Menopausal Hormone Therapy: Patch, Gel, or Pellet? Understanding Doses and Options | Dr. Susan

[@iselalopez4553]

Thank you for this explanation. I’ve been on pellets for both estradiol and testosterone for the last seven years. Never felt better. I hope this video goes a long way to debunk the idea that pellets are not ok or dangerous. Find yourself a good provider that is knowledgeable in all options available . I went into menopause at 50, started pellets at 53 and for those 3 years in between it was miserable. And yes, the pellet method is more expensive and not covered by insurance but if you do the math, it will cost a little over a hundred dollars a month. A reasonable price to have your health back. Worth every penny.

[@ezkee4674]

As a physician (anesthesiologist) my friends have been asking me about hormones and I didn’t know what to tell them. So much has changed in regard to this topic. 20 years ago an OBGyn in my metropolitan city had her medical license questioned for prescribing “bio identicals” She was before her time! Now that I’m of age, it’s time for me to get this all down. Thank you

[@marybethcoonrod9424]

The hard part is finding a doctor who is comfortable with administering and effectively monitoring pellets.

[@userkatdarbywrites]

Been on HRT for 15+ yrs. I’ve taken it all…pellets were too costly so settled on patch. Tried the testosterone cream but suffered migraines. I’m finally feeling healthy and strong. You explain everything so well that I feel really smart having worked thru these trials of meds by myself. Thanks for all your compassion in this journey.

[@Gladeeez]

So you are not on testosterone?

[@tracymcbride8328]

Also I like that you actually TEST blood levels 👏🏻. So many “menopause” Drs will say not to.

[@rosiet253]

This was super helpful! I’ve never had the oral progesterone explained like that - your explanation makes a lot of sense!

[@lolakathol4109]

Hi dr. Susan, I was getting pellets for a couple yrs. I stopped getting them and went on the patch. #1 reason I stopped is the cost!! Insurance dose not pay for it. I was paying out of pocket 400.00every 4 months . Another issue I had was my doctor . The doses were too high! Estrogen and testosterone. I started bleeding had to get a D&C. A few other test. It was stressful! Everything turned out ok though. I have been on the patch now for 3 yrs. I’m on a low dose of 0.0375 also taking testosterone and progesterone of 200. I feel good. I have tweaked things here and there. I think I have reached my sweet spot! I am 66. Thank you! For putting out great information. I watch all your videos ❤️👍

[@DebbieDaigneau]

Thanks for your expertise! I take pellets and oral micronized progesterone and love it, tired of hearing other doctor influencers saying pellets are bad and should never be given.

[@drsusan]

I totally agree. I am tired of that conversation also especially because many of them use compounded testosterone cream, which is also not FDA approved and as much less stable.

[@bethandrews6741]

@@drsusanPerfect timing on video, I just emailed one of your coworkers about changing from pellets to another form because of well known doctors saying pellets are bad. Thank you for making me feel comfortable with my decision for the last couple of years.

[@estheroppliger1075]

Really excellent video! Very informational and clear. I take pellets because in the last year, I started to spend many hours a week in really warm/hot water (fitness classes at hot springs near me) so I felt a lot of fluctuation in everything - mood, emotions, vasomotor symptoms- with the patches I had been using. At one point my labs were showing low hormones and then another time they were very high. My regular provider was very confused. So I elected to try the pellets with an experienced pellet provider who helped me understand and be comfortable with that form of administration. So far, I'm very happy. This video really clarified things for me and helped me be even more comfortable with my choice.

[@tarakuki4387]

Why you don't have at least 10 million subscribers is beyond me...Women wake up!

[@tracymcbride8328]

Thanks for the great video! I’ve tried almost everything ( patch, gel, oral) except for the spray & pellets. Currently the Divigel is working best. The biggest drawback I hear about pellets is the $. Also, if you are dosed too high with a pellet it’s stuck in you until it wears off.

[@corinav8193]

Since 3 days on Estadiol patch, Progesterone capsule (internal) and a really small amount of Androgel (1 dose). It took me a lot of effort to convince my gynecologist to prescribe the testosterone since he as well as the other doctor never heard about post menopausal women benefits from testosterone. Btw they both didn’t know what pellets were.

[@annana9297]

This was extremely helpful. Thank you for this information.

