I wish I had seen this before meeting with a hormone “expert” 3 weeks ago. I’ve been prescribed biest cream 3x a week, and progesterone cream every night; I’m post menopausal. I’ll definitely be having this conversation at my follow up appointment. It does get frustrating that not all menopause specialist agree with each other on the best delivery and dosage.
I am just learning about HRT from you. You break down and explain the whys and how’s in a make sense way!! Now I understand why I’m piling on the weight, have crappy (not crepey) skin, low energy and loss of muscle mass. Now to find a pro bio identical physician.
I am so amazed by Dr. Felice, the amount of information and the way she presents it, is just amazing, I cannot find a better word to describe it. Thank you so much for sharing it Dr. Felice 🙏🙏🙏
Dr. Gersh, you just changed MY mind. I have personally used Bi-Est 50/50 for years. I started with pure Estradiol and was later convinced it wasn’t as safe. I’m now going to switch back to Estradiol. Thank you!!!
@@MelissaC269 I would like everyone's input also--I am perimenopause...2 weeks ago I started an estradiol patch for 16 days of the month, then while still having the patch on, the last part of the month, I also take a progesterone pill. I've just started all of this---but so far, feel amazing! I went back to my doctor (GP)--and pretty much told him that I needed an estradiol patch and MICRONIZED progesterone...I have researched a lot on both of those and those both seem to be the safest. Mary Claire Haver (Hormone/menopause specialist) also takes the exact same thing...so my Dr. agreed..I went to a gyno 6 separate times, and they wouldn't give it to me, although I did all of the testing they wanted. I am grateful that my General Practioner agreed to what I wanted. I hope this helps. I love Dr Gersh--I have been watching her on all of her videos and those she has been a guest speaker. Good luck ladies!
Thank you Dr. Gersh for this. I was on Bi-Est for a long time and quite a small dose. It helped with many of your typical menopausal symptoms I suppose but I wasn’t sleeping well, I had incredible itching all the time and I’m sure it wasn’t doing my bones any favors. I tried to get my provider to put me on pure estradiol and she wouldn’t budge so I had to go elsewhere. And I’m still trying to find the right doctor but I’m not going back to Bi-Est.
I think you can have a online consultation online with her. In the descriptions of the video have the website for her clinic. I'm going to try to contact her in the website and I hope I can get a teleconsultation with this doctor because I felt she's very knowledgeable.
I think there is toi much reliance in estradiol to do so of the alpha work. Progesterone also builds bone and does other important things. One important thing it does is control the growth of estradiol. This sounds more protective. There is also information showing that we produce some progesterone the first two weeks of our cycle from other areas of our body. So progesterone plays a big role all month long.
Wow. I am stunned by this information and the amazing presentation of it. Your talk is SO organized, rational, and articulately presented! I thought I was fairly knowledgeable about E1, E2, and E3, but I had no clue about the different receptors and their functions and impact. Thank you for enlightening me! I'm taking Bi-Est cream (50:50) at a pretty high dose, but may need to talk to my doctor.
Thank you Dr Gersh, there was so much information packed into here, I'm learning all the time 😊 Yes, I'd like to hear much more about the roles of estrone and estriol in the menopausal body, and therapeutically. I'm post menopausal and have autoimmune conditions with chronic and acute inflammation, so am super interested to know more about oestradiol and the oestrogen family and autoimmune responses too. I'm in the UK, where we have static dosing up to 100mcg oestradiol patch and equivalent on licence. I'm now on 125mcg 🎉, and feel an improvement in my pain, do you think that autoimmune patients may need higher doses? The breast cancer risk warnings are still very much the first thing NHS doctors want to tell you about, so discussing inflammation and HRT probably isn't in the cards yet. Thank you so much Dr Gersh 💛💛💛
I used estriol cream for 2-3 weeks in addition to estradiol 1 mg tablet and it made me irritable. I'm aware that it's not "supposed to" have any effects, but I've read that a lot of women complain of effects. With the estradiol tablet, I'm calm and have much better mental alertness.
