HRT, migrain headaches and options..

[Stephe]

A bit of history I have always been sensitive to medications and have had unusual side effects to many. Also I have never been one to have headaches, rarely get them (maybe once a year) and normally are minor ones that a single aspirin or Advil deals with. Years ago I tried to self prescribe some HRT and started with the "normal dose" estradiol I got from a girl friend to try that she was taking. I got a nasty headache after a couple of days, felt like crap and decided I wasn't really ready to mess with this and forgot about HRT for a while

I started real HRT a few months ago after I got letter etc and decided to get serious about this. The doc started me out on spiro and slowly increased to what appears to be the "normal" dosage. I did this for about a month, was dizzy the first week a bit but think it was from not drinking enough water. Soon I felt no negative side effects at all. I love the results from this, feel calm/normal for the first time in my life, sex drive reduced to a nice level and all that. Have slight breast growth from just this and see my face smoothing out. All the "side effects" are good ones.

The problem began when I started on E. First we tried the normal estradiol generic pills. Again he started me out on a low dose. The first day was fine but the 2nd day I started feeling irritable and "hostile", also a dull headache. By day 3 I had a nasty headache but stuck with it thinking it would go away with "treatment" or maybe as the dosage increased these side effect would diminish. I increased the dosage at the rate he suggested up to his recommended dose (which seems to be a normal starting dose for most people) over a week. After about 5 days the headache was constant and the worst  I have ever had in my life. 10 days in I had been on this "normal starting dose" for about 4 days and the headache was so bad it was hard to even see clearly and I didn't feel like doing anything. Aspirin nor Advil seemed to have any effect. I was miserable. As badly as I want to be on E I said "F this" called him and he agreed to stop this med and I should come see him. About 3 days after I stopped E the headache went away and I felt fine.

He thought maybe we tried to get up to the starting dose too quickly for my system but he also said (he has been doing HRT for 15 years) he has never started anyone out as slowly as he did me.  This time he tried premirin creme and figured out a low dose to start out on. It was ~ 1/10 the dose he -started- me on last time. He wanted me to stick to this very low dose, applied to my upper leg, for a week and if no bad side effects, increase etc. Well even with this diff med and much lower dose, I had the same side effects with the same intensity. By the 4th day my head felt like it was going to explode. I called him after about a week and he was baffled but agreed something about this med was triggering these migraine headaches.

So the last attempt he prescribed the lowest dose patch (vivelle-dot estraiol), he said it should even out the E and that might help. Well same side effect and intensity even at this really low dose. The first day is fine, the second day it starts to ramp up and by the 3rd day I have a 24/7 nasty headache. I suffered through 2 weeks of this hoping that I would adjust but no dice. I'm lucky right now I'm not working as this wasn't like "a light headache", this was the "I don't want to walk outside or do anything" kind. Again we agreed this just wasn't going to work and within a few days I was feeling fine after I discontinued use.

Obviously this has me bummed out but I'm trying to be realistic about all this. Clearly life with a 24/7 migraine headache isn't something that is going to improve my quality of life. The spiro is making me feel better and I like how I feel on it. My main goal for HRT was more for emotional and facial changes not the boobs part. Also I want to lose my body hair. This last 2 weeks he added finasteride to help deal with that and so far see no bad side effects from that med. He has considered trying progesterone but finds no real information on a spiro/progesterone without E combo. Plus I have no idea if I can tolerate that either.

I feel like I'm kinda at the end of my rope on this HRT thing. I'm fine taking the spiro and something for my body hair. For me, these nasty headaches just aren't bearable and I can't function like that. I'm not sure if there are ANY other options for any other sort of E, even something that has had limited success. I would be willing to try something but it appears these estradiol type meds and me don't get along.  Also not sure what progesterone without the other E meds would do?

I feel anything is better than nothing and again, I'm mainly looking for a more feminine outwards appearance, nicer skin and smoother face, not huge boob growth. If I have to just do the spiro, well life has dealt me harder things to deal with so I'll accept it and get on with my life. If anyone has any ideas, I'm open to suggestions, especially if any of you have had to deal with this.

