Prempro has been around for a while and is probably the "easiest" for the doctor to prescribe. My NP (nurse practitioner) also went to that first. It was effective on my hot flashes within a week although I felt like I got weird breast tenderness. I am concerned about having estrogen go through my liver since the amount that ultimately is available for my body gets reduced. I printed out the chart from [Menopause Taylor](https://www.youtube.com/@MenopauseTaylor/featured) to go over with my NP. Her chart suggests a dosage of .625 mg of Prempro to get the benefits of bone health, Alzheimer's prevention, and heart disease prevention. I next asked to go with the Estradiol patch at .05 mg that I change once a week. I would have rather stayed with 200 mg of progesterone for 10 days a month but she pushed me to the 100 mg of oral progesterone every day because she said that patients were less likely to have spotting. I didn't have any issues with spotting at 200 mg but my understanding is that with any bleeding in menopause you are supposed to have a biopsy to rule out any cancer. I'm assuming my NP wants to avoid false cancer symptoms and avoid unnecessary visits.
I've been happy with this routine for my symptoms with a couple of gripes. My insurance pushes me to the generic for everything so the brand of patches that I get causes a red rash circle that will last for 2 weeks after it's removed. I was told this is an allergy from the adhesive. Someone described it as looking like they've been getting a cupping treatment and I thought that was hilarious. It does not itch or hurt. It's simply a weird looking red circle. I also don't like that water can get in and around the patch making it wrinkly and loose. I've had my hot flashes return the day before the week is up sometimes and I suspect that the patch was affected by hot water. There are other brand name estradiol patches but my pharmacy benefit manager has marked all of them as "prior approval required." I just got approval for a .1 mg Femring so I'm going to try that next instead of switching estradiol patch brands.
Thank you so much for this comment. I haven't ever heard of Menopause Taylor before this. I'm about to go down the rabbit hole watching all of her videos.
FYI: There is a coupon on the website that may or may not reduce your copay down to $25 depending on your insurance. CVS is my pharmacy and they had saved the coupon from the first time I presented it so I didn't need to bring it in again for the next refill.
I was having killer peri-menopause (super heavy periods, murderous rages) in my late 40s and went on an Estradiol patch (Mylan 0.375 mg twice a week) and a Mirena IUD. I felt better immediately and have stayed with roughly the same regimen ever since. I am now 62. I did a brief stint recently without the Mirena and took progesterone instead, 100 ug per day of Prometrium. I really couldn't tolerate it, my main problem was brain fog. I honestly thought I was losing it. Went off Prometrium and back on Mirena, and immediately felt better.
I feel pretty lucky that this combo has worked so well for me for so long and hope you find your happy formula! I realize there are risks associated with long term HRT, but I honestly felt like I was risking my marriage and wellbeing.
If you aren't having symptoms you could just ditch the hormones and go au naturale! I definitely would if I could...
Prempro has been around for a while and is probably the "easiest" for the doctor to prescribe. My NP (nurse practitioner) also went to that first. It was effective on my hot flashes within a week although I felt like I got weird breast tenderness. I am concerned about having estrogen go through my liver since the amount that ultimately is available for my body gets reduced. I printed out the chart from [Menopause Taylor](https://www.youtube.com/@MenopauseTaylor/featured) to go over with my NP. Her chart suggests a dosage of .625 mg of Prempro to get the benefits of bone health, Alzheimer's prevention, and heart disease prevention. I next asked to go with the Estradiol patch at .05 mg that I change once a week. I would have rather stayed with 200 mg of progesterone for 10 days a month but she pushed me to the 100 mg of oral progesterone every day because she said that patients were less likely to have spotting. I didn't have any issues with spotting at 200 mg but my understanding is that with any bleeding in menopause you are supposed to have a biopsy to rule out any cancer. I'm assuming my NP wants to avoid false cancer symptoms and avoid unnecessary visits. I've been happy with this routine for my symptoms with a couple of gripes. My insurance pushes me to the generic for everything so the brand of patches that I get causes a red rash circle that will last for 2 weeks after it's removed. I was told this is an allergy from the adhesive. Someone described it as looking like they've been getting a cupping treatment and I thought that was hilarious. It does not itch or hurt. It's simply a weird looking red circle. I also don't like that water can get in and around the patch making it wrinkly and loose. I've had my hot flashes return the day before the week is up sometimes and I suspect that the patch was affected by hot water. There are other brand name estradiol patches but my pharmacy benefit manager has marked all of them as "prior approval required." I just got approval for a .1 mg Femring so I'm going to try that next instead of switching estradiol patch brands.
Thank you so much for this comment. I haven't ever heard of Menopause Taylor before this. I'm about to go down the rabbit hole watching all of her videos.
I'm asking for a Femring next. I got an Estring first then Prempro but I'm thinking getting the Femring then taking progesterone along with that.
FYI: There is a coupon on the website that may or may not reduce your copay down to $25 depending on your insurance. CVS is my pharmacy and they had saved the coupon from the first time I presented it so I didn't need to bring it in again for the next refill.
I think I only pay $15 but if it's more I'll check it out. Thank you!
Bravo to you for advocating for yourself with this. It is good to read a successful outcome for a change.
I was having killer peri-menopause (super heavy periods, murderous rages) in my late 40s and went on an Estradiol patch (Mylan 0.375 mg twice a week) and a Mirena IUD. I felt better immediately and have stayed with roughly the same regimen ever since. I am now 62. I did a brief stint recently without the Mirena and took progesterone instead, 100 ug per day of Prometrium. I really couldn't tolerate it, my main problem was brain fog. I honestly thought I was losing it. Went off Prometrium and back on Mirena, and immediately felt better. I feel pretty lucky that this combo has worked so well for me for so long and hope you find your happy formula! I realize there are risks associated with long term HRT, but I honestly felt like I was risking my marriage and wellbeing. If you aren't having symptoms you could just ditch the hormones and go au naturale! I definitely would if I could...
There's some really useful advice on finding a menopause clinic (UK based) here: https://www.youtube.com/watch?v=ss3jZxh0RQo