Hi DEETLE
I've come somewhat belatedly to this thread.
What an awful confusing time you've had with the various doctors! It makes me so glad I live in UK with our NHS! OK we do have some GPs that need educating but there are strict guidelines and protocols and basically we can get any of what has been talked about free (or at minimal cost) without having to go privately,. Sometimes we have to make a bit of a fuss but it is possible.
The first thing is to clear up the issues of compounded creams. Lizab is right that they are not popular here. To be correct they are simply not on the radar because they are not approved by NHS nor by most private gynaes. They are simply not used - except by a few compounding pharmacies but most women haven't heard of them. Progesterone creams are not approved because they are not standardised and so the amount of progesterone is inconsistent. The same is the case in US. They are not approved by FDA.
In terms of equivalent to prof studd in us - I'm sure there are many practitioners but the one who is well known is Dr Elizabeth Vliet who has written amongst others a book about menopause called "Screaming to be Heard". She also talks about bio-identical hormones and the con-trick by all the practitioners that make women think they have to shell out a fortune privately to get these when the FDA approved drugs provide esatrdiool gels ( which you have) patches, and micronised progesterone in the form of Prometrium
http://www.webmd.com/drugs/2/drug-8042/prometrium-oral/details which should be available from your regular local doctor or whoever you go to for general health/gynae stuff.
Here is her Youtube talk about bioidentical hormones (just ignore the weird hairstyle!)
https://www.youtube.com/watch?v=9XfpAATJkC8You might like also to see the N American Menopause Society which is the equivalent of our British menopause Society in US
http://www.menopause.org/ . There is a find a specialist section
http://www.menopause.org/for-women/find-a-menopause-practitionerThey've got a whole page with links about bio-identical hormone therapy and the confusion between compounded ones the body-identical hormones that I have talked about above and are generally available.
http://www.menopause.org/publications/clinical-practice-materials/bioidentical-hormone-therapy If anyone tries to tell you Prometrium is not available then they are trying to make money out of you. On the NAMS website the approved products are listed here:
http://www.menopause.org/publications/clinical-practice-materials/government-approved-drugs-for-menopauseActual list:
http://www.menopause.org/docs/default-source/professional/nams-ht-tables.pdfIn terms of what you need I can't find anywhere in the thread (but I might have missed it!) where you say where you are in menopause ie what have your periods been doing re cycle etc over the past year - and how this relates to your symptoms that have worsened in the past 4 months? Also if you have only just started trying the gel you mention - and how long you have been trying out HRT? This is quite important to know how best to treat you.
Re the blood tests. The oestrogen will be in pg/ml as you are in US and that reading is normal yes, but also it depends on where in your cycle that test was taken as it varies so much so doesn't really tell you anything. As Stellajane says - she hasn't had a blood tests but her docs go on symptoms. At your age, cycle and symptoms should be enough to decide that you are menopausal and to issue standard (bio-identical - but not compounded) HRT to treat your symptoms, if this is what you want.
Depending on what you say you could start at the standard dose and then work upwards.
As Mary G says it is best to start on cyclical HRT anyway - at least to see how you feel with the extra oestrogen and then add in the progesterone. If you are post-menopausal ( ie no natural period for 12 months) then taking it every day is fine if you feel well on it - but many of us on here don't.
Please clarify about your cycle - and then take it from there.
Absolutely as Lizab says - don't accept the weird stuff your pharmacy is suggesting - you need Prometrium (the same as our Utrogestan) which is bio-identical.
I hope this is helpful - it's a bit long - and hasn't confused you further DEETLE!
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Hurdity x