You are a fantastic teacher. Thank you for the work you put into these videos. I will have to watch this one a few times so that it completely sinks in.
Hi Dr. Thanks for all this data. I will prescribed now yust estradiol only to my patients and see how improvement the symptoms and cardioprotection as well. Saludos desde. México 🇲🇽. ❤
My understanding from this video is that we should take only Estradiol instead of bi-est 80/20 as HRT because Estriol has a half life and disappears from the body by end of day, so of no use. Then you highlight benefits of Estriol and say you take it yourself. That's a bit of a contradiction. I apply 1mg 80/20 bi-est cream per day. If Estradiol is more effective, then is it possible to get a 50/50 formula? I'm not understanding the final recommendation here for women on Bi-est. Also consider progesterone taken alongside will not instigate some of the negatives of Estriol you mention. My doc is a BHRT expert so I'll stick with his prescription. Too much confusing information online! Was an informative discussion nonetheless, thank you. 💝
@YoannaDilova It is you who needs to do more research dear, rather than watch the same video on slow motion over and over again. Read articles don't just watch media influencers. Estriol balances Estradiol and negates the possible harms of Estradiol. Bi Est is good for people who were never on conventional HRT but not effective for those coming off of synthetic HRT. There you go, some information to get you started on your research so you make the most well-informed decision for yourself reducing risk of longterm adverse consequences. 😉
Thank you so much for this education. I've been on 80/20 estriol for over a year and while it has helped my symptoms I've had alot of mid stomach weight gain. Even after weight training and doing an anti-inflammatory diet. Can't lose weight or reduce belly fat. I think it has something to do with the estriol cream. Anyone else? Any recommendations?
I am taking bio-identical testosterone ( AndroForte) along with Estradiol patch . I have no adrenal glands now, as they needed to be surgically removed several years ago. I therefore don't produce DHEA or other adrenal androgens, but I am wondering if the testosterone replacement would still present a significant breast cancer risk? I have been feeling better after several months of physiological testosterone replacement.
I had my compounding pharmacist compound biest separately. I used the estridiol ny itself at first felt great. Told my Dr. I didn't want to use the estriol she said I had too,???
Age 64 and have been using topical estriol cream for about 4 years, along with topical progesterone cream for about 7 years. The end of May, I went on the Noven CombiPatch. Should I stop the estriol cream And progesterone cream cold turkey? Or taper off?
I think there is too much reliance on estradiol to do all of the alpha work. Progesterone also builds bone and does other important things. One important thing it does is control the growth of estradiol. This sounds more protective. There is also information showing that we produce some progesterone the first two weeks of our cycle from other areas of our body, not just week 3 and 4. So progesterone plays a big role all month long.
Hi Dr. Gersh I am 50 and have always been into health, working out being active, taking care of my teeth everything. Within about a year I have noticed in some areas my gum tissue between the teeth lowering and it is something I am really concerned with bc I’ve never had this be an issue until this I’m thinking the decline of estrogen. I’ve taken a deep dive trying to find more about how we can stop it. Will you please explore this bc I have not found anyone really talking about this, other areas yes but some of us women despite how healthy we’ve been all around. Please help I am really freaking out. With the lack of study on our hormones and how important they are for us. I really want to be able to do something. I’ve already doing many things that I’ve learned listening to many dedicated to this area but haven’t heard for this area. If you have will you please let me know where to find it.
Im struggling with vaginal yeast infections after start on HRT. I have not had a single one infection in 20 years I believe. After turning down birth control pills. Now Im on 3. infection in 3 months. But have so many symptomes without estradiol. Problems sleeping. Bladder issues. Cognitive problems. Heart palpations. joint pains. To mention the worst symptoms. Have a lot more, but they are easier to reconcile with. Im on cyclic regime. 100-150 mikrogram dermal estradiol every day of month and 200 mikrogram urogestan 12 days a month. Did also take intrarose for a short period of time. Help with the urge/need to go to the toilet all the time. But why do I get yeast infections, and what to do about it? do I get to much estradiol? blood samples says blood levels are 300, and reference is 300-500 for postmenopausal women on HRT, so Im in the lower range. I do not understand what is happening. I eat a very balanced diet. Very little sugar and no processed food, and exercise 30 minutes every day.
