Follow up on my estradiol bad side effects and an alternative - estriol

[Stephe]

Some background. Started HRT about a year ago. Had no issues whatsoever with the spiro but I got horrendous migraine headaches from even miniscule doses of estradiol. The longest I was able to suffer thru trying was 2 weeks (on 1/20 the "normal" dosage) and the headaches got so bad I couldn't get out of bed. Clearly I wasn't going to deal with that. After 3-4 different types, generic, premarin, trying pills and transdermal cremes and patches we gave up on that med altogether.

I was on spiro only for about 8 months and saw some results and I felt REALLY good. Lowered sex drive and other things associated with lower T. Some breast growth but slow. We added some finasteride to reduce body hair some more and again, no bad reactions to this. Almost all body hair is gone now. I added some herbal type estrogen replacements just to be doing something but doubt that really was doing much of anything other than psychological.

The good news! I was talking with my Doc and he had mentioned a while ago this place -womens international- that compounds bio-identical HRT and he said he would give them a call. He prescribed some creme type transdermal estriol and it seems I am able to tolerate this. I started on a low dose and had very slight headaches at first but like 1 aspirin would deal with it kind. NOTHING like the reaction to estradiol. Also noted coffee seemed to make them worse so backed off that which helped. After about a week, no headaches.

I'm now on "the dose" he wants me to try to get to for a month now and am seeing nice breast growth already, smoothing out of my face and zero side effects. I'm sure some of this rapid change is related to being on spiro for so long first. We might adjust the dosage after a blood test but I'm very happy I've found something I can tolerate and might be a good option for anyone who has problems like I did. I understand this is a weaker estrogen but it's WAY better than not being able to take any at all. It seems this is a type of HRT treatment they use for female menopause outside the USA. Hope someone who is having problems like I did finds this info and it helps them too.

[kelly_aus]

During my first 6 weeks of estradiol, I got migraines.. Like head-splitting, lock myself in a dark room and no pain killers helped type migraines.. Oddly enough, they went away when my dosage was increased..

But I'm glad you have found something that works for you.. Not everything is suited to everyone.

[Maja.V]

Have you had your doctor prescribe you Estrofem or Progynova? They contain 17β-estradiol (or oestradiol) and are bio-identical. You may have been prescribed ethinyl estradiol before, which is a much stronger substance, but also a lot more dangerous, as well.

The oestradiol pills can be taken sublingually, as well, to increase the effect and put less strain on the liver.

A bit off-topic, if I may ask, how long have you been taking finasteride for? I'm quite hirsute and am trying to find a way to get rid of most of my body hair with other (less expensive) means than laser.

[Stephe]

Have you had your doctor prescribe you Estrofem or Progynova? They contain 17β-estradiol (or oestradiol) and are bio-identical. You may have been prescribed ethinyl estradiol before, which is a much stronger substance, but also a lot more dangerous, as well.

The oestradiol pills can be taken sublingually, as well, to increase the effect and put less strain on the liver.

A bit off-topic, if I may ask, how long have you been taking finasteride for? I'm quite hirsute and am trying to find a way to get rid of most of my body hair with other (less expensive) means than laser.

Yes I tried estrofem with same bad results. I honestly think we tried everything. We even tried upping to "full dose" to see if that helped. It was weird, the side effects seemed to be the same at full dose as they were taking one tiny grain of it. I wasn't willing to suffer through that, life is too short. He has treated hundreds of trans patients and never seen this but not a shock for me, I have had oddball reactions to many meds in the past. I've been living full time for years with no HRT at all so wasn't something I couldn't live without. I'm just very happy I seemed to have found something I can take. Might be something people with other health issues could try as well?

On the finasteride: been on it for about 6 months at the dosage given for people with prostrate problems, not the hair loss dose, and my body hair is now very fine. I had a lot of very thick hair all over my body, needed to shave my legs daily etc. now a touch up every week or two. + kills off -all- that nasty DHT too

[phdinfunk]

Yes I tried estrofem with same bad results. I honestly think we tried everything. We even tried upping to "full dose" to see if that helped. It was weird, the side effects seemed to be the same at full dose as they were taking one tiny grain of it. I wasn't willing to suffer through that, life is too short. He has treated hundreds of trans patients and never seen this but not a shock for me, I have had oddball reactions to many meds in the past. I've been living full time for years with no HRT at all so wasn't something I couldn't live without. I'm just very happy I seemed to have found something I can take. Might be something people with other health issues could try as well?

Hey, I just want to say thanks for posting this.  I've been cruising the net and never saw anyone quite like me as much as YOU.  I had exactly the same things happen to me.  Just fine with the Spiro, felt freaking GREAT in fact.  But even like one single grain from any of the estradiol pills (Estradiol Valerate, Bioidentical Estradiol, Estanyl, etc)....  literally just the tiniest nibble from the lowest dosage pills and I would get heart-racing unhappiness.  I tried the creams, and had similar problems (though less bad).  Two different doctors in two different countries and I finally just gave up.  I'm going back to try to get into it again, and I will mention this medicine to the endocrinologist.

