I think I am too . I was told start with 0.05 mg day estradiol and no progesterone necessary post hysterectomy. I’m going back to debate this and found this info very empowering , thank you Dr Gersch
I’m 67. You don’t believe in daily progesterone when taking estradiol? My hormone doctor has me on those creams for 6 days a week for the last 12 years.
You just described the experience i jad with my doctor. So freaking frustrating. I starete doiig my own research and seekinf out doctoes that have kept with studies on HRT and menopause and keep themselves up-to-date on a regular basis!!
1 ) Find another doctor 2) Do not trust doctors on youtube that advertise tele health services at a coast of over $700.00 for a tele health visit!!! 3) Read educate yourself as much as possible! 4) If you feel a bad vibe with your gyn find another!!! I went through 5 drs and Nps and none of them seemed to have a clue about what they were doing!!! And finally most important than anything Never pay over 700.00 for someone’s advice. A women can see a doctor and get hrt even if they have money problems or no insurance. Try planned parenthood!!! And listen to Dr. Gersh so far she has been direct not misleading and I don’t see her charging outrageous money for an appt . It looks like her website is straight forward!!! Ladies this menopause thing is a hot topic now with all the baby boomers children generation x getting older. There are more scams out there targeting and misleading terrified women. I know because I was mislead. Then I educated myself and feel a power and knowledge no one can take away.
Heard so much of the brnefits of cyclic HRT but most OBGYN'S provide it durin perimenopuse and shift to continuous once you are post menopause. Thankyou for your insights.
@@gina888warhol1 I had a menopause health coach on UA-cam. I will not say her name she would not talk to me at all or answer any questions unless I gave her $1000. I mean, she would not consider taking payments or any such thing. I felt so bewildered and bereft and was beginning to lose my faith that I was ever gonna feel better. She comes off as somebody who will take you under her wing, but after emailing her that I would like to work with her I told her that I couldn't afford the $1000 but if she could break it up into one or two payments that I could definitely do that. After I emailed that she said she couldn't work with me and also she only works with professional women who are considered neurodivergent high functioning, high IQ type women. I cannot believe that she emailed that to me after following her for several months on UA-cam. She wouldn't answer my next email at all even after I told her I would pay her the thousand dollars she simply said she wouldn't work with me anymore. 😢
This dr has changed my life with her education. My dr put me on cycling after I asked her. It’s like the fountain of youth. 60 & post menopause here and reversing in age
This is amazing. My dr wants me on continuous HRT, but I’d rather go the cyclical route. Go back ten years and tell me that in the future I would actually WANT monthly bleeding. I’d have said you were insane. 😁 Knowledge is power!
Its very different - very light like half - no big deal to me. If you only take 14 days it must be the double dose - 200mg each evening instead of the 100mg - what I was instructed.
@@astralartist4 I'm getting use to the idea. Thank you for your feedback. I did "gladrags" all those years and burnt them when I entered menopause, thinking I'd never need them again!
Thank you, Dr Gersh. I wonder if you could do a follow up video on the potential impact of long-term cyclical HRT on breast cancer risk. It’s my understanding that the number of menstrual cycles a woman has experienced has been identified as a risk factor for developing breast cancer - the more cycles, the higher the risk. Would cyclical HRT produce the same changes in breast tissues as “cycling” during a woman’s fertile years? Would love to know! 😊
There would need to be a long-term study in order to prove the benefits of any HRT after menopause. No one is going to fund that unfortunately. Anyone who makes a claim without studies is speculating.
@@lisao3041 Within 30 years, all the women who are now 30 years old, will be using hrt because by everyone will know the benefits. There will be proof.
It sounds like you're describing the Wiley protocol. I've been on it for roughly 30 years and it's been a true godsend for me. I look and feel younger than my age and I'm hoping other people may benefit from it too! Thank you Dr. Gersh.
So encouraging. I'm considering this. Would you mind my asking what your range of E levels are? or how you measure? As I understand, to do cyclic dosing you really have to do transdermal, and for some reason I'm thinking you just couldn't get your levels up very high transdermally. I just started HRT ~9 months ago, 12 yrs post meno, and I'm taking E by injection and my E is around 160, I know not a physiologic level.
@@jennysiepka9900Wow, that's very low. I’ve been advised 250 - 800 as the range (from hrt docs, and also Dr Louise Newson podcasts). I got my libido back once I reached 300.