[@kellyhensley7346]

Just got my pellets yesterday. I started getting just testosterone pellets a few years before i went through menopause then added in progesterone capsules & estradiol in the pellet form...went through menopause 5 years ago & it's been a breeze! Thank you for all informational videos!

[@rosiet253]

Do you use Biote pellets? Can you feel them when you lay on your back?

[@kellyhensley7346]

@@rosiet253 no I can't feel them when I lay on my back. I only feel a lump for a few days after insertion. The pellets are more to the side, very low hip/buttocks area. Hope that helps.

[@rosiet253]

@@kellyhensley7346 are they Biote?

[@carolinarangel120]

How much progesterone are you prescribed?

[@kellyhensley7346]

@@rosiet253 I believe so but I've been using them for so long I can't remember the brand name. They are bioidentical.

[@sylviat8461]

I began the pellets with my second round this past month. I feel AWFUL this time and really didn’t feel well after the first round. Just better sleep, but that was it! This time it’s awful joint pain ALL OVER! I don’t think I will keep them up and before it’s asked, she is an experienced doctor!

[@kellywebster6428]

You have to find what works for you. Good luck on your journey 😊

[@4everyoung24]

Thank you for clarifying “bioidentical” as being available even in the non-compounded formulas. I have had people just all up in my face that compounded is the only bioidentical and is the only “natural”estrogen. You cannot convince people, especially since the patch is FDA approved and they perceive it is all a part of “big pharma.” Like, what?!?! I understand the main studies are from the patch but also in enough time there will be more from the pellet. We have to write to the people who can advocate for us and get this approved and get insurance to cover it-whatever form we chose to use.

[@4everyoung24]

Oral progesterone-a godsend for my sleep. I do not feel sleepy at all during the day. I take it about an hour before I want to be a sleep and it seems to wear off just a little before my alarm goes off. I am not kidding. I didn’t really have too many other major symptoms but I spent a year sleeping in 20 minute naps all night and even after that year I was still waking all through the night. I immediately started getting sleep when I started HRT including the progesterone. 🙌

[@rosiet253]

Do you take 100 or 200 mg progesterone? I need somewhere in between unfortunately!!

[@4everyoung24]

@@rosiet253 225

[@krooney63]

I have the same question. I’m going to go from 200 to 100 and see if I still sleep through the night. I don’t want to take more if I don’t have to.

[@4everyoung24]

@@rosiet253 220mg

[@4everyoung24]

@@krooney63 220mg

[@clt420]

Great explanation of all the delivery methods. I have been on pellets for three years. Briefly tried the creams but pellets are for me. Life changing and life saving.

[@deannawilson7223]

Thank you for the information. I have an appointment next month to discuss HRT with my provider & this information was very informative. I now feel like I have the information I need to advocate for what I think will be the best treatment for my symptoms.

[@Free_Indeed1234]

Love your videos, thank you! Please, please, please turn the music volume down. When I set the volume so your voice is loud enough, when the music comes in, it blows my eardrums.

[@pbrd4695]

Been on HRT for a while now…use to do the troche method but I hated the taste. On my second round of pellets. So much better! Don’t have to think about it. It’s awesome. Thank you dr Susan for all the helpful information.

[@meliteletemp9137]

Pellets are not reccomened by most doctors

[@sciencenerd8428]

I've been in bed for over 2 weeks. My gyno raised my Estradiol patch from .025 to .05. I felt a light nausea starting the next day. 4 days later I was a new woman! I felt fantastic. I still had a little nausea but it was fine. 3 days later I went into a huge vertigo attack. Im working to get past this vertigo and my plan is to increase the Estradiol slower.

[@kathryncurry8728]

Thank you for valuable information. Could you possibly do a video on what to do if you start bleeding, where exactly to put the patch, if you gained weight, or other problems associated with HRT? Thank you!

[@drsusan]

I have videos about bleeding please search ! Of course first call your doctor. Patch you can put anywhere but usually tummy . Lots of my videos about MHT please check them out !

[@warqamilton1604]

I use Premarin vaginal cream every 5 days 0.5 mg. I’m 76 and have been using it for the last 20 years. I feel great and no bladder leaks!

[@christianaphoumivongdhiman7930]

This was such a comprehensive presentation, thank you so much, cleared so many things for me.

