A Doctor's Guide to MENOPAUSE and Hormone Replacement Therapy
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- Опубліковано 29 тра 2024
- Dr. Rajsree Nambudripad is Board Certified in Internal Medicine and the founder of OC Integrative Medicine in Fullerton California.
This video is dedicated to all women looking to learn about their hormones, the changes that happen in menopause, and the latest updates in bio-identical hormone replacement therapy.
Learn the functions of estrogen, progesterone, testosterone, and DHEA. I explain the difference between older synthetic hormone replacement therapy and newer bio-identical hormone replacement therapy. Learn the most popular options among my patients and the pros and cons of each option.
What safety measures are important while on hormones?
00:00 Introduction
00:40 Symptoms of Menopause
01:41 Bio-Identical Hormone Replacement
02:57 Safety Measures
05:08 Types of Estrogen
06:33 Progestins vs. Progesterone
07:34 Estradiol Patch vs. Bi-Est Cream
10:08 Balance between Estrogen and Progesterone
10:20 Hormone Holidays
10:58 Testosterone
11:39 DHEA
13:07 Other Lifestyle Factors
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This information, including but not limited to, text, graphics, images and other material contained on this video and website are for informational and educational purposes only. No material in this video is intended to be a substitute for professional medical advice, diagnosis, treatment, or medical supplement approved by the Food and Drug Administration. The information provided should not be used for diagnosing or treating a health problem or disease, and those seeking personal medical advice should consult with a licensed physician. Never disregard professional medical advice or delay in seeking it because of something you have seen in this video. No physician-patient relationship is created by this video or the information provided. Furthermore, neither Rajsree Nambudripad, MD or any contributor to this video, makes any representations, express or implied, with respect to the information provided herein or to its use.
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Plz make in hindi to better understand
And avoid caffeine such a horrible hormone disruptor - adding cruciferous veggies and beans helped my menopause a lot - I didn’t realize how badly coffee was throwing off my hormones and HRT isn’t needed if no caffeine and processed foods sugar and oils.
This is one of the BEST videos I’ve ever encountered on hormone replacement therapy!!! I’m a nurse & I will definitely share this video w/ my patients as a resource. Thanks you so much!
Thank you so much for you kind feedback! I really appreciate hearing from you! Best wishes, RN
Ditto! I've seen so many and this is the best
Transformative information!! Thank you! Very easy to follow and understand! ❤
Thanks so much for watching! 😊
Thank You for all your work developing these videos. They are filled with so much needed information. Easy to understand.
Thanks for watching and commenting! Appreciate your kind feedback.
Thank you for a wonderful explanation of everything...very informative!
Thanks Carol! Glad you found it helpful.
Thank you kindly for all the information you are providing!
Thanks for your support!
Great explanation. Thanks!
Thanks for watching Jennifer!
Thanks for you video. It is very informative and helpful.
Thanks so much for watching!
Great infovideo, excellent and professional explanation.
Thanks so much for watching! Appreciate your support.
The doctors st the Hormone Rebalance Centre are the best!!! Great video
Thanks for watching!
This is one of the best videos I have seen for Bio identical hormone therapy. You just answered a question I had . Thank you Dr. Raj ❤️
Thanks so much for watching! 😊
Amazing video ❤ thank you for all this information ❤
Thanks so much for watching! 😊
I would like to thank you for sharing these video jewels. I am an Integrative Medical physician in Orlando. I Have learned so much great information from you. This added knowledge has enabled me to provide a higher level of care to my patients. Keep rocking it🙂!
That's amazing! Thanks so much for watching and commenting. There is certainly a great demand for integrative physicians these days! Best wishes to you, RN
Great info. Thank you!
Thanks so much for watching! 😊
Wow! GREAT video!!! Very well done and thank you for your detailed information! I can't wait to talk to my doctor about this! I had a total hysterectomy in 1999 and I believe I am long overdue for a review of my hormones! Thank you!
Thanks so much for watching! Best wishes in your health, RN😊
Good information in this video thank you doctor
Thanks so much for watching! 😊
Wow! Awesome video. Thank you.
Thanks so much for watching!
@@drrajsree It was so well presented and informative that I subscribed immediately. Thanks again.
