Hi Lara! Thanks for bringing those issues to the point. I am from Germany, 45 years old and after a partial emergency hysterectomy entered perimenopause. It took 8 months where I felt terrible and no doctor had a glue what was wrong. I was prescribed antidepressants and spent weeks in several hospitals.
For my luck finally one doctor agreed to my wish to make a hormone blood test and I was able to find an endocrinological gynecologist. It seems I am deeply into at least perimenopause. I am now on a small amount of an Estradiol gel and Utrogest mg. I wished women would be taught about all those things like we are visiting classes for delivering babies. Many women have had surgery as well.
We all are proactive in tackling this hormone stuff. Thought you might be interested! Anyone from the U. K taking body-identical hormones? Hi Fatima, I use utrogestan bio-identical progesterone. Anyway, hope that helps! Hi Dr Briden, I am 38 years old, and about 10 days ago I had a full hysterectomy. I am due to have a follow up appointment with my Dr in a few weeks, but the idea of HRT seems a little scary to me.
I am quite interested in the idea of natural therapies, but there is not a lot of options for young women going through surgical menopause. Honestly, I am very overwhelmed by the whole thing!! Do you have any suggestions on where to start? Very educated women sharing information on BHRT, menopause, effects of surgery. I thought you might like to check it out. I currently take mg of compounded progesterone.
Will the cream help? I have insomnia, no libido, anxiety,and generally feel so blah, unmotivated, foggy, headaches. Thanks for a great book! Hormone therapy is generally recommended after surgical menopause and the best kind is transdermal estradiol with oral natural progesterone capsules. Hi there. Thanks for the post. Just a question on the types if that is possible. You mention the 3 oestrogens to take, but Vagifem is vaginal so that would not have the effect on mood and sleep would it?
As it only has a local effect? Then Estradot is a patch and the Sandrena is a gel with much higher amounts. Is Sandrena still ok? As I see you mention Vagifem and Estradot more?
And is there a reason why Sandrena is at 1mg up to 0. Then on the progesterones, is urtogestan any different to prometrium as again I see you mention this more. Then is teva ok as I read some reviews that it is the weaker version of prometrium and some even say the synthetic form, but there is less information on this.
Thanks Susan. How about Chasteberry plus from Metagenics? Ot just Chasteberry in general? I tried BHRT and had a horrible time with side effects. I saw a different hormone specialist and now take compounded progesterone and it is worlds apart.
Do you know of any significant difference between the Brand Prometrium and a generic progesterone made by BionPharma? My doctor insisted on the generic, but I noticed that both Prometrium and the generic inserts have all sorts of side effect warnings. Does the FDA have to list the warnings because they lump progesterone in with synthetic progestins?
I am very confused and concerned. I am 46 and showing signs of perimenopause. I am not in perimenopause but I am 31 with irregular periods and I am trying to conceive. Do you suggest that I inquire about Prometrium instead? Or is this just for perimenopause? Prometrium can be used by young women for the progesterone-challenge bleed. Hi Dr. Currently nursing my 15 month old. My period returned 8 months ago without fanfare, though perhaps a little heavy. After a few normal cycles, my symptoms began- very high anxiety and panic attacks, shorter cycles days , brown bleeding on the first day, heart palpitations.
The thing is, my symptoms are the worst during my period and for about a week after. A doctor prescribed bioidentical progesterone cream, but he did not check any hormone levels. I am supposed to take it daily, plus try it during moments of high anxiety. Are there any specific tests you might recommend I request, links you could direct me towards, or other ideas? Hi savanah, I am 37 and my youngest child is 4.
I literally could have written your post word for word. I feel like I am losing my mind the week of and a few days after my period. My cycle is similar in length too. Have you benefited from the progesterone cream? How are you doing now? Hi Shay! The progesterone cream has helped, but not solved everything. This past cycle was 28 days, bleeding was much lighter, and postmenstrual period was still not great but not downright awful. I also started seed cycling about a month ago.
My periods were a bit irregular before that 7 month span, with terrible pain, headaches, and hemorrhaging. It only helps with the hotflashes if I use it under my tongue at night though. Should I try the Miconized pills instead? I have all the symptoms of insulin resistance you list in your book. Should I get rid of the testosterone in the compound? Should I add a bit of estrogen yet?
Thank you for your help!!! On more question! Would it still be better to switch to iodine? Thanks again! And thank you for writing your next book! I only regret not having tried it sooner. Any advice would be gratefully received. Is it possible that I need a higher dose of Estrogen I was given the lowest dose or that it takes a few more months before it improves?
