to one with a stellar reputation, and the cream they formulated for me had my hormones fluctuating so severely that I felt like I was seriously ill. One month I felt like nothing had changed (hot flashes, etc), the next I had constant severe panic attacks, and violent mood swings, the next month I couldn't drive because my vision was so blurry, and I was extremely confused. When my "Naturopath" doctor tested my hormone levels at that point (which I had to demand multiple times), my estrogen was at 0, my progesterone and testosterone were 3 x's what they should have been. At that point I switched to bioidentical through my gyno, and my levels stabilized (after about 6 months).

I am not saying don't use a compound pharmacy, but be aware that they are not perfect, or somehow better because they are more "natural". Mine did not accept insurance, and my hormones ran close to $200 a month. Research your options, and go with what works best for you. 

When choosing to use HRT, make sure you have a knowledgeable doctor who is well versed in all of the current available options. Even if you have not had surgical menopause, their websites are still a great resource for what HRT options are available, and offer some great tips on how to get the most of of them (placement, time of day, etc).


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## Ed3n (Sep 25, 2018)

EllisRedding said:


> Great response. The bolded is really most of what I could see, HRT being employed after a hysterectomy or some other medical procedure. Very little out there about improving the quality of life. It just seems odd. Birth control pills can get handed out like candy and it is a form of hormone control, yet other HRT type therapies looking to increase/improve quality of life seem to be scoffed at. My W started having more noticeable PMS issues (usually week or so leading up to period) and the quick answer was to simply throw her on Zoloft. No attempt to understand why this was happening, was there a hormonal imbalance, etc... No gameplan as far as long term. Take this pill indefinitely, it should mask your symptoms. I have to believe there are better options out there, or at least feel like all options should be looked at instead of just the easy route.


If AD's are helping, your wife's problems may not be hormonal, and she may actually need an AD. Most Gyno's that I have been to will use bc to control issues when possible, unless there is a reason why bc is not a suitable option (a lot of women do not tolerate bc well, or it is not hormone related). If the Zoloft is actually helping your wife, great! She found something that works! She just needs to realize that stopping it will not be a simple process, and should be very aware of all of the facts about Zoloft; good and bad. Your wife might want to do some research about Zoloft, especially how hard it is to stop taking it. It is one of the worst AD's as far as withdrawal symptoms when people try to come off of it. 

So, if she needs to be on an AD, perhaps her doctor could try her on something that isn't so difficult to stop taking (Wellbutrin and Celexa both tend to be considered well tolerated to most (I cannot take Wellbutrin at all, but Celexa was fine. It just stopped working). Everyone is different though, so finding what works really is a guessing game until the doctor gets it right). 

The right AD does not mask the issues. It ideally corrects chemical imbalances that cause the issues. If they make her feel numb emotionally, she is on the wrong one. Basically, the right AD should leave the person feeling "normal" without extreme highs or lows, or feeling like a zombie, unable to enjoy sex, etc. They should be happy when they are happy, and able to feel sad when something gets them down. If her pills are masking how she feels, she needs to go back to her doctor and let them know.

I just want to add that my HRT in NO WAY improved my quality of life in comparison to before I had my hysterectomy (excluding the pain). My doctor was very honest when she told me that she could only help reduce my hot flashes and other symptoms, and they weren't magical pills that would fix everything. Basically on HRT, I just don't have to deal with a horrid truckload of symptoms caused by surgical menopause. Other than that, I am more tired, less libido, and more easily depressed than I have even been in my life.


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## EllisRedding (Apr 10, 2015)

Ed3n said:


> If AD's are helping, your wife's problems may not be hormonal, and she may actually need an AD. Most Gyno's that I have been to will use bc to control issues when possible, unless there is a reason why bc is not a suitable option (a lot of women do not tolerate bc well, or it is not hormone related). If the Zoloft is actually helping your wife, great! She found something that works! She just needs to realize that stopping it will not be a simple process, and should be very aware of all of the facts about Zoloft; good and bad. Your wife might want to do some research about Zoloft, especially how hard it is to stop taking it. It is one of the worst AD's as far as withdrawal symptoms when people try to come off of it.
> 
> So, if she needs to be on an AD, perhaps her doctor could try her on something that isn't so difficult to stop taking (Wellbutrin and Celexa both tend to be considered well tolerated to most (I cannot take Wellbutrin at all, but Celexa was fine. It just stopped working). Everyone is different though, so finding what works really is a guessing game until the doctor gets it right).
> 
> ...