Maybe your body is still "readjusting" to new regiment, needs more time to balance things out. I didn't get a yeast infection but my first month on the same dosing, got very strange headache with pain in gums every day for over 2 weeks, but now it's all gone Have you taken any antibiotics in past couple of years? This can make you more prone to yeast & a good probiotic may help Or maybe it's a residual reaction to the intrarose... I know it must be so irritating but don't lose hope! I wish you well!
I had this discussion with my HRT provider and now I understand why she didnt want to prescribe it. The “bi-est”another prescriber here in NC was using was a compounded topical cream containing Estradiol/progesterone/testosterone 0.2mg/30mg/0.25mg/ml. Now I see why she was unwilling bc this rx combo was still called “bi-est.” I know research shows topical is the least effective route, but with fibroids the estrogen patch and progesterone pills seem to be activating my lining too much. I’m willing to try anything at this point but without any real menopause research, much less menopause with fibroids, it’s a frustrating process.
I started HRT a couple of months ago. 1 pump of Estradiol gel on skin X2 per day = 1.5 mg and 2x 100 mg of micronized Progesterone per day for last 14 days of month. Both are body-identical and available at regular pharmacy with a regular prescription. This is considered the standard "starter" dosage to be reassessed in 3 months. Not sure where you are at in menopause but if Doc is reluctant to prescribe like mine was, exaggerate all menopausal symptoms at appointment and emphasize that they are debilitating and keeping you from leading a normal life. That's what I did and got the prescription! I can't afford private so I did what I sadly needed to do to get some proper healthcare!@@123STEP23
I’m sorry, I’m 16 min into this and she is talking about inflammation as though that causes breast cancer or that you can’t have breast cancer unless you are highly inflamed. I am 59 yrs old, 128lbs, 5’5” with ZERO inflammation in my body according to all recent blood work. Like super LOW inflammation and yet, yet, I have just been diagnosed with breast cancer. I will listen to the rest of this, but something isn’t right.
In the UK estriol is more commonly prescribed than oestradiol for vulval and vaginal use. I think in the US, oestradiol might be more commonly prescribed for that? 😊xx
There are some women that can not handle the strength of E2 or others that can not tolerate Progesterone and have a uterus. Estriol does not require progesterone with its use.
Hi Dr. Thanks for all this data. I will prescribed now yust estradiol only to my patients and see how improvement the symptoms and cardioprotection as well. Saludos desde. México 🇲🇽. ❤
I wish I had seen this before meeting with a hormone “expert” 3 weeks ago. I’ve been prescribed biest cream 3x a week, and progesterone cream every night; I’m post menopausal. I’ll definitely be having this conversation at my follow up appointment. It does get frustrating that not all menopause specialist agree with each other on the best delivery and dosage.
No type of progesterone is bioavailable tramsdermally.
I am just learning about HRT from you. You break down and explain the whys and how’s in a make sense way!! Now I understand why I’m piling on the weight, have crappy (not crepey) skin, low energy and loss of muscle mass. Now to find a pro bio identical physician.
Just found this smart woman.
Consider looking up Mary Haver Claire in TX as she might have referral list in your area. Just search her site.
I recommend dr marie claire haver instead.
I am so amazed by Dr. Felice, the amount of information and the way she presents it, is just amazing, I cannot find a better word to describe it. Thank you so much for sharing it Dr. Felice 🙏🙏🙏
Dr. Gersh, you just changed MY mind. I have personally used Bi-Est 50/50 for years. I started with pure Estradiol and was later convinced it wasn’t as safe. I’m now going to switch back to Estradiol. Thank you!!!
