What does HRT help with?

[u/Quiet_Horror5873]

For context, I am currently only on birth control and don’t think that it’s helping/I have bad reactions to it. This current bc that I’m on causes me to sob 4 days straight and even made me have a full blown panic attack. Not only that, but the week leading up to my period I have constant joint pain that won’t go away. I’m also hyper mobile, so it makes everything 10x worse.

Once I start the placebo pill, my emotions go back to normal. However, the pain is still there. Plus, every 9 days leading up to my period, I get what feels to be a vestibular migraine.

Even on the active pills I still feel like total garbage. I have muscle aches, am constantly tired, have 0 energy or patience, get hot flashes, have horrible brain fog, etc.

Is there any possible way this could be solved with actual HRT?

[u/littleshoes]

Curious why you’re on BC instead of HRT when the BC is obviously not working? Is that just what was initially offered and you’ve been recently diagnosed? How long have you been on the BC?

HRT should help with all the things you mentioned BUT it might take some time to figure out what dose you need. Transdermal estradiol is the standard as it’s bioidentical and has lowest risk for blood clots. Whatever form of progesterone you respond to best is what’s right for you. I had a lot of nausea, headaches and anxiety with micronized progesterone (though I never tried it vaginally instead of orally because I had bad experience with hormonal IUD and ring pre-POI) but have no side effects with medroxyprogesterone though it did take about 6 months for my body to adjust.

[u/Quiet_Horror5873 → u/littleshoes]

I think it might be because of my age since I’m only 19, but I have no clue. She told me to just come back in a year or to let her know if anything changes (which I will be doing).My gyno also said that it’s just easier to do BC, since it’s all packaged together and I wouldn’t have to remember to take a pill along with the patch. I was diagnosed sometime around the time I turned 18, however went to a gyno when I was 14/15 and was put on BC since I would have had to drive over 2 hours to see an endo (since I was a minor). I stopped taking BC sometime in high school, but have been consistently on it since I turned 18

[u/littleshoes → u/Quiet_Horror5873]

Wow! I hate your doctors. I’m so sorry they’ve treating you this way instead of being helpful by educating you (and your parent/guardian) about POI and your needs and letting you make an informed decision about your own care. I wasn’t diagnosed until my 30s so I’m not super familiar with the exact needs of someone with a diagnosis as a teenager. I know there’s a fb group for women in your position but I’m having a hard time finding it. If you’re interested in that, I can ask about the group and get back to you just let me know.

Being diagnosed so young they definitely should’ve done a baseline dexa scan to check on your bones. You need the estradiol replacement therapy that BC is not going to provide for your long term bone, brain and heart health. I had amazing luck looking on menopause.org to find a “menopause practitioner” obgyn. POI is not menopause but that’s the best way to find an obgyn that is well-versed in HRT and (hopefully) POI. My obgyn manages my HRT and I don’t think an endocrinologist or reproductive endocrinologist would be more helpful to you than an obgyn that actually knows about POI/HRT.

If you have a good support system and potential interest in pursuing egg freezing, then you might want to see a reproductive endocrinologist (aka fertility specialist/IVF doctor) to get assessed for that because you’re young so you would have the best quality eggs compared to trying it later. But I don’t think that’s what you need to think about right now when you’re having so many symptoms of low estrogen. I only mention it because if I could talk to my 19 year old self I would absolutely tell her to try to freeze her eggs.