In this episode, we dive into the important topic of HRT (Hormone Replacement Therapy) dosing. Our discussion is inspired by a question from Leah, a 56-year-old listener who is healthy, fit, and navigating menopause. Leah has been experiencing significant anxiety and wonders if her current estrogen dose might be too low.
What You’ll Learn in This Episode
Let’s Read Leah’s Question:
“Hello there! After 6 months of deep diving I found your site! I feel like no one here in Vancouver has a full hold on how to treat me. Your information has been so invaluable, but now I’m worried I’m not being cared for properly.
I’m 56, fit, work out regularly at moderate intensity with muscle training, normal weight, healthy my entire life-no menopause issues till March.
I was a week away from a big gig and suddenly got this weird, crippling anxiety. It started with a massive hot flash upon waking one morning, then this feeling like I had just missed being in a car accident … like a fright- for no reason. It was bad enough the first week that I didn’t want to drive. It settled to about 30% and so was able to function. But it recurs at this level now and it’s been 8 months. Its the most uncomfortable feeling, and little things bring it on, like getting ready to go out and always first thing when I wake up.
I started with an obgyne who put me on .05 estradot patch with 100 mg progesterone. Hot flashes went away but nothing else. Went up to .075, no change. Also started on 2 mg testosterone ordered perivaginally.
Then I went to see a naturopath. Did a DUTCH. Test, my hormone levels looked as if I wasn’t taking anything! Also adrenals were fatigued and low cortisol.Basically everything really low but progesterone ok.
My naturopath put me on 50:50 bi-est 2.0 mg vaginally applied. Progesterone 40 mg transdermal and staying on the oral progesterone. No change after 3 weeks.
I feel like I need more hormones. My naturopath says she never gives more than 3 mg testosterone because it can raise cholesterol but all the research shows 5 mg starting dose?
I also asked her about vaginal application of biest and systemic concerns and she said because it was 50:50 the estriol would help regulate the estradiol.
After listening to all your podcasts and reading your case studies, I’m feeling like there’s so much contradicting info and I don’t want to apply it vaginally. I feel like my dose is too low, did I mention in addition to this weird anxiety, I’m also getting little hot flashes again?
I want to enjoy my life and feel like me again. This insane…
Would love to hear your thoughts and opinion?
Warmest Regards”
Whether you’re new to HRT or looking for insights on optimizing your hormone therapy, this episode is packed with practical advice and actionable tips to help you feel your best during menopause.
If you have a question, please visit our website and click Ask the Doctor a question.
Want more insights like this?
Be sure to subscribe to our newsletter for hormone Q&As, educational guides, and real-world strategies to help you feel like yourself again—especially during perimenopause and menopause.
Join the Progress Your Health Newsletter
Stay Connected
Instagram: @drvalorie
TikTok: @drvaloried
Join the Hormone Community: Click here to subscribe
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.
Discover the common and unfamiliar symptoms that you might be experiencing. Get access to cases of real women with hormonal conditions.
Hormone Coaching App: 👉 http://hormonenavigator.com/ Progress Your Hormones Community: 👉 https://www.progressyourhormones.com/ Menopausal women everywhere are asking the same question: “What’s the RIGHT starting dose for testosterone?” In this episode, hormone experts break down why testosterone dosing is NOT one-size-fits-all, and why starting too high could trigger acne, hair loss, anxiety, or even irreversible side effects. You’ll learn: The safest starting testosterone dose for menopausal women Why some women tolerate higher levels better than others The hidden connection between testosterone, DHT, acne, and hair shedding Why libido problems are more complicated than most people think The truth about pellets vs testosterone cream The side effects doctors watch for FIRST How testosterone impacts motivation, muscle mass, energy, and bone density If you’ve ever wondered whether testosterone therapy could help your menopause symptoms, this episode explains the risks, benefits, and biggest mistakes women make when starting HRT. 🔔 Subscribe for more episodes on bacterial vaginosis, hormones, menopause, heart health, thyroid, and longevity with Dr. Valorie & Dr. Maki. 👍 Like and share this video if it helped you 📩 Comment below with your top takeaway or question Disclaimer: Educational content only; not medical advice. Please discuss your labs and care plan with your clinician.
Hormone Coaching App: 👉 http://hormonenavigator.com/ Progress Your Hormones Community: 👉 https://www.progressyourhormones.com/ Are you taking the right HRT dose… or just the common one? In this episode, we break down a growing problem in hormone therapy: 👉 Younger women are overdosing 👉 Menopausal women are being underdosed And the real issue? Most practitioners treat different hormone types like they’re the same when they’re not. You’ll discover: Why estradiol patches vs creams are NOT equal The hidden mistake when switching HRT types Why “low dose” might actually be hurting you How absorption changes everything Why lab numbers alone don’t tell the full story The real difference between perimenopause vs menopause dosing This isn’t just about numbers; it’s about precision, personalization, and feeling like yourself again. 💡 If your labs are “normal” but you still feel off… this might explain why. 🔔 Subscribe for more episodes on bacterial vaginosis, hormones, menopause, heart health, thyroid, and longevity with Dr. Valorie & Dr. Maki. 👍 Like and share this video if it helped you 📩 Comment below with your top takeaway or question Disclaimer: Educational content only; not medical advice. Please discuss your labs and care plan with your clinician.
