Hormones, HRT, and Sleep Quality: How you can sleep better! | Felice Gersh, MD

[@BLE000]

Yes, this is me. I had to do my own research and start hormones on my own as the doctors didn’t know how to manage it. The neglect of woman’s health is reckless.

[@sandilang3845]

I agree, most medical research is done on men, especially for heart attacks. While in medical school there aren’t any teachings on menopause.

[@Gladeeez]

how do you get the prescription?

[@sandilang3845]

@ I believe only your Gynecologist can give it to you.

[@liznaber880]

I get estradiol overseas the website was recommended by a retired gynecologist. It’s not obligatory to supply a prescription.. just you’re doctor’s name. Yes not honest but I take a small dose .5mg estrogen daily and it’s a lifesaver for me.

[@jaymeous]

The more I learn about hormone deficiency in women, the more it frustrates me that there’s not better research and information to answer the kind of questions Dr. Gersh raised in this video. I’m disheartened by the lack of interest and funding related to menopause. Thanks Dr. Gersh for bringing forth gaps of medical knowledge and the need for more research! You continue to lead the way for women on their menopause journey. I’ve learned so much from you!

[@Haley22_22]

Read Elizabeth Bright book ‘good fat is good for a women’… won’t regret it

[@jennyahern2755]

Everyone watching this channel should hit the subscribe button! This woman is an absolute treasure. All women out there lets support this channel. All her information is sooo important for us!!! 🙏🙏❤️❤️👏👏

[@carolrobinson9897]

Thank you Dr.Gersh, I take both the estradiol patch and the progesterone tablet orally. I hope that’s OK! I just started this two months ago and I do sleep way better. I actually sleep all night now , i used to wake up a lot. So much information to take in. thank you❤

[@dawnhoffman366]

I found taking progesterone orally did help me sleep but also made me feel sluggish and low in mood. When I switched to using it vaginally, I felt a lot better, even though my sleep is not as good now.

[@alivingbalance]

Try taking a little gaba and or L-theanine for the sleep part

[@natasha09179]

During the follicular phase I CANNOT SLEEP and this video finally explained it for me! I am on HRT but my doctor keeps telling me to LOWER my estrogen dose to help this problem. I’ve been googling and researching pubmed, etc., for months, trying to figure out why what she wants me to do is not working. Now I know!!! OMG. Thank you so much 😭.

[@zraj_iv]

In the beginning I was prescribed cycling patches Systen Sequi (in Europe) 0.05 estradiol but I had to cut the E dose by half 0.025 because of headaches, nausea, vertigo, breast tenderness and water retention(+5kg) Now I'm on continuous regimen Systen Conti (+ 100mg Progesterone at bedtime) and it works perfectly👍( I tried to raise to 0.0375 but I feel nauseated again😥)

[@minatohid7855]

Thank you so much for addressing sleep. Such a needed discussion

[@evan7852]

I am in menopause and I assume if I start to bleed for 5 days I have the right dose of estradiol. 🤔😊

[@susanbielby1076]

I think you are amazing. Thank you for helping women when they need it most. Question on your talk - how do we know if we're receiving a physiological dose of estradiol? Is it a certain level in our blood labs?

[@evan7852]

I am in menopause, and I assume when I do bleed for 5 days that, I have the right amount of estradiol. 🤔😊

[@lilydesjardins5063]

Would love more videos on dosing and rhythmic HRT, what is considered a good dose and which days?

[@ahvccg]

Just with one week of bioidentical progesterone, I went from no sleep to sleeping as a child. Love bioid progesterone. Read dr. John R Lee. De Gersh is great and loves Bioidentical estradiol, but other doctors rely more in beautiful progesterone, which is related to gaba levels. Love it.

[@joannafronczak9721]

Please could you make an episode about progesterone intolerance? Thank you

[@stef3565]

Hats off to you Dr. Gersh!! Finally, some real answers. Another great video! Can't wait to hear about the better route for progesterone.

[@LeanneTorio]

The medical industry doesn't want us to be healthy... HRT would solve problems which they don't want. Just like cancer! I hope this doctor stays safe!!

[@jeepgurl1379]

My doc increased my oral progesterone dose to aid in better sleep. I’m post menopause.

[@avabishop753]

Dr Gersh thanks for this video 💯

[@russvet]

Provably a good way is to devide progesterone given rhythmically (in days when it qty is on maximum) - part for oral use, part introvaginally.

[@Teddyhall11]

I was prescribed ustrogestan 100mg x2 at night-time on an empty stomach. Within 12 hours I've got a severe reaction to it. I was covered with raised itchy red skin from head to toe. It was absolutely horrific. Never had reacted to anything in my life like this!