@@dabeezkneez8716 Thanks for your support! Best wishes, RN
Very Informative Dr.
Thanks so much Adnan! Hope you're doing great.
@@drrajsree yeah Dr. I am doing great and how about you?
@@adnankaramat1606 Doing well thanks for asking.
Love your videos.
1) Menopausal on E patch and Mirena IUD (didn’t tolerate Prometrium)
How do you do hormone holiday to balance the both hormones to prevent E dominance?
2) What are the optimal blood hormone ranges for estrodiol/ progesterone if on E patch/ Iud.
Ty in advance.
I actually love the wedding music as the background. But seriously I love your channel!
Thank you so much! I appreciate hearing from you.
Excellent video!! 🎉
Thanks so much for watching!
I really enjoyed this video I really learned a lot. I’m struggling with hot flashes now and I can’t handle them and I really need something to balance them
Thanks so much for watching! 😊
It's really useful thank you ❤
Thanks so much for watching! 😊
Love to hear your thoughts on menapause and intermittent fasting...
Intermittent fasting is great in Menopause since you don't have to worry about it affecting hormones.
You might enjoy my video on Autophagy and Fasting:
ua-cam.com/video/v5xBE1zvwUY/v-deo.html
@@drrajsreedoc, immediately after a horrible intestinal challenge that had me bed bound for 2 months, dr. Said it was highly probable to have been caused by very high stress levels. With that said I have had a LOT of gas from both ends. Burping throughout the night and sometimes day. Intestines seem to get flared up very easily. Does this have anything to do with menopause?
I went in menopause at age 27. I got auto immune ovarian failure. My anxiety has been high ever since. As well as no sec drive. It’s sucks. I don’t get those. I went through menopause at early 30”s. Omg love ur videos dr. You are amazing
Thank you kindly! I'm sorry to hear about the early ovarian failure. Best wishes in your health, RN
@@drrajsree I would love to see u. I have added my self on ur waiting list. I have SIBO. I got diagnosed 3 weeks ago. Thanks
@@irmakalember9403Yikes, that's a true challenge. I had all sibo symptoms too & unfortunately went to a terrible dr which had never heard of it. Found great natural one and has helped greatly. Imagine sibo AND menopause UGH!! 🥵😭🥵😭😭😭😭😭
Thank you so much
Thanks so much for watching.
Awesome content 🙌
Thank you so much Trevor!
Wonderful Video 😊
Thank you so much!
Good Job Rajshree Baa 👍🙌❤️
Thanks Darsana! Appreciate your support.
#thankyouDrRajsree
#informative
Thanks for watching and commenting!
Absolutely positively ❤️ it
Thanks so much for watching! 😊 Love hearing from you!
thanks so much for this video. I live in New York and I would love to see a doctor as knowledgeable as yourself .I was wondering if you happen to know and recommend a physician in New York?
Thanks so much for watching! 😊 To search for a functional medicine provider, please go to IFM.org
Best wishes in your health,
RN
Please do a part 2 on diet and lifestyle. I think low carb grain free is best in this instance. Plus dr Barnard release research on omitting dairy
Sure -- you may enjoy my videos on Autophagy, Insulin-Resistance, and Fatty Liver they have a lot of information on diet, lifestyle. Yes most of my patients do great on a paleo (grain-free) diet and dairy free.
@@drrajsree when you release the diet video I plan to share it with my mum to inspire her to eat more healthy and cut out the grains, processed foods and frequent snacks/calorie drinks. I think I.F. Will be helpful too
A million thank you’s to you
Thanks so much for watching! 😊
You are amazing!
Thank you so much! 😊
Thanks for sharing what do you think about Harmon pellets
Hormone pellets are not recommended since they can make your hormone levels really high, and can't be removed and then the hormone levels just gradually wane over a 3-6 month period. Hence, they don't mimic the natural body physiology. Thanks for watching.
What a great video to figure out the problem from the men's side. Do You know if accepting estrogen can increase the risk of any form of cancer?
Thanks for watching. Estrogen does stimulate breast and endometrial (uterine) tissues to that's why it has to be balanced with progesterone.
