Not a big fan of bio identical doctors.
You have not had a menses for approximately five months and are over age 40. There is no way to know if you've had your final menstrual period or not. The brain is working hard to try to stimulate your ovaries which is why you have a couple of small cysts and your FSH measurement is elevated. Most women require some form of estrogen
to relieve their menopausal symptoms and there is no reason that they cannot begin HRT prior to the final menstrual period. You do not have to wait to begin treatment. Progesterone
by itself is not usually sufficient to relieve symptoms unless you're using huge amounts of it. Your GYN is correct that progesterone cream it's not FDA approved and has not been adequate to counteract estrogen stimulation effect of the lining of the wound. If you have a reassuring ultrasound
showing an endometrial thickness of less than half a centimeter and have not had any bleeding then there's no reason that you should need a progesterone challenge with either Provera
or progesterone cream. In addition there is a third option which is a micronized natural progesterone in an oral form taken at bedtime which will help to make you sleepy is FDA approved is available as a generic and could be prescribed as an alternative to Provera. Approximately 15% of women do not tolerate Provera well and it makes them feel anxious.
Finally the risks of hormone replacement therapy
,HRT, have been vastly overstated in the media. There is little downside to 5 to 10 years of therapy. If you have a uterus you do need some form of progesterone but natural progesterone is available in the prescription.
The term bio identical is a marketing term not the medical term made popular by a Hollywood star who wrote a book about menopause
and staying young. I do not buy into it. I think it is a way of making money primarily. Estradiol
the same Hormone that your ovaries made in the reproductive years and is available for four dollars a month at your local Walmart. oral FDA approved progesterone also identical to what your ovaries made in the reproductive years is a little more expensive but still available as a generic. And by the way you do not state that you've been asked to do saliva tests but they are complete waste of time and money except for the person who orders the test.