[@t.t.8878]

I'm in my 70's, been using an over the counter Estrogen cream and progesterone over 20 yrs, (I still can't find a doctor in my area that will prescribe hormones due to my age) I recently had blood work & was pleased to see my estradiol level is 85. I've never used testosterone but that level was 38. My blood pressure & my blood work was all excellant. I don't take any meds either. So I guess the cream is being absorbed.

[@kellywebster6428]

Very interesting and informative. Thanks for sharing 🎉

[@denisehitchens1418]

Over the counter what is name of the supplement please. How do they test it. Blood tests or urine? It is so sad my friends were caught in the exaggerated rumor Era and range from 60 to 74. But the late 60s we have heart disease, arthritis, osteoporosis, obesity on one with depression, prolapse, all have menopause gut from 58 up, dryness, no libido.. One at 74 has early dementia. None of them have remarried who are widowed or divorced. Ones who still have husband no drive llall are non smokers so can't blame that. Looking at multiple gyno reports on you tube my friends all have signs of no estrogen. ,

[@chubbsy10]

Thank you so much for this video. I wish you practiced in AZ

[@carolwong9279]

If I lived in Texas, I would definitely come to you for a pellet but I do not trust anyone here in Bakersfield, California. So, I will just continue transdermal estradiol and testosterone. Love your videos ❤

[@kaemart8374]

Excellent information! Thank you!

[@lissettemontagano9345]

Hi. I had a partial hysterectomy 14 years ago at 41. Im 55 now. How can I know if I am within the 5-10 year window? I had bad covid in 2020 and long hauler symptoms of sinus tachycardia, migraines and asthma. I’m now connecting dots with amazing doctors like you that maybe it was estrogen deficiency. Tysm

[@cleanqueen75]

My hormone doctor has the testosterone/estradiol cream combined.

[@cookiebuzz]

Another excellent, informative video. Thank You!

[@crystalnixon5267]

I would do pellets if I had a prescriber like Dr. Susan with years of knowledge & experience. Unfortunately, the providers in my area attended a 2 day seminar put on by the pellet manufacturer & now consider themselves “experts”.

[@drsusan]

Agreed. It's terrible! Most pellet providers know very little about MHT

[@bsharp5026]

Thanks for reply re P as a suppository. IVF treatment uses P that way

[@Seblor9120]

Hello Dr. Susan, thank you so much for the wealth of information. I feel more comfortable addressing HRT. I'm on combo or Estradoil and testosterone pellet and oral Progesterone but started to bleed so was given Aygestin and told to not take Progesterone. Is Aygestin safe to take long term w/o Prog? Trying to find balance to avoid having period. thank you for your input.

[@tracycecola803]

Has anyone ever heard of a side effect of numbness and tingling in the arms and fingers? This began when I started the estrogen patch/progesterone tablets but my doctor says she’s never heard of this side effect.

[@ihomeschoolmyson]

Thank you for the video! What are your thoughts on HRT and patients who have endometriosis? Have any of your patients had an endometriosis hx and done well with the patch or pellet tx?

[@Youaintdownhome]

Thank you, very informative!

[@alenasln3437]

What about pellet wearing off prematurely? I can’t find much information about it. I feel like it happened to me: in two months after getting my first pellet my symptoms are coming back and depression is the worst of them. It probably wouldn’t happen if I use cream twice a day. Please, cover this scenario in your future videos.

[@Kellykelly863]

What’s the blood testosterone target in HRT? Is 250 too high?

[@CatamaranChannel]

Great video!

[@stephanienelson566]

My Dr just handed me a Rx for Premarin. Said im in menopause. No discussion, no brochures .. I didn't know even what to ask! It was pricey, about $50 or $60 a month, so i stopped after 6 months... However, all those side affects have been 'handled' with Anti depressants. I wish i chose differently back then.

[@blondebeautylush]

I do estradiol and testosterone micro dose injections twice a week and rectal progesterone (insert oral capsule into rectum). Best delivery methods out there I achieve super physiologic levels feel great and my insurance covers everything. Patches are wimpy HRT don’t get levels barely over 100 for most. Micro dose Injections are definitely where it’s at. Oral estradiol converts to estrone due to liver first pass. Pellets are expensive and stuck in the body for 3 months. A good practitioner will understand the nuances of micro dose bio identical depo e and e valarate Injections. There are tons of women on multiple 0.1 patches still suffering with symptoms and low levels

[@ihomeschoolmyson]

Thank you for this video!

