Hullo Ladies

Looking for a good OBGYN doctor - prefer female - in Bangkok or Pattaya. Wonder if anyone can recommend one?

I must be due for the menopause soon, and would be really interested in opinions on HRT. Read good and bad things about it. How did it effect you? Is "horse" estrogen better than chemical estrogen?

Noticed my hair thinning slightly and skin drying a little but since I had exceptionally thick hair and greasy skin, I dont mind ! Seem to remember reading that these are (just some) of the symptoms. Would HRT reverse these symptoms anyway?

Did anyone go off sex ? Someone told me this was another possible symptom.

Really interested in any comments/advice/information and thanks in advance.

The missus went in her menopause about 2 yrs ago.

She got the cold/hot flashes which was a pain in the ass cause at night I had to get outta bed several times to turn on the ac/turn off the ac, turn on the ac etc.

Other than that she seems to be allright; I think out in the farm they've never heard about HRT and whatever and just take things as they are though the doctor did recommend that she should drink a glass of milk daily to prevent bone thinning or something.

Sex is ok; it takes a bit longer and more mouthwork and such but the river still flows and unlike in the past I'm dead tired after the first round.

I wouldn't recommend HRT, there is a strong connection between it and increased risk of breast cancer.

My mother researched alot of natural methods of dealing with menopause. Try eating alot of soy products, tofu etc, it will help. Try Google, I am sure you will find alot of information on natural methods of handling menopause.

Hullo Ladies

Looking for a good OBGYN doctor - prefer female - in Bangkok or Pattaya.  Wonder if anyone can recommend one?

I must be due for the menopause soon, and would be really interested in opinions on HRT.  Read good and bad things about it.  How did it effect you? Is "horse" estrogen better than chemical estrogen?

Noticed my hair thinning slightly and skin drying a little but since I had exceptionally thick hair and greasy skin, I dont mind !  Seem to remember reading that these are (just some) of the symptoms. Would HRT reverse these symptoms anyway?

Did anyone go off sex ? Someone told me this was another possible symptom.

Really interested in any comments/advice/information and thanks in advance.

<{POST_SNAPBACK}>

I have been menopausal for the past six years. I've been through hel_l. Hot flushes, sweats, itchy skin, mood swings, depression and ten kilo weight gain. I think the sweats and the weight gain have been the worst of all. I would sweat continually for hours. It became an embarresment when I was out in public. As far as the weight goes it didn't matter how much I dieted and exercised the weight continued to pile on.

I finally went on Hrt and within three days the sweats, mood swings, itchiness disappeared. The weight is now slowly starting to come off. Before Hrt I had tried many natural remedies for menopause and nothing worked. Hrt has been my saviour.

From UK Cancer Research

HRT and breast cancer: results of the Million Women Study

Release date: 8 August 2003

SOME kinds of hormone replacement therapy (HRT) have a much greater effect on a woman's risk of breast cancer than others, according to landmark research published in the Lancet this Saturday (August 9).

The Million Women Study, funded by Cancer Research UK, the NHS Breast Screening Programme and the Medical Research Council, confirms that current and recent use of HRT increases a woman's chance of developing breast cancer and that the risk goes up with duration of use.

Current users of all types of HRT, including oestrogen-only, combined oestrogen-progestagen and tibolone, are at increased risk of breast cancer compared with women who have never used HRT. But the risk is substantially greater for users of combined preparations of HRT than for women on the other types.

Scientists at the Cancer Research UK Epidemiology Unit in Oxford analysed data from over one million women between the ages of 50 and 64. Women joined the study between 1996 and 2001 and half were using HRT or had done so in the past. The study included 9,364 cases of invasive breast cancer and 637 breast cancer deaths, registered over 2.6 and 4.1 years of follow-up respectively.

Researchers found that post-menopausal women using combination HRT were twice as likely to develop breast cancer as non users (a 100 per cent increase), while risk increased by 45 per cent among users of tibolone and by 30 per cent among users of oestrogen-only HRT. These effects were shown to wear off within a few years of ceasing use.