I’m also on this. How does one get estradiol instead? I would also need progesterone as I’m still in perimenopause
@@MelissaC269 you need a well informed doctor to prescribe it for you.
@@MelissaC269 I would like everyone's input also--I am perimenopause...2 weeks ago I started an estradiol patch for 16 days of the month, then while still having the patch on, the last part of the month, I also take a progesterone pill. I've just started all of this---but so far, feel amazing! I went back to my doctor (GP)--and pretty much told him that I needed an estradiol patch and MICRONIZED progesterone...I have researched a lot on both of those and those both seem to be the safest. Mary Claire Haver (Hormone/menopause specialist) also takes the exact same thing...so my Dr. agreed..I went to a gyno 6 separate times, and they wouldn't give it to me, although I did all of the testing they wanted. I am grateful that my General Practioner agreed to what I wanted. I hope this helps. I love Dr Gersh--I have been watching her on all of her videos and those she has been a guest speaker. Good luck ladies!
Thank you Dr. Gersh for this. I was on Bi-Est for a long time and quite a small dose. It helped with many of your typical menopausal symptoms I suppose but I wasn’t sleeping well, I had incredible itching all the time and I’m sure it wasn’t doing my bones any favors. I tried to get my provider to put me on pure estradiol and she wouldn’t budge so I had to go elsewhere. And I’m still trying to find the right doctor but I’m not going back to Bi-Est.
I wish Dr G did telemed without a visit. I love her. Dr Amy Hornaman does online and i love her just as much!!❤
You're a great teacher. Thank you for educating us. 😘
Unfortunately I can't travel to California.Also it will be beneficial that you really talk about average safe dosage.
I think you can have a online consultation online with her. In the descriptions of the video have the website for her clinic. I'm going to try to contact her in the website and I hope I can get a teleconsultation with this doctor because I felt she's very knowledgeable.
You're the best Dr Felice... Thank you for this information and for all the good you are doing in the world... ❤
I think there is toi much reliance in estradiol to do so of the alpha work. Progesterone also builds bone and does other important things. One important thing it does is control the growth of estradiol. This sounds more protective. There is also information showing that we produce some progesterone the first two weeks of our cycle from other areas of our body. So progesterone plays a big role all month long.
Wow. I am stunned by this information and the amazing presentation of it. Your talk is SO organized, rational, and articulately presented! I thought I was fairly knowledgeable about E1, E2, and E3, but I had no clue about the different receptors and their functions and impact. Thank you for enlightening me! I'm taking Bi-Est cream (50:50) at a pretty high dose, but may need to talk to my doctor.
Thank you Dr Gersh, there was so much information packed into here, I'm learning all the time 😊
Yes, I'd like to hear much more about the roles of estrone and estriol in the menopausal body, and therapeutically.
I'm post menopausal and have autoimmune conditions with chronic and acute inflammation, so am super interested to know more about oestradiol and the oestrogen family and autoimmune responses too.
I'm in the UK, where we have static dosing up to 100mcg oestradiol patch and equivalent on licence. I'm now on 125mcg 🎉, and feel an improvement in my pain, do you think that autoimmune patients may need higher doses?
The breast cancer risk warnings are still very much the first thing NHS doctors want to tell you about, so discussing inflammation and HRT probably isn't in the cards yet.
Thank you so much Dr Gersh 💛💛💛
Yes please. I would also like to learn more on MHT and how it helps or hurts autoimmune diseases.
I used estriol cream for 2-3 weeks in addition to estradiol 1 mg tablet and it made me irritable. I'm aware that it's not "supposed to" have any effects, but I've read that a lot of women complain of effects. With the estradiol tablet, I'm calm and have much better mental alertness.
You are a fantastic teacher. Thank you for the work you put into these videos. I will have to watch this one a few times so that it completely sinks in.
Me too, ot is a lot of information to take in at once.