[@muse3241]

I would love the benefits of testosterone but I have some frontal hair thinning due to perimenopause and menopause and am concerned that adding testosterone would make it worse. Please suggest something for this because I know lots of women deal with this. Thank you!

[@drsusan]

Testosterone will not cause hair loss unless it's given at doses that are too high, so the dose is the most important thing

[@MD-tp4xu]

Thank you so much for clarifying all this information once again. This is why I have been so eager to get in to your office for over 2 months. However, the scheduling staff has not been professional in following through. Could you PLEASE have the Office Manager contact me.

[@drsusan]

Absolutely can you please let us know how we can reach you?

[@MD-tp4xu]

@@drsusan can you email? I don’t want to post my phone number here. I just spoke with Molly today . Thank you so much 😊

[@drsusan]

I'm glad you spoke with Molly. She can take care of you. I'm not able to answer any medical questions by email.

[@Katepwe]

There is so much contradictory information regarding the use of pellets. Some practitioners,like yourself, thinks it’s the best while other well regarded menopausal specialists here on KZbin say otherwise. How are we, as untrained medical patients suppose to know who to believe and know what’s right for us? Plus every country is different, there’s no real standardization…… it’s making my head hurt, along with all the other symptoms I have.

[@lisahoneycutt4194]

Hello, and thanks for your advice. I am 65, have had a hysterectomy at 52, and on hrt I am currently using the patch 0.1 climara once a week. I am Yubafem 10mcg 3 times a week. I had to fight to get hrt at any level they started at the lowest mg. I was on hrt on and off, and it never worked and was scared away from it. So I am back on it. I AM STILL GETTING HOT FLASHES. Wake up four times a night, having to urinate and rolling hot flashes still. I have kaiser they did not want to give me anything, but I had a BF. I don't think the patch doesn't work for me. Kaiser does not believe in regular blood tests. Do you have a suggestion. What about two patches a week? I am fit 65 old. I do have osteoarthritis and ostepenia.

[@drsusan]

I would love to answer your questions about your personal situation. We'd be delighted to see you if you find yourself in Houston.!

[@r-jproductions1343]

Hello Dr Smith, I have a question not related to this topic. I had a robotic lap.hysterectomy abt 3 weeks ago,ovaries were kept. Surgery went pretty well. I had developed some infection abt 1 week after and was treated with antibiotics. That seems to have resolved. I finished my abx 3 days ago. The other thing that developed after surgery I started having increased BM's( upto 4×/day) since surgery. Do you know why this might be happening? Any thoughts? Is this normal after a hysterectomy? I am not taking any laxatives& didn't have any issues prior to this.Hope you read this. I appreciate all you do.

[@drsusan]

Definitely can't provide any medical advice for your particular situation unless you are a patient, but I'd be delighted to see you here in Houston

[@Sophia-su6ru]

Thank you and I love your amazing videos , how long after going on a patch before you do labs ? I presume you do fasting morning bloods on day 2 of patch cheers

[@drsusan]

You don't have to be fasting, but I usually recommend checking it after 4 to 6 weeks and I do recommend being on day two or three of the patch because it does go a little higher on day one and a little lower on day four

[@Sophia-su6ru]

@@drsusan thanks so much ! Unfortunately we don’t have pellets in Australia . Our medical system is quite anti functional medicine . I know you say we are advanced as have androfeme but we don’t have much consumer choice when it comes to estradiol. Only estradot and estraderm which are constantly out of stock , estrogel n sandrena but no mist etc . Have you had any success getting more even levels with the patch by either using some estrogel on day 4 or overlapping the patches . dr Louise Newson shared a recent reel of herself taking off a used patch but mentioned she keeps 2 on towards the end . I had never considered that . Your work in educating women is so important and I love your very clear and logical style .

[@julieellis6793]

I'm unmarried so I don't want the sex drive. Had a hysterectomy many years ago. I mainly need hormones to help me sleep. What would you suggest?

[@mspimentela]

Are pellets safe for postmenopausal women with uterine fibroids? Since estrogen feeds them, then they might grow. Also as well with the patches or gel, spray? Thanks!

