Friday, November 06, 2015

Ask the Hive Mind

So readers, I have a question. After sifting through the literature online about bioidentical hormone replacement therapy, I thought I'd ask if any of my readers have experience with it they'd like to share. My only menopause symptoms (other than weight gain) has been intense migraines, and severe exhaustion, and I'm loathe to take any of the things commonly prescribed for migraine (the side effects can be worse than  the illness). At worst, I can live with it, but I'm curious if anyone has any thoughts to share. I suppose birth control pills might also provide hormones, but it might be far more than I need (though that would be the dirt-cheap option. Birth control pills are practically free).

I do understand that not everyone wants to announce to the world they're in menopause, so if you'd rather not let it all hang out in the comments, an email would be great too. Men? If you have any anecdotal info you'd like to pass along, Id love to hear it as well.

I know a very good compounding pharmacist that I trust (she had to do some stuff for Danny when he was too small to manage pills) but of course her opinions are biased because it is how she earns her living. I'm not typically big on alternative therapies, but then I'm not terribly willing to undergo the standard ones either. Generally, I stay the hell away from doctors as much as possible.

There's almost no cancer history in my family, and I've never known of anyone that had breast cancer so I'm not too terribly concerned about the link between hormones and cancer.

So what do you think? I appreciate you taking the time to read and perhaps reply.


Grayspoole said...

Hi Goody--

Menopause is no fun . Like you, my main symptom has been migraines, along with weight gain, insomnia, and a few other unlovely problems. I have not tried bioidentical hormones, although I did give a low estrogen birth control pill a short trial (upset my stomach). I started taking magnesium taurate as a supplement, reduced my caffeine, alcohol, and salt intake, all of which I believe is helping. When the migraine starts, I use OTC decongestants (Afrin, used sparingly, really seems to ease the migraine.)

I find that buying more vintage perfume is also very helpful.

Good luck!

Goody said...


Thank you so much for your suggestions. Nose spray and a supplement sound like a good place to start. I'm finally at the point where I have to admit losing a couple days a month to a headache isn't working for me.

Now, what perfume to buy?

Bibi Maizoon said...

Well, as I've mentioned on here before I've been experimenting with my own hormonal 'replacement' therapy.
Having been a pharmacist for 15 yrs & watching the entire Premarin fiasco- (Long story but the gist is this- When I was at university med & pharmacy students were taught the 'party line' that we THINK using natural estrogens - like the conjugated estrogens derived from pregnant mares' urine in Premarin- in menopausal women is safe although it was not proven by any study at that time. In fact we were taught that using these 'hormonal therapies' MIGHT even prevent the marked increase in heart disease that often occurs at in menopausal women. Nearly every woman in the US over the age of 50 was prescribed some estrogen and or progesterone hormonal replacement therapy when I graduated from pharmacy school. Then when the actual studies came out & determined Premarin/long term use of exogenous estrogens did in fact increase the incidence of certain cancers in menopausal women- Premarin almost immediately disappeared from pharmacy shelves & doctors stopped writing rxes for it with nary a word spoken. SHHHHHH!!!)


