Question 40
Dr N,
I am a 30 yr old female who had to have a complete abdominal hysterectomy in Nov. 99 due to severe endometriosis. I also have hypertriglycridemia. After my surgery my doctor started me on Premarin 1.25 after being on the premarin for three months she had to take me off of it because my triglycerites began rising dramatically again 327 before surgery 819 after the 3 months on estrogen. She has since placed me on evista for bone protection and bellergal-s for hot flashes and night sweats. I am also experiencing mood swings. I have been taking the evista for 2 months now and the bellergal-s for 1 month with no decrease in the hot flashes, night sweats or mood swings. Any suggestions. Thank you
Reply:
Hi,
The research evidence suggests that although oral estrogens such as Premarin may increase triglycerides, transdermal estradiol, such as in patches may actually reduce triglyceride levels. I have found Bellergal to be of no benefit in reducing hot flashes.
I would make sure that you are seeing a cardiologist about your elevated triglycerides and that you are evaluated for possible causes for the elevation. These would include, a familial disorder of lipid metabolism and an underactive thyroid. In addition, even moderate alcohol intake can raise triglyceride levels in some.
Regardless, it is my impression, that you can use transdermal estradiol patches and other forms of non oral estradiol. This would be of benefit in relieving your menopausal symptoms and provide protection from the long term consequences of hormone deprivation.
I have included below an abstract or summary of an article from a journal which addresses this issue. I would discuss this with your physician and show her the article if you like. If you are still unable to convince her to prescribe a non oral estradiol preparation, find a more enlightened physician.
Make sure that you see a cardiologist about your lipids.
Let me know what and how you do.
Dr N