[@Hollowmoon007]

I would like to hear more about dosing. The Evamist spray dose, how is the dosing same or different than the patch options?

[@cparker7431]

I had a naturalpath tell me saliva is the best way to test estrogen/progesterone???? Another told me estrogen bio-identical and progesterone pill(which is what I take) just floats in the body and does nothing....I don't see him for hormones

[@parvinbiglari8852]

Thank you so much ❤❤❤❤

[@Nakidaesthetics]

Can a female with Factor 5 receive estradiol patch or pellets?

[@wandacupp7934]

Dr. Susan, How can I have my gynecologist prescribe testosterone to me in a gel/cream/pellet? I am in menopause. I was prescribed methyltestosterone but I don’t want to take a pill because I know it would be hard on my organs.

[@pambuck7043]

I'm just starting to research this in my area of NC. I understand that the blood test 1st is the way to go, Do you administer one pellet for each hormone or is it one pellet loaded with each hormone you need? Would it be administered at the same time? I'm 62 and just starting to research this subject & have reached out to local Offices here that offer these services for a consultation. Thank-you, btw for this timely video!!

[@drsusan]

Both hormones can be inserted at the same time, even though they are separate, we put them in together

[@ldavis-henry5065]

I too have started researching in the last year having never been offered MRT by any of my drs. 63 now and so thankful for the doctors in the “menoposse”. Check them out. Awesome info on their insta, also utube and of course their books. Dr. Mary Claire Haver “the new menopause” book #1 NYT best seller. 2 urologists who tell it straight with science and research Dr. Kelly Casperson, Dr Rachael Rubin. Dr Vonda Wright orthopedic surgeon just published paper on Muscularskeletal syndrome of menopause. Dr. Lisa Mosconi neuroscientist just published research paper re estrogen receptors in women’s brains. Once you follow these doctors you will find more likeminded doctors and data backed by science. Good luck

[@LoveStar333]

Is there an oral micronized progesterone without titanium dioxide, yellow dye, and aluminum? And is it safe to take oral micronized progesterone daily (vs. 12 days per cycle) if in perimenopause?

[@ranamerez8392]

i had menopause at 54

[@wandacupp7934]

You mentioned that testosterone is not FDA approved for women. Does that mean that I will not be able to get it in the US in the form of a cream, gel or pellet?

[@jerusalembelay897]

Thank so much for your reply but can you please suggest in Dallas Texas in Plano area or Dallas to get HRT I tried to google but

[@ShazWag]

I'm 60, and I've tried both the gel and the patch. On the gel I developed endometrial hyperplasia with a large polyp and needed a D&C. The patch often came off in the shower and also left my skin itchy. Over the past year I've been using the Lenzetto estradiol spray (just one pump), which has worked the best for me. I also take a 200mg progesterone capsule each evening. I don't think subcutaneous pellets are available here in Germany. I'm going to Australia in a couple of months, so I'm wondering how I'd get testosterone there. I'm guessing I'd need to see a gynaecologist. My daughter and son-in-law there are medical doctors but not gynaecologists.

[@ginaplant560]

When is the best time to take blood tests. I am taking estradiol gel 1 mg. and testosterone 87.5 mg pellet was inserted. My question is best time to test estradiol since it fluctuates through the day. I apply it twice a day. Thank you 🙏😊

[@drsusan]

If you're using anything transdermal, we generally want to check it sometime in the middle of the time between doses -so in your case, it sounds like it would be around midday

[@Gannusya17]

Dr. Susan, what is your opinion on rhythmic HRT? There are quite a few doctors who advocating for cyclic HRT that stimulates monthly bleeding, stating that the regimen has more health benefits then continuous one. What do you think?

[@drsusan]

Personally, I don't want to periods and I don't know anyone else who wants to either -there is no benefit from cycling hormones ! In fact continuous hormone therapy is what has been studied more than any other form and we get to have the benefit of not bleeding which is wonderful.

[@sunnysal3889]

So glad the Doctor answered. I was on continuous (daily) birth control for years to control endometriosis and migraines. Went straight onto daily (continuous) HRT. I am almost migraine-free now. I had nothing but problems with cycling.

