What Should My Hormone Levels Be? | Empowering Midlife Wellness

There are many opinions and a lot of controversy about the ideal levels for postmenopausal hormone replacement, so today I'm going to share what I've learned from the science, as well as my own personal experience as a patient and from thousands of patients in our own practice. I'll be talking about ideal levels for estradiol, progesterone, and testosterone, as well as discussing thyroid and cortisol levels. Enjoy!
Rebecca Glaser, MD - www.hormonebalance.org
Oura Ring - www.ouraring.com
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[@Skinthatglows69]

Forget the levels! Treat your symptoms. I suffered from peri all of my forties and told my gyno every year and she always said “ your to young to be going through peri” your levels say your fine. Found a new gyno who specializes in menapause and now I’m educated and on HRT with no testosterone and living my best life. So treat symptoms and forget about the levels. No Dr. will ever make me fell like I’m crazy again. Advocate for yourself because your the only one that knows your body and what your feeling.

[@Mr.BennyBenton]

😊❤

[@DoralinDAN]

As Dr Susan Hardwick had said that in PERI-menopause, estrogen fluctuates as progesterone declines, yet estrogen is also declining slowly (which has been termed estrogen dominance, although it's not the absolute high level of estrogen) and to get a blood level test at a certian time (she says when in the video) to determine your peri stage estrogen level during your monthly cycles. So if it's overall low at that time and fsh is high at that time, then it may benefit to do hrt. I agree Yes treat symptoms first, it's our bodies telling us what we need!

[@bodhitree1128]

Yes. Key word is advocate.

[@marcelabarbosa4625]

Would you mind telling us what your symptoms were?

[@denise3432]

Thank you I needed to see this post cause I was about to get frustrated again.

[@mihaeladog7187]

I always said last time I fet young was at 38. Now , ten yrs later , I realize my peri started right after 38. It was so sudden , at 40 I was feeing like 80 .After 45 I started to wish death with passion .The mental struggle was worst than the physical one. I was hating everyone , husband the most , and at 48 I started to look for a divorce lawyer. I suffered 10 yrs from 38-48 😩: suicidal depression, brain fog to embarrassment, joint pains and pain all over my body , irritability, feeling miserable low useless , angry all the time and making my husb life a hell. I’m 49 and been on HRT for 9 months and I am back to myself , all problems gone like magic , I feel betrayed my my own body , manipulated , a marionette on the strings for the past 10 yrs . And no dr would tell me I needed to fix my hormones 😩 .

[@denise3432]

Thank you for sharing and happy that you are better ❤️

[@Aki-wq6xh]

Thank you for sharing! Like you I have missed that so called ‘window of opportunity’ and I worry it will make things worse 😢 I hope it doesn’t! Are you concerned at all?

[@sitbytheocean5998]

Thank you for sharing your story, I can really relate to this. 😪 I am on HRT, and seeing some improvements... but still waiting to really feel myself again. How long after starting HRT did you really start to feel well again? And, are you using testosterone as part of the HRT?

[@mihaeladog7187]

@@sitbytheocean5998 I started feeling better in a couple of months. I take testo too.

[@merry5059]

Did your marriage survive?

[@robertthrailkill1368]

I am a practicing Biote physician and your presentation is excellent. So glad you quoted actual test numbers. I check labs with each pellet dose. Agree with the testosterone values. I tell patients that I will target 100 as a minimum value. I have found about 20% of post menopausal women do better with total testosterone closer to 200. It is really gratifying to have a new patient with testosterone less than 20 and then see them 3 months later over 100 and almost a new person. I too have had a few patients refusing a lower dose of testosterone.

[@VeritasElysium931]

Great information! I honestly wish that those providing hormone replacement therapy were as knowledgeable and understood the nuances of the hormone ranges. Watching a video like this helps me understand better, but it's frustrating because not everybody’s on the same page. In a different video, I heard that pellets do not actually release evenly over time. Another OBGYN doctor discussed this. The company claims that they are released gradually, but they actually spike, go down again, and then go back up. Maybe this is better or worse than creams, but it's still not a consistent dispersal over time.

[@benniececiliamattox7426]

I’ve been researching hormone replacement pellets and this is by far the best channel for concise information. I’m 73 and just diagnosed with osteoporosis and have noticed a rapid decline in my skin and muscle tone. I’m looking forward to a healthier life and more energy. Maybe I’ll get back some nice skin and bone density. Thanks for your professional/research based information.

[@denisedecker7330]

I'm 74 and just started for the same reasons. I have already broken my right ankle twice, my right tibia and right wrist. Later I broke my left wrist. All required plates and screws to repair. Good health to you.

[@msmith1821]

I had osteo. Did Prolia for awhile, Garden of life Bone system, Agical, now i'm in osteopenia making progress.

[@brendafandangle]

Dr. Barbie Taylor ( who I also follow and respect)said Hrt will not correct osteoporosis but prevent it. Can you confirm this please.

[@benniececiliamattox7426]

@@denisedecker7330 Oh my! I’m so sorry! I go for my annual bone scan and will know if all the things I’ve done over the past year have helped. Good luck to you!

[@ellenkno5233]

@@brendafandangle I just bought this book, you might check it out. Preventing and Reversing Osteoporosis, by Alan R. Gaby M.D. - I will just say this, looking at it from a common sense perspective. If HRT can cause new bone growth (and it does), why couldn't that new growth fill in where bone had resorbed?