So as I have been hurtling into menopause I've been reading everything & anything about hormonal therapy for us menopausal ladies. I have also been testing various formulations of my own. I started having insomnia, vaginal dryness, anxiety, extremely dry skin, increased migraines, irregular periods, & weight gain. I've always been VERY estrogen dominant as confirmed by my blood levels & symptoms. My symptoms were mostly due to unopposed estrogen. Hormones are a bit of a 'balancing act'. Typically menopausal ladies have problems with too many unopposed androgens & some of us suffer unopposed estrogens. Your 'fat mass' goes on producing viable estrones, and your adrenal glands can still churn out androgens even when your ovaries have long since shut down.
What I have found effective for my menopausal symptoms is a very weak topical cream containing micro ionized progesterone applied twice daily. I have had no hot flashes, very few migraines (like 2 in 6 months mostly sinus or TMJ related) , vaginal dryness eliminated completely, dry skin noticeably moister, insomnia gone, no periods, no spotting, weight stabilized (not losing or gaining weight). I also notice that I am much less anxious & have a 'sense of calm' (if that makes any sense). I do wish I would lose weight but OH WELL.
The closest thing you can buy in the US to my compounded cream is Emerita's Pro-Gest cream. It contains 450mg of USP progesterone per ounce so 1/4 teaspoon contains approximately 20 mg of USP progesterone. My cream is about half that strength. Emerita suggests applying 1/4 tsp (20 mgs progesterone) twice daily to start- at that dose my boobs were so sore I could barely walk. So there is a bit of 'trial & error' with this 'hormonal supplementation' as I call it. Blood assays of your hormonal levels can help determine your deficiencies & excesses but what form, dose, & type of hormone works for you is still just a matter of 'trial & error' unfortunately. The goal is to use as low a dose as possible to minimize long term risk & side effects. Emerita is available from many sources - directly from their company in Florida or even Amazon. Emerita also makes a very good topical estrogen cream - if you find that necessary. I'd buy directly from Emerita's website as hormones can break down in excessive heat & Amazon has had some temperature problems with storing Emerita's cream in their warehouse over the summer.
Now ALL hormones in any dose or form have risks & potential side effects. I've probably bored you long enough with this long screed, so if you have any further questions either post them here or feel free to email me & I'll answer to the best of my abilities.
Your friendly pharmacist,

Bibi Maizoon said...

It's boring around here as the tribals (or India) are still blocking the Indian border so we've no petrol, very little diesel, very little cooking gas, so I can't run the generator or drive anywhere but there is plenty of solar electricity. We're short on certain medicines too & there's not much to buy in the stores either. The Sheikh is busy opening a new shop & all the young'uns are away at school.
So, to answer Beth's question on yak cheese pizza. Yak cheese is very delicious but can vary quite a bit in texture & flavor. The making of yak cheese is not 'standardized' so you may get a parmesan like texture & flavor or possibly something more like a sharp Gruyere or even a mild Emmenthaler. It comes in big wheels with a rind just like European cheese does. It is usually cured by being brined & smoked. The variations can be caused by any number of things- the age of the cheese, the pastures the yaks grazed on, how old the milk was when it came down the mountain to be processed, how what percentage yak, nak, cow or various hybrids of cows & yaks & possibly even water buffalo milk was used. Nothing is wasted here in Nepal, even the rind of the cheese is dried & cut into pieces to be chewed as a snack or boiled as a base for soup
Consequently the flavors of yak cheese pizza can vary. The crust & tomato sauce is the main problem around here. I have an Italian friend who is married to a Nepali man & they have a restaurant. She makes the most delicious pizza crusts, makes her own sauce, and uses produce from her garden to make the sauce (Her 'Pizza Margherita' with fresh basil from her garden is divine!!!). The other pizza restaurants around here unfortunately use rather dodgy canned sauce & these awful pre made frozen pizza crust disk things that are horrid.
Yak butter- very odd stuff. The Tibetans like their yak butter a bit rancid which gives a rather bleu cheese/gorgonzola flavor - a rather acquired taste. When fresh yak butter tastes mostly like fresh cow's butter but with a tiny goat-y sharpness. Some of these high Himalayan tribes salt their yak butter heavily , others salt theirs hardly at all. It usually comes in kilo blocks wrapped in layers of old newspapers & jute twine.
Yak milk- very fatty, much like water buffalo milk with heavy cream that floats to the top. When I say 'heavy' I mean like 2 inches of toothpaste consistency cream- you can spread it with a knife. Yak milk is a bit sweeter than water buffalo milk but not as sweet as cow's milk. Water buffalo milk has a little goat-y tang to it, fresh yak milk not quite so much - but some western folks find this off putting.
Yak milk can also be curdled with an acid (like lime juice or crab apple juice) the curds are then drained & pressed in a jute bag- this is called chhurpi. It can be served fresh & soft like paneer or as a stuffing for momos. It is often left outside & hung up in bags at higher altitudes to harden & ferment & develop flavor. This hardened cheese is chewed as a snack also. Apparently the hard variety of chhurpi has found a market in the US as a fancy dog treat too.
My Kashmiri in laws think yak cheese is absolutely disgusting, although they are not adverse to yak milk or unfermented yak butter in their noon chai (salt tea). Kashmir is at around 5,000 ft so it is too cold for water buffaloes but too hot for yaks, therefore Kashmiris have cows for milk. Most Himalayan peoples raise some type of sheep or goats but sheep & goats are not milked.
I'm sure that's more than you ever wanted to know about yak dairy products.

