In this episode, we talk about Mary’s hormone concerns after ovarian failure. She is only
34, and in the last 7 years since her ovarian failure has tried many hormone
replacement options, all without the success she was looking for.
Let’s Read Mary’s Question:
When I was 27 years old I was diagnosed with iatrogenic primary ovarian insufficiency
due to chemotherapy treatments for a gestational trophoblastic disease (molar
pregnancy). I am now 34 years old, and I am currently struggling most notably, with
fatigue, low libido, dry skin/eyes/hair, low mood, annxiety, and brain fog. I began HRT
about 3 years ago, but I was not consistent.
In the beginning I tried estradiol 1mg and medroxyprogesterone 2.5mg with no symptom
relief or rise in serum levels. For 9 months I faithfully took esterified
estrogens/methyltestosterone 1.25/2.5mg and 100 mg of micronized progesterone at
nighttime. My estradiol levels only rose to 16.9pg/mL (estrogens, total 56pg/mL), and
free testosterone only rose to 0.2pg/mL (testosterone, total undetectable). The T
actually decreased.
My doctor was baffled by how stunningly this application failed. 3 months ago I began
estradiol patches (0.1mg/twice week), testosterone 1% gel (12.5mg/1.25gm) pump (1/2
pump/day), micronized progesterone (100 mg/bedtime), and Intrarosa (vaginal DHEA)
at nighttime. I do not have any current bloodwork for this new regimen. I have noticed a
decrease in my symptoms, but I am no where near where I would like to be regarding
symptom relief.
Is it possible to increase my estrogen dosing? I’ve read POI dosing will often be
signicantly higher. Fertility isn’t my primary concern (we have been blessed with two
children), but I’ve heard mixed opinions that cyclic HRT for someone my age may have
benefits outside of fertility such as the lining of the uterus becoming unresponsive to
estrogen and the ability of cyclic HRT may stimulating the uterus to reestablish this
responsiveness.
I’ve never had a DEXA scan, nor discussed bone health with my provider, who is a
university physician. I am also traveling to MN this summer to see a reproductive
endocrinologist with the Mayo Clinic in hopes of finding further solutions. Thank you for
your time.
In this episode, we break Mary’s question into:
● What is ovarian failure?
● How hormone replacement is helpful for sleep, mood, libido, energy, and brain
fog.
● Consider the long-term consequences of low to no hormones in women.
● Estrogen and bone density.
● Cyclic/rhythmic HRT vs static hormone dosing.
If you have a question, please visit our website and click Ask the Doctor a question.
Discover the common and unfamiliar symptoms that you might be experiencing. Get access to cases of real women with hormonal conditions.
Exciting Announcement! We’re launching the Progress Your Hormones Community today—a space designed to empower women with expert guidance and support for navigating perimenopause and menopause. Get access to live office hours, hormone hot seats, lab interpretation, and more! If you have a question, please visit our website and click Ask the Doctor a question. Join the Progress Your Hormones Community Stay Connected Instagram: @drvalorie TikTok: @drvaloried Disclaimer: All content in this blog, including text, images, audio, video, or other formats, was created for informational purposes only. This video, website, and blog aim to promote consumer/public understanding and general knowledge of various health topics. This content is not a substitute for professional medical advice, diagnosis, or treatment. Please consult your healthcare provider with any questions or concerns you may have regarding your condition before undertaking a new healthcare regimen. Never disregard professional medical advice or delay seeking it because of something you have read on this website. If your healthcare provider is not interested in discussing your health concerns regarding this topic, then it is time to find a new doctor.
Launching August 11: Join our new Progress Your Hormones Community! Get expert guidance, real support, and answers to your HRT questions—together, not alone. Get expert guidance, real support, and answers to your HRT questions—together, not alone. If you have a question, please visit our website and click Ask the Doctor a question. Join the Progress Your Hormones Community Stay Connected Instagram: @drvalorie TikTok: @drvaloried Disclaimer: All content in this blog, including text, images, audio, video, or other formats, was created for informational purposes only. This video, website, and blog aim to promote consumer/public understanding and general knowledge of various health topics. This content is not a substitute for professional medical advice, diagnosis, or treatment. Please consult your healthcare provider with any questions or concerns you may have regarding your condition before undertaking a new healthcare regimen. Never disregard professional medical advice or delay seeking it because of something you have read on this website. If your healthcare provider is not interested in discussing your health concerns regarding this topic, then it is time to find a new doctor.
Welcome to Episode 2 with our upgraded video setup! Dr. Valorie Davidson and Dr. Robert Maki from Progress Your Health answer a thoughtful listener’s question: Why are my progesterone labs always low even on 200mg oral HRT? If you’re taking progesterone and worried about low numbers or uterine protection, this episode is for you. 💡 We cover: ‘ ● ⏱️ Why timing your blood draw makes or breaks your lab results ● 💊 The difference between sustained-release vs. instant-release progesterone ● 🧬 How genetic variants (like CYP enzymes) impact progesterone metabolism ● 🩺 When to get a transvaginal ultrasound to assess uterine lining health ● ✅ What blood level to aim for—and when to test it ● 💡 Bonus: How your detox pathways (and even caffeine tolerance!) can affect hormones If you have a question, please visit our website and click Ask the Doctor a question. Join the Progress Your Hormones Community Stay Connected Instagram: @drvalorie TikTok: @drvaloried Disclaimer: All content in this blog, including text, images, audio, video, or other formats, was created for informational purposes only. This video, website, and blog aim to promote consumer/public understanding and general knowledge of various health topics. This content is not a substitute for professional medical advice, diagnosis, or treatment. Please consult your healthcare provider with any questions or concerns you may have regarding your condition before undertaking a new healthcare regimen. Never disregard professional medical advice or delay seeking it because of something you have read on this website. If your healthcare provider is not interested in discussing your health concerns regarding this topic, then it is time to find a new doctor.
