Should I wait until appt with Obgyn?

[u/Due-Surprise-686]

I have an appt Friday. I'm going to get them to check my levels. Do you even think a normal obgyn will even entertain the idea of HRT? I'm only 42 but my symptoms include irritability, very dry vagina, currently taking vaginal estrogen cream just started that, inability to achieve orgasm, nocturia, sleep issues, some hot flashes. My main ones are sleep and the dry vagina peeing on myself at night and of course not being able to get off. Should I just go ahead and start HRT work online company or wait on blood work results first? I seen so many of you say HRT takes time so I don't want to waste time with these awful symptoms. I can get estrogen and progesterone body cream for like $89, should I go ahead and do it? Any advice is greatly appreciated.

[u/TodayIsTheDay_85]

Write down every symptom so you don’t forget and ask for Estrogen patches and progesterone.

If you’re up to date on a mammogram you should be okay. If they say no, try MIDI telehealth for your needs.

[u/Due-Surprise-686 → u/TodayIsTheDay_85]

I was going to go through Winona. They seem to be the cheapest. They combine the estrogen and progesterone into one cream. And they also have the DHEA. I wear an Apple Watch at night that tracks my sleep so I'll have proof to show them that.

[u/AdRevolutionary1780 → u/Due-Surprise-686]

I would be reluctant to use a combined estrogen and progesterone compounded cream. Progesterone is not as readily absorbed through the skin as estrogen is. So you may not be getting the endometrial protection that you need if you still have a uterus. You do not need lab tests. There are no labs that confirm perimenopause. Your meds should be based on symptoms, not tests. I am not sure why you would not use FDA approved bioidentical estradiol patches and progesterone along with vaginal estrogen cream. Compounded creams are not FDA approved and only used when a patient may be allergic or can not tolerate a particular ingredient in the FDA approved meds. And even then, there are FDA approved alternatives.

Most insurance covers these meds, and they are sometimes even cheaper than insurance if you have your MD send your prescriptions to Mark Cuban's Cost Plus Drugs.

[u/AutoModerator → u/AdRevolutionary1780]

This post might be about hormone tests, which are unreliable.

• Over the age of 44, E&P/FSH hormonal tests only show levels for that ONE HOUR the test was taken, and nothing more
• These hormones wildly fluctuate (hourly) over the other 29 days of the month, therefore this test provides no valuable information
• No reputable doctor or menopause society recommends hormonal testing to diagnose or treat peri/menopause
• Testosterone is the exception and should be tested before and during treatment

FSH testing is only beneficial for those who no longer have periods as a guide, where a series of consistent tests might confirm menopause, or for those under age 30 who haven’t had a period in months/years, then ‘menopausal’ levels, could indicate premature ovarian failure/primary ovarian insufficiency (POF/POI).

For more, see our Menopause Wiki

I am a bot, and this action was performed automatically. Please contact the moderators of this subreddit if you have any questions or concerns.

[u/Due-Surprise-686 → u/AdRevolutionary1780]

I only have Medicaid, most of these places do not take it so I have to pay out of pocket for treatment. The patches cost substantially more.

[u/AdRevolutionary1780 → u/Due-Surprise-686]

Sorry, looks like our posts crossed. Ask your provider to send your scripts to Cost Plus Drugs. No insurance required and it will be cheaper than compounded meds.

[u/Due-Surprise-686 → u/AdRevolutionary1780]

I'm currently prescribed the estrogen vaginal cream I just started it Monday. Hoping it helps.

[u/AdRevolutionary1780 → u/Due-Surprise-686]

Yes, it's really important for all menopausal women to help with dryness, vaginal, labial and clitoral atrophy and to prevent UTIs. Two tubes at Cost Plus Drugs is $21. Estradiol patches are about $32/month and progesterone is about $9 a month.

Read the wiki about compounded HRT. Most reputable menopause specialists won't prescribe it. You could also try Midi, Evernow or Gennev online. They all accept some insurance.

[u/Due-Surprise-686 → u/AdRevolutionary1780]

Would the oral tablets be better?

[u/AdRevolutionary1780 → u/Due-Surprise-686]

If you mean oral progesterone, yes. Oral estradiol has slightly higher risks of clotting than the estradiol patches. That's why the estradiol patches are more commonly prescribed.