@andreiafad It depends on how well the woman absorbs. Start a dose/method (eg, patch, gel, etc). The dose is usually increased incrementally, every 3 months, until symptoms resolve. You can have estrogen levels checked via blood test to see.
I ❤❤love your direct advice. It’s nice to listen to somebody like you who isn’t taking advantage of women by feeding them misinformation half truths and way overpriced 700 and up for a tele-visit!!! There is No reason a woman should ever have to pay over 700.00 for a patient consult!! Thank You for being straight forward and not taking advantage.. Also is starting at 1mg of estradiol patch effective????
I respect each person’s approach. I have taken my BHRT every day , not cycling, and thankfully, my body has done extremely well these past 9 years since starting in Perimenopause. Now 57 and post menopause, I still feel great inside and out . Definitely have to look at each person’s body, health, etc. individually to figure out what works best. Thank you Dr. G for all your detailed explanations. A joy to listen to you. ❤
No bleeding again, thankyou. And I love what bleeding means and loved menstrual cycling, but not now. No. I feel gret doing what dr Gersh doesn't like. It's not only about bioidentical hormones. I also eat keto, exercise, dance, enjoy life and feel grateful.
Im 47 and post menopausal for 2 years. I believe its yway too soon and nobody is listening to me. Having this info i may believe i can go in and speak to my dr more educated to be able to get my point across better. Drs not listening seems to be a growing issue especially with women in my opinion. Only education can fix this. Ive watched a few of ur videos and I appreciate the knowledge ur offering
I've heard it said that the pharmaceutical industry educates doctors on prescribing medication and that docs are glorified pill pushers. Their goal is to fit a prescription to a specific symptom. If they don't know the answer, then it's "all in your head" according to them. They don't know the answer A LOT. I'm almost 60 and I've watched doctors become much, much worse at clinical diagnosis. To the point that they will no longer make a judgement call but instead just order labs. It's ridiculous. They don't treat the body as a unified whole nor do they listen to the patient any longer. To be able to find a doctor who actually listens, looks for answers with the goal of healing the patient is nearing the point of locating white unicorn. I paid $500 out of pocket for 30 minutes with a functional medicine doctor. He was 11 minutes late and only let me speak for 3 minutes. Then he spent another 5 minutes training a girl on a medical computer in the exam room during my appointment! "Hit F3, no backspace, it's one line up..." All while I'm trying to explain my symptoms. He actually laughed at me at one point before he caught himself. I never went back.
Thankyou Dr, replicating natural rhythm makes sense given our bodies have had monthly rythum for 40yrs. I’ menopausal and have been on a minimal, static daily dose of E & P for 5 months and still have a plethora of symptoms (inc brain fog). As women, We need to educate and inform ourselves and listen closely to our bodies. I want optimum health! I want my natural rejuvenation and natural processes to function optimally. Who cares about a couple of days of bleeding, if you’re experiencing extremely severe meno symptoms like I have… I’d be happy to bleed for a fortnight per month!!! I just want to be my normal functioning self again. I’ll check out the course, thankyou 🙏
This is so fantastic, Dr. Gersh. I will definitely sign up for your course. I am about to start HRT in perimenopause and have a lot of questions around this. Hopefully your course will help answer these questions. One question that I would really like to know as well is whether a woman in her 70ies could start HRT if she has never been on HRT before and went into menopause at 54. She has a lot of anxiety and trouble sleeping as well as vaginal dryness but otherwise very healthy, very physically active, healthy body weight, great insulin sensitivity, low APO-B, Coronary Calcium Score of 0, low blood pressure and no medication. Could she potentially benefit from HRT if the HRT is prescribed in the way you normally prescribe to patients? Thank you so much in advance.
I can’t answer questions about any specific individuals … but as a general statement, I do not concur with the so-called timing hypothesis and strongly believe that even a late start on hormones is good. Early initiation of hormones is best … but if you don’t have any absolute contraindications, the present is the time to start on HRT! Better late than never … as they say!
Hi DrGersh, what information. Thank you. Been taking HRT for 7 years. Just learned the importance of bleeding necessary and importance of cream instead of pills. Contacting my Doctor to change my Estrogen pill to cream and take progesterone for 14 days. Can you become president of a new Women Initiative?
I understand cycling the progesterone, you only bring progesterone in on your second half of the cycling ..But the estrodial? Is that continuous? Same levels throughout the month? Or cycling the estrodial also? If yes, when do you bring estrodial in and for how long? How do i cycling an estrodial patch?