Hi Dr. Thanks for all this data. I will prescribed now yust estradiol only to my patients and see how improvement the symptoms and cardioprotection as well. Saludos desde. México 🇲🇽. ❤
Thank you greatly, Dr. Gersh. Have to replay several times, to absorb it all.
My understanding from this video is that we should take only Estradiol instead of bi-est 80/20 as HRT because Estriol has a half life and disappears from the body by end of day, so of no use.
Then you highlight benefits of Estriol and say you take it yourself. That's a bit of a contradiction.
I apply 1mg 80/20 bi-est cream per day. If Estradiol is more effective, then is it possible to get a 50/50 formula?
I'm not understanding the final recommendation here for women on Bi-est.
Also consider progesterone taken alongside will not instigate some of the negatives of Estriol you mention.
My doc is a BHRT expert so I'll stick with his prescription.
Too much confusing information online!
Was an informative discussion nonetheless, thank you. 💝
You go and educate yourself first. listen to the conversation carefully... again
@YoannaDilova It is you who needs to do more research dear, rather than watch the same video on slow motion over and over again. Read articles don't just watch media influencers.
Estriol balances Estradiol and negates the possible harms of Estradiol.
Bi Est is good for people who were never on conventional HRT but not effective for those coming off of synthetic HRT.
There you go, some information to get you started on your research so you make the most well-informed decision for yourself reducing risk of longterm adverse consequences. 😉
@@SPower-yl9wwI concur.
You dont know if your body is going to convert. Just like thyroid. Not everyone convert Ft4 to FT3. There is data on E3
Exactly!!
What is the estradiol dose?
Depends on the woman and her current levels
You are 🎉 legit my favorite!!!!!
Wow this is amazing info!
Brava! Excellent lesson! Thank you, doctor!
Dr.AFTER LISTENING TO THIS,I DONT UNDERTAND WHY ALMOST EVERY DOCTOR STILL PRESCRIBE BI-EST? I HOPE THEY GET TO LISTEN TO THIS VIDEO. THANK YOU
Thank you so much for this education. I've been on 80/20 estriol for over a year and while it has helped my symptoms I've had alot of mid stomach weight gain. Even after weight training and doing an anti-inflammatory diet. Can't lose weight or reduce belly fat. I think it has something to do with the estriol cream. Anyone else? Any recommendations?
I'm having the same issue. It's been very frustrating.
I am taking bio-identical testosterone ( AndroForte) along with Estradiol patch . I have no adrenal glands now, as they needed to be surgically removed several years ago. I therefore don't produce DHEA or other adrenal androgens, but I am wondering if the testosterone replacement would still present a significant breast cancer risk? I have been feeling better after several months of physiological testosterone replacement.
I had my compounding pharmacist compound biest separately. I used the estridiol ny itself at first felt great. Told my Dr. I didn't want to use the estriol she said I had too,???
Age 64 and have been using topical estriol cream for about 4 years, along with topical progesterone cream for about 7 years. The end of May, I went on the Noven CombiPatch. Should I stop the estriol cream And progesterone cream cold turkey? Or taper off?
I think there is too much reliance on estradiol to do all of the alpha work. Progesterone also builds bone and does other important things. One important thing it does is control the growth of estradiol. This sounds more protective. There is also information showing that we produce some progesterone the first two weeks of our cycle from other areas of our body, not just week 3 and 4. So progesterone plays a big role all month long.
Hi Dr. Gersh I am 50 and have always been into health, working out being active, taking care of my teeth everything. Within about a year I have noticed in some areas my gum tissue between the teeth lowering and it is something I am really concerned with bc I’ve never had this be an issue until this I’m thinking the decline of estrogen. I’ve taken a deep dive trying to find more about how we can stop it. Will you please explore this bc I have not found anyone really talking about this, other areas yes but some of us women despite how healthy we’ve been all around. Please help I am really freaking out. With the lack of study on our hormones and how important they are for us. I really want to be able to do something. I’ve already doing many things that I’ve learned listening to many dedicated to this area but haven’t heard for this area. If you have will you please let me know where to find it.