[@faithf5846]

Purrrrrrfectly stated! I am tired of UTIs…having a temp yuk! Antibiotics. Yuk. Thankful for your UTI information ❤

[@jantrevino9345]

Vaginal estrogen cream stopped my UTI's. Vaginal atrophy was my problem. I'm post menopausal.

[@humaalimd6004]

I’m an MD and even I learned some pearls Ty dr. Hardwick

[@KeithFarmer-z3b]

don't listen to her. Even her units are wrong. And there are studies showing what the minimum E2 levels should be to prevent osteoporosis.

[@idahardy4052]

@@KeithFarmer-z3b What studies? If you’re going to post comments in disagreement, you have to produce evidence and more than just oppositional statements. What experience have you had with dosing patients?

[@SagiDragon]

This was amazingly informative, detailed and concise. I’ve watched a few channels looking for levels for all the hormones mentioned in this single video! I have an appointment with an endocrinologist shortly so I’m going in very well informed. So grateful to you 🙏🏽❤️💕

[@bodhitree1128]

Progesterone micronized in lipophilic cream gets absorbed. Saliva test is used for transdermal route for progesterone. Not blood test. Same with estradiol.

[@2getherWeAreWAND]

I'm 47 and peri- menopausal my Testosterone levels are 430 and my Estradiol level is 281. I'm trying to fix my mojo and these results make me question if these levels have anything to do with it. I'm working off of my labs from a year ago, I am going to get my blood work done again next week. However my hair loss has decreased I am on really good vitamins however I do feel a whisker growing, only one for me that's one too many. My voice hasn't changed but my sex drive is non existent. It's like an old friend that I want back! My doctor was awful and specialized more in males then females. I'm so grateful to have found you.

[@chaddavis6411]

If your Estradiol is too high, or too low, it will greatly lower your libido. It sounds like yours is way too high at that level. No need to have your Testosterone or Estradiol that high. Hopefully lowering it will help.

[@2getherWeAreWAND]

@@chaddavis6411 Wow so mine is too high? Thank you for your response. I'm going to see what I can do about that.

[@jennysiepka9900]

ive never seen someones test level so high to be honest.....

[@donnawhitecotten361]

I am so happy I came to see you this week. Love you and your clinic staff! I just want to thank you for doing this research and then explaining it to us in a way that makes so much sense. Thank you for being an advocate for us menopausal women 🥵🙂

[@Katepwe]

@@paulohlsson27what are you contributing to this topic. I’d suggest you stop these random reply’s, it’s creepy.

[@Candleflower42]

Dr.Susan thank you soooo much for this. Am 69 and was put on HRT 8.5 years. A year ago asked my PCP for a level - she said it wasn’t necessary as I was on a typical dose (and I’d been taking just half the dose originally prescribed) but she agreed and estrogen was 557. She said it was high but would be since I’m supplementing. Got a second opinion from nurse practitioner and she was aghast, said should be no more than 100, preferably 60. I’ve listened to so many podcasts but no one mentioned actual numbers and I didn’t know who to believe. I had no menopausal symptoms and was only taking for osteoporosis, and after a broken femur I got a DEXA after 7 years and it was the same, so had to be the HRT as I get little exercise. I was reluctant to go off it, but have been for a year and have been getting nervous re the bones, good to know I can keep it at 60 and still get bone protection. I feel no different on or off the hormones even with such a wide range. (NP took level after I was off awhile and it was 100) Thanks again!

[@Hibernia2324]

There are no established levels for these hormones. No one should be aghast.

[@Candleflower42]

@@Hibernia2324 I have thought that since mostly no one mentions levels than does it really matter? But then why would Dr. Susan agree with this NP? And seems if there are risks to estrogen than the more of it you have the greater the risk. Thanks for your input.

[@Hibernia2324]

@@Candleflower42 Office visit + blood work. Science-based docs go by symptoms, which also don't correlate with low levels for everyone.

[@user-xs9835]

What is your daily estrogen dosage now?

[@Candleflower42]

@@user-xs9835 I saw a doc and he agreed go back on, which I already had. I only take BIEST 1.25 progesterone 50 and testosterone 1mg. He retook labs and estrogen was up to 130, had gotten to 90 off it and suppose would have gotten lower. I’ll ask him to retake in 6 months, curious if it keeps climbing which I assume it will. Weird since that’s a low dose, but did keep my bones from getting worse over 7 years, , unless it was the strontium which I also take.

[@cheryltaylor4894]

I so appreciate your presence and how you are educating me in a way that no one else has!

[@MaureenMccarthychun-dg6qk]

Dr. Smith, Enjoy your information, thank you. I recently discovered you. I think everyone should be treated individually. Different preferences and hormone responses to the pellets. I have taken pellets for years.. And prefer my testosterone at 500. I cannot take estrogen or progesterone as I've had a breast cancer ER+ PR+ Testosterone .. Is a game changer for me. Love your info..

[@thetotalpackage2005]

This was the most helpful video ever! I shared it. I'm peri and estrogen is 325 so high, breast tenderness. I tool 300mg of progesterone and tenderness is going away. I will get my t3 and testosterone checked

[@ksr3228]

Oh my gosh. So much great information. I do HRT, estradiol and progesterone. It's been a life saver. I'm going to check in to testosterone with my Dr. I cannot gain hardly any muscle from working out and have almost zero libido. Thank you!

