Joey Basson writes January 28, 2010
I used Primogyn Depot for about 20 years, but I believe it has been discontinued in South Africa. I am now really struggling to find something that really works for me.
The injection was perfect. Do you have any suggestions?
reply: Hi Joey,
DRUG COMPANIES GANG UP TO SUPPRESS CHEAP EFFECTIVE AGENTS -AS THEY DID FOR 25 YEARS EACH WITH LITHIUM AND METFORMIN IN USA, STILL BLOCKING HUGELY BENEFICIAL USE OF CANNABIS; AND at the end of 2008, without notice or warning, they conspired to abolish CHEAP APPROPRIATE NON-ORAL HRT IN RSA- the depot injections MIXOGEN, DEPOTRONE, even PRIMODIAN DEPOT, PRIMOGYN DEPOT.
NOW APPROPRIATE NON-ORAL HRT COSTS ALMOST 5 TIMES AS MUCH TO USE, AS eg CREAMS, PATCHES, SPRAYS, IMPLANTS FOR BOTH MEN AND WOMEN- AND FOR WOMEN WITH FAR MORE BOTHER.
Now the only way we are going to get such injections back in RSA is if there is enough interest to fight through the red tape to import from overseas. But South African administration is now so degenerate under the corrupt Zumas that it takes 2 years to get desperately needed doctors and sisters registered here – and who cares about appropriate HRT for the aging? Certainly not the notorious “doctor” or “Rev” Zumas since they dont give a fig for evidence or human -especially the poor and womens’- rights..
if you live too far away, we can do a personal consult by email+- phone +- skype – via the necessary questionnaire by email- for you to discuss and implement with your local GP.
see numerous updates the past year at https://healthspanlife.wordpress.com/?s=HRT
22 March 2009
An update review by Barry Wren from an Australian Menopause Clinic again debunks the myth that appropriate HRT in postmenopausal women PMW increases the risk of breast cancer, cardiovascular disease CVD and thrombosis. It stresses that “benefits of HRT include less: symptoms of menopause; osteoporotic fractures, ischaemia and cardiovascular-related death, forgetfulness, dementia and colorectal cancer; and improved well-being, quality of life, vagina, sexual enjoyment and bladder capacity, with increased longevity. Oral OHT doubles the risk of thromboembolism”. But on it’s own in the young women in the Womens’ Health Initiative, oral equine estrogen (premarin) reduced all major risks even new breast cancers and death from breast cancer.
As we hear regularly in women who have unwisely followed hysterical advice to stop HT, stopping appropriate HT leads to fairly rapid loss of many of the above benefits. It has been obvious for a century if not millennia that permanent appropriate Human Hormone Replacement HRT of any of the dozens of our hormones that run out is (like a complete supplement of all the vitamins, minerals and the biologicals other than HRT) prudent if not essential.
But we have to understand the reasons, risks and different regimes available. Nobody may prescribe or administer any sex HT Hormone Therapy without the necessary up-to-date training and experience, ensuring that the patient is having the necessary periodic examinations to ensure both safety and that the SHRT is appropriate. So patients must not self-treat with over-the-counter supplements.
But only doctors and pharmacists who have costly current dispensing licenses may dispense and compound any hormone creams. And oral HT including phyto/plant hormones are under suspicion of promoting cancer long term, let alone hepatic first pass effects like thrombosis and gallstones, and fluid retention oedema and hypertension (Genazzani ea 2008) .
INJECTION: tiny safe self-injection of combined hormone subcutaneously (like insulin) is easy every one to three weeks, as most men use for HRT. Monthly injection of depot preparations that last about three weeks is not advised for anyone, especially not women with a womb as they are liable to have break-through periods. But unlike men, many women prefer to use hormone creams daily. The Depot hormone injections have climbed in price – what is now available averages about R75 per month. BUT (unless she gets the injection from her doctor regularly & proportionately every 1 to 3 weeks), women have to lay out about R1000 for self-injection (since pharmacists will not likely split a multi-vial or a set of three vials).
Provided that they ensure that they are appropriately trained in such therapy, all doctors are licensed to give periodic chronic injections – which should always be exclusively by tiny subcutaneous injection to avoid the notorious ie potentially crippling complications of intramuscular injections. But if nothing else is required, doctors are entitled to charge about R100 fee for the responsibility of an injection visit. Like insulin, patients easily learn to give it themselves- for men about 160mg depot-testosterone every 2wks (as opposed to 1gm testosterone undecanoate Nebido every 3 months- or about 1/10th of the male dose for women deficient in testosterone).
Synthetic ie xenohormones – those not normally produced by humans- eg progestins, ethinylestradiol- may be invaluable (although by no means essential) for birth control; but should not be used for PMW, especially not orally.