Basically it's been frustrating because I've never been able to actually be FUNCTIONAL while taking estrogen, even after a couple of months.  I guess everybody's body is different, and mine just always overreacted in the heartbeats department.  I have got a doubled heartbeat (ventricular bigemini) anyways, and I always wondered if this had anything to do with it.

But anyways, I'm just happy to have read this.  I know it's an old post but it gives me hope.  How did things turn out for you with the estriol?

[phdinfunk]

I should add that my heart is just kind of over-reactive anyways.  Half a cup of coffee, a small amount of Marijuana, etc, will make me feel very bad.  I've been curled into the fetal position, hearing my pulse in my ears and unable to work due to half a cup of coffee before.  Had a cup of coffee and two strips of bacon trigger an INSANE headache with double vision, etc.  I had to cut all that out many years ago because my heart would just POUND. 

I've seen heart docs and they have told me everything is benign, even healthy.  I bicycle maybe 40 miles every week in very mountainous countryside and can hike with a big bag of stuff for six hours straight.  I just have an extremely sensitive system for some reason.  Zinc and Magnesium help, a lot.

I bring that up because I'm curious if the OP also fits this profile.

[Wynternight]

I'm on dutasteride and have to wonder if it's better than the finasteride. Hmm...what to do?

[JLT1]

This isn't right.  Estriol is a liver metabolite of both Estradiol and Estrone.  It will bind with everything in the human body that estradiol will bind with although it doesn't bind as strongly.  Based on everything I know, what you are describing is impossible, so either the dosages you have given us are wrong or you are not telling us the exact form of the estrogens you previously tried or your liver is shot. So, before I go digging to solve this, I want you to check on the exact form of the estrogen you were taking.  Exact.

Also, I'm asking a moderator why your name thing is strange.  It doesn't say visitor or anything else. 

[Devlyn]

Old thread, she's no longer a member.

[JLT1]

That's to bad....  I think I figured out an answer to her problem...  It isn't the estradiol that causes a problem, it's the fluctuations in concentration that causes the problem...

I also think we could fix this... 

Sorry,

Jen

[ImagineKate]

Yeah I am the happiest person in the world, no headaches nothing if I have a consistent dose of estradiol (estrace) taken sublingually and on time. Change dose or miss a dose and my head wants to explode.

[justpat]

   Very interesting, I have had horrible migraines all my life about every4-6 weeks apart for over 40 years. My crew used to kid me about having PMS plus some other things.. Once I was settled down on HRT the headaches are GONE ! I still do get one for one or two days occasionally but they seem to be my fault when I screw up on taking my meds.Also as a side note all of my joint pain is gone and I feel great except I eat everything in sight !  My weight though has stayed the same just now it is different places .      Just wanted to add the headaches were always on the right side and I was told recently they were very likely hormone related.

[nola]

Hi, I just started estradiol and had some bad side effects like headaches, tachycardia, body temperature really hot like a fever almost, dizzy, spaced out, forgetful,, i lasted two weeks hoping it will go away. I was also on 1/4 of the prescribed dose. I have tried two different brand of patches and bio identical cream with estradiol and estriol in its formula.

My Doc said He is going to change me to estriol only see how I do, I asked my Doc if estriol will give me the benefits of testosterone or estradiool would give me in regards to other essential functions for the body like to protect yuo from osteoporosis etc, and he said no that estriol would not give you those protections, so if Im low in t and low in e, then my long term usage of this hrt will it harm me?

[Mariah]

Hi Nola, welcome to Susan's. I look forward to seeing you around the forums. Good luck and Hugs
Mariah

[AnonyMs]

Looking at those old posts I can't help but wonder what would happen if they tried implants. They are bio-identical (at least the ones I have), and very very even blood levels. I don't suppose it would be much fun if you have to remove them, but its possible.

My Doc said He is going to change me to estriol only see how I do, I asked my Doc if estriol will give me the benefits of testosterone or estradiool would give me in regards to other essential functions for the body like to protect yuo from osteoporosis etc, and he said no that estriol would not give you those protections, so if Im low in t and low in e, then my long term usage of this hrt will it harm me?

As you mentioned you need T or E protect you from osteoporosis. If you're low in both then yes, this HRT will harm you, eventually. Search the forums as there's been discussions about this, and people with osteoporosis.

I think you'd want to talk to someone really expert about this, and possibly get bone density tests to watch out for problems before they get bad.