@@Lifes_FrostingThanks for stating this. Ive been looking for this information. Somehow I didn't agree with my doctors assistants not saying both hormones need to be taken for 13 days only. Makes total sense that Estrogen should be continuous and progesterone only for second half of cycle.
I am on the highest dose patch 0.1 and 200mg P oral every night. Is that dose of patch enough?? What level of estradiol should I be looking for? If i wanted to cycle how many days would I stop taking progesterone? 7? Thank you for any advice.
No progesterone for the first 14 days of the month. Nightly progesterone for next 14 days the no progesterone for final two or three days of the month. The period/bleeding will start as soon as you stop the progesterone and last a few days. Restart cycle next month.
@@pennynichols various lectures and anecdotal information. A woman would adjust for what works for her. Generally 10 - 14 nights of progesterone each month. However some women take a progesterone for 14 days every 3 months.
@@bellaevidencias Thx for the info. When going off progesterone for those 2-3 days do you think it's a good idea to stop the estradiol too before cycle restart?
@@LillTheDancer If you have the flexibility, it will better mimic a natural cycle if you reduce estradiol at the end of the cycle. But your low estrogen symptoms may come back. You can self-adjust your dosage if you take estradiol orally or transdermal. You can better adjust if you take estradiol sublingually.
60’yrs old. Have started my third month of The Wiley protocol. Cycling. Between my chemical free diet, exercise & now the hormones. My body is back to being 30. I am post menopause. My body had turned in to an alien.
@@louisefraser5328 My estradiol cycles, as well. starts at 4 ml, gradually increases, then decreases. i use a calendar to mark the days so that I don't have to think about what day I am on.
What is the optimal physiological level of estradiol and progesterone? How to supplement in perimenopause? How can we distinguish between relative and absolute estradiol dominance by symptomes so that we can better adjust the dosage?
It takes awhile , I take pop only progesterine small dos helps with extreme heavy periods I dont take it that long either , when my hormones are low is when I take it , right after period I'm perimenapause the only thing it's helpful is the heavy periods makes them kinda light , estrogen I do not take it's strange how bc combo had higher amounts than pop or vs versea strange
I have heard Dr. Gersh point out that progesterone does not only have the function of protecting the uterus. It has many other functions in the body (which makes sense evolutionarily speaking) so one would want to cycle progesterone as well if your goal is optimal health even if you do not have a uterus.
No problem! The uterus is a good marker of the hormonal effects … but is completely unnecessary for giving hormones and the regimen is the same with or without that organ.
I tried cyclic HRT and the bleeding was very heavy, even heavier than it was when I had a period. I opted out. I'm currently on 0.05 estrogen patch and 100mg of progesterone daily. what you are saying makes a lot of sense.
So did I! I was on 200mg progesterone two weeks on and two weeks off. I bled like two weeks each month and it was terribly heavy like something was slaughtered inside of me. My iron levels became very low too. It was nothing like a normal period. Ever since I'm taking 100mg progesterone daily, the bleeding stopped. Unfortunately, the nightsweats are back though :-(
@@carlottataykowski143 some women are incredibly sensitive and will start bleeding without continuous progesterone. Some women need to take it 12 hours apart. In order to prevent bleeding. if you were experience is inconsistent progesterone causes bleeding, you might just have to take it continuously.
@@lisao3041 0.05 patch is low? I thought it was standard. I’m on my own because these doctors are clueless. Can you please tell me what’s a good dosage?
It seems estradiol therapy should be started along with progesterone prior to menopause. Does this affect ovarian production of these hormones, when they applied topically?
I'm post menopause and too much HRT aggravated my fibroids, caused polyps to grow in the cervix and uterine lining and caused the lining to get so thick that I had to have a D&C. While I believe in HRT in theory, it doesn't seem to like me.
Can you explain how to do this if the typical prescription dose does not? Doctors just don’t want to prescribe differently than the “normal” dose. Thank you. 😊
As much as having periods sucks, all the evidence shows better health outcomes, breast cardiovascular etc with cyclical than continous progesterone. I will take that.
@@lisao3041 Progesterone goes up 2 weeks after period. She doesn’t need to cite anything. It’s a fact. The other 2 weeks is low so don’t take progesterone.
@@LillTheDancer It's easy to cite a link to a study, even on UA-cam. But I think any rather substantial claim should be able to be justified or it's just wild speculation.
