Estradot bioidentical hormone therapy VS Compounded BHRT

Posted by andreamayo @andreamayo, Mar 31 12:32pm

Hi!
I am 56 years old, 5 years post menopausal and am considering bioidentical hormone therapy (BHRT) for the next 5 years for bone health.
My spine is -3.7. Hips - 2.4.
My Naturopath doctor has suggested Compounded BHRT and my MD is also open to prescribing BHRT (which would be Estradot I presume).
My question is how do I decide between Estradot, estradiol 17B BHRT from the package prescribed by an MD or Compounded BHRT.
Health benefit either way?
Is there a big cost difference? I'm in Vancouver, Canada.
I don't have a private medical plan so will be paying for the medication out of pocket either way.
Thanks in advance for any insight.

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@mayblin

Could you tell me more about pallets vs cream? My gyn said to use patches or gel, while she uses gel herself. Would pallets deliver hormone more consistently or more conveniently or both? Are pallets compounded? If they are, then are they FDA approved?

Also I was told by my gyn that there is no need for blood work for testing hormones b/c at my age 61, hormone levels are next to none. Dose wise she is flexible, whatever is need for bone health and up to my endo and me. How do you determine a good dose for bone purpose?

Testosterone is not mentioned at all by my gyn. She mentioned I need micronized progesterone with estradiol patches. Does testosterone serve for bone health here, or is it for other body function(s)?

Thank you very much!

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@mayblin

Could you tell me more about pallets vs cream? My gyn said to use patches or gel, while she uses gel herself. Would pallets deliver hormone more consistently or more conveniently or both? Are pallets compounded? If they are, then are they FDA approved?

Also I was told by my gyn that there is no need for blood work for testing hormones b/c at my age 61, hormone levels are next to none. Dose wise she is flexible, whatever is need for bone health and up to my endo and me. How do you determine a good dose for bone purpose?

Testosterone is not mentioned at all by my gyn. She mentioned I need micronized progesterone with estradiol patches. Does testosterone serve for bone health here, or is it for other body function(s)?

Thank you very much!

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OK I attached the website so you can read all about the hormones. Press on the hormones for women after you’re done reading the top it will give you very interesting information.

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@dooshie

Ur very welcome. If possible, do some research to help with your decision. Many doctors are still of the belief that older women should not take HRTs. But many doctors are not well educated or up to date on the positive effect they have on women.

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Best of luck to you! Your Cardiologist sounds like he is wonderful! Keep us posted!

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@nme1985

Best of luck to you! Your Cardiologist sounds like he is wonderful! Keep us posted!

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Thank u. He’s a bit quirky but very personable…and very thorough. He doesn’t rush me in and out, spends time wanting to know what my concerns are, then runs bloods.

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@nme1985

Best of luck to you! Your Cardiologist sounds like he is wonderful! Keep us posted!

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Thank you so much for all the info and links, @nme1985! Best wishes to you too!

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@dooshie

Thank u. He’s a bit quirky but very personable…and very thorough. He doesn’t rush me in and out, spends time wanting to know what my concerns are, then runs bloods.

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You are lucky to have a caring physician. I like him and I don’t even know the man 😂 best luck and God bless.

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The general recommendation is for estradiol delivered through a transdermal patch along with oral micronized progesterone. The conventional estradiol patches that you can get with prescription through your regular pharmacy are bioidentical. You can also get the oral progesterone there but since it has peanut oil and artificial colorings, I prefer to get that through a compounding pharmacy. It is not necessary to get your estradiol through a compounding pharmacy and it is less expensive through a conventional pharmacy. I would recommend looking up Dr Felice Gersh. She has been prescribing HRT for decades and really knows her stuff. She does not recommend pellets. Over the years, she has seen levels that climbed way too high with pellets and it is more difficult to control since it's inserted into your body. Much easier to manage levels with a transdermal patch and safer too. The lowest dose of transdermal patch estrogen is .025 and at that level, there have been positive bone effects demonstrated. Many integrative practitioners will prescribe in the .025-.05 range taking into account your comfort level and risk factors.

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@teb

The general recommendation is for estradiol delivered through a transdermal patch along with oral micronized progesterone. The conventional estradiol patches that you can get with prescription through your regular pharmacy are bioidentical. You can also get the oral progesterone there but since it has peanut oil and artificial colorings, I prefer to get that through a compounding pharmacy. It is not necessary to get your estradiol through a compounding pharmacy and it is less expensive through a conventional pharmacy. I would recommend looking up Dr Felice Gersh. She has been prescribing HRT for decades and really knows her stuff. She does not recommend pellets. Over the years, she has seen levels that climbed way too high with pellets and it is more difficult to control since it's inserted into your body. Much easier to manage levels with a transdermal patch and safer too. The lowest dose of transdermal patch estrogen is .025 and at that level, there have been positive bone effects demonstrated. Many integrative practitioners will prescribe in the .025-.05 range taking into account your comfort level and risk factors.

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Does Dr. Gersh have you have a blood draw for testing levels of estradiol and progesterone after you have been on BHRT? Does she have a recommendation as to what blood levels of these hormones should be for efficacy in building bone?

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@vgkime

Does Dr. Gersh have you have a blood draw for testing levels of estradiol and progesterone after you have been on BHRT? Does she have a recommendation as to what blood levels of these hormones should be for efficacy in building bone?

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She did test hormone levels but I did not go back to her for a review as she's very expensive and I didn't feel the need. My bones held somewhat steady at the .025 range so I go by that. She increased me to .0375 so perhaps I will have a better outcome on the newer dose. I'll let my Dexa determine efficacy.

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@teb

The general recommendation is for estradiol delivered through a transdermal patch along with oral micronized progesterone. The conventional estradiol patches that you can get with prescription through your regular pharmacy are bioidentical. You can also get the oral progesterone there but since it has peanut oil and artificial colorings, I prefer to get that through a compounding pharmacy. It is not necessary to get your estradiol through a compounding pharmacy and it is less expensive through a conventional pharmacy. I would recommend looking up Dr Felice Gersh. She has been prescribing HRT for decades and really knows her stuff. She does not recommend pellets. Over the years, she has seen levels that climbed way too high with pellets and it is more difficult to control since it's inserted into your body. Much easier to manage levels with a transdermal patch and safer too. The lowest dose of transdermal patch estrogen is .025 and at that level, there have been positive bone effects demonstrated. Many integrative practitioners will prescribe in the .025-.05 range taking into account your comfort level and risk factors.

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teb, Thank you SO much for answering my original post question. It got hijacked as per the norm with replies to other peoples feedback.
I will compare the pricing in Canada between pharmacy and compounding pharmacy!
I'm seeing my MD today and the ND next week. 🙂

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