In developed countries, among 1,000 postmenopausal women who do not use HRT, there will be about 20 breast cancer cases between the ages of 50 and 60.

For every thousand postmenopausal women who begin 10 years of HRT use at age 50, there will be five extra cases of breast cancer among users of oestrogen-only HRT and 19 among users of oestrogen-progestagen combinations. So combined HRT causes four times as many extra breast cancers as oestrogen-only.

The study also found that current users have a 22 per cent increased risk of death from breast cancer compared with women who have never used HRT, although the result was of borderline statistical significance. It is too early to estimate the number of extra deaths associated with HRT use.

Lead author Professor Valerie Beral, Director of the Cancer Research UK Epidemiology Unit, says: "We estimate that over the past decade use of HRT by UK women aged 50-64 has resulted in an extra 20,000 breast cancers, oestrogen-progestagen therapy accounting for 15,000 of these.

"Combined oestrogen-progestagen HRT is usually prescribed for women who still have a uterus, to avoid the increased risk of cancer of the uterus caused by oestrogen-only therapy.

"Since our results show a substantially greater increase in breast cancer with combined HRT, women need to weigh the increased risk of breast cancer caused by the addition of progestagen against the lowered risk of uterine cancer.

Comparing the risks is by no means simple, and women may well want to discuss options with their doctor."

Julietta Patnick, Director of the NHS Cancer Screening Programmes, says: "Women often ask us about the factors that can influence the risk of developing breast cancer, and we worked with the study team to initiate the Million Women Study to help find answers to such questions.

"Through NHS Breast Screening Units, over a million women were recruited to the Million Women Study, making it the largest ever study on the factors that can influence women's risk of breast cancer.

"I would like to thank the 66 Breast Screening Units and the women who took part in this study. I hope that the results will help provide women with the information they need to make an informed choice about use of HRT."

Dr John Toy, Medical Director of Cancer Research UK, says: "Previous reports have indicated that breast cancer risk increases in women taking HRT and this vast new study, the largest ever conducted, has allowed accurate assessment of the size of the effect.

"On a national scale, with so many women taking HRT, the number of extra cases of breast cancer has been quite large, but the increased risk does start to fall on stopping treatment.

"It would be sensible for a woman to take HRT for only as long as it is necessary to deal with her medical problems as advised by her doctor. A woman wanting to take HRT for a long time would be extremely wise first to consider carefully the findings of this large study and other relevant research."

My mother was diagnosed with breast cancer while on HRT after having a radical hysterectomy. Her doctor took her off the hormones immediately. She went from normal hormonal levels to zero in one day and had to learn how to deal with her symptoms without the use of HRT. I, for one, will never use HRT when I become menopausal. Its certainly your choice to use it but that doesn't really mean that it is appropriate for others. If you have a history of cancer and breast cancer in your family then I would avoid it entirely.

So sorry to hear about your mum, SBK, I can only begin to imagine what she, and you, must have gone through. I fully appreciate how this alone would make you feel re HRT.

My mum died of smoking related problems and because of my constant exposure to cigarette smoke I do get breathing / respiratory problems. And I have never ever smoked in my life - not one puff!

The info you provided from the clinical trial data is fascinating. I have put a copy in a new folder of info which will help me decide ultimately what to do regarding HRT.

The previous lady in the thread who explained her symptoms alsohas my sympathy, I too have the dreadful itching. From what I have gleaned so far, it is apparently a rather rare symptom of menopause, but with me it is so bad that I draw blood regularly. Feels like something burrowing into ones skin. The sweats sound particularly bad, thankfully, I don't have them - yet ! The insomnia is by far the worst, second must be itching.,

What it boils down to, it seems to me, is, it depends how much risk one is willing to take. And how adversely the symptoms of menopause effect ones life. Certainly it would depend also upon how those nearest and dearest are effected by the symptoms. I can imagine the mood swings, depression and night sweats causing discord.

