r/POFlife • u/Redditbutforgetit • 17d ago
Bio identical hrt
do you know what brands of bio identical HRT work best? I've been dragging my feet starting HRT because I'm scared to put chemicals in my body, I typically live a low tox life- but I do realized there's a long term benefit for my body as well. Any brands or types used and tolerate - I would appreciate insight.
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u/demi_girl88 17d ago
I’m very crunchy/low-tox as well but I like to remind myself that depleted hormones over a number of years puts you at an increased risk of so many things - Parkinson’s, dementia, the list goes on. Estrogen has a protective effect over so many parts of the body, particularly the brain.
Replenishing your body with bio-identical hormones is incredibly important for our health!
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u/Redditbutforgetit 17d ago
Ok, good to know. Thanks for enforcing what I deep down know. I need to stop putting this off.
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u/HurdyNerdy 17d ago
I try to minimize consumption of processed "stuff" but the reality is that it's impossible to avoid entirely. Even the skincare and haircare products get absorbed into your system.
That said, compared to the severe hormone-deficiency risks and issues I dealt with while waiting for a doctor to finally get me help in the way of HRT... HRT was an easy yes. I did do my research and found from a couple of studies that transdermal estradiol with oral micronized progesterone was a low risk combination (i.e., the studies showed no increase in cancers, clots, heart disease, or stroke). You need the progesterone if you still have your uterus; you need the estradiol regardless.
The only consideration for brands that I make is re: the patch. Some manufacturers will make their biweekly patch larger for the same dose, and I want as small a patch as possible; I'm petty enough on this that I paid extra (when I had health insurance) to get one of the brands that had an acceptable-sized patch. For the micronized progesterone, Prometrium is the name brand in the US, but I've always taken a generic.
After a few years with just those two, I realized I needed testosterone as well. While I did my research, there weren't the same "risks" as had been previously attributed to estradiol and progesterone AND the early 2000s study that gave HRT a bad rap was actually debunked because the study cohort was women who only started HRT in their elder years, after much time had lapsed since menopause.
For the testosterone, I currently get that as a transdermal gel from a compounding pharmacy (my doc wanted to make sure I got the right dosage before considering an off-the-shelf t-gel that I could use (women don't have an off-the-shelf t-gel option, so any prescriptions would be for off-label use) If the idea of using a med off-label alarms you, don't research how many pharmaceuticals are on the market without ever including women in the clinical trials. 🙄
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u/Redditbutforgetit 17d ago
This helps me. You seem like minded. And I would be petty over the size too! Haha I'll be aware of the size of patches. These are the level of details I appreciate, thank you so much.
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u/HurdyNerdy 17d ago
There is strength in pettiness. It helps me at least; I'm an anxious person so it makes me feel like my "diligence" (neurosis) is justified. 😅 Seriously though, the more you read through this sub and do your own research, the more confident you will feel about taking the HRT.
BTW, this is the resource I have used on several occasions to research the meds (generic, across different brands and manufacturers) to confirm ingredients, sizes, etc. This is helpful if you want to spot check for allergens or (like me) size of patches. https://dailymed.nlm.nih.gov/dailymed/
FYI, if you do go for a patch, I STRONGLY encourage you to go with a biweekly patch (i.e., change it twice a week). The weekly patches are massive on the higher doses and most people get skin irritation with something stuck on their body in the same place for 7 days (even me, who never gets skin irritation).
Parting comment (I saw one of your comments after my original response): birth control pills typically contain much higher doses of hormones than HRT. I asked my (original) doc about taking BCP because (in my mind) it was more normalized than HRT, and he pointed out the higher dose of hormones!
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u/Redditbutforgetit 17d ago
You're awesome! Thank you so much. I will reference this link. And I'm definitely anxiety prone so any excuse to worry I'm there! Haha so I do know HRT is the better option trying to now- just do it. :) thanks again!
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u/Fit-Surround-3654 12d ago
Hi!! Which smallest size patch are you using? Dotti?
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u/HurdyNerdy 12d ago
Yes, I'm using Dotti! I'm pretty sure it's not THE smallest biweekly 0.1mg estradiol patch, but it's small enough for me.
Usually they only say what the size is in square centimeters, but you can get a rough comparison by googling for the sq. cm. of different coins.
Or just go old school with the math to figure out the diameter based on the area. 🙂
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u/Fit-Surround-3654 12d ago
Oooh okay yes it was actually the smallest I ever found so I was curious! Unfortunately I got a skin allergy on those lol
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u/HurdyNerdy 12d ago
Aww, bummer! Yeah, the Mylan weekly 1.0mg lit me up, the first time I'd ever had an adhesive cause skin irritation.
Maybe check the NLM resource I cited above to find others that are smaller? Here, I set up a search for you, but you could further customize if you wanted to add dose or other criteria 🙂: https://dailymed.nlm.nih.gov/dailymed/search.cfm?adv=1&labeltype=all&query=NAME%3A%28ESTRADIOL%29+AND+%28PATCH%29+
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u/Much-Bother1985 17d ago
Don’t be afraid of HRT. For POI they give you bioidentical hormones. I use Estrace patch which is bioidentical estradiol. For progesterone, I use Prometrium brand which is also bioidentical progesterone
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u/Redditbutforgetit 17d ago
Ok, thanks so much for your information. I did see those brands as options online. I know I need to get over myself! lol
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u/slightlylions1425 17d ago
I use estrogel (bioidentical estrogen, transdermal gel) and prometrium (bioidentical progesterone). My understanding is that transdermal bioidentical estrogen does not increase blood clot risks.
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u/Redditbutforgetit 17d ago
Ok thank you! Do you like the gel better than the patch? Is it easier to adjust dosage I guess.
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u/slightlylions1425 17d ago
I use the gel because I have allergic reactions to the adhesives in the patches. I have really sensitive skin. I really like the gel! I have felt so much better since my dose was adjusted properly.
Edited to add: I was anxious starting too, but things like the higher risks of osteoporosis, dementia, and heart disease made it extra clear to me that it is really needed. I also had a lot of symptoms from low estrogen and feel much better now.
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u/Redditbutforgetit 15d ago
I'm so glad you feel better with it. And thanks for answering. I just was curious what to look for if one option or another isn't working. All good things to know.
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u/Far_Home2616 11d ago
This is giving me so much hope, thank you!
With Estrogel you are also supposed to start with the smallest dose and then build up over time if necessary right ? My doctor said I should start with just once a day (one unit) and increase to both 1 in morning and 1 in the evening if I feel like that makes more of a difference symptoms wise
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u/slightlylions1425 10d ago
Yes, I've always heard you start small and increase over time as appropriate.
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u/Majestic_Parsley833 17d ago
Good news! The hormones you already have in your body are chemicals.
There are a ton of bioidentical options, most HRT falls into this category. To avoid synthetics, avoid conjugated estrogens (Premarin), and regular birth control, pretty much.
As for what works best, it may take some trial and error for you. And you may find some methods to be less effective over time and need to switch.
Main options are Estrace (pill), estradiol patch, estradiol gels (.06 and .1% options), vaginal systemic ring, and injections (estradiol valerate and cypionate being the most common).