Beth Waltz said...

First, locate a production of "Menopause, the Musical" and attend it sans spouse or male offspring. They won't get it. My favorite scene is the hippy lady whining " the jungle, this damn hot jungle, no one! sleeps tonight," whilst the other females circle her chanting "she's a bitch, she's bitch" to the drum beat. No sleep, big teeth and sharp claws, and a ravenous hunger for steak just about sums up my change of life. Fortunately, at the time I was living close to a little shop that stocked Chinese meds and teas -- super strong oolong, that's the ticket! With ginger snaps! Simply a fortuitous combo of caffeine and ginger? Possibly, because those ingredients appear in many folk recipes for relief of menoupausal symptoms.

Since you asked, Goody, I'd also suggest a consultation with an ENT specialist to verify that you're not dealing with sinusitis on a grand scale resulting from all the dental trauma. Neti pots are tricky for some, but both my MD and my pharmacist highly recommend trying simple saline solutions before prescription meds.

Absolutely fascinating discourse on yak dairy products! "Eat the Blog" is well named -- I consider it a non-pretentious thrifty foodie's buffet of conversational topics! Has Danny ever attempted to make cottage cheese?

Propagatrix said...

I entered the land of menopause quite a while ago (hysterectomy at age 38) and gained weighr. I'm also growing a beard. Am seeking laser removal for the latter and probably getting surgery for the former.

What is your gyno recommending for you?

Goody said...

You watch, it will be the next hipster-food fad and we'll be seeing yak milk lattes.

We have made cottage cheese (and cream cheese) with various results, though it has been a while. I have vegie rennet to hand, maybe we should try again.

I've used saline spray, which other than helping a dry nose hasn't done much.

I haven't seen an obgyn since Danny was born, and that was nearly 11 years ago. *shrug*

Laser hair removal is probably one of the greatest advances civilisation has made. I'm not quite ready for it, but I feel better knowing it is there. Good luck with it.

msarborvitae said...

I would try traditional Chinese herbs. A lot of info on the net,just type in Chinese herbs for menopause. Also other non Chinese medicine herbs are very effective as well for some people. I am pretty anti doctor and anti pharm and I work in the medical

Pull Your Socks Up! said...

Goody darling!
I don't think it's started yet and my Mum and four older sisters are way too coy about the subject, much to my disgust. I'll be putting the call out to all and sundry when I feel things are moving into this stage, so it's great to see this post and read about other people's experiences. I feel it's going to hit me like a brick wall and I probably won't know why I feel I'm going mad!! xoxoxoxoox

Bibi Maizoon said...

Did my comment regarding the Emerita cream not pass moderation or did it get lost somewhere whizzing across the vast morass of the internets?

Goody said...

I found it! It was buried in the spam folder with the several hundred pieces of crap from Russian spammers I get daily. Sorry about that.

I like the idea of a do-it-yourself approach, and the Emerita cream sounds like a good option. I don't mind a bit of trial and error-it could be interesting.I sat out experimenting with drugs in my youth, so the thought of experimenting with hormone replacement in middle age strikes me as only right. Compared to what some women are suffering through, I almost feel silly complaining about it. I'd have to have a range of emotions to experience any turmoil, I guess. The headaches are killing me though-I hate being unreliable, and when a migraine hits there isn't much I can do except lie in a dark room. I do get a bit of a warning from my vision, but that still doesn't do much good if I can't stop it.