[@treesarose97]

I was underdosed with estradiol for years and now I sleep better but I am so upset that my health has declined due to all those years as I complained about the various issues. As I educated myself I went back and pushed for better dosing. Did labs too and they verified my complaints. When I can afford it I will be going to the drs my Compounding’s pharmacy refers to.

[@GirlJustDIY]

I'm 59 and just started HRT 6 months ago. My Gyn wanted to keep me at the lowest dose for the least amount of time. I quoted the Menopause Society position and indicated I want and deserve to feel better after 15 yrs of misdiagnosed symptoms. She upped me to .0375 after 3 months and recently I asked for more. Her email response indicates she isn't going to fight me for an increase after I do labs this week. It infuriates me that we've been given the short end of the stick for decades, but thankfully the tide is turning. We have to keep fighting for ourselves and so our daughters can easily be treated with preventative HRT during peri.

[@alivingbalance]

@@GirlJustDIYgood job advocating for yourself!

[@treesarose97]

I appreciate your situation for sure. Providers don’t get enough education on this

[@AS-yh6xu]

@@GirlJustDIY I hope you get what you think you need for Your health! I don't quite get it why doctors fight us for not their but our health! they don't pay $$ or possible consequences anyway. pure power struggle. I also did my research and went to 2 docs to get what I need- they didn"t have much to say after a while. Many docs don't stay up to date on research.

[@larajohnson8174]

Have been on HRT (estradiol, prometrium and testosterone) for 7 years and I have yet to sleep through the night. I wake up multiple times. No caffeine, no alcohol, no sugar. I don’t know what to do!

[@larajohnson8174]

Thank you for the video! ❤

[@msm1309]

Increase the dose , estradiol should be 100 in your blood and add melatonin , vitamin D , ashvaganda .

[@cozinha8945]

I am right there with you; it's super frustrating. Mg is helpful along with Sleep Breakthrough, a supplement by Bioptimizers. A full 7-8 hrs of uninterrupted sleep is a thing of the past for me.

[@crystalnixon5267]

I have the same issues. I’m wondering if maybe I’m not on a high enough estradiol dose.

[@larajohnson8174]

@@crystalnixon5267 My doctor refuses to go higher than manufacturer’s product availability- ie I’m on 100 estradot and that’s all she’s willing to prescribe

[@jeepgurl1379]

Can you talk about RT3 and what causes an increase?

[@ShamanicLiving]

look into sublingual use of progest-e to get progesterone in with minimal conversion into allopregnenalone.

[@BethAMcHugh]

Can you prescribe Estradiol for me? I am in Georgia. How would I go about this? Thank you so much Dr. For your help. 💐💐💐

[@marthaj67]

Check the North American Menopause Society's site for a local gynecologist who meets their criteria. S/he should prescribe HRT for you if you're a candidate.

[@Stampabay]

She will only prescribe if you make the initial office visit….

[@Stampabay]

@@marthaj67the menopausal providers are not only expansive and do not accept insurance they also want to lower your cholesterol by prescribing statins and pushing their personal trainer friends.

[@mtntm5628]

Thank you for this very informative video.

[@we4utube2]

What a great video.

[@elevateyourlife-felitad]

Wow, this is a very informative video and explains why I've been having frequent trips to the restroom at night! My testosterone levels are elevated & I was wondering if ther may be a connection. This is we must continue to do our research & not totally rely on doctors. Thank you Dr. Gersh!

[@russvet]

The info you give is so interesting! Waiting for your videos every time 😊 Unfortunately there is no something compared informative for men. My husband is 48 (as me)) and some symptoms seems to be the same as women get in peri. But usually only testosterone level is under discussion for men.

[@ElizabethGalarza1]

I agree about men having the same problems, the doctors focus is only in testosterone. My husband has been having symptoms of what I believe is a hormonal imbalance, anxiety, he can't stay sleeping, I don't know how to help him. His doctor prescribed sleeping pills but we're afraid of the side effects. Dr. Joseph Mercola wrote an article about progesterone for men, he says that he's been taking it for over a year, the dose is very small, we're going to try that before giving up to sleeping pills.

[@Monica.r7]

Looking forward to the next episode 🩷 TY so much Dr Gersh!!!

[@ТаняНестеренко-ж9о]

Принимаю мажу на тело,эстродиол 5 мг и прогестерон 100 еще ДГЕА25 Сплю прекрастно ,мне53 года Спасибо ❤️слушаю и мне подходит. В Украине есть все трансдермальные препараты

[@cat10131]

What blood tests do you recommend in order to determine if one is getting the proper amounts of estradiol and progesterone, and how often should these be done?