VERY informative video! I'm 74 years old, post-menopausal since age 38, and have always refused to take Premarin for ethical reasons. I have insomnia, weight control issues, dry skin, sore joints, and osteoporosis. I eat well and am otherwise in excellent health -- no heart disease or diabetes. Am I too old and far-gone to benefit from bioidentical hormones?
It’s rare to start hormones at age 74. Sometimes there are other non-hormonal ways to improve those symptoms. Thanks for watching!
Hello doctor.... I m new subscriber to ur channel.... Ur videos r good informative.... Plz do a video on rhumetoid arthritis...
Welcome and thank you for subscribing! Great suggestion I will keep this in mind.
Does it make sense to consider hormone replacement therapy if I have already entered menopause (stopped menstruating about 3 years ago)? I continue to have hot flashes (10 years now).
I also have psoriasis (since the age of 15), Sjogren's syndrome (onset a few years ago) and SIBO.
I follow a dairy-free, grain-free, low starch, low FODMAP, low-lectin, almost vegan (salmon weekly hydrolyzed collagen daily), organic diet. I eat cruciferous vegetables 2 to 3 times a day. My main sources of protein are homemade organic soy milk kefir and yogurt, and walnuts.
I am currently treating SIBO for the third time, despite maintaining this strict diet and taking a ton of nutritional supplements.
I adore all of your videos! They're so well made. If you ever move to Montreal, Canada, I'll be your first patient 🙂
Yes if you have hot flashes you can consider hormone replacement therapy at any time and it can improve your quality of life. Thank you for watching.
Are you following Dr Rajsree SIBO treatment protocol? I started in November and by the end of January, my SIBO was gone! I haven't felt this good in almost 2 years. (It started with a C-diff infection)
THANKYOU♥️
Thanks so much for watching! 😊
You make sense
Thanks for watching!
Thank you. Excellent video. I have a question: can vaginal suppositories also be used?
Yes, some women like them for vaginal dryness. Thanks for watching!
Enjoyed your video. I have been taking BI-Est cream with progesterone and testosterone as well as DHEA in pill format for 8 years. Many of the symptoms are lessened but I cannot control my weight. I am 40 lbs heavier than before I started the regime. Should the dosage be adjusted or should I discontinue using these products?
It's good to discuss with your doctor to see if there are other causes of weight gain and check your hormone levels. I typically don't find the BI-est to cause weigh gain if dosed appropriately.
Awesome Awesome Awesome video!!!
Thanks so much for watching!
What do you recommend to minimize the skin irritation with the estradiol patch. Unfortunately, my skin has been breaking out with the patch! However, I really see the benefits of the medicine!
Sorry to hear this -- perhaps you have an allergy to the adhesive in the patch.. You might want to try a different form of hormone replacement. Like the Bi-est cream I mentioned in the video. Please discuss this with your doctor. Thanks so much for watching! 😊
I use evorol Conti patches
Thanks so much for watching! 😊
Dear Dr. Nambudripa, thank you very much for a very important and timely video! I have been on a hormonal therapy for a year, but unfortunately not very good results. How can I become your patient? Many thanks, Lyudmila.
Thanks for watching. If you are local to my office in California, please call us to be on our waiting list 714-523-8900.
How ca n I become your patient
i, m in the stage of menopause . useful video❤️
Great video - my male doctors in New Zealand are not keen to prescribe- however this will give me the knowledge - so if I had the patches will I need progesterone as a tablet ?
Yes if you use estradiol as a patch, you need progesterone as a capsule to balance it. Thanks for watching!
Thank you Dr Raj very helpful. I thought the increased risk of breast cancer was unfounded and due to a poor study done many years ago. Is that not the case?
Yes, but estrogen still stimulates breast tissue which is why we have carefully monitor hormone replacement, balance with progesterone, provide hormone holidays, do mammograms, etc. If you're under a care of a knowledgable provider, usually it's quite safe.
I have 1 of the MTHFR genes. Is it possible to take bio hormones…I’m 58. After children I had problems w blood clots while using birth control..had to stop. I do feel great though.
Thank you, and yep your videos are amazing! I’ve been sharing lots w my family and friends
Thanks so much for watching!
