Ortho-Prefest is yet another
of the newest forms of HRT -- but with a difference: Unlike other forms of
continuous HRT which deliver both an estrogen and progestin every day, Orth-Prefest has
what's called a "pulsatile delivery." In other words, there are two
different pills -- some with just estrogen and some with both estrogen and
progestin. Every three days, you switch between the estrogen-only pills and estrogen
plus progestin pills. So you're getting estrogen continuously, and progestin every three
days for three days.
The theory behind this? Many women find that they suffer more side effects from
progestins, so by taking the progestin in this sequential manner, side effects are
minimized -- and you're still getting enough progestin to balance out the estrogen and
keep your uterine lining from building up too much.
More specifically, the clinical studies done on Ortho-Prefest found that most women had
few side effects -- and was especially promising in the area of breakthrough bleeding,
something that often poses problems for women on continuous HRT. In addition, it
appeared to have a beneficial effect on blood lipids -- fat in the blood which can lead to
cardio-vascular problems.
Given the apparent lack of many common side effects, many doctors recommend
Ortho-Prefest for women who've had problems on other forms of HRT, particularly other
forms of continuous HRT.
- Standard dosage: 1 mg estradiol, 0.09 mg norgestimate
(progestin delivered every 3 days for 3 days)
- Pros: Appears to cause fewer side effects than the other
oral forms of combination HRT -- such as breakthrough bleeding, etc., chiefly because
you're not getting as much progestin....but you are getting enough progestin to balance
the estrogen. Estrogen in Ortho-Prefest is bioidentical.
- Cons: Synthetic progestin -- so it's not bio-identical
to the hormones your body naturally makes