[@ctdali]

Look into dhea and ashwagandah as well.

[@pumpkinpie025]

@@ctdali Not sure I would take DHEA while simultaneously taking estradiol as DHEA converts to both Testosterone and estradiol.

[@Dandelion_flight]

I never realised I should take progesterone in the night. I have been taking it first thing in the morning since I started two days ago. No wonder I dont feel better, I feel so sleepy! Ladies, learn the lesson from me. It is so important to educate yourselves. The pharmacist where I bought my estradiol patches and promethrium told me that I should take the latter in the morning on an empty stomach and she told me to apply the patch on the upper part of my body. I told her that shouldnt the patch be done on the lower body such as my butt or abdomen. Then she went away to check and came back telling me I was right. LOL.

[@drsusan]

Oh my goodness it is so crazy how people give you misinformation ...progesterone is only absorbed when you have food in your stomach and you definitely don't want to take it during the day because it makes you sleepy -so good for you for asking! and take it at bedtime after dinner, and that way it will absorb and you will feel sleepy at the right time!!

[@Dandelion_flight]

@@drsusan Yikes. The pharmacist told me I have to take the Prometrium on an empty stomach. I did that twice the last two days in the am but after watching your video, I did not take it this morning. I will take it tonight after dinner. Good to know I actually can take with food. She is a young pharmacist and looking back, she definitely did not know what she was instructing about. Thank you Dr Susan.

[@dabeezkneez8716]

Oh no! My gynae has me taking the combined oral HRT in the morning with my levothyroxine first thing in the morning on an empty stomach. Does this mean the progestin part of the pill is less or not effective?

[@Dandelion_flight]

@@dabeezkneez8716 Hi, combined oral HRT meaning? Do you take oral estrogen? That is not ideal as oral estrogen passes through the liver and it can increase the chance of blood clots. I can't remember the exact details now but I know the best is patches. About progesterone, I now have another pharmacist tell me that it has to be taken on an empty stomach without chewing at least half hour before food. It is also stated on the label on the box. Also labelled that the progesterone may affect mental alertness and coordination! I am surprised to see that. I want to take it to feel better not get extra issues! So I have written to the company that makes it to get clarification, just waiting for reply. I also notice that the progesterone gives me dizzyness few hours after taking. I experienced that few times so far.Had to lie down for a little bit to recover. Read online that it can do that. Now I will take the progesterone only before bed and avoid taking during the day.

[@jeepgurl1379]

I take oral progesterone at night just before bed.After 4 weeks I now have dizziness from the time I wake up til about noon. I can’t take that form (prometrium). I wanted a lower dose but NP said Prometrium doesn’t come any lower so I’m waiting Cor some to be compounded at 150 mg. She has me on the lowest dos of estrogen. I also take testosterone (mine was in the tank). I can’t wait to see my labs are. I take DIM as well but I am VERY sensitive to estrogen. Other than the sensitivity, I have been feeling more like myself. I wonder how long before DIM starts to snow some promise?

[@natashyas4149]

Estrodial 40-80, will feel good. When higher than 80 - breast tenderness, water retention. Below 40, will get hot flashes, might sweats, etc.

[@natashyas4149]

FSH - pituitary - from brain, to stimulate estrogen production. Low 5 or lower when young fertile. When it gets higher, it will go up to try to make estrogen - when menopausal. Want it to drop by 50 percent if on estrogen. Want it to be between 40-80 if on treatment.

[@amymasreliez8957]

No hair loss, no irritation or mood changes, very calm and even keel, no acne but high testosterone at 87. High insulin sensitivity. Not sure since I'm 1 year post menopause. Total testosterone and free testosterone all in the mid range. This part is consistent with your analysis. I take a DHEA supplement, though. You covered this 😮 Progesterone is low at .1 and Estradiol is less than 15. Hemoglobin A1C is 4.9 low mid-range. I fast 36 hours once per week and stopped my strength training though. Thyroid is optimal. Sleep is great. Trying to solve this.

[@alexandraferreira561]

Dhea increases your testosterone,also estrogen..❤

[@brendafandangle]

The pellet stacking makes so much sense , thank you.

[@R.N.LosAngeles]

Have you been checked for ovarian cysts?

[@brendafandangle]

@@amymasreliez8957 DHEA increases testosterone.

[@2getherWeAreWAND]

Your skin looks amazing! I wish I could see more of your skin. You look younger then 6 months ago. I just found you and only saw a video of yours from 6 months ago.

[@DougKremer]

My Wife’s (48) testosterone just tested at 17 total. Her Dr “that’s perfect”. She needs a new Dr.

[@msmith1821]

My testosterone is 44 the Dr. says its too high. I may have to find another Dr.

[@jennysiepka9900]

omg she totally needs a new dr!! my level is 170 on BHRT and i feel amazing!!

[@redbonegirl1757]

@@jennysiepka9900My T is

[@bmcdonald7303]

Mine was 16 and doc said it was low!

[@DougKremer]

@@bmcdonald7303I agree.

[@natashyas4149]

Cortisol - 6x in 24 hour period for cortisol curve. High in morn, low at night. Stress.