USING CREAMS: it is indeed best for women to (initially) juggle the balance of the three hormones (all of which are made to the highest standard in South Africa) until you have determined what ratio and quantity suits you best.
For the slim small older woman who needs both hot flash control and energizing, memory, ache relief: the first priority is to control hot flashes, skin & hair without arousing breast and womb discomfort:
so try the 0.25% Bies(trogen) (E2 + E3- usually 1:4 ratio) initially 1/2 ml scoop 1 – 2 x/day with the progesterone 3% cream initially just ¼ to 1/3 ml scoop a day ie 4 to 1 or 3:1 . This is ideally rubbed into the face as makeup- or if you like, dilute them in simple aqueous cream. Increase the combined dose to double if necessary to get control of the flashes – but the higher the Biest dose, the higher the risk of waking the breasts and womb, or getting thrombosis and ankle swelling.
And (unless your androgen level is still high) use just enough Testosterone cream 0.5% eg 1/2 to 1 scoop once (or twice) a day – below the waist ie vaginally or between the thighs or on the soft sole of the foot – to energize, improve alertness, libido, muscle and bone strength. Supplementing estrogen and progesterone alone may suppress necessary androgen.
In the bigger plump younger woman, who desires memory, energy, fat loss and libido rather than hot flash and skin improvement, using testosterone below the waist and progesterone on the face in the above gradually increasing doses often suffices, without the fattening and breast-womb arousing risks of extra estrogen. Such women often make enough estrogen from testosterone and in their excess fat stores.
But once the average women is well past 60yrs, low-dose estrogen often becomes advisable anyway for balance.
Old women benefit from and tolerate perhaps 1/6th to 1/10th the doses of appropriate balanced human sex hormones of younger women.
THE THREE PRIME HUMAN SEX HORMONES: there are no risks from any appropriate HRT, only risks from avoiding it. Progesterone alone lacks some of the benefits of testosterone and estrogen eg on muscle- bone and hearing. Of the three hormone types, only androgen protects and improves muscle mass and strength. Testosterone excess (hairy face, acne, anger, clitoris growth, husky voice) is easily avoided with sensible balanced dose adjustment. Progesterone and testosterone have major benefits that estrogen may lack eg on hyperimmunity and inner hostility- issues that may not concern the gyne surgeon.
(Bi)Estrogen excess- especially if used alone- does the reverse (of testosterone): promotes endometriosis and breast activation; excess actually weakens muscle eg bladder leak by melting collagen; it fattens; has little benefit directly on depression (although it does reduce dryness and pain); may promote thrombosis since unlike testosterone it does not diminish clotting; and may promote anxiety, hostility- this is why progesterone cream is often the best for monthly PMS and for perimenopausal anxiety (against the raging hostility from estrogen swings).
Above all else, remember that estrogen stimulates both breasts and womb- so estrogen must always be balanced by enough progesterone and(/or) testosterone. And if the hormones are allowed to run out by widening the gap between injections beyond two weeks, or between cream doses by more than two days, vaginal bleeding likely will occur.
The initial outlay cost of the three different hormone creams is up to R500 retail- you find out for yourself how long each tub lasts; as opposed to having an experienced pharmacy eg the manufacturing AntiAging pharmacy in Gauteng compound ie mix what you want in one or two tubs that will last a few months. Try your local pharmacy – but finding one with experience is difficult.
PREVENTION? OR WAITING FOR DISEASE FROM NEGLECT TO CRIPPLE YOU? Many gynecologists (like urologists) are primarily surgeons concerned with reproduction, menstrual, pelvic and cancer problems, and treat the menopause years often with fattening hormone pills (HT- which have more risks) and surgery.. They do not have to deal with the much wider irreversible medical problems of old age (obesity-diabetic, insulin resistance, lipidemia, vascular, immune, fracturing, arthritic, visual and hearing loss, depression, and dementias – and no least, common sudden premature death)# – which are largely AVOIDABLE with appropriate natural supplements from the beginning, including balanced non-oral human sex hormones. As a BBC news report this month says, memory (ie cellular) deterioration begins on average before age thirty.
It is not the gynecologist, but patients and Family/ general practitioners GPs and specialist physicians including endocrinologists and geriatricians who have to deal long term and medically (not surgically) with these easily preventable crippling killer diseases.. Surgery cannot address the basic pathogenic cause of chronic degenerative disease.
The discomfort and fattening of the 5-10 MENOPAUSE years is a concern for all doctors – and the earlier the menopause (whether natural or surgical), the more important it is to start appropriate simple balanced non-oral HRT and other effective medical prevention of fattening and diabetes eg other insulin sensitizers like metformin. Avoiding the late postmenopausal silent killer degenerative diseases of aging (# above) is crucial essential duty of doctors – but mostly of patients themselves, since- obstetrics and trauma aside- most doctors earn more by disease than by prevention..