[@annalisegrunewald8172]

This is fascinating. So even if your 40 and perimenopause there is no medical reason to do cyclical progesterone? I have done so much research on this and still thought the cyclical sounded unneeded especially when I read after one year you can go to continuous.

[@jerusalembelay897]

Hello thank you so much for all your videos. where you suggest to get HRT please let me know I live Dallas tx . Thanks

[@drsusan]

Menopause.Org is a great resource or we see patients remotely! Completemidlifewellnesscenter.com

[@Mrstriplejranch]

Curious why men have the option of at home injections, but women don’t?

[@Karikk72]

100mg micronized progesterone. Anyone else have this dose make them groggy the next day ? Anyone else have this increase their anxiety? Almost to the point of feeling nervous or agitated? Am I alone here or anyone else experiencing this ?? It does help me sleep a bit better but the anxiety is bad

[@CatamaranChannel]

You could try to lower the dosage and try 50mg twice a day? And very important imo, eat during or before you take it.

[@CatamaranChannel]

Another thing, do you take estradiol?

[@meliteletemp9137]

Some woman have progesteron intorelance

[@Karikk72]

@@CatamaranChannel yes I take estradiol patch. Have no uterus so I don’t need progesterone to protect that. But doctor said it would help with anxiety and sleep

[@Karikk72]

@@meliteletemp9137 thank yu

[@sharondube9207]

I had an endometrial ablation surgery. Do I need to take progesterone? I currently use estrodial gel and no testosterone.

[@drsusan]

Yes if you have a uterus absolutely need progesterone regardless of ablation

[@dkc9102]

Can you take DHEA along with receiving hormone pellets? From what I've read, DHEA helps reduce belly fat for women.

[@drsusan]

You can. But DHEA is a testosterone precursor. So I don't recommend it if taking testosterone. No good studies on belly fat . That's all nutrition and exercise. However MHT helps with sleep energy and muscle conservation if you exercise !

[@krooney63]

I just started taking 200 of progesterone but was curious if it will still help with sleep with the 100. I feel kind of groggy in the morning and was wondering if I will still get the benefits of progesterone on 100. Does progesterone also keep the fibroids at bay? Perhaps I should stick with the 200.

[@drsusan]

Either dose is safe. 200 mg helps some women more with sleep- you could try 100 and see!

[@MoiraStanley]

Have been taking Sandrena gel, but am worried about the carrier formulation as it has propylene glycol, carbomer 934p and other synthetic ingredients. Surely this is toxic to the body?

[@drsusan]

It's bio identical estradiol. I've never heard of any issues with the carrier molecules in the gel

[@shelleybettger595]

A chart would be so helpful so we could take to our appt for recommendation. Seems like the Drs do not know what blood test to run. I agree that is almost impossible to find a DR that agrees with HRT. I walked out of my appt because my DR/OBGYN told me she would not ever subcribe HRT for someone my age (I was 59 and only 4 years into menapause). Is a RN pr NP okay to get treatment from?

[@drsusan]

We have NP's on our team - important thing is who is supervising them! Menopause.org is a great resource or we see patients remotely !

[@juleszimmer1210]

I’m allergic to the glue on the patches so i choose to use the cream instead as our skin is our largest organ

[@annalisegrunewald8172]

Even with durinf perimenopause it's ok to do continuous progesterone orally. I was so looking forward to improving my sleep throughout the month but the cyclical means half the month poorer sleep!

[@annalisegrunewald8172]

Even with periods and still regular * can you take progesterone continuously?

[@drsusan]

You can use it continuously!

[@annalisegrunewald8172]

🎉oh thank goodness. Thanks for replying. Love your videos!

[@annalisegrunewald8172]

100mg daily enough to keep menstruation at bay?

[@JellieNellie]

Why aren’t estradiol or progesterone injections available like testosterone?

[@drsusan]

Estradiol injections are available and progesterone injections are as well! Most people don't like them because progesterone makes you sleepy. That's frequently used for pregnancy Complications, and estradiol given in an injection has a very variable absorption that can go up very high and down very low, which is why we want to give something a little bit more continuous.

[@JellieNellie]

@@drsusan I appreciate your response! My brother-in-law is studying to be a PA. During a conversation about MHT, we both wondered why injections aren’t often used. Now we know!

[@chubbsy10]

I take 200 of progesterone , it doesn’t help with sleep anymore. How would I know if I should increase it to 400?