[@natashyas4149]

No extra estrogen for peri-menopause. B/c it's fluctuating so much. Can go from day 1- very low (hot flashes etc) to 2 weeks later - very high (breast tenderness etc)

[@janinelaino1847]

Im using testosterone cream and been feeling so much better ....its what works for the individual...also i got my blood drawn 24 hours after using my cream and testosterone at 212 free testosterone at 23 so its not true that it falls to zero an hour after using it. Also cream i feel is safer but again that's my personal preference Im 53 and feel 25

[@debbieurias5151]

Oh my gosh!!! I have learned so much after watching 2 of your videos. Please help me, my new Dr. Has told me that she will not right me a prescription for my 12.5 estrogen (yellow) with out explanation. About me, I'm 67, I had a complete hysterectomy at age 34. Now I've had one apointment with her she did blood work. I then got a phone call about the blood work from her personal saying Stop taking your Estrogen!!! My blood work showed I have some heart damage (high enzymes) asked the person how? I've tried this in the past, and it makes me crazy and all kinds of things hot flashed, vivid nightmares, And all the other stuff associated with with draws. She just coldly stated "your too old for that !!" No I'm dealing with Anxiety Nightmares feeling like I'm gonna die With no help. I asked you how do I do this She had no answers just said you're too old to have symptoms. Please help me!!

[@gal2727]

Get a different doctor. Stop playing the victim and stand up for yourself!!!

[@lyrical-feline]

Find a better doctor who listens to you, collaborates with you in the management of your health. It’s your body, your health and your doctor is a service provider to you. Get the right team around you. Move on from this doctor asap.

[@ellenkno5233]

I don't know if you found someone good, but look for a chiropractor/functional medicine dr. THEY will help you!

[@cathy2893]

Fantastic video. Great info! Great, clear presentation! Thank you!!!🙏

[@natashyas4149]

TSH - want 1-2. Can be normal but still have low thyroid function. T4 : T3 ratio 14:1. Low thyroid - low energy, cold extremities, hair loss, changes hair, skin, nails, weight gain. *Check FREE T3 - usable, not bound to a protein. Want T3 (2 you feel horrible) (4.5 is metabolism too high - causes heart disease, osteoporosis). WANT 3-3.5!!

[@MsKati30]

I am 44 years old and found out that I was post menopausal at 41. Although shocking, in hindsight, it explained a lot. I am on 0.075 estradiol patches, 200 mg of Prometrium at night, and 2 mg of compounded testosterone three times per week. I feel fantastic and would actually like to raise my estradiol level if possible, but I do see that my latest blood work came back at 416 pg/ml for total estrogens- I am not experiencing any bleeding, nor any breast tenderness, so this is odd to me considering what was said about blood levels in this video. Estradiol itself is 136 pg/ml Should I be going by total estrogens or by Estradiol? Thank you so much! I love your Content, and I wish that you were local

[@TheShumoby]

You're fine. You're younger. You're still use to higher estradiol. Go with how you feel. Look at your estradiol. 136 pg/mL is fine especially if you have no negative symptoms.

[@jenniferforehand2675]

I’m 42 and also post menopausal levels, though I still get periods. And these levels have been for a few years- it definitely explains the struggle! I’m glad I switched doctors to someone more informed and look forward to not feeling an alien in my body anymore.

[@ruthrouchard4089]

This was soooo clear and helpful! Thank you!

[@agsjnsks4538]

Can you educate the doctors?

[@sharoncastaneda597]

Thank you sooo much! So very thorough and informative. I now feel like I have a foundational knowledge and understanding with which to start my hrt journey 🥰💕

[@mkwil65]

This is so incredibly educational! Thank you so much Dr. Susan 🙏🏻 My testosterone level is 16 including free testosterone and my GYN said it was fine in the “typical” range of 2-50. I don’t feel great and would like to explore pellets. She offered a cream which as you stated is very inconsistent. I would love to schedule an appt with you but I live in Miami, FL. Is there a an option for those of us who don’t live in Houston? 🙏🏻❤️

[@drsusan]

Hi there yes, that is a very low level of testosterone and you would feel great with it being a little bit higher. I am only licensed to practice in Texas so we'd love to see you if you want to come here or you could check out providers who offer hormone pellets on the biote.com website

[@Teresa-pg7wb]

Very good!I love your videos.

[@cozinha8945]

My T level was non-detectable before taking the gel. I'm now at 82. The levels my practitioner used showed normal ranging from 40-120

[@cleanqueen75]

My hormone doctor always does periodic bloodwork on me to check my levels.

[@beatscatmommy1735]

What an amazing video. Subscribed!!!

[@Kellykelly863]

Thank you for the great video! I learned a lot.

[@serg1740]

Progesterone has been a lifesaver for me. My anger and brain fog about 8-10 days or so before a cycle was due (although sometimes late in peri) was unbearable and eventually would have cost me relationships and career. Much more leveled out just taking progesterone oral at night 10 days a month when it plummets.

[@jaykaira9939]

That’s good to hear, what mg of tablets do you take each night please ? Is it 100 or 200mg? Do you also take any estradiol with it? I have been suffering only from insomnia 😢

[@serg1740]

@@jaykaira9939 100 mg at bedtime and it does make me a little more sleepy. No estrogen for me because I have estrogen dominance (it’s still at levels of someone younger while everything else goes down) which causes the extreme anger. I will likely start testosterone soon though as that’s gone down naturally.