Quite agree, if there is any breast cancer in the family, I would rule it out instantly. There isn't, thank God. I do know someone who has been on it for more than 15 years - she swears by it. And is youthful and lively still!

There are so many types of HRT, having done a little research now, it is daunting. I will continue - and thank you so much to those who responded.

From UK Cancer Research

HRT and breast cancer: results of the Million Women Study

Release date: 8 August 2003

SOME kinds of hormone replacement therapy (HRT) have a much greater effect on a woman's risk of breast cancer than others, according to landmark research published in the Lancet this Saturday (August 9).

The Million Women Study, funded by Cancer Research UK, the NHS Breast Screening Programme and the Medical Research Council, confirms that current and recent use of HRT increases a woman's chance of developing breast cancer and that the risk goes up with duration of use.

Current users of all types of HRT, including oestrogen-only, combined oestrogen-progestagen and tibolone, are at increased risk of breast cancer compared with women who have never used HRT. But the risk is substantially greater for users of combined preparations of HRT than for women on the other types.

Scientists at the Cancer Research UK Epidemiology Unit in Oxford analysed data from over one million women between the ages of 50 and 64. Women joined the study between 1996 and 2001 and half were using HRT or had done so in the past. The study included 9,364 cases of invasive breast cancer and 637 breast cancer deaths, registered over 2.6 and 4.1 years of follow-up respectively.

Researchers found that post-menopausal women using combination HRT were twice as likely to develop breast cancer as non users (a 100 per cent increase), while risk increased by 45 per cent among users of tibolone and by 30 per cent among users of oestrogen-only HRT. These effects were shown to wear off within a few years of ceasing use.

In developed countries, among 1,000 postmenopausal women who do not use HRT, there will be about 20 breast cancer cases between the ages of 50 and 60.

For every thousand postmenopausal women who begin 10 years of HRT use at age 50, there will be five extra cases of breast cancer among users of oestrogen-only HRT and 19 among users of oestrogen-progestagen combinations. So combined HRT causes four times as many extra breast cancers as oestrogen-only.

The study also found that current users have a 22 per cent increased risk of death from breast cancer compared with women who have never used HRT, although the result was of borderline statistical significance. It is too early to estimate the number of extra deaths associated with HRT use.

Lead author Professor Valerie Beral, Director of the Cancer Research UK Epidemiology Unit, says: "We estimate that over the past decade use of HRT by UK women aged 50-64 has resulted in an extra 20,000 breast cancers, oestrogen-progestagen therapy accounting for 15,000 of these.

"Combined oestrogen-progestagen HRT is usually prescribed for women who still have a uterus, to avoid the increased risk of cancer of the uterus caused by oestrogen-only therapy.

"Since our results show a substantially greater increase in breast cancer with combined HRT, women need to weigh the increased risk of breast cancer caused by the addition of progestagen against the lowered risk of uterine cancer.

Comparing the risks is by no means simple, and women may well want to discuss options with their doctor."

Julietta Patnick, Director of the NHS Cancer Screening Programmes, says: "Women often ask us about the factors that can influence the risk of developing breast cancer, and we worked with the study team to initiate the Million Women Study to help find answers to such questions.

"Through NHS Breast Screening Units, over a million women were recruited to the Million Women Study, making it the largest ever study on the factors that can influence women's risk of breast cancer.

"I would like to thank the 66 Breast Screening Units and the women who took part in this study. I hope that the results will help provide women with the information they need to make an informed choice about use of HRT."

Dr John Toy, Medical Director of Cancer Research UK, says: "Previous reports have indicated that breast cancer risk increases in women taking HRT and this vast new study, the largest ever conducted, has allowed accurate assessment of the size of the effect.

"On a national scale, with so many women taking HRT, the number of extra cases of breast cancer has been quite large, but the increased risk does start to fall on stopping treatment.

