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.

In this episode, we answer a listener’s question about her HRT dosing. ‘Donna’ is 63 years old and has been on some type of hormone replacement therapy for the last 13 years. Hormone therapy is not ‘one size fits all.’ There are so many types of menopause hormone therapies that each treatment needs to be […]

In this episode, we answer a listener’s question about her HRT dosing. ‘Donna’ is 63 years old and has been on some type of hormone replacement therapy for the last 13 years. Hormone therapy is not ‘one size fits all.’ There are so many types of menopause hormone therapies that each treatment needs to be tailored to the individual. And overtime hormone treatments will change due to age, specific health goals, symptoms, and life changes. Even stress can create a need to adjust hormone doses. Let’s Read Donna’s Question: Good morning, I am 63 & postmenopausal (menopaused @ 35). I was from age 50 to 58 on a combo bio identical hormones Biest (?) & progesterone 200mg. A few years ago the doses were dropped to Prometrium 100mg & Biest 0.3mg (1.5 mg divided by 4 days). My doctor isn’t interested in bioidentical hormones so I instructed myself. Now at 63, I am “reasonably” well but some vaginal atrophy/dryness, still some moodiness & bad sleep. I tried stopping & got really “weird” emotionally. I tried Estriol cream but it’s messy + Prometrium 100mg. Going back on the torches + Prometrium? I was going to try patches but your podcast made me reconsider. Any advises please. With kind regards We take Donna’s question and discuss: – What is vaginal atrophy or also known as genitourinary syndrome of menopause (GSM)? – Different types of hormone replacement: troches, patches, creams, and others. – Prometrium vs progesterone. – Not all doctors have a knowledge base of hormone replacement. – What is biest? – What is estriol? – How hormone replacement can help mood. – How to help treat vaginal dryness due to menopause. If you have a question, please visit our website and click Ask the Doctor a question.

In this episode, we discuss a question from Janice, a podcast listener’s question regarding the benefits of estrogen therapy for heart health. There is much evidence to show that estrogen has cardiovascular protective benefits. We wanted to discuss how estrogen benefits heart health and can help reduce the risk of cardiovascular disease. Janice’s Question: Are Biest 50:50 sublingual tablet safe? My Dr. prescribed 2.5 mg tablets but told me To take ½ tablet in AM and ½ tablet in PM. I’m worried about blood clots, cancer etc. In this episode, we dive into: ● Estrogen and its positive effects on cholesterol. ● Differences between men and women in terms of cardiovascular risks. ● Women have less risk of cardiovascular disease because of estrogen levels in the body. ● How does estrogen can help reduce the risk of heart disease? ● What is cholesterol? ● HRT and Cholesterol ● Break down the components of cholesterol and what they mean. ● How does estrogen help manage blood pressure? ● Types of estrogen hormone replacement can be used for menopause to help ● How weight gain occurs in menopause to increase risks for cardiovascular disease. If you have a question, please visit our website and click Ask the Doctor a question.

In this episode, we talk about the benefits of estrogen on bones. A listener’s question (Alison) inspired this episode. Alison asked if taking vaginal biest has the same heart and bone effects that other estrogens and estrogen therapies have. So, we wanted to expand on estrogen’s role in helping keep bones strong and healthy. In this episode, we expand Alison’s question into: ● What is bone formation and resorption? ● How does estrogen help with bone formation? ● How does estrogen help discourage bone degeneration? ● What lifestyle factors contribute to promoting healthy bones? ● What lifestyle factors contribute to bone degradation? ● Hormone replacement (HRT) and bone density. ● The lowest dose of estrogen for osteoporosis. ● What supplements can help with bone health? If you have a question, please visit our website and click Ask the Doctor a question.

In this episode, we talk about hormone treatments for perimenopause and menopause. There is a vast distinction between perimenopause and menopause when it comes to treatment options. We often see women who are being treated for menopause when they are genuinely not in menopause. Meet Linda: Linda is a listener who sent us a question on our website about her hormone replacement treatment. Linda is in her 40’s and has her period regularly. She was given an estradiol patch and gained 20 pounds. Linda is in perimenopause, yet being treated for menopause. This will cause weight gain and other symptoms, which we discuss in depth in this podcast. Let’s Read Linda’s Question: Hello, I am 44 still cycling. I am currently on estradiol patch 0.05 and progesterone and testosterone cream. Since I switched from Biest cream to the patch, I have put on 20lbs. Help. In this episode, we break Linda’s question into: ● Differences between perimenopause and menopause ● Does a woman in perimenopause need to take estrogen? ● Weight gain and hormone replacement ● What is estrogen dominance vs progesterone insufficiency? ● What symptoms will occur is estrogen levels are too high? ● What hormones should a woman take in menopause vs perimenopause? ● Does hormone replacement cause weight gain or weight loss? If you have a question, please visit our website and click Ask the Doctor a question.