almost out of estrogen
June 29, 2011 2:51 PM Subscribe
Can anyone recommend an estrogen product (cream or transdermal spray) I can buy online, without a prescription, to control hot flashes? It needs to provide the equivalent of the 3 mg estradiol that I'm currently getting from a prescription product.
I've been using a prescription estrogen product, Evamist, for a couple of years, mainly for control of hot flashes. It's a spray that's applied to the skin. It has no progesterone, only estrogen (a plant-derived estradiol). It works, I love it. But I'm about to run out; there are no more refills on the prescription, and I won't be able to get a new prescription for a while.
My rheumatologist and primary care doctor agree I should be taking the estrogen, but they won't prescribe it for me, because Gynecologists Prescribe Estrogen. I have a great gynecologist, but she won't give me another prescription over the phone because it's been almost 2 years since I've seen her. I already talked her into stretching this rule for me once, and I don't feel comfortable asking her again. I had an appointment to see her last week, which would have solved the problem nicely, but I was too sick to go. This is a chronic sick--I'm mostly stuck in the house for the near future. When I next get out, it'll be for higher priority medical appointments, so I'm not even trying to set up the gyno visit for a few weeks (months?).
I see that there are a bewildering array of OTC estrogen and estrogen-ish products available--I know I want one of them, but which one? Ideally, it would be a transdermal cream or spray, that would deliver a dose pretty reliably equivalent to the 3 mg estradiol that has been working for me.
Considerations to keep in mind:
no patches (allergic to adhesives);
no pills;
no progesterone--(no uterus, so no need for it);
must be something I can order online and have delivered pretty quickly (before I go up in flames);
doesn't necessarily have to be plant-based, though I'd prefer it;
no debate about the wisdom or not of taking estrogen--I've researched this in detail, and discussed it with my excellent doctors, and we all agree it's clearly a good choice for me, for now.
I've been using a prescription estrogen product, Evamist, for a couple of years, mainly for control of hot flashes. It's a spray that's applied to the skin. It has no progesterone, only estrogen (a plant-derived estradiol). It works, I love it. But I'm about to run out; there are no more refills on the prescription, and I won't be able to get a new prescription for a while.
My rheumatologist and primary care doctor agree I should be taking the estrogen, but they won't prescribe it for me, because Gynecologists Prescribe Estrogen. I have a great gynecologist, but she won't give me another prescription over the phone because it's been almost 2 years since I've seen her. I already talked her into stretching this rule for me once, and I don't feel comfortable asking her again. I had an appointment to see her last week, which would have solved the problem nicely, but I was too sick to go. This is a chronic sick--I'm mostly stuck in the house for the near future. When I next get out, it'll be for higher priority medical appointments, so I'm not even trying to set up the gyno visit for a few weeks (months?).
I see that there are a bewildering array of OTC estrogen and estrogen-ish products available--I know I want one of them, but which one? Ideally, it would be a transdermal cream or spray, that would deliver a dose pretty reliably equivalent to the 3 mg estradiol that has been working for me.
Considerations to keep in mind:
no patches (allergic to adhesives);
no pills;
no progesterone--(no uterus, so no need for it);
must be something I can order online and have delivered pretty quickly (before I go up in flames);
doesn't necessarily have to be plant-based, though I'd prefer it;
no debate about the wisdom or not of taking estrogen--I've researched this in detail, and discussed it with my excellent doctors, and we all agree it's clearly a good choice for me, for now.
Response by poster: Problem, is, see, I'm sick. I'm pretty good at being persistent and irritating and persuasive and all that, but it takes ENERGY. I ain't got none to spend (phone calls are especially taxing). If I had the energy it would take to track down my primary or rheum, and either change their mind or get them to talk to the gyn, I'd be in good enough shape to go back to work. And nope, I don't have someone who can do this for me, either. And I already did the "one month to tide me over" deal with the gyn; this is the next month. She already said, "please don't ask again."
The reluctance of the PCP and rheum to write this Rx seems to be based on not wanting to step on another doctor's toes, or not wanting to prescribe something they're not familiar with. Neither of them is against me taking it--in fact they support it--but they are unbudgingly convinced that it's someone else's job.
I'm not looking for a dubious substitute for a legitimate drug. There are lots of apparently genuine estrogen creams available OTC. I'm thinking that someone here must have had a decent experience with at least one of them.
posted by Corvid at 6:24 PM on June 29, 2011
The reluctance of the PCP and rheum to write this Rx seems to be based on not wanting to step on another doctor's toes, or not wanting to prescribe something they're not familiar with. Neither of them is against me taking it--in fact they support it--but they are unbudgingly convinced that it's someone else's job.
