[quote]Wileykit wrote:
Thankyou for the links but they all apply to HRT given to postmenopause women - i’m 33 and it’s different for women who are menstruating. The cancer risk is real, doctors may make mistakes and be uninformed sometimes, but you can tell when they are talking sense…[/quote]
When I was 39 and menstruating when they shut down my pituitary and said I was going to become peri menopausal. In reality, my estrogen levels dropped to those of a post menopausal woman. I then had to be treated as a post menopausal woman even though I was not at post menopausal age I had the symptoms of low estrogen in post menopausal women and the risks for cancer were just as real.
If I have abnormally low levels of estrogen then I have something in common with post menopausal women.
If estrogen alone has been used to treat women with low estrogen and low progesterone due to menopause - and post menopausal women are even at greater risk of cancer than me due to:
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An already life time exposure to estrogen, and;
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Low declining levels of progesterone
then common sense tells me I am in a better position to sustain a small dose of estradiol treatment to compensate for my abnormally low levels given that sufficient levels of progesterone are naturally produced by my system.
My second observation is:
The birth control pill is carcinogenic.
Yet that does not prevent doctors from freely prescribing it to children from the age of 12, knowing she will likely mature into a woman having a long history of using it.
Why do you think that is?
I asked my husband to add something because he is a medicinal chemist very familiar with hormones and I had discussed this with him:
Of course if a person considers that if there is any risk to taking estradiol then they don’t want to do it, that’s a personal position that clearly a person can have.
It’s quite different however to say that something cannot be done or should not (for others) be done, such as administering estradiol without progesterone according to the individual case, out of citing cancer risk as if that proves the matter.
Estradiol at any time, including naturally-produced estradiol, has cancer risk for at least some women. We know how to obliterate estradiol levels in women by administration of, for example, letrozole, and can essentially eliminate this cancer risk. In some cases this is actually done, according to the individual case, because for that individual the risk is so high that doing so is worth the cost. But in general it is not done, because the benefit of natural estradiol levels is considered to be worth the associated risk. It is not so simple as, estradiol is carcinogenic, therefore it must be taken in conjunction with a progestin. Which incidentally does not eliminate or even drastically change the cancer risk.
It may be the case, I do not know, that in the UK estradiol will not be prescribed at all, or not without a progestin. If so then a doctor cannot be gotten to do it and it is a moot point anyway. If so, it would be example of banning something without substantiated reason. In the US it can be done and is done.
As to the studies AlphaF cited being cases of postmenopausal women and women with ovaries removed, there is good reason that that is who the studies are on. The reason for prescribing estradiol or any estrogen, other than for birth control, is going to be because estradiol levels are abnormally low. Where this is an area of broad clinical importance is for the postmenopausal woman and for the woman whose ovaries have been removed. It’s relatively rare for a woman outside of those conditions to have for abnormally low estradiol levels AND have concurrently normal progesterone AND be unwilling to use birth control pills, and those women are most likely not really an area of interest to doctors or of much interest for grant money to be awarded. Grant money goes to areas of interest according to a number of factors. Application of a generic drug to a problem of not much interest to doctors is not something that is easy to get grant money for, if at all. I wouldn’t expect such a study any time soon if ever.
Do the studies, however, answer what happens when providing estradiol alone, without a progestin, and answer the question as to whether it can be done and is done? Yes. No problem found.
A person could argue though, “Well, maybe there is something about being that old, or having had the ovaries removed, that makes it safe for them to have normal-range estradiol levels that are provided by taking estradiol orally, but if the woman [/i]hasn’t[/i] reached that age or still has her ovaries and gets to those same levels, this doesn’t prove it’s not dangerous for her! There could be a reason!”
Well, if not wanting to take estradiol to get to normal levels on the basis of “there could be,” without having a substantiated reason, then that’s a personal decision and a judgment call.
But we might consider where the burden of evidence should be. And what is it that constitutes common sense and what doesn’t? That’s not always so clear-cut and two different people may not agree on what is “common sense” and what isn’t.
Let’s say for example that a doctor asserts that the same, normal-range estradiol levels with the same normal-range progesterone levels are safe enough if gotten either from natural entirely production or by taking both an estrogen and progestin, but risking cancer if gotten by having the same good natural progesterone levels already and taking only estradiol to bring that level up to normal.
I personally would say that the burden would be on the doctor to support such a claim. Some evidence of some kind would be called for, or at the very least, some physiological or biochemical rationale that was in accord with at least one known fact. But if someone finds the doctor’s assertion to be common sense even without any such thing, well okay, that can be their decision then. But is it a fact that it’s common sense? Actually it’s a completely unsupported argument.
And i get tired from exercise easily so prefer yoga and swimming as they are more relaxing! Have started playing badminton again too tho 
The tories are really fucking up the NHS here right now. I just argue til i get what i want tho… my health is important to me… thats why i question everything…
And he also failed to mention the wheat allergy test which i’d discussed with him (in letter to my gp). Plus he kept going on about my hayfever (which was irrelevant) and made no sense at all. Sometimes i wish i’d studied medicine! Still you have to laugh… i’m going to ring up and ask him to re-do his letter properly 