"It would be sensible for a woman to take HRT for only as long as it is necessary to deal with her medical problems as advised by her doctor. A woman wanting to take HRT for a long time would be extremely wise first to consider carefully the findings of this large study and other relevant research."

My mother was diagnosed with breast cancer while on HRT after having a radical hysterectomy. Her doctor took her off the hormones immediately. She went from normal hormonal levels to zero in one day and had to learn how to deal with her symptoms without the use of HRT. I, for one, will never use HRT when I become menopausal. Its certainly your choice to use it but that doesn't really mean that it is appropriate for others. If you have a history of cancer and breast cancer in your family then I would avoid it entirely.

<{POST_SNAPBACK}>

try antihistamines for the itching, I also get it (although not menopausal I do have a hormone imbalance - see the previous thread about contraception) & I am prone to severe itching in the nighttime, esp. if I get too hot.

I guess I'm menopausal. It's sort of hard to tell. I had a simple hysterectomy years ago, which left me with intact ovaries and hormones, but no obvious way of noticing I am menopusal.

I have had warm, as opposed to hot, flashes. I get uncomfortably warm, and the back of my neck will perspire, but that's all. I have always had incredibly dry, itchy skin so no change there. No mood swings, no depression, no irritability; but then I have always been extremely even in mood, no PMS or anything. I have the insomnia, for sure.

Can we just not talk about the weight gain? I'd go on HRT just to get rid of the weight, as it's a more immediate risk to my health than breast cancer. In fact, I might do that when I get to Thailand.

I guess I'm menopausal. It's sort of hard to tell.   I had a simple hysterectomy years ago, which left me with intact ovaries and hormones, but no obvious way of noticing I am menopusal.   

I have had warm, as opposed to hot, flashes. I get uncomfortably warm, and the back of my neck will perspire, but that's all. I have always had incredibly dry, itchy skin so no change there. No mood swings, no depression, no irritability; but then I have always been extremely even in mood, no PMS or anything. I have the insomnia, for sure.

Can we just not talk about the weight gain? I'd go on HRT just to get rid of the weight, as it's a more immediate risk to my health than breast cancer. In fact, I might do that when I get to Thailand. 

<{POST_SNAPBACK}>

Hi Cathy

Thanks for your reply. I believe that it is possible to determine if one is "pre-menopausal" by an apparently simple blood test to assess hormone levels. You would probably have to know at what stage in your cycle you are, or maybe not?

I intend to get this test, once I have located an OB/GYN in Bangkok.

As to weight gain, I too am putting on lots, mostly around the middle, which is apparently one of the worst places. Seems impossible to shift, but given the links with HRT and b/c it seems drastic. But agree, the health risks of weight gain seem more immediate. Smacks of the devil and the deep blue sea!

Wonder if you are relocating here or spend part time stateside and part in Thailand. What a great combination that would be.

,

Thanks for your reply. I believe that it is possible to determine if one is "pre-menopausal" by an apparently simple blood test to assess hormone levels.  You would probably have to know at what stage in your cycle you are, or maybe not?

As to weight gain, I too am putting on lots, mostly around the middle, which is apparently one of the worst places. 

Wonder if you are relocating here or spend part time stateside and part in Thailand. What a great combination that would be.

Yes, they need to know where in your cycle you are to determine if your hormone levels are normal or not, since the hormones fluctuate so much during the month!

My weight around the middle has given me high blood pressure and triggered type 2 diabetes...which caused a lot more more weight gain. So for me, the health concerns aren't just theoretical.

I will be returning to Thailand to live permanently in the late spring. I do hope to meet you once I am there! I will be living in Korat, but I anticipate trips to Bangkok every month or two. I can't wait to get back to my Thai home and neighbors.

I go to Dr Anong Lekagul at Bumrungrad Hospital. I find her very easy to talk with as she has a down to earth manner about her and you can even joke with her.