[@drsusan]

You could just simply give it a try. It's very safe to try.

[@tammy9691]

What about sublingual? I was on the HRT pill for several years but had gastric bypass 4 years ago and stopped absorbing the medicine so my doctor just put me on sublingual.

[@drsusan]

I mentioned that's not my favorite but certainly if it works for you that's great. The absorption is extraordinarily variable.

[@tammy9691]

UGH!!! Of course that's not what I wanted to hear but I do appreciate your honesty. I've not been taking it long enough to know if it's doing anything yet. I'm kinda akin to Murphy's Law though so.... ¯\_(ツ)_/¯

[@marygaul5681]

Menopause at 53, HRT therapy for three years after. Scared off of therapy due to WHI. Now 78, is there any possibly I can return to MRT? I am using estradiol vaginal cream for GSM. Thank you for your excellent, well articulated presentations.

[@drsusan]

It's not that it's impossible. You just won't get so much of the benefits. I'd be happy to talk to you about it if you come see us in Houston

[@marygaul5681]

@@drsusan yes, please. I am located in El Paso and will call to make an appointment.

[@j.j.l.]

What about past that magic “10 year” window? And post hysterectomy? Are those women supposed to give up and not receive HRT? Nice glasses, by the way. 😊

[@drsusan]

I mentioned that ideally we would want to start on hormones in the first 5 to 10 years after menopause, but we can continue on them indefinitely as long as we start on them early and I did mention hysterectomy we can take either or both estradiol and progesterone if we want the benefits of progesterone thank you for the compliment on my glasses

[@j.j.l.]

@@drsusan Gotcha. Maybe I misunderstood. Can you then clarify the “as long as” part for me? That is, if someone started the HRT late (after 10 years out), can they not then take hormones indefinitely? Thanks.🙏🏻

[@bsharp5026]

Wondering about P used as a suppository either V or R? From online groups this seems preferred method for many.

[@drsusan]

No studies on amount needed for uterine cancer protection .

[@mistiewielang9390]

Do different brands of pellets work differently? Like maybe our bodies absorb them differently? My doctor changed brands. 6 wks after pellet insertion my Estrogen was 72 and Testosterone was 78. I had breast tenderness and hot flashes for 3 months after getting these pellets. At 4 months after insertion I was really feeling like I was due for more pellets. Got my labs drawn and Estrogen was at 129 and Testosterone was at 136. Which shouldn't be possible. I haven't started anything new as far as supplements. I don't take any medications accept 100mg Progesterone pill daily. My doctor kept questioning me and acted like she didn't believe me that I hadn't taken any new hormones or hadn't had any new pellets. So she told me I'm good to go for atleast 2 more months. But I feel crappy like my body is ready for them. I'm so confused!

[@michellebailey4769]

I get pellets (estrodiol and testosterone). I was going every 3 months but because I work out and am active, my body processes them faster. So now I go every 10 weeks which is the soonest my doctor will re-insert. Everyone’s body will process the hormones differently. I started on the estrogen patch, but after getting bloodwork done while on the patch, my body was absorbing very little estrogen from the patch.

[@drsusan]

Everybody absorbs things differently and there is something called a stacking effect which causes causes levels to go up with successive pellets, which is why we check after every two pellets After a bit of time, you will figure out exactly where you land and you learn how your own body responds

[@deborahc7113]

i been gaining belly weight, thought it was from prog, but maybe its the high Tot T

[@drsusan]

Generally, the reason for gaining belly fat has more to do with insulin resistance, so I would definitely check into that and great detail. I've got videos about insulin resistance as do lots of other speakers that you could look into.

[@deborahc7113]

@@drsusan ty i will look at that video, had labs that said im not insulin res, but i heard if tot t too high that cld cuz it, also my estradoil is too low 🤷‍♀️

[@lolafalula]

If you take progesterone, do yourself a favor, find and watch Ben Bikman, PhD (Insulin IQ) episode on estrogen. He talks about progesterone at the end.

[@GloriaBoza-x2p]

Is Biote an option for someone who has been on menopause for over 10 years?

