Transdermal HRT

More please! I am 75 and having trouble getting .y providers to agree. What do I have to lose and it is my body my choice.

Taken early in menopause, it appears to be very protective of the heart, brain and bones. Post menopause, there is a small increased cardiovascular risk in the first year of use that seems to diminish after that. If you have a personal or familial history of CVD, that might preclude its use. We don't really know what the true risk of breast cancer is as that very small increase in cases noted in the WHI study (1 additional case per 1,000 women) was with oral estrogen and as you've mentioned, overall risks may be lower with transdermal. There was no increase in death from breast cancer. We really need new studies done with bioidentical transdermal estradiol to determine true efficacy and risk.

After my full course of Forteo, I opted to go on HRT. I was about 62 at the time, 10 years post menopause so not ideal according to the studies but I still felt it was the best option for me. That was about 5 years ago when docs were still abiding by the post-WHI study data, being risk averse to HRT. I finally convinced my endo that it was the best option and he agreed to "lowest dose for shortest amount of time" which, at that time, was the mantra. The acceptance of HRT is gaining as a preventive but not as much for the preservation of bone (though it used to be used as a pharmaceutical in osteoporosis for that purpose). I am now seeing a menopause specialist who is extremely experienced in the use of HRT (for decades). She is evaluating my bloodwork and history to determine whether I can increase my dose. Though the low dose I am on has mostly maintained my gains from Forteo, overall, things could be better. I will be seeing her for a second appt next week to evaluate.

We have to make tough decisions when diagnosed with osteoporosis. All drugs have side effects. Forteo was my first choice to increase my bone density as it is a hormone that the body recognizes and utilizes. I went on HRT for the same reason. Overall, we have to take some sort of risk with any drug we opt to take so best to evaluate risks vs benefits of each option to make a decision we are personally comfortable with.

Would love to hear more as you receive more results. Very helpful. Thanks

Thank you! Keep this info going. I have pretty much decided after being told by my endo, McCormick and my own deep learning now for about 9 months that I should go on Forteo as a bone builder, but have heard Gersh speak a few times and some others and really wonder and am interested in the HRT option as something I might want to use following that as a maintainer. I am soon to be 66 and about 10/11 yrs post menopause.

I am 71 and 16 years post menopause and am seriously considering HRT. I met with my cardiologist yesterday and he was neutral. I am seeing an osteoporosis specialist and I had planned to ask her at my appointment next week (but my appointment was canceled by her office and I may not get in until January). I have an appointment with gyn in 2 weeks to discuss with her.

I am 80, have been on HRT since age 50. Using estradiol patch at lowest strength for the past 5 years or so. Have had many discussions with gyn doc about this and ultimately is my decision. I feel protective effects outweigh the possible negatives. I do not expect to ever stop it. I do not take for osteoporosis, I take for overall benefits.

I’m still discussing using a higher dose of transdermal HRT plus prometrium with my doctor. She isn’t averse to the lower dose but is warns about stroke risks after age 70. The transdermal HRT studies don’t appear to agree. Did you have any hair loss on Forteo? I’m seeing comments here about an increase in belly fat and hair loss. I’m supposed to start it soon. Of course the trials showed osteosarcoma in mice…but not humans yet.

From the American College of Obstetricians and Gynecologists re stroke and transdermal HRT:

“Studies that compared oral and transdermal ET have demonstrated that transdermally administered estrogen has little or no effect in elevating prothrombotic substances and may have beneficial effects on proinflammatory markers, including C-reactive protein, prothrombin activation peptide, and antithrombin activity. Also, in contrast to oral ET, transdermal ET also may have a suppressive effect on tissue plasminogen activator antigen and plasminogen activator inhibitor activity 2324 25 26 27 28 29.

The Estrogen and Thromboembolism Risk study, a multicenter case–control study of thromboembolism among postmenopausal women aged 45–70 years, demonstrated an odds ratio for venous thromboembolism in users of oral and transdermal estrogen to be 4.2 (95% CI, 1.5–11.6) and 0.9 (95% CI,0.4–2.1), respectively, when compared with nonusers 10. Transdermal estrogen had no increased risk compared with nonusers. Similar results were reported elsewhere 30 31 32 33 34 35 and of particular importance, in women who were stratified for weight 36 and the presence of prothrombotic mutations 37.”

Never any of these issues with forteo

Same here. I am 70 and have taken some form of HRT since early menopause at 42. I recently switched from oral to the CombiPatch, within months a slightly elevated liver enzyme dropped to normal and my cholesterol readings improved. I plan to stay on HRT for life.