Hormone Coaching App: 👉 http://hormonenavigator.com/ Progress Your Hormones Community: 👉 https://www.progressyourhormones.com/ Think menopause ends when symptoms fade? Think again. In this episode, we break down “deep menopause,” a phase rarely discussed but critical for long-term health. While hot flashes and mood swings may disappear, deeper issues like bone loss, muscle decline, insulin resistance, and cardiovascular risk can quietly accelerate. Discover: Why feeling “fine” can be misleading The hidden risks after age 60 How hormone therapy should be approached differently The real reason muscle loss speeds up aging What most doctors overlook about long-term menopause care This is where prevention becomes reversal, and strategy matters more than ever. If you’re serious about longevity, energy, and protecting your future health, this is the conversation you can’t afford to miss. 🔔 Subscribe for more episodes on bacterial vaginosis, hormones, menopause, heart health, thyroid, and longevity with Dr. Valorie & Dr. Maki. 👍 Like and share this video if it helped you 📩 Comment below with your top takeaway or question Disclaimer: Educational content only; not medical advice. Please discuss your labs and care plan with your clinician.
Hormone Coaching App: 👉 http://hormonenavigator.com/ Progress Your Hormones Community: 👉 https://www.progressyourhormones.com/ Is it normal to feel worse years after menopause, even when your labs look fine? In this episode, doctors break down the hidden phase called middle menopause—the stage no one explains, where symptoms shift from hot flashes to something more confusing and frustrating. You’ll learn why: Your cholesterol suddenly increases (without changing your diet) You feel more tired, inflamed, or even pre-diabetic Weight gain seems uncontrollable Intimacy becomes painful Your body no longer feels like your own This isn’t just “aging.” It’s a hormonal recalibration phase that most doctors overlook. Discover the real reason behind: Rising LDL cholesterol Insulin resistance & blood sugar spikes Vaginal dryness and urinary symptoms Increased stress sensitivity despite a “better” life Plus, learn how lifestyle, hormones, and modern tools like personalized hormone tracking can help you take back control. 👉 If you’ve ever thought: “Why do I feel worse now than before?” — this episode is for you. 🔔 Subscribe for more episodes on bacterial vaginosis, hormones, menopause, heart health, thyroid, and longevity with Dr. Valorie & Dr. Maki. 👍 Like and share this video if it helped you 📩 Comment below with your top takeaway or question Disclaimer: Educational content only; not medical advice. Please discuss your labs and care plan with your clinician.
Hormone Coaching App: 👉 http://hormonenavigator.com/ Progress Your Hormones Community: 👉 https://www.progressyourhormones.com/ Are you experiencing symptoms of menopause, but not quite there yet? There’s a confusing phase most women go through that isn’t clearly defined: the transition between late perimenopause and full menopause. This stage is often misunderstood, misdiagnosed, or completely overlooked. What you’ll learn: The REAL difference between perimenopause, “in-between,” and entering menopause Why your estrogen levels suddenly feel like they’ve “left the building” The surprising symptoms no one warns you about (brain fog, night sweats, mood shifts) How your body tries to rebalance itself and why it feels chaotic What your lab results (FSH, estradiol) actually mean during this phase If you’ve ever felt like your body changed overnight or your symptoms don’t match what you’ve been told, this is the clarity you’ve been missing. 👉 Plus: Learn how to track your symptoms and understand your hormonal phase with precision. 🔔 Subscribe for more episodes on bacterial vaginosis, hormones, menopause, heart health, thyroid, and longevity with Dr. Valorie & Dr. Maki. 👍 Like and share this video if it helped you 📩 Comment below with your top takeaway or question Disclaimer: Educational content only; not medical advice. Please discuss your labs and care plan with your clinician.
Hormone Coaching App: 👉 http://hormonenavigator.com/ Progress Your Hormones Community: 👉 https://www.progressyourhormones.com/ You’ve been told your labs are “normal”… but you still feel exhausted, moody, gaining weight, and not like yourself. So what’s really going on? In this episode, we break down one of the biggest misconceptions in women’s health: why “normal” lab results don’t always mean optimal health, especially during perimenopause and menopause. Discover why symptoms like brain fog, poor sleep, weight gain, and mood swings are often ignored… and how traditional lab testing can miss the full picture. We also reveal how tracking patterns over time and combining symptoms with deeper hormone insights can unlock real answers and personalized solutions. If you’ve ever felt dismissed, confused, or stuck… this conversation will change how you look at your health forever. What you’ll learn: ● why normal blood tests don’t show hormone imbalance ● How to read hormone labs in perimenopause ● early signs of perimenopause in your late 30s ● What hormones to test for women over 40 ● why you feel bad even with normal lab results ● How to track hormone changes over time ● best lab tests for female hormone health ● The difference between normal vs optimal lab ranges ● How hormones affect sleep mood and weight ● How to create a personalized hormone health plan 🔔 Subscribe for more episodes on bacterial vaginosis, hormones, menopause, heart health, thyroid, and longevity with Dr. Valorie & Dr. Maki. 👍 Like and share this video if it helped you 📩 Comment below with your top takeaway or question Disclaimer: Educational content only; not medical advice. Please discuss your labs and care plan with your clinician.