How & how much?! I'm up to 0.1 estradiol & increased my prog to 200/ night. I'm having spotting. I won't tell my doctor because she would immediately order an ultrasound and possibly another painful biopsy! You are verifying what I've been suspecting and trying to figure out all along. Part of the time on my HRT I was feeling great and then I was spending a week or two feeling crappy. I want to cycle but I also was prone in perimenopause to hormonal migraines and want to know how to navigate around that I've never been able to figure out. Trying to get an appointment with you as I am nearby!
I’ve heard other doctors say that having periods increases risks for certain cancers while taking progesterone daily epsiclakh in iud form such as mirena reduces many risks including cancers. I am wondering if you can address that topic Dr Gersh. Thank you for your detailed videos. They’re excellent.
Dr Hersh provides a very convicing and detailed explanation of the necessity in cycle the progesterone. Unfortunately she is not providing the simple way to do this. The people posting comments are trying to help and are also asking the same questions. Not sure why Dr Gersh can't answer. Maybe its in a book she sells. Does anyone know this?
@@SS-dp7ltshe is not selling a book. The method of delivery of hormones is based upon the Wiley Protocol. It is a rhythmic dosing schedule of hormone application in the form of creams.
The one gift of menopause is no more bleeding! I couldn't imagine starting with the hassle of periods all over again. Would rather put up with the lingering vasomotor symptoms I have, as annoying as they are 😰 ... and doing everything else I can to live a healthy lifestyle.
I hope more doctors become well informed as it relates to this topic. Can someone tell me how soon after starting the Cyclic HRT will the period bleeding start?
Thank you for your thorough explaination. Im currently using progesterone in cream form from a holistic dr. Coco March. I wasn’t comfortable with adding estradiol cream but now I understand it. Just need to find a good dr with intergrative background medicine. I hope more good drs that care step up. Thank you again. 😊
Thank you Dr Gersh, this information is so vital for women! If I haven’t gotten my period in six months, how do I figure out the timing of my cycle to know when to take estradiol and when to take progesterone?
Thank you very much!! Please speak in details how to mimic the cycle. And for the “period time” you recommended to stop all hormones and restart after with a small dose ?
Yes. That is my question too. I want to understand exactly how the cyclic theory works out in day to day so I can have the conversation with a local doctor.
Can anyone explain as to why women on HRT who bleed are such a scary stuff for doctors? Why all the scans and biopsies? In an endometrium buildup simply a cause for stopping progesterone and letting a woman bleed ? Or, is it more complex than that?
I’m so glad I found you! I want to inform myself in what’s to come for me! I’m 48 and still have monthly cycles but I want to know ahead of time how to help and support my health. I’m still confused in what to do but I’ll keep listening to you!
I was on the Wiley protocol for twelve years, and it worked great for me until it didn’t. During the last two years I’d developed fibroids and my periods got so heavy that I became anemic. My Wiley practitioner, who is not a gynecologist, tried to adjust the dose throughout that time, but in the end I had to quit it. My gynecologist basically told me the fibroids were no big deal and blamed the hormones. After I changed gynecologists I got an Estradiol patch and progesterone caps, which works well for me. I also had a hysterectomy. I’ll never go without hormones.
I’m getting AFUL terrible pains during perking doing cyclical. It’s so bad I can’t cope with the pain I thought I was having a miscarriage. I’m going to try Continous now to see what happens. It’s supposed to be better here in the UK they are saying that it’s better
I was trying to do cyclical as well but now I’ve only about a few days in an I’m already have bad uterine cramps and haven’t started the progesterone it’s disappointing but the cramps are massive I believe I’ll have to go back to continuous.
So I have recently found a hormone doctor for BIHT that wants to precribe progesterone & estradial statically not in a cycle as I would prefer. So are there any recent studies that I can share with him to support the claim for the cycle method and it's benefits for longevity? Thank You for these videos.
Oral contraceptives are not a favorite but sometimes need to be used to control uncontrollable bleeding. Of course they also are contraceptives. But as a general rule, I prefer human identical hormones over endocrine disruptors!
Thank you for your explanation of cycling. I do that… estradiol daily and progesterone every four months for 5 days/100 mg progesterone vaginally when I go to sleep. I have a vaginal bleed about 5-7 days later. I’ve been doing this for about 25 years. At 70 years of age I may cut back on estradiol due to aging changes at 70. But will continue but at a lower dose. I’ll seek out a doctor that will help me with this change. I’ve subscribed to your channel. Many thanks😊.
