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[Rose]

Thank you for that! The thought of going without HRT had me quite worried, andius x

[Hurdity]

Rose - doctors are not able to precisely tailor the amount of oestrogen to give you based on a blood test.  If you are post-menopausal they will give a rough idea of where you are, and then a medium patch or gel dose would be good to start with, although many docs will want to start with as low a dose as possible.  Symptoms are the best guide. It's not a precise science. Women react differently to how much gets into their system with different HRT types and modes of delivery. I can't remember how old or where in meno you are? Don't be persuaded to have expensive tests and a specially tailored amount of oestrogen. A friend of mine in Oz wasted a lot of money on expensive (private) treatments but what is needed is to just start with a standard dose. Appreciate that some products are difficult to get in Oz though

Hurdity x

[Rose]

I am 57 and menopausal for 8 years now. I don't think my GP knows anything about bio identicals as that's why I went privately to a doc who specializes in the menopause as have my friends. It's certainly more expensive and I don't know if I will be able to afford them if they are too expensive. I will try to see another GP at the practice just to make sure. Over here you can choose between at least 10 docs at one practice! I will try for a female GP. Thanks for info Hurdity and andius.

[Hurdity]

Hi Rose

Sorry I can't remember what you are taking but I think we have discussed that all HRT which contains estradiol is bio-identical - whether taken as tablet or transdermally (gel or patch), so any GP should be able to prescribe this. You wouldn't need to describe it as bio-identical because most of the oestrogens are except for the horse ones - premarin premique and the like. This can be given as oestrogen only

The main problem in Oz ( I think you are there and maybe I've mentioned this already?) is that I understand that progesterone (as in actual progesterone) is not available - although maybe just not in micronized form like in UK and Europe as Utrogestan. It is available in US. Those in OZ I know buy it on-line because I think the only alternative is progesterone cream privately which is not adequate in protecting the uterus and I think consultations are expensive.

Here is what I found from the Australian Menopause Society:

Types of progestins

    Progestins are synthetic hormones that mimic the action of natural progesterone. (Progestogen is a term that includes natural progesterone and progestins)
    Progestins may be derived from progesterone or other steroids (such as testosterone) and most have other biological effects in addition to their progestogenic effects
    Progestogen tablets for HRT contain medroxyprogesterone acetate, norethisterone, drospirenone or levonorgestrel. Micronised progesterone capsules (a form of natural progesterone) are available in New Zealand but not yet Australia.
    Progestogen can also be delivered via a patch.
    An alternative method is to deliver the progestogen directly into the endometrium using the levonorgestrel containing intrauterine system (Mirena).
    Troches have not been scientifically evaluated. Progesterone creams are ineffective in reducing endometrial thickening and there is evidence that they do not protect the endometrium.

Here's the link:
http://www.menopause.org.au/consumers/information-sheets/23-menopause-combined-hormone-replacement-therapy

Therefore you would have to persuade the doc to prescribe you separate oestrogen (as estradiol - in whichever mode you preferred) and progestogen (any of them). You would have to pay for the prog but then if you didn't want to use it you would have to chuck it! They would be unlikely to prescribe you oestrogen alone. Then you would have to obtain the Utrogestan online somehow. I know it can be done easily.

The other progestogen - not bio-identical but most similar to progesterone is dydrogesterone formerly available separately as Duphaston but no longer, and only now as part of Femoston (tablet HRT).

Hope this helps and I'm not repeating myself!

Hurdity x

[Dancinggirl]

Just wanted to add another option to what Hurdity has suggested.  If they are available in Oz you could have a Mirena fitted to protect the uterus while taking gel or patch oestrogen.  I've had one for the last 4 and half years (I'm 57 and very post meno).  You get some break through bleeding for the first few months but after that little or no problems and less progesterone related issues than other forms.
Good luck.  Dg x

[Rose]

Well thank you all for all that info! now it seems that I'll only need oestrogen so will have to look that up so I'm prepared for whatever they decide to give me. Will I need oestrogen immediately after op? Any of you scientific ladies would be a great help! I really admire how you find things, make sense of them and inform us. I am more the tea and sympathy lady as I'm sure you've guessed!