I have benign breakfast lamps. Is it safe to use estradiol as a HRT? MANY THANKS
It's best to discuss with your doctor. Thanks so much for watching! 😊
I have been using HRT for the last year. 100mcg micro Progesterone and divigel 1mcg. First 6 months, I had no problems with spotting. After that, it started spotting or acting like a regular period. Immediately I called my doctor, and she said to continue the dosage. she checked the blood test but continued the same. When getting the spotting, what do I need to do? Do I need to stop the medication or continue? Am I taking a higher estrogen dose? I want to know your thoughts. Please help me!!
Spotting is often a sign of too much estrogen. You might want to get a second opinion from another doctor.
Women have reported their menopausal symptoms disappearing after having celery juice - 2 cups every morning, pulp removed, 30 minutes before breakfast. I was doing it every morning for 3.5 months this year, and have personally not experienced period pain since.
Thanks for sharing! Celery juice is great for reducing inflammation.
Thank youuuuuuuuuuuuu!
Thanks for watching!
I use forefront health biodentical progesterone from wild yam is that safe this one is to rub on gums I don’t like that so I put on my thin fast of wrist is this safe
Thanks for watching!
After grade 1 breast cancer 10 years ago would you recommend hrt please?
No, especially if ER+
Thanks for watching.
Thank you so much for this video. How long do women need to be on the Bi-Est?
Some choose to use it long term since it helps them feel better. Others go off after a few years. It's a personal decision. Thanks for watching!
A quick question dr.is it always recommended a progesterone supplement along with any form of estrogen supplement like vagifem or Premarin vaginal cream for any one with uterus ??
Even if it is a short trial of vagifem ??
For vaginal creams, some would argue progesterone not needed. For systemic estrogens, for sure needs to balance with progesterone. To be safe however, may be good to balance with progesterone.
Thank you dr. Rajsree. Is hormon replacement indicated in the absence of menopause simptoms, just for maintaining the youth?
Not usually, but that is a personal decision each patient should make. Thanks for watching!
Hi Doctor...I love your videos, talks, advise. Can you do a video about male hormones. Also, how can I become your patient?
Here's my video on Male Hormones:
ua-cam.com/video/bKKmAkkEOpE/v-deo.html
I apologize I'm not taking new patients at this time. I hope some of the tips in this video can help you. To search for a functional medicine provider, please go to IFM.org
Best wishes in your health,
RN
From juicy 🍇 to dried raisin.. nailed it
Thanks so much for watching! 😊
Hi I have just started watching your videos. They are easy to watch with very important information and I am now following you on Facebook and Instagram.
I am 57 and post menopause I have never taken Hrt . At the beginning of my menopause I had a few hot flushes . The last year I have started to get more belly fat . I have started fasting and going to the gym. I am vegetarian and I am trying to cut down on sugars. I don’t eat pasta or bread very often if I eat bread is usually sourdough bread. Only drink water sometimes green tea or peppermint tea . I take MCT oil with aloe Vera juice and take a daily gut supplement .
Is there anything else I can do to lose the belly fat? Thanks
You might like my recent video on the Hormones That Control Your Weight and Metabolism.
Thanks for sharing ...I wanted to ask 2 questions….1.how many patches used a month? I'm 53 yrs old and 26 months ago stopped my cycle...2.better I use hrt patches.? Thank you..
It depends on your symptoms. Please discuss with your doctor for personalized guidance.
I had cryptogenic cerebellar stroke which am now on Lipitor and Plavix. Can i take patch estrogen so it doesn’t go through the liver?
That's a gray zone. It's best to discuss with your physician to review the pros and cons of hormone replacement therapy.
I am on one pump on Estrogel .06% estradiol and 100mg prometrium, but lately i am having a bit of hot flashes etc, so i increased to two pumps and i feel better my question is do i have to increase the progesterone as well?
Please help
Thank you so much for all the info
I apologize I can't advise you directly on dosing. Please discuss with your doctor and have your labs tested as well. Best wishes, RN
Thank you ❤️
Get the yearly mammograms, self exams every month because breast cancer is a reality
Why do you get neausa vertigo in post menopause thank you ♥️
You should discuss with your doctor since there could be many reasons for this. Best wishes, RN
What type of testing is best when analyzing a patients hormone levels?