I am 46 so probably already in at least the pre-men state if not full blown. My older sister said she went through it for 10 years before it was over. I get some night hot flashes, very very irregular cycles. I have had some weight gain ( a couple of kilos) but thats hard to say where it came from as I just went through radioactive iodine treatment for an over active thyroid.

Haven't really considered taking anything that just isn't my style. I feel I know my body well and anything that changes my hormones has always bothered me. I guess I feel if it is a natural course of change I will adapt and get to know that too. Who's knows we will see as time progresses.

My mother and older sister both had no decreased sex drive so I am not expecting it. (That would be horrible)

I guess I'm menopausal. It's sort of hard to tell.   I had a simple hysterectomy years ago, which left me with intact ovaries and hormones, but no obvious way of noticing I am menopusal.   

I have had warm, as opposed to hot, flashes. I get uncomfortably warm, and the back of my neck will perspire, but that's all. I have always had incredibly dry, itchy skin so no change there. No mood swings, no depression, no irritability; but then I have always been extremely even in mood, no PMS or anything. I have the insomnia, for sure.

Can we just not talk about the weight gain? I'd go on HRT just to get rid of the weight, as it's a more immediate risk to my health than breast cancer. In fact, I might do that when I get to Thailand. 

Hi Cathy

Thanks for your reply. I believe that it is possible to determine if one is "pre-menopausal" by an apparently simple blood test to assess hormone levels. You would probably have to know at what stage in your cycle you are, or maybe not?

I intend to get this test, once I have located an OB/GYN in Bangkok.

As to weight gain, I too am putting on lots, mostly around the middle, which is apparently one of the worst places. Seems impossible to shift, but given the links with HRT and b/c it seems drastic. But agree, the health risks of weight gain seem more immediate. Smacks of the devil and the deep blue sea!

Wonder if you are relocating here or spend part time stateside and part in Thailand. What a great combination that would be.

,

The test is FSH (follicle stimulating hormone) and needs to be done at the very beginning of the cycle.

The dangers found with HRT are associated with long-term use, the current belief is that it is not dangerous if used for only a short time. Before the landmark control trial, doctors were recommending iot for indefinite periods of time to prevent osteoporosis and also in the (unfounded, as it turns out) belief that it might decrease risk of heart disease. So those of you who are really suffering and do not have any risk factors (like family history breast cancer or hypertension) should not be afraid to seek relief. But only in the lowest necessary dose and for the shortest time necessary, coming off it once you're through the change.

Another important point that doctors usually don't mention is that the study was on the HRT that is commonly used, which is horse estrogen plus a completely synthetic drug (progestin) that is not remotely related to natural progesterone. The reason for not using natural, human estrogen and progesterone to replace same is very simple: money. Natural substances can't be patented so no profit. It is unknown whether there would be the same, or any, health risks to the use of natural human HRT, and it will almost certainly remain unknown because these studies are funded by pharmaceutical companies who have no interest in finding that out. However, it is not unreasonable to assume that the natural forms would be safer. They certainly have fewer unpleasant side effects -- progestin (provera) is miserable to take whereas natural progesterone has no known side effects other than a slight sedation which wears off.

Anyhow - the natural products are produced in Europe and available in Bangkok. Estrogel is natural human estrogen in a gel form which is nice becayuse it is easy to titrate down to the lowest needed dose. Found in many pharmacies (not to be confused with the vaginal cream, though..estrigel should not be applied to mucus membranes, it'll sting). Natural progesterone is availabel in 2 forms: utrogesten, a micronized oral form, and progestogel, a gel. They are much harder to find. I've gotten tham at the large pharmacy on the south side of SUkhumvit between soi 2 and ploenchit, and Villa market pharmacy usually has the progestogel.

I guess I'm menopausal. It's sort of hard to tell.   I had a simple hysterectomy years ago, which left me with intact ovaries and hormones, but no obvious way of noticing I am menopusal.   