[katrinaw]

Nice big warm welcome to Susan's Nola

Sorry a little housekeeping 

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At the start it is always a try and see basis, as tests are taken the medications are altered to find the best balance for your well being...
There must be a balance of E and T, again how the use of Anti Androgens and Oestrogen are administered will depend on your makeup. I would keep asking your Dr and explain each set of symptoms, unfortunately its never a one size fits all as you are aware.

Best wishes for you in that respect...

And as I said Welcome and look forward to seeing you about...

L Katy 

[nola]

Thanks for welcoming me to Susan.
I
also like to ask if anybody has had the same symptoms I,ve had using the bio identical transdermal estradiol/estriol combo gel?. I get spaced out, light headed, forgetful, sleepy like im drugged.I was also taking 1/4th of the prescribed dose to start. I suffer from panic attacks and anxiety and I feel some symptoms getting out from the hrt.
anyway I had to stop after 2 weeks cause I was feeling out of my mind, the only thing i didnt do was not take the micronized progesterone my doc told me to take along with the e gel, he says this alliviates the symptoms of e alone.
I have not tried it yet, since im waiting to stop working so I can transition without work stress.

[phdinfunk]

So, it looks like there is a group of us, perhaps a minority, who have bad reactions to HRT.  The reactions follow similar patterns sometimes including headaches, tachycardia, body temperature increases, anxiety, and other negative effects.

In my case and at least one other woman on this thread, we can rule out some kind of psychological resistance because both of us handled anti-androgens well and happily.  Besides, in my case, I was so blissful about my breast growth on HRT but couldn't tolerate the side effects easily.  I only bring this up because this is the theory most forum items have presented to me over the years, psychological resistance forming some kind of abreaction.

My liver function was tested at least before my first go around with HRT and was fine.  So, I am curious about the forum user Jen's theory regarding fluxuations.  How could this be tested?  Bear in mind those of us having these symptoms don't want to once again take a normal dose of estrogen due to having had bad reactions to even relatively small amounts.  Is there a way to test your idea while gradually ramping up the dose?

Anyways, I cannot figure out how to PM People on here, but would love some ideas of what to try.  I am traveling until July or August, but would love to get back on HRT ASAP as soon as I get back home.

Also, I'm curious if the other women here who have had these symptoms have found a way to get past this problem.

--Lyra

[KayXo]

So, it looks like there is a group of us, perhaps a minority, who have bad reactions to HRT.  The reactions follow similar patterns sometimes including headaches, tachycardia, body temperature increases, anxiety, and other negative effects.

In my case and at least one other woman on this thread, we can rule out some kind of psychological resistance because both of us handled anti-androgens well and happily.

psychological resistance forming some kind of abreaction.

I wouldn't rule out a psychological resistance to E as E can have a profound impact on the psyche similar to anti-depressants. Anti-androgens don't have this effect. The addition of bio-identical progesterone could prove useful as it reduces anxiety.

Did you try taking E NON-ORALLY? and more specifically, by intramuscular injection, where E2:E1 ratio is more natural. I also did not tolerate E orally or even when taken by patch but by way of injection, it was a different story.

Reactions may also have something to do with too much estrone, or how E is metabolized orally and effects on blood pressure OR excipients in pills/patch causing allergic reaction.

One person mentioned fluctuations so that perhaps pellets would prove useful?

Also, you say you are sensitive to things like coffee and bacon which is high in histamine. When one is stressed, coffee worsens it, obviously and your histamine levels are already high, a normal reaction from stress so that anything you eat that is high in histamine may increase the risk of histamine overload with all the accompanying symptoms (dizziness, heart racing, etc.). I think estrogen also increases histamine levels in the body, if I recall so that could be why.

Trying to touch all bases.

[phdinfunk]

I did not know anything about that histamine connection.  That gives me something useful to bring up with the endocrinologist next time.  Thanks Stephe!

I'll look into this, as I would really like to find the culprit.

I've been reticent to get injections, since I've had squirrelly reactions at relatively low-doses before I would guess injections could go really really really wrong.  I have tried creams and it's basically the same as oral in terms of my reactions.  I do notice it 'hits' faster, though.

The thing is, sometimes it's like I can just get everything balanced properly and the estrogen contributes to the blissful feeling.  But it's like I'm balacing on the edge of a pin.  The second or third time I was doing it, I really experimented a lot and with just the right amount of estrogen gel and a tiny bit of micronized progesterone, I was really really happy.  But it was still hit or miss.  And if I got the progesterone wrong, it was a lot worse than getting the estrogen wrong (in terms of headache and palpitation).

You know, in Taiwan where I live, I have a lot of access to healthcare, and I can get pretty much whatever I want.  It's pretty libertarian with scripts and stuff (I've seen other expats get addicted to Opoids this way, in fact).  But I do have to educate the docs a little more than I would probably have to in the states.  So, I do appreciate any leads I can get.

Thanks,

--Lyra