The answer to your question is .... depends on the patient. I would agree that subcue or transdermal delivery of estradiol is the ideal replacement, as that is what most closely represents the delivery from the ovary (estradiol) and fat (estrone). But for patients with dermatitis or irritation at the site of injection, oral estradiol is just fine. The WHI gave estrogen a false bad rap. The result was everybody and their momma jumping on the band wagon making all kinds of unsubstantiated claims. The transdermal and subcue folks went after the route .... the “bio-identical” hoax went after the source. The fact still remains .... estrogen is NOT some evil hormone as falsely advertized by special interest trying to make bank on their biases. As far as your choices .... I leave that up to you. But don’t do like an ignorant friend of mine who because her Aunt three times removed had breast cancer, refused estrogen for hot flashes ..... now she has vaginitis and osteoporosis. Mammograms do wonders for saving lives.
That was my original point....that the drug is more effectively and healthily delivered directly in to the blood stream as opposed to through the digestive system. I don't believe it's an evil hormone. There are others that can also help in some of those symptoms. Look, my mom took DES while pregnant with me so I've always been a high-risk patient in that regard. I do my research and I have an amazing doctor. I'm just not about taking a daily pill and pretending there are no consequences.
Just for discussions sake (because human health risk assessment is what I do ... Ph.D. And all), there are a lot of factors for each woman to consider. But oral is not bad. The first pass route in the liver just splits the conjugation that is used as a carrier. The estradiol from a pill is no different from the estradiol from any other route. Prempro got a bad rap because the stupid media wanted it to. To be fair, the newer low dose Prempro preps weren’t studied in the WHI, and as such, none of the risk from the tested high dose are applicable. But that won’t stop politically motivated players from mak8ng the false claims. I’m glad you have a good doctor, but my experience is they are not trained in risk assessment, and are just as likely to buy the hype as the next person .... and even more so, take the advice of their lawyers and avoid any risk of a law suite from a tainted jury that hates “Big Pharma”. To all those haters I say ... good for them ... do not take another Pharma product ever, and that includes the cheap generics (that were also created by the evil Pharma industry). People like to bash Pharma for higher prices, but they are ignorant of the fact that Big Insurance is the reason new meds cost so much. As far as consequences .... the consequence of doing anything is always weighed against the risk.
Generics: The drug store I get my Rx from recently went to a different brand of generic for my diabetes meds. Supposedly same, but my blood sugar went up over 50 points. Finally got back to what I had been taking for years, now, back down below 100. I know generics are supposed to be the same, and I clearly lack formal training in pharmaceuticals, but there was a BIG difference when they switched!
used to be it was who you are now not what you were that was important. You could rise above mistakes of your past. Now with twitter and liberals, you are noting but your past. You are the worst thing you ever did in your life.
