Nancy wrote:I just left my yearly ob/gyn appointment and my dr has me on Duavee. Does anyone know if this will be sufficient for helping to prevent AD? I am about to turn 49. I tried to explain to him that I need to keep the estradiol to progesterone ratio in my blood at 1:5. He did not seem to know what I was talking about. He seems quite reasonable, so if I asked him to change my prescription, I think he would.
Nancy, Duavee is a new medicine that is FDA indicated for menopausal hot flashes for women with a uterus, and osteoporosis. It is different than any other product on the market in that it combines a conjugated estrogen (formally known as conjugated equine estrogen or CEE) and a SERM, or selective estrogen receptor modulator. There is no progesterone in Duavee. The SERM has been added instead of progesterone to help prevent endometrial cancer from unopposed estrogen. Most other SERMs on the market are for osteoporosis or breast cancer treatment. As far as prevention of cognitive impairment, studies that have used CEE would be the closest to predict benefit and risk. I am not aware of any studies looking at SERMs and cognition. There are none looking at Duavee, it is too new.
I apologize if you have posted elsewhere why you wish to start menopausal hormone replacement, but what is your motivation? Is is purely for cognition or are you having quality of life issues with hot flashes? And why did your doctor select Duavee for you as an individual? Most conventionally trained doctors do not measure estrogen and progesterone levels after starting treatment and would not be familiar with estrogen to progesterone ratio targets. There are a lot of older posts from other E4 women, both in this thread and another under the "Drugs" discussion category, discussing their journeys with menopausal hormone replacement. If you haven't looked at both of these, you might find them illuminating.