Hello I am glad to hear that I take progesterone 100 mg every other day for about 3 years now I am starting to believe now I have to go and get a biopsy I am very nervous
So you only have to take progesterone for five days out of four months? I’m on estrogen and progesterone, but I cannot and do not take the amount of progesterone that they give me because I cannot tolerate it, I would love to know I can only take it every four months!
Yes 100 mg insert into the vaginal before you go to sleep for 5 days in a row. About 5-7 days a period. For me it lasts about 4-5 days. No side effects from the progesterone. About 20 years ago I tried progesterone orally and I felt hot and sleepy. This is not acceptable because I work full time. I’m close to 70 years old and still work full time because I want to. Progesterone daily made me feel awful so this regimen I presently follow works with hardly any side effects. Just a menstrual bleed. Eat plenty of protein and veggies to balance your hormones and carbs with fiber. Mini meals works best for best. I learned all this from retired gynecologist Dr. Larrian Gillespie. She wrote books like the Goddess Diet and the Menopause Diet. Maybe it’s on Amazon. Take care.
@@liznaber880wow Thought I was the only one who can't tolerate progesterone. I've been taking rstradiol for about fifteen years. Have tried progesterone in every form and always brings back the tortuous night hot flashes. Because I do not take progesterone I have had seven D&Cs for uterine lining build up in 15 yrs. . I discovered vaginal progesterone for 5-6 days causes a bleed. Unfortunately, the bleed is so heavy that the last one I just had I was going through a super tampon every 45 minutes. I was up four times one night to change. I like the idea of continuing to do this, but the bleed is so intense!
I had to have a hysterescopy prior to my Obgyn prescribing hormones because of my uterus lining was too thick (7mm). After he confirmed that there wasn't cancer, he gave me the prescription for estriol, progesterone and testosterone.
Can a woman over 70 safely begin HRT? Unfortunately, I did not get this information after menopause. Now I have osteoporosis and very low energy with no explanation.
Thank you. 😊 Are you suggesting taking Estrodial all month transdermally and using the progesterone only one week per month during menopause as if the body never changed? Also, How much would be a physiological amount of Estrodial?
If a 53-year-old takes an average of how many mg of estradiol per day for BHRT, will bleeding occur? I don't speak English, I barely understood the video. Best regards
Thank you making this video. I was just started on Estradiol patch and Progesterone. I am post menopausal. Have a womb and recently diagnosed osteoporosis.
Of course they'll pay for HRT if it's prescribed for their standard reasons. Why do you think they'd pay for the estradiol but not the progesterone? Unless you have no uterus.
I hope Dr. Gersh answers this - I am trying cyclic progesterone. I stopped taking it on day 15-30 with no bleeding happening. Resumed progesterone and 10 days later while on the progesterone, got a period. Now what? Do I stop again on day 15? I thought if I’m going to bleed it will be 1-3 days after stopping the progesterone. I use a .1 patch and 200 mg of micronized progesterone
I am 72 y and take 3mg estradiol patch 2 time a week and 14 days 200 progesterone orally. 10 days later while on progesterone got a period for 5 days. I continued taking the progesterone for these 5 days. I started with HRT 2 months ago. In the first month no period but it happens in the second month.
Can someone please explain exactly how to cycle? Do you continue estrogen for the whole 28 days with 12 days of progesterone or do you totally stop both for a number of days?? 🙏😊
I was recently prescribed HRT and the Dr gave me both options. He said if I choose cycling. It's Estrogen day 1-25, progesterone only days 15-25. Then wait for a bleed. First day of bleeding starts over again as day 1. I just started though and so far I had opted for the continuous protocol. I'm considering switching it up to cyclic now though.
Thank you for informing us women. You give vital information. However no where in the video do you tell how much estrodial and progesterone us women should be taking cyclically. For me it would be very beneficial to have this information so I can advocate for myself. My gynecologist is very conservative as regards hormones. Her only focus is alleviating symptoms which can be done with a small amount.
@tela1653 Optimal amount varies from woman to woman. I was able to achieve a period with .075 transdermal estradiol patch and 200 mg of Progesterone - both bio-identical. Others may be able to achieve this with less some may need more. It took me a few months to get here as my practitioner wanted to start me out with low levels and adjust up. I just finished my first cycle with a period and I feel so much better. My inflammation, joint & muscle pain is subsiding. Other symptoms like hot flashes have completely disappeared. Breast fullness, collagen and muscle/strength that I lost has returned. I'm thrilled that I found Dr. Gersh when I did.
