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Bioidentical hormone therapy - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Very Good Posted in: Thyroid Problem and Hormonal Problems
Answered by

General & Family Physician
Practicing since : 2005
Answered : 2305 Questions
User :   I have recently (3 months ago) started bioidentical hormone therapy at the In April I received one pellet of estrogen and one of testosterone. I am a female - 60 years ago and was having typical post menopausal symptoms such as vaginal dryness and decreased libido. A few weeks after the 1st pellets I had a second blood draw and subsequent insertion of one more testosterone pellet. Now my testosterone level is over 300. I am now having difficulty with voiding and have no UTI. I have urgency with incomplete emptying of bladder and feel pressure near the urethra. Was wondering if the testosterone therapy could contribute to clitoral enlargement is such a way as to hamper voiding? I can't get in to see my regular gyn for a couple of weeks and am quite miserable and am considering going to our local ER for relief. As you may know the Bioidentical Hormone is not FDA approved in the US but has been used in with much success as I understand it.

Doctor :   Let me read your query.
User :   Is someone there?
Doctor :   Hello.
User :   OK thanks
User :   Hello to you
Doctor :   Since when are having difficulty in voiding?
User :   There may be no connection as thinks but I am not so sure?? No problem ever until I started the hormone therapy but the increased sexual activity may have caused some trauma in the area. My husband (64) is also going to HRC Medical. I went yesterday and was given one more pellet of estrogen and no testosterone. I also take Progesterone 50 mg from a compounding pharmacy. I have had 3 separate episodes like this in the 3 months since starting the hormones.
Doctor :   Do you have any past history of diabetes or hypertension?
User :   No hx such as that!
Doctor :   Ok.
User :   Wondering also if I may have some prolapse to the bladder but I do not feel any protrusion or anything such as that. Are you familar with the bioidentical hormone therapy that Suzanne Sommers advicates?
User :   Clinics such as this are popping up all over the country!
Doctor :   testosterone therapy does contribute to clitoral enlargement. But that does not cause voiding.
User :   Also, not UTI the last 2 episodes! I am a nurse and work in a clinic prn where I was able to get a Urinalysis done.
User :   Did you mean that should not cause trouble with voiding.
Doctor :   What was the report for Urine analysis?
Doctor :   Yes.
User :   Everything was normal both times with exception of a trace of protein of the first report. The second UA was all clear.
Doctor :   Ok
Doctor :   Now difficulty in voiding is due to lack of bladder tone
Doctor :   but that is not a side effect of BHT
User :   Just having trouble getting in to see someone quickly and am quite uncomfortable and frustrated.
Doctor :   Yes, I do understand
Doctor :   For now, what I suggest you is to practice an exercise
Doctor :   which shall tone the bladder well
Doctor :   like while passing urine
Doctor :   stop, start and again stop
Doctor :   repeat the cycle like that
Doctor :   You might be aware of it
Doctor :   it shall improve the urinary musculature
Doctor :   which shall help you improve with the symptoms
User :   You are speaking of Kegel's? I have been trying that some
Doctor :   Have you practiced it?
Doctor :   yes you are right
User :   Have done it quite a bit in the past. It's just that now I can only dribble a very tiny amt and still feel an extreme urge to go. Constantly feel like I am about to bust!
Doctor :   Ok
User :   Almost feels like an obstruction near the urethra because I feel extreme pressure in that area. Thus I wondered if swelling in that area could be a factor? What is your background?
Doctor :   I am a Family Physician
User :   OK...thanks!
Doctor :   Do you feel any pain while passing urine?

User :   Would you avoid the ER route if at all possible. I am sure they would catheterize me. :( I do feel some discomfort when passing urine but it is not burning in nature...more like pressure that is unrelieved.
Doctor :   Ok
Doctor :   since you are mainly experiencing it in the urethra
Doctor :   it should subside in a few days
Doctor :   catheterization shall become mandatory

User :   Yes and low in my bladder area. Do you think I may just have some trauma from sexual activity? That might be a possibility.
Doctor :   if there is lot of incontinence
Doctor :   Urethral injury is most common during intercourse
User :   No incontinence. I am not loosing any urine involutarily.
User :   Just have increased sense of urgency and the need to empty but can only dribble...
Doctor :   Ok

Doctor :   if you are not able to empty it properly
Doctor :   then it is bladder tone
Doctor :   if you are able to put pressure, but there is an obstruction like
Doctor :   then it is urethral
User :   I am sure bladder tone is a factor with my age and all. Didn't quite understand your last communication about the pressure. Could you phrase again? :)
Doctor :   meaning if you can force it down properly
User :   you said there is an obstruction what?
Doctor :   but something is obstructing the way
Doctor :   obstruction like an inflammation in the urethral wall
Doctor :   urethral stricture
Doctor :   even an urethral stone(less common)
User :   it is very difficult for me to force the urine down. I think that is the problem..Hopefully it's that simple. Not sure about the possibilty of a stone. I guess it could be.
User :   I think inflammation in the urethral wall is very possible!!
Doctor :   Yes, it is
Doctor :   if it is difficult to force it down
Doctor :   then bladder tone is the factor
User :   Like I said this has happened 2 other times and then we settled down with regard to sexual activity and it resolved. Thank you for your help.
Doctor :   kiegel's exercise
Doctor :   continue with that
Doctor :   Thanks for consulting, bye for now
User :   First time I have tried online MD ...I will continue with Kegels and see my Doc
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