Im struggling with vaginal yeast infections after start on HRT. I have not had a single one infection in 20 years I believe. After turning down birth control pills. Now Im on 3. infection in 3 months. But have so many symptomes without estradiol. Problems sleeping. Bladder issues. Cognitive problems. Heart palpations. joint pains. To mention the worst symptoms. Have a lot more, but they are easier to reconcile with. Im on cyclic regime. 100-150 mikrogram dermal estradiol every day of month and 200 mikrogram urogestan 12 days a month. Did also take intrarose for a short period of time. Help with the urge/need to go to the toilet all the time. But why do I get yeast infections, and what to do about it? do I get to much estradiol? blood samples says blood levels are 300, and reference is 300-500 for postmenopausal women on HRT, so Im in the lower range. I do not understand what is happening. I eat a very balanced diet. Very little sugar and no processed food, and exercise 30 minutes every day.
Maybe your body is still "readjusting" to new regiment, needs more time to balance things out.
I didn't get a yeast infection but
my first month on the same dosing, got very strange headache with pain in gums every day for over 2 weeks, but now it's all gone
Have you taken any antibiotics in past couple of years? This can make you more prone to yeast & a good probiotic may help
Or maybe it's a residual reaction to the intrarose...
I know it must be so irritating but don't lose hope!
I wish you well!
I had this discussion with my HRT provider and now I understand why she didnt want to prescribe it. The “bi-est”another prescriber here in NC was using was a compounded topical cream containing Estradiol/progesterone/testosterone 0.2mg/30mg/0.25mg/ml. Now I see why she was unwilling bc this rx combo was still called “bi-est.” I know research shows topical is the least effective route, but with fibroids the estrogen patch and progesterone pills seem to be activating my lining too much. I’m willing to try anything at this point but without any real menopause research, much less menopause with fibroids, it’s a frustrating process.
What are the physiologic sise for estradiol? My do. Is giving me estrone cream snd blood pressure meds .. it’s WRONG they won’t listen to me.. help !!
Ugh not sise meant to say dose.
I started HRT a couple of months ago.
1 pump of Estradiol gel on skin X2 per day = 1.5 mg and 2x 100 mg of micronized Progesterone per day for last 14 days of month. Both are body-identical and available at regular pharmacy with a regular prescription.
This is considered the standard "starter" dosage to be reassessed in 3 months.
Not sure where you are at in menopause but if
Doc is reluctant to prescribe like mine was, exaggerate all menopausal symptoms at appointment and emphasize that they are debilitating and keeping you from leading a normal life.
That's what I did and got the prescription! I can't afford private so I did what I sadly needed to do to get some proper healthcare!@@123STEP23
I’m sorry, I’m 16 min into this and she is talking about inflammation as though that causes breast cancer or that you can’t have breast cancer unless you are highly inflamed. I am 59 yrs old, 128lbs, 5’5” with ZERO inflammation in my body according to all recent blood work. Like super LOW inflammation and yet, yet, I have just been diagnosed with breast cancer. I will listen to the rest of this, but something isn’t right.
Blood work isn't necessarily going to show inflammation.
Why would a doctor give menopausal women estriol? It’s not estradiol..
It's pretty good for skin doesn't enter the bloodstream
In the UK estriol is more commonly prescribed than oestradiol for vulval and vaginal use. I think in the US, oestradiol might be more commonly prescribed for that? 😊xx
There are some women that can not handle the strength of E2 or others that can not tolerate Progesterone and have a uterus. Estriol does not require progesterone with its use.
@@kkr5595 wow! I had no idea. But isn’t estradiol the active hormone and the best for osteoporosis.
Hi Dr. Thanks for all this data. I will prescribed now yust estradiol only to my patients and see how improvement the symptoms and cardioprotection as well. Saludos desde. México 🇲🇽. ❤