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HRT Holidays for Women

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 Posted 12/26/2013 8:10:19 AM
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Some women take the same doses of estrogen and progesterone every day, 365 days a year. Others take hormone holidays, every month or every few months.

My new doctor recommends bi-est days 1-25, progesterone days 10-25, then nothing to the end of the month. Her reasoning: trying to match natural pattern, holidays improve absorption so higher doses aren't needed over time.

What do others recommend? Is there a special plan for hormonally sensitive woman? I have a history of PMS, hypothyroidism and irritable mood. I've found supplements to improve my mood, but I still experience a lot of ups and downs when I change hormones, especially estrogen. It feels like my metabolism is on a roller coaster, super tired one day, too wired the next. I can't imagine living like this for the rest of my life.

If I did change my hormones every month, how would I do blood tests for thyroid and other hormones? They'd never have six weeks of stability. In the past changing my estrogen dose has required a change in my thyroid dose, too.

Do holidays increase bleeding or simply shed endometrial lining that you don't want building up anyway?

Do DHEA and pregnenolone need holidays, too?

Thanks,
Elaine


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 Posted 12/29/2013 9:52:31 AM
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hi Zork,

Replication of a youthful pattern of release is a common hormone recommendation. Blood tests can be done at the same point in a cycle.  If one is replicating a 28-day cycle, the three days of no hormones you describe aren't exactly what goes on in the body, as there is usually some estrogen and progesterone present (which could still be the case if your body is producing small amounts of the hormones), although there is a decline immediately prior to the initiation of menstruation. However, if you are not menstruating, there is room for innovation.  With estradiol patches, it is recommended to change the location within the recommended area (abdomen) with each patch to avoid saturation, so perhaps the hormone holidays avoid saturation as well.  Life Extension has not recommended holidays from DHEA and pregnenolone, but if you are curious, you could try discontinuing them for a few days and see if you can tolerate it and/or feel their effects more upon their resumption. 

Concerning your thyroid dose, your physician is the one to assist you with the fine-tuning it may require.  Regarding the bleeding you are asking about, are you saying that it is more than what normally occurs with you? 


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 Posted 1/1/2014 7:31:15 AM
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Regarding thyroid, my question was how to TEST it if you're taking hormone holidays every 4 weeks, since it takes 6 weeks for the thyroid to adjust to hormone changes and you're changing them every 4 weeks.

Regarding bleeding, I wasn't commenting on my situation (complicated), I'm just trying to figure out if holidays will change bleeding patterns.

Thanks,
Elaine
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 Posted 1/1/2014 8:41:28 AM
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Holidays could initiate or increase bleeding.  Estradiol withdrawal can cause it as can progesterone initiation or withdrawal.

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 Posted 2/10/2014 7:13:29 PM
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It's inappropriate to take hormone holidays. 

Female sex steroids are dosed so that you match the natural youthful cycle. Generally estradiol from days 5-15 and progesterone from about days 15 - 24. Depending on response, progesterone dosing (days and dose can be modified). This is not a holiday, it's attempting to match the natural cycle. 

Clinical data clearly shows that following this dosing schedule reduces aptosis (growth of cancer).  There is no advantage to taking these meds all month. 

The balance of the hormones should be taken constantly with the exception of thyroid that has a winter and summer dose for most patients. 
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 Posted 2/13/2014 9:48:03 AM
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Matching the youthful cycle is a great goal. It's always my first choice to keep things as natural as possible.

However, there are disadvantages that affect some women such as increased bleeding and mood swings. Few women with mood swings are going to want natural dosing if it worsens mood. Yes, there are other options to deal with mood swings, both medication and supplements, but it's not an easy problem to solve even when your hormones are stable. Declining estrogen is a powerful trigger for mood swings.

There's still no answer to the thyroid question. After any hormone dose change (especially thyroid or estrogen), you're supposed to wait 4-6 weeks, then blood test to make sure your thyroid levels are good. Someone who stops taking estrogen every 25 days may not be stable, so the blood test may not represent steady state. I suppose if you extend the cycle length from 28 to 32, you could test your thyroid at 4 weeks every time.

Elaine
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 Posted 3/4/2014 6:58:56 AM
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JimC wrote:

>> Clinical data clearly shows that following this dosing schedule reduces aptosis (growth of cancer).

I was unable to find studies supporting rhythmic dosing as opposed to static dosing.  Along the way, however,  I did find some negative reports about the Wiley Protocol .

Could you point me in the right direction?

My GYN said that bioidentical hormones for postmenopausal women slightly increase the risk of some cancers and reduce the risk of others.  She also says that dosing is just a matter of preference; since most women dislike the effects of hormone swings, she recommends static dosing.   If she's wrong, I'd like to know.

Thanks


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 Posted 5/4/2014 1:15:17 PM
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I have tried both methods of dosing.  I have severe symptoms of PMS one day after I stop taking estrogen and progesterone.  Being 62 years old and working a full time stressful job doesn't mesh well with mood swings, lack of sleep, severe hot flashes, low energy, and mental disfunction.

I've discussed this with my Dr. and she suggested that I use the static method.  This method works for me and I will continue as long as I'm working.

Anne
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 Posted 5/5/2014 4:15:57 AM
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Welcome to the Forums, horticultured.

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 Posted 5/5/2014 12:58:54 PM
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Zork,

If you are having symptoms associated with hormone therepy such as moodiness, irritability, etc, that is strong evidence that your dose of one or more hormones is incorrect.  There is no reason that you can't follow a natural hormonal cycle and be symptom free.

If your doctor is treating your lab form and not you, that may be part of the problem.  After the initial lab work, much of the dosing is based on your physical and mental symptoms and complaints.  Routine follow-up lab work is required to ensure there aren't gross deficiencies/excess.

Let me give you a quick example of what I mean. 
Women that have large breasts have high estradiol.  Women that don't have lower estradiol.  A woman that presents with large breasts and estrogen dominance will generally require more progesterone than a woman with smaller breasts.  You aren't going to be able to pick up this level of information from lab data.

As soon as an experience doc sees your silouette, he/she will already have clues to what your hormonal excesses and deficiencies are.  After a complete exam and history, there sholdn't be any suprises with the lab testing. 

Thyroid
Again, adjustments are not make based on a lab form, but on your symptoms.
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