The pH is always normal and lab test showed normal flora repeatedly, but my Gyn insists that it is BV. I still had a lot of burning and discharge, but little less of the other irritations.
I worry about taking estrogen for life. I would prefer getting rid of the BV first. I tried oral and vaginal probiotics and a candida diet without success.
The thing is that for menopausal women, a vaginal estrogen probably is the best way to get rid of BV. The best is probably a combination of estrogen and the vaginal probiotic I describe in my book with the strains Lactobacillus rhamnosus, GR-1 and Lactobacillus reuteri, RC Look into these: Good Love Balance gel.
Vinegar plus water recipe for vagina use helps give the right pH to encourage good microbes. Get unsweetened yogurt and smear it around. Coconut oil will kill a lot of microbes, only best if you have high yeast.
Use a suppository with probiotics Good for female—you can insert it or open an smear it around. If you have histamine intolerance, learn how to manage it.
I have a lot of vaginal issues burning, discharge, irritation as if something is in there. The vaginal estrogen helped minimally after 3 m. But now that I tried to reduce the dose by half, it is getting worse. Is there another way to balance the vaginal microbes?
I think vaginal estrogen is quite a good treatment. I was prescribed mg of oral micronized progesterone from a compounding pharmacy in the U. I weigh pounds. Do a search on ChrisKresser. You will likely find these suggestions for prevention: Lower or eliminate grains due to phytates which bind to minerals when they are in your gut with your food. Take bone broths or collagen. Optimize your calcium to magnesium ratio. Eat enough protein. Get fat soluble vitamins D3 and K2.
I also take Pure Encapsulations Mineral and I add 15 mg of zinc. Also, do weight bearing exercise plus walking or other exercise. My mother died of a heart attack. My mother also had that and my bones are tiny. Hello, Lara I started taking magnesium pills but I got an allergic reaction : , I got eczema on my face skin. Your book was a big eye-opener for me. Can you recommend anyone in Sydney or Switzerland for suspected post-pill pcos? Thank you so much. Hello, my mom is 69 years old and now days still suffering from hot flushes, not sleeping, joints pain, etc.
Thank you very much. The book exists in Spanish! Magnesium is safe to start at any age. I recommend she tries that first because 69 is a little too old to start any kind of hormone therapy. What alternatives would you suggest? Also can estrogen be taken safely without progesterone? Is there a herbal alternative to Prometrium? There are only progestins which are only needed to protect the uterus. Most informative thank you. Re starting estrogen you say in the first year of menopause… is that one year after last period?
To have an idea around timing. I ve started already on progesterone cream made from yams…it is helping for sure but maybe not enough?? My sleep is barely happening! Am taking Dormidiana…is this a histamine? Does help sleep for sure. Is this ok? Like the article above. Estradiol patch plus mg of progesterone. My dose of estradiol has been increased to. I just got a period today. Is it ok to be on continuous HRT if I just had a period?
Is this normal? Best to check with yours. Is there great risk to not taking hormones at age 48 after a total hysterectomy which occurred at age 43? I took compounded cream hormones for a couple of years, but then stopped.
I took progesterone mg on the last two weeks of my cycle due to heavy periods and bloating. I saw a huge difference, I was retaining liquids, and with the progesterone I felt lighter and my heavy period was lighter too. I thought it was a tooth I was having problems, but I think it might be cesation of progesterone intake. Could that be possible? Should I try mg instead of mg I;m 40 years old? What time of day should Ashwaghanda be taken if on HRT?
Can they be taken together? Is it ok to supplement with Ashwagandha while on HRT estradiol patch and prometrium capsules as you recommend? I see you recommended taking a few days break about once a month. Can you please elaborate on that? Dr Briden, Thank you for your work and for writing your book. I have a few questions: Can a 66 year old balance her hormones if she has never done so in her life time? But just recently am experiencing many itchy hives on my upper arms and upper back.
In addition see more dark spots on my face, and arms and am very tired. I am wondering if Synthroid and Cytomel thyroid medications are not enough and a small dose of iodine might correct my problem? I have just learned of estrogen excess from your book and also realized my histamine issue has escalated recently. I am allergic to aspirin and have a touch of asthma. Are these symptoms related to estrogen excess and histamine sensitivity? My weight is the highest its ever been and I am always depressed.
Can you explain what you think I might be dealing with, without an official diagnosis? I understand the limitations through this comment format. Thank you, Confused Briden, despite the hormones they gave me a few months ago not being bio identical, would you consider them equally safe? I do eat well over g of carbohydrates and have no vitamin or mineral deficiencies according to my blood tests, yet my estrogen is still drastically low.