I order routine blood tests for estradiol, progesterone, testosterone, DHEA-sulfate, thyroid hormones (TSH, free T4, free T3)
I'm curious about the window of HTR. I'm 56 and had my last period at 51. Have I missed my opportunity?
No, I can be started at any age if there are symptoms that need to be addressed.
This is an excellent video. Just one question, would a woman have a period during the hormone holidays?
Great question. No, typically the hormone levels are not high enough to cause a period. We want to avoid any bleeding or spotting which could be a red flag of too much estrogen or abnormal cells in the uterus.
@@drrajsreethank you 😊
If I take a DHEA supplement, should I use it like a lifetime hormone supplement?
Blood levels should be monitored to determine if continued supplementation is needed.
Thanks Dr, for the info, just subscribe to your channel. i just started using CEE few days ago to curb the effect of my severe hot flashes. But seeing you explained it consequences i became afraid. Please can i use DHEA . Thanks in anticipation❤
Thanks for watching and subscribing! Yes maybe you can ask your doctor about Estradiol Patches -- it's the easiest and most popular option these days for HRT, generally also covered by insurance. Yes I recommend DHEA if patients' levels are low. Optimal is 150-250 on lab for DHEA.
@@drrajsree Thanks Dr for your time 🌹
I have tried bioidenticle hormones but I get so tired or sick. When I was pregnant every time I had to have iv’s because I would get so sick. But I’ve been having hot flashes and no sleep for 6 years. My hair has been falling out that whole time. What can I do?
Thanks for watching. It's best if you can work with a provider directly for personalized guidance. Please check out my video on Hair Loss.
Best wishes, RN
I’m 59 years old. I have not had a menstrual cycle for at least 10 years I found out I was in menopause after I stopped taking the provera shots for birth control. I don’t get hot flashes or brain fog , I have gained weight in the last 4-5 years and I do have increased muscle aches . I sleep ok and I don’t really have mood swings. I am also seeing signs of sagging skin and aging. Also my ob doctor switched me from regular birth control to provera in my mid forties because I have varicose veins in my legs which have been less painful since I stopped taking any kind of birth control. My Question is if I have some symptoms but not all of menopause what treatment would be best and does a ob doctor do all the testing or is there a special doctor that I need to see?
Some OB/GYN's do testing and treatment. Otherwise you could see a functional medicine provider trained in bio-identical hormone replacement.
I loved this but now I am very confused. I have an appt to get a pellet type hormone replacement not covered by insurance. I also tried to find someone here in NC that specializes in hormone replacement, an impossible task near me.
I don't recommend pellet type hormone replacement. It causes very high levels of hormones and can't be taken out once inserted. The levels gradually decline over a 3 month period.
Thsnk you!
What is a good balance between E and P? Is there a general ratio as a guideline?
Not exactly.... There's a range
Thanks for watching.
Can you up your evorol Conti patches l am on evorol Conti patches small dose
Thanks so much for watching! 😊
Question?
Why aren’t you mentioned troche compounds as one of the HRT?
What is the pro and con of troche in HRT?
Thanks
I use them rarely. For estradiol troches, some of it gets swallowed so it does get metabolized by the liver which is not ideal (oral estradiol should be avoided as it increases blood clotting factors). Progesterone troches are fine.
For the last two years, I have been using bio-identical HRT treatment. Now, my thyroid TSH level is high. Do I need to increase my armor thyroid?
Please help me out?
If your TSH is high, please discuss with your doctor about increasing your Armour dosage.
Hi doctor, a question: if pregnenolone is converted to DHEA why do we need DHEA too? Thanks
It's helpful when taken together. Thanks for watching!
@@drrajsreehelpful in which way doctor? Thanks ❤
I started my first bio-identical hormones two days ago and I feel much better. Unfortunately, this brand (Xiromed) is made with peanut oil and contains titanium dioxide, therefore my peanut intolerance makes my nose run and sometimes stuffy. Who knows what the titanium will do. Maybe it's worth the price I will pay.
Sorry to hear this! There are compounded pharmacies that make without peanut oil and fillers.
Only if your at risk for blood clots. Oral estradiol is more studied then the patch or gel. Both pose same risks besides blood clots
Thanks for watching!