I do completely agree, Zoloft has been a big help for my W so far. From what I have read, Zoloft is often prescribed from more severe PMS symptoms (premenstrual dysphoric disorder) which may or may not have been what my W's gyn was prescribing for. My issues since the start though are:

- No sort of comprehensive bloodwork was done first. It was simply take this pill every day b/c of your symptoms (hence the reason why I do believe it could simply be masking some of the symptoms, maybe not). No attempt to understand WHY these symptoms got worse.
- No discussion with my W about the possible side effects (I guess you could put this on my W as well for not pressing the doctor). In particular, the potential sexual side effects she was not aware of when she started taking until I brought up as I researched. She is on a low dosage, so maybe this is something she will avoid. The question though, is this something that the longer she takes the more likely the sexual side effects will impact her (which as you mentioned, withdrawing from is only going to get harder). Timing wise, we are finally at a much better place in our marriage, so any sort of unnecessary sexual dysfunction could really set things back.
- No long term game plan. This is basically an open ended prescription. Each time she goes back to the gyn, if all is going well, she will just continue on. How will she know if she still needs it, Why put an AD or any other prescription medication in your system if you don't need it?

I will continue to be 100% supportive of what my W chooses, b/c at the end of the day I want her to be happy and feel the best she can. However, I do want to make sure all options are looked at. Maybe after looking at everything, an AD is the best fit. What I do keep pressing my W on is to be honest/open with herself about any possible sides (I think there is always the chance she may dismiss signs of side effects for fear of having to get off Zoloft). For example, she noted that in particular this past week she has been unusually tired (maybe unrelated, but something to keep tabs on). A few days ago she took her Zoloft dosage in the morning instead of at night and said she felt like a zombie all day (maybe unrelated, maybe it was b/c the morning dose was too close to the previous night dosage, something to watch). Trying to find the balance b/w "don't rock the boat" and looking at other options.

When I spoke to my HRT doctor (they specialize in women as well), I mentioned exactly the symptoms my wife was dealing with. He said that was very common with many of his female patients that he treats. I then mentioned she got put on Zoloft to combat and you could hear him sigh over this. Now, I understand as an HRT doctor, naturally he is going to lean towards his type of treatment, but his general thought was that here we go again with a doctor handing out prescriptions without trying to get to the root cause of the issue. This is part is why I started this thread. I tried to do research on HRT for women, and aside from HRT related to hysterectomies, I found very little information (the video I posted on the OP being one of the only things I could find where the person seemed to be in a similar situation as my W).


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## Rowan (Apr 3, 2012)

EllisRedding said:


> When I spoke to my HRT doctor (they specialize in women as well), I mentioned exactly the symptoms my wife was dealing with. *He said that was very common with many of his female patients that he treats. I then mentioned she got put on Zoloft to combat and you could hear him sigh over this. Now, I understand as an HRT doctor, naturally he is going to lean towards his type of treatment, but his general thought was that here we go again with a doctor handing out prescriptions without trying to get to the root cause of the issue.* This is part is why I started this thread. I tried to do research on HRT for women, and aside from HRT related to hysterectomies, I found very little information (the video I posted on the OP being one of the only things I could find where the person seemed to be in a similar situation as my W).



Yeah, you actually see that a lot in medicine still. There's a long and storied history of considering anything female-related to be just a bit (or more than a bit) the result of that woman being hysterical, crazy, overly sensitive, overly emotional, etc. And to treat women mostly with something to fix their moods, rather than something to fix whatever else might actually be going on with them medically. Throwing antidepressants at women, without actually checking for possible root causes, is still much too common in medical practice. It's getting better, but it still happens far too often.

I was in my mid-late 20s before a medical professional wanted to actually investigate the "sick headaches" I'd been plagued with since childhood. Yep. They really were migraines. Nope. The anti-depressant and anti-anxiety drugs various doctors had been handing out like candy since I was 14 really weren't helping them. And weren't going to. Because I wasn't crazy or depressed or being overly dramatic or malingering. I was having _migraines_. Bad ones. That 30 minute conversation with an NP when I was 28 changed my life. Because suddenly, I was being treated for my actual medical condition, rather than being assumed to be automatically a bit dramatic just because I was female. 