I have had warm, as opposed to hot, flashes. I get uncomfortably warm, and the back of my neck will perspire, but that's all. I have always had incredibly dry, itchy skin so no change there. No mood swings, no depression, no irritability; but then I have always been extremely even in mood, no PMS or anything. I have the insomnia, for sure.

Can we just not talk about the weight gain? I'd go on HRT just to get rid of the weight, as it's a more immediate risk to my health than breast cancer. In fact, I might do that when I get to Thailand. 

<{POST_SNAPBACK}>

Hi Cathy

Thanks for your reply. I believe that it is possible to determine if one is "pre-menopausal" by an apparently simple blood test to assess hormone levels. You would probably have to know at what stage in your cycle you are, or maybe not?

I intend to get this test, once I have located an OB/GYN in Bangkok.

As to weight gain, I too am putting on lots, mostly around the middle, which is apparently one of the worst places. Seems impossible to shift, but given the links with HRT and b/c it seems drastic. But agree, the health risks of weight gain seem more immediate. Smacks of the devil and the deep blue sea!

Wonder if you are relocating here or spend part time stateside and part in Thailand. What a great combination that would be.

,

The test is FSH (follicle stimulating hormone) and needs to be done at the very beginning of the cycle.

The dangers found with HRT are associated with long-term use, the current belief is that it is not dangerous if used for only a short time. Before the landmark control trial, doctors were recommending iot for indefinite periods of time to prevent osteoporosis and also in the (unfounded, as it turns out) belief that it might decrease risk of heart disease. So those of you who are really suffering and do not have any risk factors (like family history breast cancer or hypertension) should not be afraid to seek relief. But only in the lowest necessary dose and for the shortest time necessary, coming off it once you're through the change.

Another important point that doctors usually don't mention is that the study was on the HRT that is commonly used, which is horse estrogen plus a completely synthetic drug (progestin) that is not remotely related to natural progesterone. The reason for not using natural, human estrogen and progesterone to replace same is very simple: money. Natural substances can't be patented so no profit. It is unknown whether there would be the same, or any, health risks to the use of natural human HRT, and it will almost certainly remain unknown because these studies are funded by pharmaceutical companies who have no interest in finding that out. However, it is not unreasonable to assume that the natural forms would be safer. They certainly have fewer unpleasant side effects -- progestin (provera) is miserable to take whereas natural progesterone has no known side effects other than a slight sedation which wears off.

Anyhow - the natural products are produced in Europe and available in Bangkok. Estrogel is natural human estrogen in a gel form which is nice becayuse it is easy to titrate down to the lowest needed dose. Found in many pharmacies (not to be confused with the vaginal cream, though..estrigel should not be applied to mucus membranes, it'll sting). Natural progesterone is availabel in 2 forms: utrogesten, a micronized oral form, and progestogel, a gel. They are much harder to find. I've gotten tham at the large pharmacy on the south side of SUkhumvit between soi 2 and ploenchit, and Villa market pharmacy usually has the progestogel.

I would like to thank every lady who took the time and trouble to reply. The responses were absolutely fantastic and highly interesting replies. The information on natural hormones, as opposed to equine, and the length of usage is interesting. And I now have a doctor and hospital in mind, thanks to another lady. But how alarming that the menopause can trigger Diabetes.

The ladies who read (and reply to) this forum are great! Thanks again to each and every one.

The dangers found with HRT are associated with long-term use, the current belief is that it is not dangerous if used for only a short time.

I agree totally with this. You may only need to take it for six months and then come off it gradually.

The only reason to stay on it for ten or fifteen years (yikes!) is because it was thought to lower the incidence of heart disease and some women think that it will slow down the aging of skin etc.

Our bodies were not meant to be producing eostrogen forever.

True, the current belief is that short term use is ok. But the current belief 10 years ago was that it was ok to take it long term.

Sorry if I sound alarmist about all this but my mother has had breast cancer twice (each breast about 10 years about, two seperate cancers, not a recurring one) so I am quite experienced with the problems HRT can cause.