Thanks again for taking the time to post with your help, and I'm sorry about the spam folder-I suspect mentioning products probably gets it flagged. I get a lot of spam for various drugs available online.

@ Desiree
It is SO GOOD to hear from you! I've been following your Instagram, and admiring your wardrobe, cheering your schooling, and being impressed by your ability to do yoga (I'd be like a bug flipped on its back, legs kicking in the air trying to roll over). I don't think the menopause would DARE give you a hard time.

Goody said...


I can understand why working in a medical field would turn you anti!

My only experience with traditional Chinese medicine came through a co-worker years ago that was enthusiastic about ginseng. He showed up with all these vials of dark liquid, and I tried some for about a week. I'm sure today if someone handed me a vial of some unlabeled liquid and said, "try it" I might decline, but in your twenties you think you're immortal. Long story short-I had tonnes of energy, but I also had the craziest irregular heartbeat that lasted well after I stopped taking the stuff. About a year later, my husband comes home from Chinatown with a box of ginseng vials not knowing about my experience. I nearly ran from the room in terror. I did make him get rid of them though-he's more of a lightweight with that sort of thing than I am.

So no ginseng! But I will take a look at some of the other herbs being used for menopause symptoms. Thank you for taking the time to comment and offer help-I appreciate it.

Connie said...

Ohhhh. Thank you for asking this question. I love hearing what everybody has to say. Menopause hit me like a Mack Truck. If there was a symptom I had it. I actually felt like I was losing my mind and was put on a MALE doctor. Of course. I was not losing my mind I was just losing my hormones. I went to a FEMALE naturopath of a certain age. It is important to find someone who has experienced some of the same things you are going through. My first naturopath was a male. Big mistake. I know I sound like a man hater but there are some girl things that are GIRL THINGS. Sooo...I am currently on bioidentical hormones. It is important to get blood work done before starting and intermittently throughout the treatment. Also. It's a bit like testing a recipe. You have to track your symptoms and adjust. My boobs became gigantic and so sore. Then my anxiety was off the charts. I was gaining weight like a pro wrestler. I experimented. Less of this. A pinch more of that. Chill overnight. Serves 4. Etc. Luckily I didn't commit any major crimes during the adjustment period but I am finally feeling as normal as I probably ever will. Sure I'm fatter. Though I rarely get hot flashes or headaches any more. My anxiety has lessened somewhat. I can wear a bra without wincing. And I am using my unspent tampon money for B12 shots once in a while. And yes. Get yourself to "Menopause the Musical" if possible. It is medicine in itself. I wish you the very best of luck, Girlfirend!!!!!

Goody said...

If my boobs get any bigger, I'm gonna have a problem.

That's good to know that it isn't an immediate quick fix, and that it might take some time adjusting. I haven't started looking at prices, and I don't know if insurance would cover it (doubtful) but hopefully it is affordable treatment.

I'm now armed with so much good information and feedback from everyone, I'm sure *something* will help.

Thank you hon!

Connie said...

Oh Yeah. I get it. My boobs at their smallest are way too big for my bod. I so envy my flat chested friends. Insurance may cover the hormones. Mine did! If you have any questions while you're going through this, if you decide to do it, feel free to email me for some support. I wish I had had someone to talk to besides the doctor while I was playing hormone roulette with my body. I swear, if men went through this there would have been a good safe easy way of dealing with it YEARS ago. I do sound like a man basher, don't I?

Goody said...


Thank you. I'm not afraid of aging, but I'm scared to death of doctors. I don't think you sound like a basher at all-if someone doesn't "get it" then they don't, regardless of their anatomy. My worry is that as soon as you walk through the door, you cease to be a person, and are biologically reduced to your hormones. When that's coming from a male doctor, it can feel particularly insulting. Then, they start trying to throw anti-depressants at you because you *must be* depressed (and a woman!) and they use them to treat everything from a cold to back pain. Sigh. I don't know if I have more contempt for doctors, or the pharmaceutical industry. I *do* know that if I'm going to be a test subject, I ought to be getting paid for it.

Like I said, I'm a terrible patient, so I steer clear as much as possible.