When we started this podcast and writing articles, we were very naive about who would want to read this stuff. Honestly, I didn’t think anyone would want to listen to a husband/wife couple-docs that only dealt with hormone balancing. Being an introvert, I am really pushing myself outside of my comfort zone with these articles and podcasts.
I cannot believe how many readers and responses we have gotten. I am absolutely amazed at how many responses we have gotten from people outside of the USA. I am truly flattered and amazed that people from all over the world are reading and listening to our content.
With that said, we have gotten lots of comments and questions from readers/listeners. It is hard to answer them one on one. So I wanted to write an article answering some questions that we have gotten. Some of these questions are from the states and others outside of USA.
Regardless of where we are from, we still experience hormone issues. I believe these questions might help others going through the same hormonal imbalances. And help us to know that our concerns are valid and we are not alone.
Question – Sherry
Hi, What is Estriol made from? I know that Estradiol is from equine urine, and I stopped taking it for that reason and also it caused my breasts to get really large and very tender. I want a natural menopause supplement that isn’t animal derived. Does Estriol fit this description? Thank you, Sherry.
This is a great question. Many people are not sure of what BHRT and hormones are made from. Actual estradiol is not made from horse urine, or also known as equine estrogens. There are conventional hormone prescriptions that are made from horse urine.
These are commonly called Premarin and Prempro to name a couple. But estradiol is a bioidentical hormone. But as we talk about on this episode, estradiol is the strongest form of the bioidentical estrogens. Estradiol is an amazing hormone. It helps with bones, mental energy, hot flashes, sleep, libido, and vaginal atrophy to name a few. But like I mentioned, estradiol can be quite strong.
That is why Sherry is having the breast tenderness. For vaginal atrophy, we use estriol, which is the weakest, most gentle of the estrogens. It is great for vaginal dryness and atrophy without the side effects that estradiol can cause, such as breast tenderness and uterine thickening or spotting. So to answer Sherry’s question, both estradiol and estriol are bioidentical. But the estradiol may have been too strong for her, and that is why she had the breast tenderness.
Question – Rachelle
I have vaginal dryness, and I noticed a little bit of spotting today. I haven’t had sex in over 3 yrs, but I do walk a lot. And I use cream from time to time. I also have a lot of burning off and on. The cream seems to help, but I don’t want to use it too much. That laser sounds worth it but too expensive for me. I was concerned about the spotting. I just had my pap smear done, and it came back good.
This questions came from an article that we wrote about vaginal dryness. The laser that Rachelle is referring to is a procedure that doctors are using to relieve vaginal dryness and incontinence. It works really well for both, and usually, only three treatments are necessary. But the drawback is that it can be costly, and insurance does not usually cover right now. We have seen many patients that have vaginal pain from atrophy even without intercourse. Typically, active women, especially walker and runners will get chaffing in the vaginal area. So Rachelle should consult her doc about the spotting. But most likely Rachelle needs estriol vaginal suppositories or cream to relieve her atrophy.
Question – Oliv
I live in Scotland and get a prescription for estriol every 56 days if necessary. I recently started to use it for vaginal atrophy, and it is gradually helping but seems to be taking a long time. My GP is quite happy with estriol. Anything would be better than this constant burning pain associated with this condition. My GP says I will have to use it once weekly for the rest of my life. Oliv.
I love that Oliv is using the estriol for her vaginal atrophy. As estriol is safe and effective for vaginal dryness. Most likely the dosage of the estriol is too low. I have to say this, or my attorney will give me quite an earful: this is for info only, not to replace medical advice Oliv needs a higher dose of the estriol. Usually, to start, I have a patient use the estriol vaginal every night for seven nights. After that, use twice a week at night. Also to answer Oliv’s question, for vaginal atrophy it will need to be used most likely for the rest of her life.
Sometimes is a woman is using an adequate dose of systemic BHRT they do not need the vaginal estriol. But usually, a woman needs the estriol for the rest of her life for vaginal atrophy. She might need it once a week, twice a week or twice a month. As the frequency of estriol application vaginally really depends on the individual. I would like to give a great big thank you and shout out to Sherry, Rachelle, and Oliv. Thank you for taking the time to write these questions to us. If anyone has questions about hormones, please feel free to send an email to [email protected].
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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.
