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].