[AbraCadabra]

Why not give phytoestrogen a try?

Otherwise there are estradiol-gels on the market that can be dosed extremely low using pump plungers.

It seems I may neither mention any products either here. So you welcome to send me an email if feeling to persue this route and then check with your doc.

Greetings,
Axelle

[umop ap!sdn]

Spiro tends to cause breast growth so you will probably get some even without E. I'd be wary of phytoestrogens though because I've heard they can be bad for you.

[Stephe]

Thanks for the replies.

I'm not sure on the phytoestrogens, I took them a long time ago and never really noticed anything (good or bad) but possibly with spiro they might do something? I can see how some people might mega does them to try to replicate what the "real" E pills do and that would cause problems I'm sure. I'll discuss this with my doc and see what he thinks.. I'm still not sure about the Finasteride, it that is even needed with Spiro (I read to blocks the conversion of T to DHT but if T is real low is this even an issue?) and about adding progesterone by itself with spiro.. Might just stick with spiro only for a while and see how things progress.

[VeryGnawty]

I can see how some people might mega does them to try to replicate what the "real" E pills do and that would cause problems I'm sure.

Megadosing phytoestrogens wouldn't really do anything, as most phytoestrogens have a minor effect to begin with.  A very small number multiplied several times is still a very small number.

[Sally Martin]

Hi
Annoying circumstance, now that you've found yourself.
For me it's the other way around, tried selfdosing and found out that E takes away my constant headache, unless I smoke (cursed thy be, stupid habit!)
Are you doing nicotine patches btw?, just a longshot, might be that some other medication interfers with your reaction to E...
Love Sally

[Randi]

I am sorry that estrogen is doing this to you-I know how much you want it to work for you. I have had intense migraines since puberty and still do but not as regularly as I once did. Estrogen did not change them for me and I can only hope they will go away as I get older. The only thing that helps me is to go to sleep-when I wake up they are always gone and it is usually months before I have another one but not always. Some days I have them back to back.

This is such a long drawn out process that phytoestrogens are practically useless unless you are using it to avoid hot flashes. I have read that some people have seen results from them but I remain unconvinced-I didn't but that doesn't mean that you will not.

Randi

[Stephe]

I'm on no other meds so don't think this is an interaction with anything else. Years ago I tried E while not on spiro and had same side effect. Obviously I have no idea if this officially "A migraine" or what it is, but it's not bearable and is like a 24/7 headache that literally blurs my vision it hurts so bad. Turns me into a shut-in. As soon as I get off this med, it goes away and I have never had headaches in the past, VERY rarely (once or twice a year) a one advil kind that I think most people get.

This doesn't feel like anything other than a med reaction to me. If it was something an advil would cover up, I'd be willing to ride this out for a bit and see what happens but it's not a mild reaction. It just feels like -poison- to my system for whatever reason. Doing some research online I see some females have complained about this same thing, and given a MUCH larger % of females have taken this drug than males, it would make sense if this side effect was going to show up, it would be reported by that group. I'm really not interested in getting into the "take this med to offset the reaction of this one and then we can treat the side effects of that one" loop. My doc agreed and doesn't think we should try treating the headaches for the rest of my life. I -am- going to go to another endo for a second opinion but not holding my breath for a "magic pill"..

I'm also not going to stress over this too much or ruin my health trying to force this med my body clearly doesn't like. The spiro seems to not cause any problems and I'm seeing some results from just that, mainly -feel- calm and much more normal if that makes sense.

I'm not even sure about adding Finasteride. I wonder besides blocking T to DHT,  reading papers is likely this drug creates chemical depression from the way it reacts to progesterone conversions. They finally added depression to the long list of side effects. Clearly the feminizing and sex (ED etc) related side effects are not something that I'm concerned about and would welcome. But I have to wonder, given this drug is a shotgun approach, what other chemical conversions it is negatively affecting we don't know about yet?

Life has dealt me worse curve balls than this and I'm past the "OMG I'm not a woman if I can't take E" idea. I'm getting some FFS in august and life is good so just going to move forward!

Thanks for your responses and concerns.