[@CatamaranChannel]

The 100-150 pg/ml might be incorrect, because the ref range for women 18 year old and above is 0.1 - 0.9 ng/ml Which in your case would be 100 - 900 pg/ml. Men ref range is around 2.8 - 8.0 ng/ml.

[@DeborahMowatt]

Yes, I was just looking at those number for her Testosterone. 100-150 ng/dL is what I think she should have stated not 100-150 pg/mL. That's a big difference.

[@janinedance102]

So informative. Thankyou. I’m on Femoston 1/10 HRT tablets here in Australia. So affordable. In perimenopause and I feel great in every way. Fixed libido too 😊

[@TheNordicHunter]

Hi. My girlfriend is in perimenopause and lost all her libido. How long did you have to be on the pellet before you saw results? She seems down as well and I’m guessing it’s because she doesn’t feel 100% like a woman because of it and feels bad she isn’t interested in me. Same as a man that needs a blue pill. I can only imagine what that feels like. Also, do you have any side affects at all? The pills are for testosterone only, right?

[@MC-mm3wz]

Thank you for this video. It really went in depth and helped me to understand more of the changes I'm experiencing.

[@CatamaranChannel]

Pellets peak right after insertion, and are a risk if you don't have the right dose. Sideeffects your stuck with, if thats the case, for 3 months because you cant pull them out. Cream is a 100 time superior, imo, because you can adjust and finetune treatment on a daily basis.

[@puffchickpam1]

Is that what you’re currently using? How long you been on it? I’m considering cream.

[@LeighClark-zf8oi]

Labial cream (mucous membranes) seems to be better absorbed than cream applied to the skin.

[@CatamaranChannel]

@@LeighClark-zf8oi The main thing is, you need liposomal cream and find the most thin skin on your body and apply it.

[@CatamaranChannel]

@@LeighClark-zf8oi Just the normal compounded bio identical 2% or 4% testosterone cream is fine. There are indeed more receptors around the labia. Don't use the cream internally, it will burn like crazy because of its high absorption base/ liposomal. For that you MUST use the vaginal cream 0.02% or 0.2mg/ml. Which has a totally different base.

[@ceciliafuentes3299]

Thank you for the amazing detailed and clear information.

[@petrinafriede4509]

I wish that I had found your site years ago, Thank you for your effort on behalf of women.

[@paulohlsson27]

Hi petrina, how's your day going with you?

[@lisamullis8471]

So much information!! Thank u

[@nursekate3124]

Excellent video! Thank you! Would love to see a video on treatments for side effects when we are on HRT (Acne with testosterone, namely), and explaining labs like SHBG, DHT, DHEA

[@placebo6922]

My testosterone is at the lowest limit and I have acne. No one can say from what I have acne. I suspect prostaglandins. As when I had Covid I took one week ibuprofen and made no new acne. When I stopped it came back. It’s hard!

[@11nica5]

I agree that advocating for yourself is the KEY but it’s good to also know that there’s “normal” levels which is what conventional doctors use which has NOTHING to do with optimal health vs. optimal levels which is real prevention and disease control which you won’t find with a GP.

[@marisasanchez5108]

This was very helpful. I’ve been taking HRT for 7 years and never had my blood levels tested. I read that increasing Vitamin D can also increase testosterone levels - are higher levels of vitamin D necessary to make that happen? I also read ashwaganda supplements can increase testosterone .

[@drsusan]

I've never seen an association between vitamin D and testosterone, but I would be very important for you to check the levels of all of your hormones and your vitamins in my opinion

[@jonnetathompkins9200]

@@drsusanm

[@barbarabindzus2134]

That was sooo helpful! 🙏🙏🙏💖

[@cindysmallwood2695]

My experience with pellets is not as described. High high at first. Then too low at end. Surprised you didn’t mention my worst side effects with hi T. Road ragey type agitation. Not good. Once it’s in. It’s in. 2 days off of my kind of exercise. Hi cost. Prefer creams

[@mishkaandsuka-doubletroubl3729]

Loved this video!! Thanks so much! ❤

[@claudiasummers2383]

The BEST video I have found on this topic. So happy I came across your channel. I subscribed ASAP. I do have a question. In my recent blood work from 02-15-2024 my testosterone (shbg) is 92.7 but my "free testosterone" is 0.86. I was prescribed a compounded cream to apply to either my inner thighs or inner wrists. I am a bit confused. If I start applying this cream how will it know to increase my free testosterone (not even sure what that is) and not my overall testosterone number?

[@maggiemac7678]

Really appreciate your information. Never heard it before.

[@lynnemclaughlin8785]

I use test/ cipronate 1.5ml weekly. Estrogen patch , oral progesterone. I did not have a good experience with pellets. I find the injections to be more controlled.

[@nanjaconetty5475]

Hi Lynne. I hope you don’t mind me asking about the testosterone shots? This is the first I’m hearing that those as an option. Do you give yourself the shots? I’ll have to ask my dr about them too. Is it working vs pellets? Thank you.

[@celeuciaclynnehunter4461]

Awesome explanation

[@msmith1821]

My testosterone is 44, my Dr. told me its high, after listening to this video, it sounds low, which makes more sense, I am having a hard time building muscle. I walk 5 miles 3x a week and go to the gym on other days. What should say to the Dr.