Large doses of phytoestrogens do not help hypothalamic amenorrhea and in fact, have an anti-estrogen, ovulation-suppressing effect.
And in answer to your question, the safest protocol for short-term hormone replacement for HA is body-identical hormones. I was prescribed topical estrogen gel and a progesterone tab just 8 months ago when i discovered I had osteoporosis to preserve my bone density until I get my period back.
I have been suffering with HA since 15, and I am 26 now. I broke my hip 10 months ago which is how we found out about the osteoporosis. My question is, is HRT safe? I stopped the HRT 4 months in, afraid, and am now taking red clover extract because I have found studies it helps with bone density in menopausal women, despite the fact I am not kn menopause. Do you have some insight?
The current protocol is to give body-identical hormone replacement Estraderm patch plus Prometrium during the recovery phase of HA or RED-s. But, of course, the more critical part of the plan is to recover your cycles by increasing your food intake at least calories per day plus grams carbohydrate. I am seeking information about progesterone use for a post menopausal woman I am Like so many people with adrenal fatigue issues, mine stemmed from a period of severe stress that I hope will be getting better.
The term "bioidentical hormone therapy" is used to describe hormones that are identical or nearly identical to the molecular structure of hormones produced naturally by your body.
Technically, your body cannot tell bioidentical hormones from the ones your ovaries produce. There are two basic schedules for HT — continuous combined estrogen and progesterone daily , or cyclic estrogen daily, progesterone days a month to mimic the menstrual cycle.
Both HT schedules are effective in protecting the endometrial lining to prevent endometrial hyperplasia and cancer. Even women who are on cyclic regimen of HT eventually stop having periods usually within a year. In order to keep an older woman menstruating, higher and higher doses of hormones would be needed, which I believe to be unsafe. DHEA, on the other hand, is the androgen primarily produced by the adrenal glands.
At present, androgens are not thought to be a mandatory part of menopausal hormone therapy since their medical benefits have not been clearly established, except in specific groups of women.
Some women with autoimmune conditions such as lupus may benefit from DHEA supplementation. Small studies have indicated that in women and men over 65 years of age DHEA may provide benefits including improvement in mood, muscle strength and bone density.
Sex drive libido in women is a complicated issue. Many women may complain that they have no spontaneous desire, but when sufficiently stimulated are able to respond and enjoy sexual activity.
These women have an intact responsive desire but a lack of spontaneous libido. In order for a woman to desire sex, she has to be relaxed, has enough energy, have a reasonably healthy body image, and be happy with her partner, and not be distracted. For many women, it may seem almost as difficult to meet all the criteria mentioned above as for the planets to be aligned!
Women have to be relaxed to enjoy sex, while men have sex to help them relax. Furthermore, women have to feel love and intimacy in their relationship with their partner to desire sex, whereas most of the time men experience intimacy through sex.
Women and men are just not on the same page when it comes to sexual desire. This homework list may include certain lighting, music to set the mood, and specific activities in foreplay and of course, spending more time in foreplay usually helps!
So androgen therapy may or may not be helpful, but certainly can be tried after pros and cons are discussed. Finally, expectations should be realistic. Even in instances where testosterone therapy is helpful in enhancing sexual desire, it will not create aggressive prowess in an otherwise sexually passive woman. There is no FDA approved testosterone product for women, so testosterone is usually custom-compounded. Laboratory assays for testosterone are challenging in women due to the much lower circulating levels in women as compared to men.
I prefer to measure blood levels of DHEA-Sulfate and Testosterone total, bioavailable and free levels using reliable laboratories. The use of androgens must be individualized for each woman and appropriately monitored. I do not recommend the use of pregnenolone.
Pregnenolone is a precursor steroid which can be transformed in the body to other steroid products including progesterone, estradiol, testosterone, DHEA, cortisol and aldosterone. In my opinion, the most important guideline is that one must individualize hormone therapy. Each individual woman must evaluate her own needs and risk factors with her personal physician in deciding about hormone therapy.
Adjustment in hormone therapy should be based on her own individual response with focus on her symptoms rather than hormone levels. Like the reservoir patches that were first designed, these patches continuously release natural, bio-identical estrogen into your system, but they tend to cause less skin irritation. According to one manufacturer, only about 9 percent of users developed significant skin irritation — about half that of Estraderm reservoir patch users.
The matrix patch was first introduced in , when the Climara patch came out.
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