My Experience with Bioidentical Hormone Replacement Therapy (BHRT)
I get many questions about my experience with Bioidentical Hormone Replacement Therapy (BHRT). Is it right for everyone? Probably not. Was it right for me? Absolutely. I am not a medical expert and I don't understand all the workings of the human body. But, because I don't take my own medical procedures lightly, I have done research for myself before approaching my doctor and want to share what led me to investigate BHRT along with my experience afterwards.
What is Bioidentical Hormone Replacement Therapy (BHRT)?
When a person's hormone levels are unbalanced, hormone replacement therapy can be used to treat symptoms they may be experiencing. Hormones derived from plant estrogens that are biologically identical to the ones our body makes are called bioidentical hormones. I chose the cover photo because bioidentical hormones come from sweet potatoes! Here are a couple of websites you can view to get more information:
https://completemidlifewellnesscenter.com/
https://www.health.harvard.edu/newsweek/What-are-bioidentical-hormones.htm
My History
During my mid-thirties, my menstrual cycle was out of control. I was bleeding more days out of the month that not. My cramping was debilitating. I had no energy. I often felt lightheaded and dizzy, probably because of the amount of blood loss I was experiencing. I was miserable. Because I was either bleeding or having severe cramps or both, my sex life was nonexistent. There was an episode in particular that sent me to the ER. I was working out of town. When I wrapped up my meeting and started the one-hour trip home, I was having extremely painful cramps and felt very dizzy as I was driving. I had been bleeding heavily over the past several days. I pulled over on the side of the road before I fainted. When I came around, I called my husband and told him what was happening. He drove about 45 minutes to pick me up, then drove about an hour to take me to the ER. We sat in the waiting room for almost 5 hours before they called me back. The doctor ran some tests, then basically told me that there wasn't anything wrong with me. He told me to get some rest and take some Aleve. These episodes continued but I refused to go back to the ER to only be humiliated. I would call my OB/GYN when I couldn't take it anymore, but they couldn't get me in for a month or more. When I finally got to see her, she couldn't find anything wrong with me except for ovarian cysts. I was told that this was just part of being a woman. She removed my IUD and put me on birth control pills and prescribed Naproxen (which is Aleve) for the pain. When the pill didn't improve things, she began giving me Depo-Provera injections. After 6 months with no improvement, my OB/GYN thought it may be a good idea to look into getting a hysterectomy. So, at the age of 38, they took out my cervix and left my ovaries. The surgeon had to open me up during surgery because I had internal bleeding. I was not prepared for the amount of time it would take to recover from the surgery, emotionally or physically. Hormone replacement was not suggested because I still had my ovaries. Although I still get ovarian cysts and have to deal with that pain, at least I don't bleed all month long and have constant cramps. But, after turning 40, I had a whole new group of symptoms to deal with.
My Symptoms
I don't regret having the partial hysterectomy. It helped improve my life in many ways. But, as time has gone by, I have developed other symptoms that are unexplainable:
Extreme fatigue - I mean needing an afternoon nap every day.
Lack of energy - to exercise, to clean my house, to garden, etc.
Weight gain - that is near impossible to lose.
Low libido - I would go for months with no desire at all.
Vaginal dryness - when I would feel like it, it was often painful.
Mood changes - I might cry watching a commercial or get angry at the smallest things.
Urinary incontinence - if I sneezed or coughed or laughed, I needed to change my underwear. Or, when the urge to pee hit, I would have a matter of seconds to get to the toilet.
Frequent urinary tract infections - at least every couple of months.
Sleeplessness - I would wake up multiple times every night or have a difficult time falling asleep.
Body aches and pains - my back; my shin bones; my joints in my knees, elbows, and wrists. I even had what I thought was restless leg syndrome at night.
Loss of concentration and feelings of mental cloudiness - forgetting something I had just been thinking about, not remembering names of people I see regularly
Frequent headaches - not migraines, just nagging ones, at least every couple of weeks.
Anxiety and mild depression - I wrote a whole blog post about it. Read it here.
I told my OB/GYN at the time about my symptoms. He referred me to a psychiatrist who put me on Zoloft. It helped with the anxiety a touch, but everything else was the same or worse. I had just resigned to the fact that I would have to live with it for the rest of my live and I was most definitely crazy.