[@reneerobinson6691]

Great information! Thank you for empowering so many of us struggling ladies with knowledge, especially when so many doctors are staying in the dark ages of misinformation from the WHI study. I am currently on .05 Estradiol patch and would like to have my Estradiol tested. I was on low dose birth control but at 54 changed to .05 Estradiol patch twice a week and oral micronized Progesterone. It’s been over 4 months and I now have night sweats, dryness and increased joint pain. Luckily we have a local lab that allows self testing for Estradiol, but I'm not sure when to test. Does anyone have information on what day to test after applying patch? I change my patch every 84 hours at 8am on Wednesday and 8pm Saturday. Thank you in advance for any help or information!

[@melaniestell5383]

Please explain how too much testosterone can cause hair growth AND hair loss? Thx

[@drsusan]

Too much testosterone cause both of those things in a male pattern- so you can lose hair in a male pattern and grow hair in a male pattern... that would mean facial hair on the top of the lip or chin , and then losing hair at the crown

[@Corrans]

Hair loss on head, hair growth on face and arms etc

[@serenasandstrom8569]

When you say Testosterone 100-150…is that free testosterone and what unit measurements?

[@queen-b9414]

I asked the same question and she never answered. I’m not sure why Free T is not mentioned. You can have a high total, but if you have a low free T I can’t see how it’s doing you any favors.

[@EchosJourneys]

Amazing video. Thank you!

[@jannlittle4745]

I feel better above 100.. But I do take iodine and that keeps breast tenderness almost Nile...and testosterone gives me energy too. She also gave me 200 mg progesterone because I was losing hair. I guess thats why I feel better with Estradiol 100..

[@carmenbreit6485]

I found this information very helpful. I'm just starting my journey on HRT and it is so difficult finding a provider that has any knowledge about women in menopause. I've discovered that some of my symptoms are from the level of estrogen I'm on is too high. The Dr. I've been seeing increased my progesterone to reduce the symptoms. I believe he should have reduced the estrogen. I've sent him a message with that request and I'll have to see what his response is.

[@leslielaneashevillencrealt5072]

I use pellets also but my doctor had me on way too much testosterone and I got foliculitis really bad and crazy rash and hair loss took me 3 months to figure out I was on too much mine was over 300

[@traceyland7217]

I feel best with my T around 400. No SE

[@blondebeautylush]

Biote is the worst method for testosterone replacement to many peaks and valleys. I do twice weekly injections

[@proverbs3150]

Excellent information …

[@krisbrubakertrader5052]

Dr. Susan Hardwick-Smith When you say T levels that you like being 100-150pg/ml are you taking about total T or Free T, or what? Please clarify. Thank you.

[@christinaherren]

Your skin looks great buy the way.

[@menenassefa6404]

Great information. I with you r my dr.

[@chequitasafik9872]

Dr. Susan can you do a video for perimenopausal women who have lots of horrible symptoms and want to do HRT in order to be symptom free?

[@drsusan]

There's a video on my channel you can watch to learn all about perimenopause and HRT kzbin.info/www/bejne/aGW5ZGhom9N5pck

[@lauratriscaro7512]

@@drsusan 27:43

[@vickylynn1424]

I'm Very happy to have found this video. My question is whether I should be taking the Progesterone with no uterus. Thank you.

[@bellaroccisano4156]

She said you can in another video. Taken at night only for sleep 😊

[@Phoenixrises89]

There has been new research out American menopause society - April 2024 which is worth looking at. Most people are saying yes because of all other heath benefits.

[@yunazyskind411]

Thank you Dr Susan for a very informative video. I am a nurse practitioner working in primary care. One of my patients who is doing HRT pellets asked me a question- her testosterone level is 215 and she feels great however she has very slight clitoral enlargement. Is this side effect permanent or can be modified with a lower dose of testosterone pellet? Or it’s irreversible? She just started this treatment 2-3 months ago and overall feels much better then before. I would greatly appreciate your response and thanks again

[@annastevens5132]

Dr. Susan, are the testosterone levels you recommend (100-150 ng/dL for most) from blood draws taken 4-6 weeks after inserting the pellets? The BioTE website implies that testosterone levels will go down after 4-6 weeks: "...End organ response to testosterone remains optimal...when testosterone levels at 4-6 weeks after pellet insertion are 150-250 ng/dL. Steady state is subsequently achieved at approximately half of these levels equaling 80-120 ng/dL, which is in the physiologic to slightly supra-physiologic range..." If the levels are 100-150 at 4-6 weeks, they will then decrease to 50-75 ng/dL later in the process, and maybe that's OK?

[@kroyal4296]

I’ve heard it’s way better to do 24 hour urine test for hormone levels instead of blood test because it fluctuates throughout the day. Also, for some of the hormones you’re not giving the units which makes a big difference if you’re talking about pico grams per millilitres or nanomoles per liter.. please advise

[@jeepgurl1379]

She has the units on the screen when she talks about it for testosterone.

[@ComplexityUnveiled]

I like the pellets. However, if you travel for any length of time, particularly overseas, it's not like you can drop in just anywhere for a pellet refill. Where does that put you? On oral Estrodiol pills and troches until returning to your home base. It would be useful if there was a global network of provider colleagues for such purposes.

