My journey with bioidentical hormone replacement therapy (BHRT) began about eight years ago when I began having horrible bleeding problems. Since then, I have spent countless hours reading everything I could find on hormones, perimenopause, and menopause. What I have learned is that the medical profession really knows very little. There are few concrete answers. For example, no one really knows what causes hot flashes or fibroids. Some doctors say women do not need to replace their hormones while others believe hormones should be replaced to levels we had in our 20's. The contradictions are endless.
One thing that is certain is that hormones are very powerful and should be used with great care. The use of hormones should never be taken lightly and should be used under a doctor's supervision. But only a good doctor that is knowledgable about bioidentical hormones and is willing to work with a woman to adjust her therapy to whatever makes her feel better in the safest possible way. Just having a doctor write me a prescription for Premarin or Prempro (synthetic hormones) with a cookie cutter dosage and later down the road more prescriptions for the side effects, and possibly a hysterectomy was not acceptable to me. Unfortunately, that was all that was offered to me by all of the doctors I visited in the area where I live.
I'm not an affluent person. I am a secretary supporting myself. I can't fly off to an expensive women's clinic in another state. Nor can I afford the time and money for a doctor within driving distance in an upscale neighborhood, which is where most doctors advocating bioidentical hormone thereapy (BHRT) seem to be found. It seems that once again the best health care is mainly for the wealthy.
I made many attempts to find a local doctor that would work with me on a BHRT program. The doctors I visited either said there was no such thing as bioidentical hormones or they had never heard of them. A few got downright testy as though I were talking about voodoo medicine. How is it that BHRT has been on television, the news, and is all over the internet, but a doctor is not aware of it? I believe that many doctors are so controlled by the pharmaceutical companies and the insurance companies that they purposely avoid bioidentical hormones. Out of necessity, I simply took control of my own hormone therapy. That was about eight years ago. I am not dead. I feel fine, have a good energy level, and most people do not realize how old I am (I'm 57). I also believe I have prevented an unnecessay hysterectomy for myself. I have experimented carefully over the years, adjusting dosages and methods to my changing body. My purpose here is only to share with you what I have tried and what has worked or not worked for me.
Back to my story...
In my late 40's my periods began to get heavier and heaver and longer and longer. Sound familiar? I hoped it would go away. Instead, I just started bleeding continuously. I ended up in the emergency room needing a blood transfusion. The doctor I went to after that gave me a complete physical and all the appropriate tests. I was diagnosed with a "grossly enlarged uterus" and "a forest of fibroids." He wanted to do a D & C, which I didn't want. (It was never made clear to me whether or not the fibroids played a role in the heavy bleeding I was experiencing.) So he reluctantly gave me a three-month prescription to stop the bleeding with a warning that if it did not stop I would be getting a D & C.
The prescription drug stopped the bleeding in two days. I loved the stuff. As soon as I took it, I felt great. Up to this point in my life, I didn't know much about hormones. But I was curious about the drug I was taking and looked it up online. It was a high dosage of a synthetic progestin with a lot of possible side effects and risks, especially for long-term use.
I also learned that the bleeding I was experiencing was due to a lack of progesterone because I was out of eggs and no longer ovulating. No ovulation, no progesterone. But the ovaries are still producing estrogen, which causes the lining of the uterus to keep growing without the progesterone to stop it. The lining keeps building up causing a lot of bleeding as it tears off. It also sloughs off irregularly instead of all at once like a normal period. This causes the continuous heavy bleeding. This is called hyperplasia and can also cause cancer. The progestin was replacing the progesterone I was no longer making, opposing the growth caused by the estrogen, and changing blood vessels in the lining to allow normal shedding that prevents the lining from becoming too thick. My periods were normal and controlled on the progestin.
After my three-month prescription ran out, the doctor would give me no more when my symptoms began to return. He wanted to do a D & C. I felt like I was on a slippery slope to a hysterectomy. I got back online and ordered an over-the-counter bioidentical progesterone cream. I figured if the synthetic progestin worked, the natural progesterone would too. I was right. I used it as directed and progesterone alone worked for me for several years.
I went to a different doctor a year later for a PAP test. He found no evidence of fibroids. I told him I was using an over-the-counter progesterone cream. He said, "I don't care if you use it. It's not doing anything but costing you money." But I knew it was working by the way I felt and by the fact that my fibroids were undetectable.
I have been on bioidentical hormones for about eight years. During the last few years my estrogen levels have dropped significantly causing more severe hot flashes and other symptoms, so I have added bioidentical estrogen to my regimen. Have I had problems along the way? Yes. It can be difficult to balance the estrogen and progesterone, which is the key to BHRT. Overall, my quality of life has been greatly improved. I am hot flash free, I sleep well, and I would be miserable without bioidentical hormones.