[@sherylmorgan4802]

Wow she is amazing love to hear. She has so much information and easy to understand.😊

[@VeritasElysium931]

Love your videos!!! Thank you ❤

[@Zinnie988]

Can you also address the needs for women in clinical menopause and the dosing they need as uterus, ovaries are removed? 😮

[@gingermonroe4153]

Hi. Just started watching ur vid however im suffering from an upside down sleeep like my circadium rhythm is upside down Been suffering from various sleep cycles Cant get any help wake up at 630pm Just was given Estradiol vag cream but had a bad reaction so i stopped it however will try it again Really appreciate u n ur info Went t urologist n gyno didnt really help me bout hormone Go into whats called Coma sleep Gbu Happy holidaze🎉❤any help would b great

[@GirlJustDIY]

Try going outside for sunrise and sunset for a few weeks. That's said to help reset your circadian clock.

[@Sariah]

I’ve been taking progesterone 400 mg capsules at night. Your right. It turns into pregdelone (misspelled). I’m going to use one capsule vaginally to see if that helps. Im already on pellets (estrogen & testosterone) and still cannot sleep. I’ve been taking 300 mg of gabapentin to help me sleep at night. Im on a 50 mg estradiol pellet. I will ask him to increase it. Subscribed!!

[@Katepwe]

You might want to consider changing the delivery method of the estrogen to either topical or a patch as it’s easier to control the dosage with these delivery methods. The progesterone can then be taken orally and the testosterone topically, again because the dosage is better regulated.

[@Katepwe]

What is an adequate dose of estrogen? What do you consider a tiny dose? I take 0.50mg daily but when I increased it to 0.75 to address the continued sleep and mood issues my breasts became very engorged, heavy and sore and once the dosage was decreased those symptoms disappeared.

[@SuzyTodd-j6l]

How do you get your provider to prescribe more estradiol? I’m on a 0.1mg/day patch but she won’t go higher than that even with labs showing low estrogen (20-30)! I’m in a somewhat small rural community and I’ve found a NAMS-C ob/gyn in the nearest urban area but that appt is 6.5 months the out. My sleep is minimal and I wake up almost everyday at 3:30! It’s super difficult.

[@Katepwe]

If you have a uterus you should also be taking micronized progesterone to protect it. If you don’t, progesterone can also be helpful for sleep.

[@april73showers]

I don’t think you ever tell us what optimal lab values are for estradiol. Could you please discuss that?

[@SeraphinaNYC]

Hi Dr.. Gersh ! I'm taking 200mg of oral micronized progesterone and .75mg of topical estradiol gel (.1%) each night. How many mg of the gel do you give your patients? I'm 48 years old and in late stage perimenopause. I do wake up earlier than I should, but my sleep quality has been outstanding since starting this regimen.

[@kteam4u]

I really enjoy your videos! Thanks for taking the time to make them, but It would be great if you quantify what exactly do you mean by physiological doses? I understand it may be different for everyone (i assume) but could you please give at least a quantifiable reference range of exactly what would be your operational definition of “physiological doses?” You mention this term very frequently but Ive not heard you say exactly what that means. It would be good to understand this in a quantified manner.

[@ApostleAliciaKee]

Physiological dosage is dosing at a level that prevents the three major diseases in women: Alzheimer’s, bone loss, and cardiovascular disease. This has been mentioned in several of her videos (amongst other menopause clinicians). The estradiol patch must be minimally dosed at 0.05mg. Orally, I believe is 0.625mg -0.1mg (as it has to pass through the liver and some is lost through the liver’s metabolic processes). Each route is different to prevent these diseases; and each has its pros and cons (I.e., orally, vaginally, spray, or gels). If you are solely going after symptom relief, start low and titrate until you find relief; however, keep in mind that relief does not equate to what your body needs physiologically to combat the three main diseases of post menopausal women. Lastly, hormones are metabolic. This means they can be used or metabolized differently in each woman depending on how active the woman is and how much body fat (adipose) tissue she has.

[@kteam4u]

@ thank you so much for answering my question! I really appreciate it!!!

[@anonanonymous1970]

Do you recommend pregnenolone supplements as a source of progesterone??

[@JeannetteFast]

What about post menopausal women , iam using bio identical hormone topical , having problems waking up at 3am and 4am

[@corinav8193]

Thanks for sharing. I’m having the same problem and I find it exhausting. Haven’t found a solution yet although taking 200mg Progesterone and 75ug Estradiol patch (every 3,5 days). Some one advised me to take GABA. Tried that since yesterday. Probably to short to notice any improvement yet. 😊

[@fitbusymomcoachjuliewillia3735]

Can you supplement gaba

[@kimbraid1194]

Very interesting with respect to Estradiol helping with sleep. I currently split my estrogel application between night and morning because I was told it could keep you awake. Maybe I should move my full dose to night?