My Experience
In the meantime, we moved to a new city and I had my "I have hit rock bottom" stage. You can also read about it here. While lying in bed all day one day, I came across a You Tube video that inspired me to get up and not give up. Dominique Sachse is one of my favorite influencers to watch. She did an interview with a doctor from Houston named Dr. Susan titled "Over 40? Is it Menopause, Mental Health, Relationships, HRT, or Sexuality?" Let me tell you, it spoke directly to me! I thought, this is it. I have to do something about this. I can't continue to live my life this way! I had seen that the nurse practitioner at my primary care clinic specialized in women's health and sexual wellness. I called and made an appointment that day.
I had a few acquaintances who had hormone pellets. When they first told me about it, I was very leery even though they said how it changed their lives. I mean, it just seemed SO weird to have a small tube the size of a grain of rice with hormones in it inserted into the subcutaneous tissue of your backside. I thought, "there is no way in sam hell I am going to get that done." But, after watching Dominique's video and studying up on Dr. Susan's website, I began to be a little more openminded. Maybe it could help with my symptoms and it definitely wouldn't hurt to talk to a medical professional about it.
The day of my appointment, I was armed with some knowledge and a lot of questions. I went in and told Jamie, the nurse practitioner, all of my symptoms I had been experiencing. She listened to me and it felt so good. She didn't think I was crazy. In fact, she told me that she had experienced some of the same things I was going through and she thought she could help. She told me about the hormone pellet and what it did for her. That is why she was so passionate about helping other women going through the same thing. She explained what it was and the procedure for inserting it. She told me about the risks and how the FDA had not yet approved the procedure but all of the hormones in the pellet were FDA approved. She also told me about the additional benefits like how it could reduce my chances of getting heart disease, osteoporosis, colon cancer, and Alzheimer's Disease. Then she gave me a book to read explaining everything in detail. Jamie told me that she wanted me to have a complete panel of bloodwork done first so she could see if there were any underlying conditions I might have or if the hormone pellet would even help. She said she wanted to see that first and go over it with me before I made any decisions. I was totally wowed! She didn't think I was crazy! She actually listened to me, told me I wasn't alone, and that my quality of life could improve but wasn't pressuring me into doing anything! This was so different from what I was used to!
I got my blood drawn that day then went back a week later to hear the results. It showed I had low levels of testosterone and Vitamin D. I had not gone through menopause yet, but she felt I was in perimenopause. My thyroid levels were also low. Other than that, everything looked good - no underlying causes. Jamie told me that she thought the hormone pellet would help. She told me to think about it and, if I decided to try it, to call back and make an appointment. I asked her if she had time to do it that day. She asked if I was sure. I said yes and she made time. She also prescribed a hypothyroid medication and put me on 10,000 mg of the vitamin ADK and an estrogen blocker.
The insertion was not bad. The worst part of it was the lidocaine shot used to numb the site and it wasn't bad. I didn't feel anything else. Jamie put a steri-strip and bandage over the incision and told me to take some Tylenol if I needed it when the lidocaine wore off. I had to leave the bandage on for 24 hours and not get the site wet for 48 hours. It was easy and worth every bit of mild discomfort I had. Jamie said that I would probably start noticing a difference in how I felt in about 10 days. It only took 7.
The first thing I began to notice was I no longer felt so fatigued. I no longer feel like I need a nap at 3:30 in the afternoon. Then I noticed that I was doing more - like cleaning the house, planting a garden, and walking the dog. I have energy! The next thing was my libido. My husband and I are acting like we did in our first year of marriage before having kids! And, it is usually me that is initiating it! No issues with dryness or pain. I also feel like I am more focused at work. I am checking everything off my to-do list by the end of the day. I have also noticed that my back and shin bones aren't aching anymore. I have had two headaches but they were both mild. I chalk them up to seasonal allergies. I no longer feel depressed and my anxiety is significantly less. I am off the Zoloft! There are also a few symptoms that I am still experiencing. I am working on losing the weight I have gained, but it is coming off slowly. I still wake up during the night and often feel like I am not getting a good night's sleep. And, although I haven't had a UTI in a long time, I still better find a bathroom when the urge to pee hits!
I am on my second round of Bioidentical Hormone Pellets (you usually need a new one every 4 to 6 months). I understand why I was leery before, but like my acquaintances that had it done, this has changed my life for the better. I did not give up. I became my own advocate. I educated myself. And, it paid off. I feel better than I have in a long, long time! If you are experiencing some of the same symptoms that I was and don't know what to do, please talk to your doctor. Do your own research. Ultimately, it may not be for you, but it never hurts to learn more. You deserve to feel normal. You are not crazy. You can get relief. Never give up or give in when it comes to your health!