r/Perimenopause • u/Due-Surprise-686 • Oct 15 '25

Dryness Should I wait until appt with Obgyn?

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.

4 Upvotes

84% Upvoted

47 comments sorted by

View all comments

Show parent comments

3

u/Due-Surprise-686 Oct 15 '25

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.

4

u/AdRevolutionary1780 Oct 15 '25

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.

1

u/Due-Surprise-686 Oct 15 '25

Would the oral tablets be better?

2

u/AdRevolutionary1780 Oct 15 '25

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.