I'm not looking for a dubious substitute for a legitimate drug. There are lots of apparently genuine estrogen creams available OTC. I'm thinking that someone here must have had a decent experience with at least one of them.
posted by Corvid at 6:24 PM on June 29, 2011
There are lots of apparently genuine estrogen creams available OTC.
I'm on HRT, and have taken Estradiol before. The Evamist you are using has 17b Estradiol. I've taken various estrogens in pill, gel and patch form, and presently have a cream version I apply to my thigh.
Now, 17b Estradiol is approved by the FDA to treat menopausal symptoms. Over-the-counter "apparently genuine estrogen creams" are not. And there's very good reason for that: OTC creams contain phytoestrogens, and in clinical tests, phytoestrogens have NOT been effective for treating hot flashes. All estrogens are NOT the same.
I'm glad your Estramist works so well for you. But that does not mean that you can just substitute any estrogen source to take its place. There are currently 8 different kinds of estrogen approved by the FDA, like your Estradiol, and they're all different and carry different risks. For example, Equine-based estrogen (Premarin) is 78% much more likely to cause blood clots than esterified estrogen. And some estrogens are bioidentical and others are not, and it appears that the bioidentical versions may be better for long-term use, but even that is debated.
Also, all women are not the same. As you can see, I've gone through a lot of different forms of estrogen myself, delivered in various ways, to find what is best for me. And there are women in my immediate family who are also surgically post-menopausal, as I am, and yet the HRT that worked for them did not work at all for me, and vice versa.
So I know you are sick and looking for a way to just order something online, but if you already have serious health problems, this is NOT something you should be fooling around with. I'm afraid you are going to have to find some way to get to your gynecologist's office. If you have to make multiple appointments in the event that on any given day you might be sick, then maybe that's what you need to do.
I know you think they won't work with you at the Gyn office, but I think the problem is that, because you have not seen the Gyn for two years and you have other health issues, they don't want to just refill your Rx without making sure you can handle it. They are worried about covering their own asses. The office probably WILL be flexible on scheduling and canceling appointments because there's no downside for them there.
posted by misha at 9:17 PM on June 29, 2011 [2 favorites]
I'm on HRT, and have taken Estradiol before. The Evamist you are using has 17b Estradiol. I've taken various estrogens in pill, gel and patch form, and presently have a cream version I apply to my thigh.
Now, 17b Estradiol is approved by the FDA to treat menopausal symptoms. Over-the-counter "apparently genuine estrogen creams" are not. And there's very good reason for that: OTC creams contain phytoestrogens, and in clinical tests, phytoestrogens have NOT been effective for treating hot flashes. All estrogens are NOT the same.
I'm glad your Estramist works so well for you. But that does not mean that you can just substitute any estrogen source to take its place. There are currently 8 different kinds of estrogen approved by the FDA, like your Estradiol, and they're all different and carry different risks. For example, Equine-based estrogen (Premarin) is 78% much more likely to cause blood clots than esterified estrogen. And some estrogens are bioidentical and others are not, and it appears that the bioidentical versions may be better for long-term use, but even that is debated.
Also, all women are not the same. As you can see, I've gone through a lot of different forms of estrogen myself, delivered in various ways, to find what is best for me. And there are women in my immediate family who are also surgically post-menopausal, as I am, and yet the HRT that worked for them did not work at all for me, and vice versa.
So I know you are sick and looking for a way to just order something online, but if you already have serious health problems, this is NOT something you should be fooling around with. I'm afraid you are going to have to find some way to get to your gynecologist's office. If you have to make multiple appointments in the event that on any given day you might be sick, then maybe that's what you need to do.
I know you think they won't work with you at the Gyn office, but I think the problem is that, because you have not seen the Gyn for two years and you have other health issues, they don't want to just refill your Rx without making sure you can handle it. They are worried about covering their own asses. The office probably WILL be flexible on scheduling and canceling appointments because there's no downside for them there.
posted by misha at 9:17 PM on June 29, 2011 [2 favorites]
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Just to be clear: is this just a general postion they've taken in the past, or is it a specific "no, sorry, you can be on it but we won't help you get it, even under these particular circumstances" you've received recently? I ask because I've had other specialists put in prescriptions for my routine meds in a pinch, even if they're not the ones who general prescribe it (i.e., my oncologist put in a levoxyl and a percocet refill for me when both my endocrinologist and surgeon were out of town at the same time).
posted by scody at 4:04 PM on June 29, 2011