how do you know which is best for you HRT or Bio-identicals ?

Posted by kris1130 @kris1130, 3 days ago

I am 56yr old and have been post menopause for 7 yrs. I am recently have been told osteoporosis of spine (lower end of scale) and cognitive issues. Primary mentioned talking to my GYN regarding HRT in hopes of it helping. I understand the difference between HRT & bio-identical (since I prefer more natural over synthetics meds) . I have an appt with a PA in my gyn office next week but I'm wondering if I should look for a Dr on bio-identical.
ANY guidance or questions I need to ask or testing needed, will be greatly appreciated. I know that not having estrogen can't affect the brain and many other parts of body. I have recently had test that shows inflammation in brain and higher percentage of me getting Alzheimer.
We only get 1 body and what we feed it can make things worse or heal it. I'm looking to heal 🙂
thank you in advance

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Profile picture for blueskies1530 @blueskies1530

The brand of Estradiol patch I use is Mylan; Kroger fills it. Both of my obgyns have been happy to prescribe it.

I prefer a compounded Estradiol vaginal cream over the commercial one. It's gentler on my skin. My first NP prescribed it. My second took over calling it in.

For vaginal Estradiol suppositories, I've used Vagifem 10mcg tablets and Imvexxy 10mcg pearls. I'm post-op total hysterectomy right now, so I'm not sure which I'll return to. If you have already ample moisture, Vagifem can be enough. If not, then Imvexxy might absorb better. My urologist is actually the one who started me on this as my first vaginal estrogen because I was getting UTIs.

For oral Progesterone/Prometrium, I like the micronized pearls that all the major pharmacies fill. Compounding pharmacies will make in-between/any dosages in capsules in extended release form.

I hope this helps.

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@blueskies1530
Thank you for the informative information. I will do more research on the above.

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@blueskies1530
Thank you for the informative information. I will do more research on the above.

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@kris1130

I just noticed your age. I tried to endure until menopause but endometriosis made perimenopause too painful. When I started on Estradiol patches at 47, I started at .025. It quickly helped my joint pain/inflammation in my wrists and my fibromyalgia. Now that my ovaries and uterus are gone my obgyn moved me up to .100. My NP will run bloodwork in two months to see how I'm abosrbing these hormones. I'm very grateful. It can often take more than one professional in your corner to get your menopausal needs met so I know that can be stressful but don't give up.

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@laura1970
My primary feels I may have familial hypercholesterolmia, after several rounds of blood work done, monitoring my food intake . I don't fit the "profile" or lifestyle of one who would have elevated cholesterol. So not a definite answer and my primary doesn't feel I need any medications since my eating habits/lifestyle can lower it.
So crazy something our body produce(s) naturally can stop making. Then our bodies start breaking down, due to lack of the hormones and when we try to find "things" to bring balance we end up with illnesses and possibly dying from stroke/heart attack.
My GYN years ago gave me estradiol cream but that was for dryness only, she never mentioned hormone balance. I never truly used the cream .

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@kris1130 does part of why he feels you may have familial hypercholesterolemia because of a strong family history of heart attacks or strokes?

My impression is that vaginal estrogen creams are absorbed into the bloodstream with the intensity to increase cardiovascular risk? Does anyone else know differently?

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Profile picture for kris1130 @kris1130

@laura1970
My primary feels I may have familial hypercholesterolmia, after several rounds of blood work done, monitoring my food intake . I don't fit the "profile" or lifestyle of one who would have elevated cholesterol. So not a definite answer and my primary doesn't feel I need any medications since my eating habits/lifestyle can lower it.
So crazy something our body produce(s) naturally can stop making. Then our bodies start breaking down, due to lack of the hormones and when we try to find "things" to bring balance we end up with illnesses and possibly dying from stroke/heart attack.
My GYN years ago gave me estradiol cream but that was for dryness only, she never mentioned hormone balance. I never truly used the cream .

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@kris1130 you may be a good candidate for a VAP test which is a fancy cholesterol screening that gives much more info than the usual cholesterol check.

I copied and pasted as chrome says it better than I could

The VAP (Vertical Auto Profile) cholesterol test is an advanced lipid test that provides a detailed breakdown of cholesterol and lipoprotein particles beyond the standard lipid panel. It measures various subtypes of LDL, HDL, and VLDL cholesterol, including small dense LDL particles, and lipoprotein(a), which are important markers for cardiovascular risk. This test uses ultracentrifugation to directly measure lipid fractions rather than calculating LDL cholesterol, making it more accurate in identifying hidden heart disease risk.
The VAP test is useful for people with normal routine cholesterol tests but who still have risk factors or family history of heart disease. It provides a comprehensive profile that helps guide more personalized treatment strategies to reduce cardiovascular risk. The test is considered more precise in evaluating lipid abnormalities and detailed cardiovascular risk assessment than routine cholesterol tests.

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Profile picture for laura1970 @laura1970

@kris1130 you may be a good candidate for a VAP test which is a fancy cholesterol screening that gives much more info than the usual cholesterol check.

I copied and pasted as chrome says it better than I could

The VAP (Vertical Auto Profile) cholesterol test is an advanced lipid test that provides a detailed breakdown of cholesterol and lipoprotein particles beyond the standard lipid panel. It measures various subtypes of LDL, HDL, and VLDL cholesterol, including small dense LDL particles, and lipoprotein(a), which are important markers for cardiovascular risk. This test uses ultracentrifugation to directly measure lipid fractions rather than calculating LDL cholesterol, making it more accurate in identifying hidden heart disease risk.
The VAP test is useful for people with normal routine cholesterol tests but who still have risk factors or family history of heart disease. It provides a comprehensive profile that helps guide more personalized treatment strategies to reduce cardiovascular risk. The test is considered more precise in evaluating lipid abnormalities and detailed cardiovascular risk assessment than routine cholesterol tests.

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@laura1970
Wow! Thanks for the information. Very interesting and will look into it.

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