Hormone Replacement starting at 75yrs old

It was a transdermal cream from a compounding pharmacy. Estriol/Estradiol 50:50 0.3 mg per 0.5gm and Progesterone 25 mg per 0.5 gm both per two clicks from the container which you twist to dispense. Both could be applied vaginally or on the abdomen, inner thigh or inner arm. When I was out in California helping my daughter I first had a consultation with a naturopathic doctor who only prescribed the estrogen first to prevent any side effects. Then she was going to add in the progesterone. But I came back to Arkansas and had to see my regular doctor who said she had to prescribe both. I didn’t have any side effects with just the estrogen but boy, I sure did when I added in the progesterone. I started cramping just like I was going to have a period, with bloating, constipation and worse hot flashes so I had to stop. The problem was my regular doc didn’t have much experience with bioidentical hormones and couldn’t guide me and told me to call the compounding pharmacy which weren’t a lot of help except to say that I was on too low a dose but I was too scared to continue until I got back to “normal” I do still have my uterus and know I have to take the progesterone if I use the estrogen.

Can you explain how you feel the vaginal estrogen has been life changing and what benefits you are experiencing? Do you still have your uterus and have to take progesterone as well?

I just started bioidentical HRT. I’m 65 years old and 15 years post menopause.
I found a gynecologist that specializes in HRT and was willing to prescribe to me. I’m hoping this will help stabilize bone loss.
I’m wondering about the side effects from the progesterone.
I have an estradiol patch that I change weekly. It’s .0375/day, also take 200 mg micronized progesterone, and vagifem vaginal insert.
Besides breast tenderness that the doctor said would go away with continued use, I’m experiencing a very heavy discharge. No cramping, no bloating, no constipation.
Is it your experience that I may have other side effects as I continue on the therapy? Is having a discharge normal on HRT?
I read that sometimes there can be an intolerance to the progesterone and that lowering the dose might help.
After much research I decided not to use pellets or compounded hormones, as I am sensitive to most medications, and it was my understanding that once the pellets were inserted I could not have them removed if I had a reaction.
Appreciate any insight you can provide.

It has given me back so much - no more burning, no dryness, no more bladder issues like pressure to go but unable to yet always feeling like I needed to, no painful (if not impossible) sex - that's a big one. Yes, I have my uterus and do not take progesterone. No need to do so since the vaginal estrogen works locally, not systemically. It restores the vaginal area as it was before menopause. I hope this helps.

I didn’t stay on the hormones very long but I would think that any side effects you experience will probably be at the start of HRT. If you are experiencing bleeding (if that’s what you meant by discharge) I would think that is not normal (you definitely need to let your doctor know) however I have read that some women start having periods again. (Not a pleasant thought) I would not have chosen the pellets either, because I am super sensitive to drugs and if I have a bad reaction, I want to stop. The transdermal compounded cream I was using was easily stopped. If your progesterone is oral, you can definitely lower the dose because initially I took the oral progesterone 100 mg but it affected my sleep negatively although I was really hoping for better sleep as I read it sometimes helps. I ended up using the transdermal progesterone but not for more than a couple weeks or so because I didn’t want to have cramps every day that felt like I was going to start my period! From everything I have read, HRT will stabilize bone loss which was one of the reasons I was thinking about seeing a new doc and trying it again. I only have osteoporosis in two spinal vertebrae and I do not want to take the meds. Maybe someone else on this forum can let us know if they experienced side effects after being on the HRT for awhile.

I am 77 and after reading the risks associated with starting HRT at my age, had kind of backed away from it. Would love to hear more as to why you started at 76, and what benefit you have noticed so far. Maybe I should reconsider...

That is great to know because the last GP that prescribed the bio-identical cream told me I HAD to take the progesterone. What kind of a doctor prescribed your HRT?

Hi @rswartz. Your doctor may be hesitant to have you start HRT because nicotine can interfere with this medication.

According to an article in PubMed, from the National Institute of Health, “It has been proven that, depending on the type, duration and intensity of nicotine consumption, smoking can reduce or completely cancel the efficacy of orally administered estrogens. Not only does smoking diminish the otherwise well-established beneficial effects of estrogen on hot flashes and urogenital symptoms and its positive effects on lipid metabolism, i.e. by reducing cholesterol, but smoking also specifically reduces estrogen's ability to prevent osteoporosis.”
Here is the complete report:
https://pubmed.ncbi.nlm.nih.gov/15638743/
It sounds as though your doctor may have concerns that the medication won’t be able to work as well as intended for you. Are you having menopause symptoms?

Listen to the podcast of Kelly Casperson MD, who is a urologist in Washington State. Especially listen to episode 291

I noticed that the study seems to refer only to orally administered estrogen. What about transdermal or pellet estradiol?