[@1245JL]

Great info🎉

[@belleweather]

What about the difference in levels measured via saliva vs. blood when on HRT! The numbers of very different. Saliva is preferred by many MDs...when using cream...

[@fixhormones]

Saliva is the preferred testing methods for topical creams. Blood results are not accurate on creams

[@drsusan]

I am not a fan of creams as I mentioned, and I also think salivary testing is not necessary in my opinion. Blood levels are just fine.

[@pennythepuppy2411]

What is the unit used to calculate the 100-150 optimal range? Does it refer to Total or Free testosterone? I want to be able to compare it to my lab results.

[@bastianm5478]

Crazy that nobody answered this

[@jeepgurl1379]

The screen showed 100 - 150 pg/ml

[@heidistepien8996]

I am perimenopause and would lose my mind without HRT. Are u not prescribing it to women who are peri-menopausal? I did not finish video so maybe you clear that up later.

[@jannlittle4745]

I feel better above 100.. But I do take iodine and that keeps breast tenderness almost Nile...

[@kimbrand1512]

I just started at 62 . Estrodiol patch .025. The cream gave me infections. Sounds funny,, but can you put the cream in other places for benifits?

[@kimbrand1512]

Can you put estrodiol in skin like wrist?

[@chaddavis6411]

Fantastic information!

[@WandaBennett-t8s]

Thank-you

[@nanjaconetty5475]

Thank you for the great information. Wondering how you feel about the troche’s and if they are tolerated well by the liver? I am on one a day estriol 2.4mg/estradiol 0.6mg/testosterone 2mg all in one troche. I’m not sure why dr split the estriol/estradiol ? I am post menopausal age 65. And also how do you feel about testosterone in a shot form?? First I’ve heard of it is in these comments. I’ve tried pellets but looking for a less expensive way to manage my hormones with good results. Losing muscle tone and low libido are my main concerns. And I work out a lot!

[@denisedecker7330]

Change practitioners. Mine cost about 300 including visit every three -four months.

[@MaryBethMcCoy]

You are on Biest, which is a compounded combination of 2 bioidentical estrogens. The estriol is a weaker estrogen which is shown to be protective against breast cancer and estradiol is the more potent form of estrogen. I also take Biest along with progesterone and testosterone in a troche. If you are losing muscle tone and still have low libido, your testosterone dosage should be raised and if you still have your uterus, you should also be taking progesterone.

[@Bonnadorable]

Do thyroid hormones affect estrogen, testosterone levels and vice versa? I recently started taking thyroid meds and have been on HRT for 20 years.

[@sonyafly]

What about for someone with fibroids?

[@bernaditasahilan3463]

All hormones test insurance will not pay for it. Very sad

[@angieflowe3925]

I follow many doctors who are very against pellets because you can’t control the dose

[@amberdaniel6742]

I have a Biote pellet and my testosterone is now 365. What should I do? My provider told me that we will just adjust the dosage next time, but I am worried about side effects.

[@drsusan]

The good news is it Will wear off over time and it doesn't cause any harm to be high for a short time, but definitely was dosed way too high. I would ask them to give you about half that dose next time -that's a good example of how that dosage calculator is way too aggressive!

[@marthayonamine390]

Hi there, what was your initial testosterone dosage? I’m experiencing the same with the levels. Thank you in advance. Also, I feel like Dr. Susan is God sent. I came across her video at my most desperate moment.

[@jeepgurl1379]

@amberdaniel6742, how did it go? Mine is around same (389) and I was told they lowered it from the model’s recommendation. I plan to wait until my next blood test before I give them the okay to do another implant. I will also ask for 1/2 the dose.😤 If not, I’m changing doctors.

[@AR-gh1pc]

Are there ever exceptions to using creams vs pellets if you have gut issues or possible problems with absorption? Years ago I did progesterone cream at night and found it helpful but I took higher dose (maybe 2 pumps vs 1), and it would immediately help my sleep, but when I tried oral 100mg, I noticed no change. I assumed the systemic oral version just wasn’t absorbed, but sounds like my dose was just too low.. ? (AND, I think they told me to take it in the morning and I had always taken the cream before bed. Hmmm. Perhaps, mystery solved. Haha.). I had long history of progesterone deficiency, prior to menopause. Is there a upper limit? Do certain individuals ever need 300mg or more?

[@healthyteddy]

I am having the same problem right now. Pill 100mg didn't work so trying 150mg cream tomorrow. It's much more expensive though.

[@denisedecker7330]

I take 200 progesterone. I was taking orally, but now as a suppository. Does help with sleep. Creams can transfer to pets etc.

[@audreyardale5503]

Help! I’ve been overdosed Testosterone for 2 years. Was told 200-300 optimal - BioT provider. Now have male pattern hair loss. Is this permanent? Not doing a next pellet until levels come to the 100-150 range. Very concerned.

[@shelly7017]

My new gynecologist is telling me my testosterone level should be 36 or lower.