Very informative nd helpful. I m a perimenupausal woman , we don’t have trained doctors here in India. How can I seek consultation from you.?? Pls, guide.
Thanks so much for watching! 😊 I apologize I'm not taking new patients at this time. I hope some of the tips in this video can help you. To search for a functional medicine provider, please go to IFM.org
Best wishes in your health,
RN
My dr has me on bioidentical troches. How do you feel about them?
Yes they are used sometimes and can provide good absorption. I prescribe these for a few select patients.
My last period was January 2021 I was 46 turning 47 in July that year. Should I be on HRT? Does that seem too young to have finished menstruating?
That is a little early. You should have your doctor check your labs to verify if you are truly in menopause.
@@drrajsree Thank you. 🙏🏼
@@bobbiierullo2673 You're welcome
What is the name of the actual FDA approved progesterone prescription that is NOT a progestin? I would like to ask a local physician about a prescription.
It can be prescribed as generic "progesterone" now, but the other brand name is Prometrium.
@@drrajsree thank you so much.
Can you talk to us about hormonal IUD? How they impact menopause? I’ve had one for three years now and I’m premenopausal.
@@mrsmc2612 you're most welcome!
@@nounan1013 Great suggestion for a future topic/ video. Thanks for watching.
How long should a person stay on bioidentical hormones?
It's a personal decision. Some of my patients choose to stay on it long term due to the great benefits. That's why I encourage the "hormone holidays" (days off from the hormones as I described in this video) to help improve the safety for long term use. Of course they should be closely monitored by a qualified provider.
@@drrajsree Thank you for your response. I just started watching your videos and appreciate the time and effort you spend on them to educate us.
@@debraresman6310 Thank you kindy!
What's the name of the song in the background
I believe that's Pachabel's Canon in D Thanks so much for watching! 😊
Dear madm, I am in the stage of menopause and hashiottothyroiditis. Can I take hormon therapy.
Generally Hashimoto's is not a contraindication for hormone replacement in Menopause. Please discuss with your doctor for more guidance.
Thank u mam 😍😍❤️
Very useful video
@@meenakumari7886 Thanks so much!
My doc recommended Premarin but I don’t want it cause of side effects should I ask for Bi Estrogen cream my vagina very dry
Yes you can ask for it; hopefully your doctor is knowledgable in this area. Best wishes, RN
I didn't have my priode and i have pain i feel i will have my priode but no priod .
Please can you tell me how i can take Progesteron in one day how much?
How long ?for take my priode back
It's hard to advise you here. Please discuss with your doctor. Thanks so much for watching! 😊
I am 31 doctor has told i have premature ovarian failure. So early menopause I can never have child. Can this be reversed doctor. Or I can have child with my own egg. My fsh is 28 and amh is 0.01
For definitive premature ovarian failure FSH should be > 40, but low AMH does suggest low ovarian reserve. You may want to get a second opinion from another provider. Thanks for watching and best wishes, RN
Dear Dr. You are amazing! Do u do video calls? I have insurance. I would love to become your patient 😊.
thank you! Unfortunately my practice is at full capacity at the moment. Thanks for watching.
I am at 54.l am in post menopause. Suffering severe hot flashes since four👍🏻years. Severe means so severe. Hot flashes with fluttering. Both day time and night. Insomnia💐also. Can l possible hormone therapy? Is it safe for me?
It's best to discuss with your doctor to discuss the pros and cons. regarding safety.
👍
Thanks for watching!
I never went through it becoz of omega 3s evening primrose oil and then advocados
Thanks for watching. Yes that’s a great tip!
I am in my 60s loosing hair not shut if hormones therapy can help
Yes it can sometimes help, but there are other factors that cause hair loss. Please watch my video on Hair Loss for more details.
Can a woman get preagnent after menopause at the age of 43? HRT will effect her preagnency or not.
Hormone replacement therapy cannot allow a menopausal woman to become pregnant
So do u start when ur period stops? Or when do u start?
When your symptoms begin, that is when hormone replacement can be helpful. Some women begin prior to Menopause, because they have symptoms during perimenopause.
How can I find a doctor to work with in Michigan?
To search for a functional medicine provider, please go to IFM.org
Best wishes in your health,
RN
Thank you!