It can take a lot of pushing and insisting and changing doctors to find one who actually listens to you and believes you. And it can take a lot more of all of those if you're female. So, if you wife is getting handed an antidepressant without any other investigation - and she's not clearly actually depressed - then it might be time for a second opinion. One with a doctor who's more interested in helping to treat her actual symptoms than in getting her to stop complaining about them by convincing her that they're all in her head.


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## minimalME (Jan 3, 2012)

Rowan said:


> Yeah, you actually see that a lot in medicine still. There's a long and storied history of considering anything female-related to be just a bit (or more than a bit) the result of that woman being hysterical, crazy, overly sensitive, overly emotional, etc. And to treat women mostly with something to fix their moods, rather than something to fix whatever else might actually be going on with them medically. Throwing antidepressants at women, without actually checking for possible root causes, is still much too common in medical practice. It's getting better, but it still happens far too often.


I had a doctor for years who kept offering me antidepressants for no other reason than I was a mom. :surprise:


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## CharlieParker (Aug 15, 2012)

Rowan said:


> Yeah, you actually see that a lot in medicine still. There's a long and storied history of considering anything female-related to be just a bit (or more than a bit) the result of that woman being hysterical, crazy, overly sensitive, overly emotional, etc. And to treat women mostly with something to fix their moods, rather than something to fix whatever else might actually be going on with them medically. Throwing antidepressants at women, without actually checking for possible root causes, is still much too common in medical practice. It's getting better, but it still happens far too often.


And that's because there aren't any vibrator sales reps bringing lunches and other goodies. 

But seriously, that's awful.


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## Diana7 (Apr 19, 2016)

Hrt patches are far better than tablets as you need to take a much larger dose of tablets for the right dose to get to where it needs to. 
I went straight onto oestrogen patches after a hysterectomy at 46, and before that I was already getting hot flushes. 
I had everything removed including both ovaries and have been on the patches ever since, although I am on half the dose I was now.

I hope that I can stay on them for good, my doctor keep om-ing and ah-ing about taking me off, but I want to stay on. I am in the UK so we have the NHS,so cant really do much if they tell you to stop and refuse to carry on prescribing them.


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## Ed3n (Sep 25, 2018)

Diana7 said:


> Hrt patches are far better than tablets as you need to take a much larger dose of tablets for the right dose to get to where it needs to.
> I went straight onto oestrogen patches after a hysterectomy at 46, and before that I was already getting hot flushes.
> I had everything removed including both ovaries and have been on the patches ever since, although I am on half the dose I was now.
> 
> I hope that I can stay on them for good, my doctor keep om-ing and ah-ing about taking me off, but I want to stay on. I am in the UK so we have the NHS,so cant really do much if they tell you to stop and refuse to carry on prescribing them.


I tried HRT patches (several variations), and had a lot of issues with them. Because of my metabolism, they didn't last as long as they should have (3 days) so I had to change them more often. The cost was high, because I needed more patches than typically prescribed, so I had to fight with my insurance to approve more patches. I switched to oral HRT,and take half the dose that my patch was. I have two pills at different mgs, but most days I only take the higher mg dose. On bad days I take the lower dose as well as a booster. For me, it is more effective, and easier to manage, than HRT patches.

Everyone is different. For some the creams and gels work great. Others swear by patches, be it the ones made from yams, or bioidentical. Some of us do better on oral. I tried them all, and settled on the pills because it is what worked best for me.


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## Ed3n (Sep 25, 2018)

The reason you are not going to get all of the comprehensive testing you would like has very little to do with a doctor, and everything to do with your insurance company. If they do not believe it is warranted, they refuse to cover it. So, the doctor may want to do more, but is well aware that insurance will reject anything they try to do. 

So many people blame doctors for failing to treat them, and while that absolutely happens, it is typically an insurance company who is making the choices to reject tests that could be helpful in diagnosing a patient that has unusual or difficult to diagnose issues. 

My husband and I have spent more time fighting our insurance than our doctors for years. Our doctors are great. Our insurance is top-tier, and still fights every test they deem not medically necessary. If you want more from the doctor, prepare to deal with your insurance company. It is not your doctor's job to do so. It is one of the most irritating experiences when it comes to medical care; fighting with the insurance company for coverage you should have, but they decide you really don't qualify for. Good luck!


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## EllisRedding (Apr 10, 2015)

Just came across a couple of interesting summaries:


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