[@drsusan]

In general, we want to start hormones within the first 5 to 10 years because after that damage has already been done to our blood vessels, which is irreversible so in general, we would be very cautious about getting hormones to someone who's been menopausal for more than 10 years, but that's something you need to discuss with your doctor

[@suzetteshares]

I'm 65 and will be making an appointment this fall. I'm hoping 🤞 it isn't too late!

[@GloriaBoza-x2p]

@@drsusan thank you so much for your reply. I started on Biote in November of last year and it has been rough because I’ve been spotting a lot on and off. Currently on estradiol patch and 100 mg of progesterone. All kinds of test have been done to eliminate malignancy. My body is just having a very hard time adjusting to the treatments. Thank you for all your videos. Very helpful!

[@AnjaGraf-s7l]

When you speak of Testosterone, which one do you mean? The free one?

[@anaf9314]

Why the dosages very different between patch and cream please? My doctor really didn't explain it

[@drsusan]

That is pretty much what most of this video is explaining if you listen to it, it will tell you exactly the answer to your question

[@roxannb2746]

Can you address the cycling of progesterone for just two weeks a month.

[@drsusan]

For post menopausal women that would induce a menstrual cycle, which is something that most of us don't watch so the standard of care is to use it continuously If your perimenopausal and still having menstrual cycles, this can be a great idea

[@roxannb2746]

​@@drsusan Thank you for your quick response. In your experience would there be any benefits to cycling post menopause. I've heard some argue that it's benefit is that it does mimic nature.

[@deborahc7113]

are estradiol injections effect? was gettn 1mg, estradoil level 26, now increased to 2mg inj. Tot T 309, Free T 143.8 pg/ml w T injs? ur thoughts pls😊 yes i have all T symptoms..30mg T inj every 2wks

[@Katepwe]

You won’t get an individualized medical response here.

[@deborahc7113]

your right ​@@Katepwe

[@deborahc7113]

just wondering doc thought on Estradiol injections delivery method?

[@patriciapyper4617]

Why does your blood pressure go up please thank you ♥️🌹

[@drsusan]

Blood pressure is related to many personal factors. I'd be happy to talk to you about that in person if you find yourself in Houston

[@elinashome-economics]

And something for a breastcancer survivor?

[@drsusan]

I have videos on this topic - depends on stage /grade of cancer. We would be happy to see you in Houston or remotely !

[@JodizzleSlotRizz]

Pellet is superior.

[@John-xq2gd]

I’m 42 and just feel awful, no energy at all and my brain is not functioning like I forget many things etc. I am on progesterone to help sleep, am I too young to go on all three hormones therapy?

[@ldavis-henry5065]

Check out Dr Mary Claire Haver menopause specialist “The New menopause”. Urologists and hormone specialists - Dr Kelly Casperson, Dr Rachael Rubin. Dr Vonda Wright - ortho surgeon and menopause. Dr Lisa Mosconi neuroscientist. All on Instagram, utube. Amazing doctors with scientific data and research papers

[@drsusan]

It depends on your situation. I would have my bloodwork, checked and look into all of these hormones the best time to draw your blood if you're having periods is during your cycle and if you're not having periods, you can check it anytime of the month.

[@John-xq2gd]

@@drsusan I am still on my period every 26 days every month. But I feel like I have so many premenopausal symptoms 😔

[@randymcgovern4601]

No one talks about women past the 10 year time frame and starting menopause therapy. Is it possible?

[@drsusan]

I have actually talked a lot about that in my previous videos. Ideally, we want to start in the first 5 to 10 years because that's when the damage is done that we can prevent. It's not that you can't start it later you're just not going to get the same benefits

[@lpeace777]

How about troches?

[@drsusan]

I mentioned those in the video if you listen, you will hear my opinion

[@patriciapyper4617]

Why do you have the shake s l am on evorol Conti patches vertigo and neausa please thank you for this video ♥️🌹

[@drsusan]

Can't comment on your personal situation but would be happy to see you in Houston !

[@lissettemontagano9345]

Hi. I had a partial hysterectomy 14 years ago at 41. Im 55 now. How can I know if I am within the 5-10 year window? I had bad covid in 2020 and long hauler symptoms of sinus tachycardia, migraines and asthma. I’m now connecting dots with amazing doctors like you that maybe it was estrogen deficiency. Tysm

[@AnjaGraf-s7l]

When you speak of Testosterone, which one do you mean? The free one?

[@drsusan]

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