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Doctors' Answers to "Frequently Asked Questions" - Estrostep

These comments are made for the purpose of discussion and should NOT be used as recommendations for or against therapies or other treatments. An individual patient is always advised to consult their own physician.

Premarin Concerns [posted 11/4/98]
Question: I had a total hysterectomy in 1994 and was immediately prescribed Premarin. I asked my doctor how long I need to take Premarin and her answer was "forever, it keeps us young." I dislike the idea of taking anything forever and would like information in order to make an informed decision as to whether I need to take Premarin "forever," or if I can discontinue, or decrease gradually as nature must have intended. What would be the side affects? Could I do well with one of the newly advertized "natural" or herbal estrogens? I have listed the medication I currently take and I will soon be starting Lipitor to control cholesterol. Thank you.

Answer: The best current drug to decrease cardiovascular disease is estrogen. Women still die most frequently from this class of problems, not cancer or other problems. A very good study was done on nurses which showed both an increase in longevity and an increase in quality of life in women taking estrogen. If there is a strong family history of breast cancer it should probably be avoided and reloxafene taken instead. For a women who has elevated cholesterol, this would be one of the best drugs going from my prospective. As to natural estrogens, there is no direct evidence that there is any difference in your body's response. Nature must have intended for us to have elevated blood pressure and diabetes mellitus;but, we treat these with increased longevity. Your call, but, a great drug for longevity and quality of life.

Estrostep Side Effects [posted 8/4/98]
Question: I have just begun my third month of estrostep and immediately after I started, my appetite disappeared, and when I do get hungry enough to eat much of anything I feel terrible. I have no energy and everything bothers me. I get much angrier than before and have generally lost my previous joy for living. Someone on this site said that she lost weight on Depo-provera, and it was suggested that progesterone might be the culprit. Could that be the case here, too? I've only lost 5 pounds, but I was thin to begin with, and my coworkers are starting to gossip that I have an eating disorder. What other formulations might work better for me? Triphasil made me horribly depressed, so my ob-gyn suggested trying this. I'd rather avoid the hassle of trying 10 different kinds to find a suitable one because if I have to go through this every month I'd rather go back to condoms. I work in a profession where concentration and emotional stability are imperative.

Answer: Sexual steroids have several diffuse effects. Unfortunately, everyone tends to be different and predicting which medication will work is difficult. For example, most patients have an increased appetite with these medications. You'll need to slowly work through different formulations with different amounts of estrogen/progesterone until you find one that works.

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