Tuesday, January 13, 2009

On Bio-Identical Hormone Replacement Therapy

I just got back from a visit with René McCarty, PA-C. This is my second month on bio-identical hormone replacement therapy. I am a believer. Nineteen months ago, the hot flashes started. No problem. I figured I would take the hot flashes in stride and make this passage as I have the others in my life: just forging ahead, not letting “mother nature” keep me from enjoying and living as I chose. Let me just say that I did not appreciate how very much I valued a good night’s sleep. Cranky and cross, I decided to try over-the-counter products to deter the hot flashes. No luck.

After a few months, I saw my family practitioner. I asked about bio-identical hormone replacement therapy. His opinion is that, if you are going to take HRT, it should be one of the traditional pharmaceuticals, but he suggested and prescribed Effexor. By that time, I was feeling depressed and so, thought, “why not?” I will give him this: my hot flashes stopped and I slept again, but, I was in a fog. I would be in situations where I knew that typically I would laugh and be enjoying myself, but I had to force myself to have the response I would have naturally had before. I felt disconnected. I took myself off the Effexor. The hot flashes returned.

Within a month, I had a follow-up visit scheduled with my doctor and saw his nurse practitioner. I told her that I had taken myself off the Effexor and why. She prescribed birth control pills. That helped with the hot flashes, regulated my erratic cycles, and got me a night’s sleep. What it did not get me was feeling better. I grew apathetic. My waist thickened. I sprouted back fat! I stopped working out (btw, I know that contributes to the problem… I just didn’t care). When I looked in the mirror, it seemed I had aged ten years in less than one. I knew I was in trouble when I saw my daughter’s name on my caller ID and just didn’t have it in me to answer the phone. I had to try again to get past this!

I tried being vegetarian, giving up artificial sweeteners, going organic, psychotherapy, chiropractics and massage therapy. I resolved to not start a big project (I save historic multi-family properties). I had my lead levels checked (lots of sanding and scraping old paint). I started back running. I took myself off the birth control pills (the hot flashes had returned).

At this point, my joints ached. My tendons and muscles were foreign to me; I just had no reference for feeling so badly. It was not like anything I had ever experienced. I am not a stranger to muscle aches and pains. I have run four marathons, all in my forties, among other things. But, this was different; I felt like a crone. Not in a wise way.

In a last ditch effort, I started myself on a slew of OTC supplements from the health food store, Sam-E, True Calm, Multi-Vitamin with minerals, Calcium with D, Vitamin C, HTP-5, Osteochondrotin and made myself an appointment to see a Physician’s Assistant who my husband, my counselor and my massage therapist all recommended. I took the saliva test to determine my hormone levels. She prescribed a bio-identical hormone replacement topical cream based on my lab results. This concoction was compounded in the pharmacy next door. I was cynical by now and referred to it as my Snake Oil.

It has been almost two months since I have been using the bio-identical hormone prescription and I feel entirely different. I am still having hot flashes and she increased the level of estrogen in this prescription. But, I cannot begin to tell you how much better I feel physically. I can cope with the hot flashes now that I am not decrepit! But, she tells me we can tweak the levels until the hot flashes are under control and I will be grateful for that also. But, most of all, I am happy to be feeling better generally!

One disclaimer: I do believe there are other factors in my improved well-being that include acceptance of this place in my life and others that I will discuss at another time. But, I do believe this is a primary factor.


  1. I am glad you are feeling more like yourself. It is a good thing you didn't settle for being in that fog....I would imagine that some people would. Acceptance of life changes, not an easy thing at all, for any of us. You are doing great ! : )

  2. Thank you so much, Dawn. Change IS difficult. Knowing what we have to accept v. change is tricky. In the end, we are the only ones who can know.