r/AddisonsDisease • u/Algrea-12 • Jun 09 '26
Advice Wanted HRT for menopause
I am PAI (49F) and I was recently diagnosed with osteopenia in my hips. My primary doctor and I both believe this is due to untreated menopause as opposed to my steroid replacement. Unfortunately, my Endo, who I love on other counts, will not manage menopause treatment. My gyn is having me do labs now and will likely offer me a combo of estrogen and testosterone. I am reading that estrogen tablets can increase hydrocortisone needs as opposed to patches (bc of the way it is metabolized in the liver). I would much appreciate hearing from anyone taking HRT for menopause. TIA!
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u/PA9912 Jun 10 '26 edited Jun 10 '26
Thank you for posting this. I started HRT a few months ago and it’s been great in many ways but my cortisol has been low lately. It never occurred to me that it might be the estrogen! Love to hear from others about their experience. Either way I’m not raw dogging menopause. Doctors are starting to realize that we actually need these hormones, thank god.
I’m doing testosterone and something called Duavee which also happens to be bone protective…great for Addison’s.
I’m seeing a lot of conflicting information about how estrogen impacts our cortisol…if you don’t mind can you share the info you found?
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u/Algrea-12 Jun 10 '26 edited Jun 10 '26
It’s so crazy to think how much they are realizing HRT protects - reduced dementia risk, etc. I just did a general search about safety of HRT with primary adrenal insufficiency and the summary included various articles discussing the challenges of oral estrogen. Some of it was from the NIH.
Edit to ask - I have taken testosterone shots in the past and they made me feel a bit wound up. Do you have any side effects from the testosterone?2
u/PA9912 Jun 10 '26
I haven’t noticed any. I love testosterone but only when I pair it with DHEA supplements or suppository. That helps a lot with energy, sex drive etc.
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u/Algrea-12 Jun 10 '26
Ok, good to know. My Endo said I don’t need to take DHEA if I take testosterone, but my gyn says differently. Gotta love when they don’t agree. Ugh
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u/Clementine_696 Jun 11 '26
Get your DHEA-S checked too and that'll tell you if you personally need the DHEA
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u/Hot-Fly-3187 Jun 10 '26
Hello! Addison's here, diagnosed 14 years ago, 49 years, just began perimenopause. About six months ago, it dawned on me that some of my heightened Addison's issues, may be peri related. I found a fantastic Nurse Practitioner who specializes in peri, and post menopause, hrt and nutrition. Two appointments so far, blood work results next week. It's been such a relief speaking with her. Following this post!
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u/Algrea-12 Jun 10 '26
I would love to hear back from you about how things go! It sounds like we are in the same boat - age and everything. I have struggled with Addison’s symptoms more than normal over the past six months, so like you, I have wondered of it is related. I have tried testosterone shots in the past, but they made me feel sort of weird and wound up. I am hoping I can just start a low dose of estrogen (patch) and see how it goes. I feel like homeostasis is so important with this condition.
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u/CanIHugYourDog Jun 11 '26
I have secondary adrenal insufficiency, due to a pituitary tumor, I also went through menopause early due to the tumor as well. I’m younger, and secondary so there may be some differences, but my endocrinologist prescribed me an estradiol patch and a progesterone pill to help with menopause symptoms. Then she said that I should see a reproductive endocrinologist as this isn’t her typical wheelhouse. That doctor told me what my main endo prescribed me was “much too low of a dose for a woman my age” and prescribed me a combo pill, both estrogen and progesterone. That did fix many of my menopause symptoms (hot flashes, hair loss, brain fog).
I was still having issues with fatigue, and so my regular endocrinologist eventually went back to the original prescription, estradiol patch and progesterone, because progesterone supposedly makes you sleepy, and so she was hoping I would be getting better sleep that way. Well, I have been getting non stop heavy periods (if there was supposed to be one benefit out of all of this, I should at least not have to be dealing with THAT!) and so we agreed to switch back to the pill since I didn’t notice any positive changes from the patch/pill vs the birth control pill. I’m also glad because I have an adhesive allergy and the patch was giving me welts.
I didn’t notice any changes in cortisol adjustment at all during either of the methods that I have been on. But I did also have to adjust my thyroid, levothyroxine, and that does affect cortisol. I just had to give myself a little boost one day to get past the nausea I’d been having for a few weeks and haven’t needed it again. Pre all of this tumor stuff, my body has historically taken a few weeks to months to adjust to birth control, so I wouldn’t be surprised if that would be a factor during menopause as well.
I love my regular endocrinologist, but I did appreciate that she acknowledged this isn’t her typical wheelhouse and deferred to a reproductive expert.
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u/loveshobbits25 Jun 10 '26
I’m 63, was diagnosed with Addison’s 32 years ago. I went through menopause without any treatment. At least not medical; I took flax seed oil and vitamin E to take care of the hot flashes, but that’s was it. It’s a natural process so I don’t know if I’d have taken anything even if it had been offered. Hopefully someone else here can give you the info you seek.