In this episode of the Progress Your Health Podcast, Dr. Valorie Davidson and Dr. Robert Maki answer a listener’s question about spotting and night sweats after starting hormone replacement therapy (HRT). Lisa, age 55, shares her experience using Bi-Est cream, oral progesterone, and testosterone—and why she’s now experiencing unexpected bleeding and sleep disruption. We break down: ● Why spotting can happen after starting HRT—even with low estradiol levels ● The difference between estradiol and estriol in Bi-Est cream ● How progesterone protects the uterine lining ● When to increase vs. decrease HRT doses ● The role of cortisol and adrenal health in night sweats ● When to order a transvaginal ultrasound ● How body type, menstrual history, and hormone sensitivity influence dosing ● Why cookie-cutter HRT doesn’t work for most women 💡 Plus, we share details about our upcoming Progress Your Hormones Community, launching in August 2025—a safe space for women navigating perimenopause, menopause, longevity, and personalized hormone education. If you have a question, please visit our website and click Ask the Doctor a question. Join the Progress Your Hormones Community Stay Connected Instagram: @drvalorie TikTok: @drvaloried Disclaimer: All content in this blog, including text, images, audio, video, or other formats, was created for informational purposes only. This video, website, and blog aim to promote consumer/public understanding and general knowledge of various health topics. This content is not a substitute for professional medical advice, diagnosis, or treatment. Please consult your healthcare provider with any questions or concerns you may have regarding your condition before undertaking a new healthcare regimen. Never disregard professional medical advice or delay seeking it because of something you have read on this website. If your healthcare provider is not interested in discussing your health concerns regarding this topic, then it is time to find a new doctor.
In this episode of the Progress Your Health Podcast, Dr. Valorie Davidson and Dr. Robert Maki dive into a question from Sabrina about the accuracy and usefulness of saliva versus blood testing for hormone replacement therapy (HRT). 👉 Is saliva testing more accurate for transdermal Bi-Est creams? 👉 Why does your estradiol look low in bloodwork but high in saliva? 👉 Does skipping your hormones before testing give a better result—or just confuse the picture? 👉 What’s a true 80/20 Bi-Est ratio, and how can you read your prescription dose properly? 👉 Why might oral progesterone make you anxious instead of sleepy? You’ll learn: ● How to interpret blood and saliva test results when you’re on HRT ● The pros and cons of different testing methods (serum vs. saliva vs. urine) ● The real reason your progesterone might backfire and worsen sleep ● Why your estrogen dose may be too low—even if your labs say you’re “in range” ● How to work with your practitioner to adjust your HRT plan safely This episode is perfect for anyone on HRT who’s feeling confused about their labs, frustrated by persistent symptoms, or stuck between conflicting advice. 🧠 Bonus: Dr. Davidson breaks down estrogen ratios and cream dosing using real-world examples. If you have a question, please visit our website and click Ask the Doctor a question. Join the Progress Your Hormones Community Stay Connected Instagram: @drvalorie TikTok: @drvaloried Disclaimer: All content in this blog, including text, images, audio, video, or other formats, was created for informational purposes only. This video, website, and blog aim to promote consumer/public understanding and general knowledge of various health topics. This content is not a substitute for professional medical advice, diagnosis, or treatment. Please consult your healthcare provider with any questions or concerns you may have regarding your condition before undertaking a new healthcare regimen. Never disregard professional medical advice or delay seeking it because of something you have read on this website. If your healthcare provider is not interested in discussing your health concerns regarding this topic, then it is time to find a new doctor.
In this episode of the Progress Your Health Podcast, Dr. Valorie Davidson and Dr. Robert Maki dive deep into a question from “Amber,” a 49-year-old woman struggling with extreme perimenopausal symptoms — despite being on progesterone, an estradiol patch, and thyroid medication. 🔍 Topics Covered: ● Why HRT (Hormone Replacement Therapy) might not be working ● Common perimenopause symptoms: sleep issues, fatigue, brain fog, weight gain ● The pitfalls of cookie-cutter hormone prescriptions ● How cortisol, stress, and over-exercising sabotage your hormones ● When estrogen dominance, low progesterone, and thyroid dysfunction overlap ● Could progesterone be making things worse? ● Why rhythmic hormone dosing may offer a better solution 💡 Learn why so many women feel dismissed or misdiagnosed during this transition—and how to find a treatment that actually works for your body. If you have a question, please visit our website and click Ask the Doctor a question. Join the Progress Your Hormones Community Stay Connected Instagram: @drvalorie TikTok: @drvaloried Disclaimer: All content in this blog, including text, images, audio, video, or other formats, was created for informational purposes only. This video, website, and blog aim to promote consumer/public understanding and general knowledge of various health topics. This content is not a substitute for professional medical advice, diagnosis, or treatment. Please consult your healthcare provider with any questions or concerns you may have regarding your condition before undertaking a new healthcare regimen. Never disregard professional medical advice or delay seeking it because of something you have read on this website. If your healthcare provider is not interested in discussing your health concerns regarding this topic, then it is time to find a new doctor.