[@Jennifer-jf7nx]

I’m curious how come you don’t mention free testosterone? Some doctors I have listened to say your total could be 200 but if you have a high SHBG it’s binding it all up or most of it and only what’s free and unbound is what’s getting into your tissues. Some women have a total of 200 testosterone with a free of 0.9..and they still have symptoms of low T. Also what I find difficult with pellets and what I see other women say is like me I’m a super fast converter so my level can go from 20 to 347 with one 100 mg testosterone pellet so if lowered to a 50 testosterone pellet now it’s barely going to last me a month and no one can afford to pay 400 dollars multiple times a year or want to be cut that many times.. that’s why I see in my hormone groups on Facebook many women prefer injections they say it keeps them even and if they need a little more they can add a little 1 week or not so much the next they like being in control. I’m just wondering how pellets would work for someone like me who goes through them super fast.. I did them in 2018 and went from total T of around 20 to 347 by my 6 week labs and I was only given a 100 Mg testosterone pellet

[@nanjaconetty5475]

Hi jennifer. What hormone groups are you on on FB? I am also a fast converter with pellets. Have you tried the injections yet?

[@annieoakley1565]

By the way, I'm having almost constant aching in my ovaries and sometimes kidneys.

[@cleanqueen75]

I had an obgyn tell me that she she’s women come in bleeding and then was diagnosed with ovarian cancer from taking hormones. She was a little hateful with me taking them.

[@denisedecker7330]

"A" case?! Correlation not causation.

[@shannonscheffel7366]

I'm 55 years old and 5 years post menopause. I pretty much made it through all the worst symptoms without any HRT. The lingering symptoms, and the most troublesome, are zero libido and severe vaginal dryness. So I finally decided to go see the only gynecologist in our tiny middle of nowhere town, a male. Very nice guy and more than willing to put me on HRT. He said he could not put me on testosterone because he can't prescribe it in small enough doses. He did prescribed me oral estradiol 0.5 mg, and 100 mg oral progesterone. I take them both at bedtime. After three months the dryness is much better, the libido has not changed at all. I had a follow-up appointment. Increase the estradiol to 1 mg, to see if that helps with the libido. I'll be starting that tonight. I asked about patches for the estradiol, because I'm worried about blood clots, and he said I don't need to worry about it because I'm not overweight. Is that true? Other than helping with the dryness the only other thing I've noticed since beginning HRT is my belly has gotten huge. I've gained two full inches in my waist in 3 months 😩 I don't know what to do. Help please! P. S. I do not have any breast tenderness or any symptoms of high estrogen other than the big belly.

[@TheShumoby]

If your worried about clots, take it sublingually. Make sure you leave the saliva thats accumulated for 30 minutes.

[@shannonscheffel7366]

@@TheShumoby I can do this with my regular tablet? It doesn't have to be a specific sublingual tablet?

[@jamiehoward6906]

Can you adress insulin resistance and higher testosterone?

[@crh251]

I’m post menopausal and have been on an estradiol patch and an oral progesterone. I recently got my estradiol and progesterone back. Both were from a blood test. My estradiol is 69 pg/ml. I’m not sure how that would be converted to the ng/ml measurement. My progesterone is 2.2 ng/ml.

[@GwenMotoGirl]

I’ve been on HRT for about 7 years. I take 125 mg oral progesterone at night. At 200 mg dose, I felt severe sorrow and could not stop crying, and that was only change at that time, so I feel fairly certain that the increase to the 200 mg dose induced these feelings. Have you heard of this? Progesterone at 125mg doesn’t seem to help with my sleep. I don’t have a uterus. I’m thinking about stopping progesterone.

[@GwenMotoGirl]

I came back to listen again and this time, I understood what you said about free T3. Mine has been high and most recently at 5.0 and I’ve had diarrhea for years. This makes sense, finally. I’m getting my levels checked again soon. I’m getting biote pelkets in 2 days, switching from compounded creams. Thank you!

[@Dandelion_flight]

How do we convert pmol/L to ng/flight? I have never seen a unit such as 'flight' in my whole life before. I had to insist to my the first GP I saw in Jan that I wanted my hormones checked. She refused to give me a referral for it, can you believe that? Just because I no longer have my periods she said that was good enough to tell me I am post menopausal! When the blood test came back, my estradiol was

[@Hibernia2324]

She was correct. Blood testing is very inaccurate and a waste of money. Levels can change from morning to night and day to day. Also, symptoms often do not correlate with low levels. This is well known and has been for years.

[@Dandelion_flight]

@@Hibernia2324 So are you expecting to see my blood estrogen to be less than 20 in the morning and than it will go to 500 at night? Duh. Even if blood test is not the most reliable it is still something! The reason why the first GP dismissed me testing for my female hormones was to save taxpayers' money! She never said it was not accurate. She allowed me to do all other investigations including thyroid and lipids etc. I persisted and then she relented and put the female hormones too. And take note my family pays lots of tax too! LOL. I will never go back to see her again!

[@drsusan]

Sounds like you are on a good path, but give it about two weeks and you will feel much better

[@Dandelion_flight]

@@drsusan Thank you so much Dr Susan! xx

[@rossanatullo1914]

Thank you for such great and educational information- so needed! You mentioned you take plant based biodentical progesterone, is that compounded? What are your thoughts on micronized progesterone (Promethium). I take 100mg every night and 0.05 estradiol patch and has worked great for my symptoms. Thank you.

[@drsusan]

Prometrium is plant-based bioidentical progesterone- just under a brand-name it's exactly the same thing

[@paulohlsson27]

Hi Rossana, how's your day going with you?