conjugated estrogens and skin problems

[katia]

i've been on a [very common conjugated estrogen] medication for almost two years.  unfortunately my skin hasn't reacted very well to  this medication since i only need to be in the sun for a few minutes [even with sunscreen and in a very cold weather] and i burn very badly [with blisters].  i've been told that estrogens [derived from animal sources] are known to cause irregularities in skin pigmentation, extreme sensitivity to the sun and irritation.  has anyone experienced similar reactions with conjugated estrogens? are there [conjugated estrogen medications] that are [not] obtained from [animal sources?]  i guess i could ask my endo next time i see him but that won't be for another six weeks at least. so any information you'd like to share will be greatly appreciated. :  )

[Steph]

i've been on a [very common conjugated estrogen] medication for almost two years.  unfortunately my skin hasn't reacted very well to  this medication since i only need to be in the sun for a few minutes [even with sunscreen and in a very cold weather] and i burn very badly [with blisters].  i've been told that estrogens [derived from animal sources] are known to cause irregularities in skin pigmentation, extreme sensitivity to the sun and irritation.  has anyone experienced similar reactions with conjugated estrogens? are there [conjugated estrogen medications] that are [not] obtained from [animal sources?]  i guess i could ask my endo next time i see him but that won't be for another six weeks at least. so any information you'd like to share will be greatly appreciated. :  )

Hello Katia.

I haven't experienced any adverse side effects (yet) but these are some of the side effects to the skin that are caused by estrogens:

Skin:
The skin becomes thinner and therefore more translucent and pinkish (spider veins may appear or be more noticeable), more suscepitable to tearing and irritation from scratching or shaving, increased tactile sensation, and slightly lighter in color due to a slight decrease in melanin (pigment).

Skin becomes softer

Sebaceous gland activity (which is triggered by androgens) lessens which lowers the amount of sebum (oil) production on the skin and scalp, consequently the skin becomes less prone to the formation of acne due to the less quantity of oil that is produced

The skin's pores become smaller due to the low quantities of sebum produced
Body odor (skin, sweat, and urine) will become less "metallic," "sharp," or "acrid" and more "sweet" and "musky."

Many apocrine glands (type of sweat glands) become inactive and body odor decreases. Sebum also contributes to body odor, which the production of is reduced by anti-androgens (as described above).

More subcutaneous (under skin) adipose (fat) tissue accumulates. This gives a more puffy/softer appearence. Consequently dimpling, or cellulite, will be more apparent on the thighs and buttocks due to this along with the thinness of the skin.

Susceptibility to sunburn increases possibly due to the thinner skin and/or less skin pigment.

Because of the increase in adipose tissue in the hips, thighs, and rear, stretch marks (striae distensae) may appear on the skin in these areas.

I would definitely see my Dr/endo about this, may be it just requires an adjustment to the dosage.

Steph

[Stormy Weather]

Yes, I was also on [insert name of most prevalent form of conjugated estrogen] for years pre-op. I now have chloasma on my forehead... post-op, I'm now on estradiol valerate, synthetic but bio-identical; the chloasma still remains.

The tide is turning against the use of conjugated estrogens for TSs and genetic women. You might want to talk to your prescriber about moving to a more contemporary regimen.

[katia]

You might want to talk to your prescriber about moving to a more contemporary regimen.

Thank you gals!  thank you stormy weather.  i've talked to him [my endo] about switching me to a [less archaic] hrt treatment but i generally get the same answer "it's the most common med in mtf patients" i'll keep on insisting and we shall see.

[Hazumu]

Katia;

You may also wish to investigate non-swallowed estrogen.  There are now sublingual, transdermal and injectable routes of administration that don't put the shock load on the liver (all the blood from the gut, with its absorbed nutrients and meds, goes through the liver before returning to the body.  Other routes of administration bypass the liver, and only what bit of blood that gets shunted through the liver gets processed/filtered/metabolized.)

I've used transdermals.  I have to be especially careful to take care of the places I stick them, as I have eczema and rough, patchy skin can interfere with good adhesion.  But because they don't shock-load the liver, they can be safer.

Talk to you Dr/Endo about these choices/alternatives.

Karen

[BrandiOK]

  I use injectable "non-animal based" estrogen and I haven't had any problems other than being a tad moody the day or two before my injection. 

  If your endo isn't willing to work with you on different HRT methods I would highly suggest looking at changing doctors.  Simply saying "it's the most common med in mtf patients" is not only close minded and uneducated but insulting.  Your endo should be better informed and willing to work with you to achieve your goals. 

[Melissa]

I have used both the subligual tablets (dissolved under the tongue) and the injectibles.  I'm currently on the injectibles.  I have noticed recently that my skin takes so much longer to heal than it used to.  I mean scars can take months and months to fade now instead of weeks like before.  Also I can't leave bandaids on for long, because it seems to irritate my skin.  I don't think this is the same thing you are experiencing, but I thought I would post it anyhow.

Melissa

[katia]

i'm [not] really willing to switch my hrt to the [synthetic] kind.  according to my endo, only the purple pill brand   contains [all 10 essential conjugated estrogen components] derived from [animal sources] which isn't the case with the synthetic types.  unfortunately the only known conjugated estrogen medication which exists today is derived from the [e. caballus] species and i don't know if i want to swallow [animal waste matter] for the [rest of my life].

[Stormy Weather]

Your endo is talking nonsense and appears to have swallowed Wyeth's promo blurb hook, line and sinker.

I suggest doing some research of your own to find out the difference between 'natural' and 'bio-identical' and what compounds are really in those tablets, many of which are not naturally found in the human body. Hank Gooren's research from the University of Amsterdam is good starting point.

Furthermore, levels of estrogen from conjugated estrogens can not be accurately measured in blood tests, rendering them useless for long-term monitoring.

I do sympathise though, because apart from the side-effects, I had a shapelier body and face from them, but long-term the risks to your health are far higher, particularly from breast disease and thrombosis.