Hormone replacement therapy - cyclical necessary?

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Chrisweides
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Hormone replacement therapy - cyclical necessary?

Post by Chrisweides »

Hello,

I am on HRT and taking continuous estrogen. I started with continuous progesterone but then became anxious about the non natural cycle that produces and also I read that Alzheimer is best prevented with cyclical HRT.

However, I find I cannot sleep without progesterone. In the days since I only take estrogen, I had severe insomnia. I have this sometimes with progesterone as well, but not as often and more in the form of maintenance insomnia whereas without progesterone I have onset insomnia as well. Meaning I more or less don’t sleep at all.

Something I found definitely supporting cyclic is https://pubmed.ncbi.nlm.nih.gov/20410196/
Or better in https://www.jneurosci.org/content/27/48/13357

Of course it’s mice…

Can any of you help me out with studies which form of HRT really is best (as currently known) to prevent Alzheimers? I don’t want to torture myself for nothing if continuous progesterone is good as well. If it seems like cyclic is the best way, I may have to take other sleep meds because all natural efforts to improve sleep have failed.

Thank you

Chris
51 years old. APO E3/4. Mother, grandmother and great grandmother had/are starting with dementia. Afflicted with anxiety disorder atm. Very eager to save brain and live a long healthy life. Grateful to you all for your knowledge and kindness!
NF52
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Re: Hormone replacement therapy - cyclical necessary?

Post by NF52 »

Chrisweides wrote: Fri Sep 16, 2022 4:23 pm Hello,

I am on HRT and taking continuous estrogen. I started with continuous progesterone but then became anxious about the non natural cycle that produces and also I read that Alzheimer is best prevented with cyclical HRT.

However, I find I cannot sleep without progesterone. In the days since I only take estrogen, I had severe insomnia. I have this sometimes with progesterone as well, but not as often and more in the form of maintenance insomnia whereas without progesterone I have onset insomnia as well. Meaning I more or less don’t sleep at all.

Something I found definitely supporting cyclic is https://pubmed.ncbi.nlm.nih.gov/20410196/
Or better in https://www.jneurosci.org/content/27/48/13357

Of course it’s mice…

Can any of you help me out with studies which form of HRT really is best (as currently known) to prevent Alzheimers? I don’t want to torture myself for nothing if continuous progesterone is good as well. If it seems like cyclic is the best way, I may have to take other sleep meds because all natural efforts to improve sleep have failed.

Thank you

Chris
Hi Chris,

Those 3xTransgenic mice have been specifically developed (hence the "translation" of "genetic" material) to ensure that they develop Alzheimer's pathology (amyloid plaques) and impairments. That makes them helpful to study for basic research--not so helpful when applying the results directly to women!

Here's an excerpt from a. 2021 article about research done by Dr. Roberta Brinton, who focuses on women's health and Alzheimer's and has gotten several grants from the US National Institutes on Aging (NIA) to study hormones in women.
“This is not the first study on the impact of hormone therapies on neurodegenerative disease reduction,” said Roberta Diaz Brinton, PhD, director of the UArizona Center for Innovation in Brain Science and senior author on the paper.But what is important about this study is that it advances the use of precision hormone therapies in the prevention of neurodegenerative disease, including Alzheimer’s.”

Hormone therapy is the most effective treatment for the symptoms of menopause, which can include hot flashes, night sweats, insomnia, weight gain and depression. During the study, Dr. Brinton and the research team examined the insurance claims of nearly 400,000 women aged 45 and older who were in menopause.

They focused on the effects of individual U.S. Food and Drug Administration-approved hormone therapy medications, including estrogens and progestins, and combination therapies on neurodegenerative diseases. Additionally, they evaluated the impacts of the type of hormone therapy, the route of administration – oral vs. through the skin – and the duration of therapy on the risk of developing disease.

They found that using the natural steroids estradiol or progesterone resulted in greater risk reduction than the use of synthetic hormones. Oral hormone therapies resulted in a reduced risk for combined neurodegenerative diseases, while hormone therapies administered through the skin reduced the risk of developing dementia. Overall risk was reduced the most in patients 65 years or older.

Additionally, the protective effect of long-term therapy lasting longer than one year on Alzheimer’s, Parkinson’s disease and dementia was greater than with short-term therapy of less than one year.

“With this study, we are gaining mechanistic knowledge. This reduction in risk for Alzheimer’s disease, Parkinson’s and dementia means these diseases share a common driver regulated by estrogen, and if there are common drivers, there can be common therapies,” said Dr. Brinton, who has researched neurodegenerative diseases and the aging female brain for more than 25 years. “The key is that hormone therapy is not a treatment, but it’s keeping the brain and this whole system functioning, leading to prevention. It’s not reversing disease; it’s preventing disease by keeping the brain healthy.”
You need sleep and your brain likely is asking nicely for some of that progesterone. If it were me (15 years younger!) I'd take it happily, especially since I didn't sleep well during those years either and never connected it to menopause!
Researchers Take a Step Toward Advancing Precision Hormone Therapies to Reduce Alzheimer’s Risk
4/4 and still an optimist!
Chrisweides
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Re: Hormone replacement therapy - cyclical necessary?

Post by Chrisweides »

Thank you! That is very helpful.

I wish I had a doctor who does precision hormone therapy. Mine just uses „two or three sizes fit all“ and so do the other doctors here. Probably too much estrogen is better than too little on the brain side, but it would be so much better to get exactly what I need.

Interesting fact: after five days without progesterone all my symptoms suddenly got a lot better including sleep on estrogen only. I can only say I don’t understand whats going on :)

Best

Chris
51 years old. APO E3/4. Mother, grandmother and great grandmother had/are starting with dementia. Afflicted with anxiety disorder atm. Very eager to save brain and live a long healthy life. Grateful to you all for your knowledge and kindness!
circular
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Re: Hormone replacement therapy - cyclical necessary?

Post by circular »

Chrisweides wrote: Fri Sep 16, 2022 4:23 pm I am on HRT and taking continuous estrogen...
I'm still mystified why some give advice to cycle post-menopausal progesterone to better mimic pre-menopausal progesterone cycles, but we don't hear any corrollary advice to cycle post-menopausal estrogen to better mimic pre-menopausal estrogen.

I think we know these hormones are important for us, but I don't think anyone has any idea how much we need generally speaking much less on an individual level. Dr. Anne Hathaway, who has done a lot of research in this area, said she really couldn't say how much we need (sorry I don't have the timing or location of that statement handy). Maybe I've missed some more recent research about it?

I wish I could offer a more helpful reply. FWIW don't cycle either one. I don't want cycling progesterone to disrupt my sleep.
ApoE 3/4 > Thanks in advance for any responses made to my posts.
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