[@Jess33-w1o]

I wonder that as well. I take mine in morning...but split dose would be worth a try

[@JeannetteFast]

I need more specific for a healthy post menopausal sexually active, have difficulty to stay sleep what is my best for hormone replacement , please !

[@TheresaShowalter]

In perimenopause was on Prometrium 200 mg days 16-25. It made he so dizzy then I would sleep for several hours and wake up around 3 AM and couldn't sleep. Quit taking it and then I developed new onset anxiety. Do you do phone consults for out of state?

[@jeand7768]

So interesting. My lining thickened on estrodial and I was bleeding so my doctor told me to go off. Why isn’t there any standard yet!!!!???

[@arizonasierra]

That's crazy. You just need to take more progesterone. Need new dr.

[@abbycroft0]

.1 estradiol patch 200 mg progesterone.still can’t sleep

[@jessicahitchens6926]

The Estradiol is too low. The Progesterone could also be too low. Are you not taking Magnesium Glycinate at night as well. And some Melatonin?

[@cozinha8945]

I increased my E2 to .125mg, P4 200mg and still I am unable to sleep through the night. I also take testosterone.

[@TaniaFallon]

On top of my HRT I take melatonin and magnesium glycinate- zzZZZzzz

[@ldavis-henry5065]

@@jessicahitchens6926magnesium L theonate I find the best for sleep

[@arizonasierra]

Magnesium Glycinate before bed is great for helping sleep.

[@sbc8730]

I was wondering how do I make appointment with you?

[@LeanneTorio]

I get 3.9 mg patch sleeping is so much better plus dreaming like crazy

[@anahiddominguez6700]

Can you offer virtual appointments? I contacted your office, but no response.

[@evan7852]

Maybe is it possible to take the oral progesterone tablet vaginal?

[@lyudmylashumey263]

Yes, Utrogestan works in that way

[@ibop9514]

Yes, I do take it intra vaginaly for 10 days of the month.

[@arizonasierra]

I take vaginally too... days 14 to 28 . Cyclical method to see if i can bleed. Will get more benefits from the estradiol 😊 1 find that it dissolves fine.

[@MandyPoulin]

​@@arizonasierraso more benefits from the E2 because the E receptors will be better with only 1/2 month Prog? Like happens naturally? So if post meno woman takes E2 (I use E2 gel 1 mg/day and 100 mg Prog same every day....will I not absorb as well? Should I take a break? How many days/month no HRT...like early cycle days when E is low, no P....maybe 3-5 days?

[@Tabitha_K]

I take micronised progesterone made for oral use intra-vaginally, every evening: 100 mg around 6 pm, and pushed up until it’s around the cervix. I use Estraderm MX 75 patches. No bleeding - and despite what Dr Gersh says, I do not want thickening of the uterine lining. I have a history of atypical endometrial hyperplasia (pre-cancerous condition) from transdermal oestradiol and cyclical progesterone use.

[@anahiddominguez6700]

Is it ok to be on estradiol patch at 0.0375 and dhea at 5mg? I have symptoms of a low testosterone and I am constantly waking up early too.

[@arizonasierra]

I'm on .075 estradiol patch. 100 progesterone i take vaginally. And take 25 to 50 mg dhea every day at 61 yrs.

[@alisondelancey6446]

So,so rich.

[@nicolebrewster4352]

Does progesterone give anyone else a heartburn feeling when they take it?

[@CenturyRide]

Yes it does. One thing you can try is chewing Xylitol gum. It's great for cavity prevention too but it really gets rid of GERD/reflux feeling.

[@MBT372]

How much estradiol?

[@rebeccaketner816]

It’s different for each person. A lower dose feels better for me, but for most a .05 patch 2x a week works.

[@kimbraid1194]

Very interesting with respect to Estradiol helping with sleep. I currently split my estrogel application between night and morning because I was told it could keep you awake. Maybe I should move my full dose to night?

[@Jess33-w1o]

I moved from 2 pumps of estrogel to 4 and feel 100% better...

[@MBT372]

@@Jess33-w1o wow I do only 1 pump

[@MBT372]

@@Jess33-w1o thanks! But 4 pumps is so expensive!

[@feliciak.696]

What if you had a radical hysterectomy? Do you need progesterone? I’ve been told, no.

[@Katepwe]

You don’t if you don’t have a uterus but it can help with sleep plus there are many health benefits regardless.

[@janetleephoto59]

She’s not going to answer your questions.