Love the content and information…So where does one start? Since we are mimicking the cycle, do I stop taking all HRT temporarily and start over say the first of the month..? And how do I know what doses for each. Can I request something from my MD, who by the way is an OB not Menopause specialist… perhaps thats the answer. A specialist.
71 y.o. In good health except for osteoporosis despite HRT use for 19 years and Prolia injections for 7 years. Now thinking that the daily .5mgs of estradiol is completely inadequate . I take prometrium tablets 14 days a month. Would like to switch to a patch with a higher dose of estradiol. Its hard to get the MD to let me stay on hormones due to my age. Its very frustrating.Im more concerned about breaking a hip than cancer at this point. Uterine ultrasound shows no problem.
Ok so I've watched quite a number of your videos and Dr. Havers (thanks both!!)...but...WHAT amounts of estradial and progesterone should we be taking? Im utterly confused, and have no idea what to ask/tell my doctor! Thanks.
@@jamiesouza 3 months ago I started on Lenzetto estradiol spray, 2x1.5 mg each day, plus progesterone tablets at night. Works fantastic! Hope that helps!
I love Dr Gersh!! I have learned so much! I took the course and followed the instructions exactly. I had the worst mood swings of my life. I was depressed, weepy, and irrational. The cramps were so intense and the "period" lasted two weeks. I powered through for three months. I almost ended up in divorce court. I had horrible PMDD when I was in my reproductive years. The treatment was birth control pills without taking the inert pills. That worked for me but I only did it for a few years. When I stopped the PMDD came roaring back. So my question is how does a woman who can not handle the hormone drop each month proceed? I am currently using a static regime with a very high dose of estrogen and I am joyful and energetic. Do I just stick with that? Or maybe try the cyclic regime less often?
DrGersh, in my earlier notes I chose to remain in blissful ignorance, but now some deep questions are knowing at me 🤔 As this is a HUGE topic I’ve decided to make a video, and let you know when posted. 😉 I invite others to check it out and comment ❤
Thank you, Dr Gersh. Would you also recommend cycling estradiol and progesterone for someone without a uterus? I appreciate all the information you are kindly imparting.
@@FeliceGershMD Estradiol blood level of 50 is enough? I would have thought it would need to be higher to cycle? Question what do you think about Estradiol injections? Thank you!
@ylqinsun389 I believe both have to be in the right amounts to achieve a period. For me it took .075 estradiol patch and 200 mg Progesterone. Some women may need less, some more.
So it's safe to cycle off and still be on Estradiol? I'm confused because Progesterone is supposed to protect our uterus while taking Estradiol. I'm post menopause and want to do this. Hope someone will answer please. Thank you! I love learning from you!
@AnnieSimmons1 Estradiol is continuous. Progesterone is cycled - taken last 12-14 days of the month. Both have to be at optimal levels to achieve a period. This can take some time to find the right levels for you.
Yes because you can’t see osteoporosis developing. It also has benefits of heart health protection and preventing dementia. I didn’t really have symptoms, but it’s best to start BHRT.
this is great information but would be the "accurate" amount of estradiol ..I just started on BHRT and have been given 0.5 which I think is th minimal and 200mg of Progesterone? Thank you!!
So what/ how much is the physiological amoun??? I am 72 and I just convinced my doctor to prescribe estrogen because I have insulin resistant, diabetes, osteoporosis, etc., and he prescribed 1 mg. of Estradiol in tablet form (and also micronized progesterone capsules for daily use). So now I’m wondering if the estrogen is going to do anything.
I have a very simple question. I hope someone will clarify. I understand the cycling off the progesterone for 2 weeks per month. Should we also lower our estradiol at that time or should we stay on a static high dose? My concern is without progesterone for 2 weeks our uterine lining will become to thick because of the high dose of estradiol.
@pennynichols I take transdermal estradiol in patch form - 2X weekly every week - so on it all the time. Progesterone last 12-14 days of the cycle. You will need to have dosing high enough to have a period. The period sheds the uterine lining. This takes some time to find the right levels. Most physicians only give the lowest amounts to resolve unwanted symptoms of perimenopause/menopause like hot flashes.
Is there a free source of dosing information for oneself? Have no idea if what I’m taking is sufficient or how to cycle. Don’t live in CA. Am disabled and low income. HRT is so important I think.
UA-cam can be one of the most beneficial resources at no cost. Thank you, Dr. Gersh! You're helping countless women.
Glad you think so!
@@FeliceGershMDI’m 52 and still on cyclical HRT. So after listening I’m wondering, Do I ever change to continuous HRT?
I would also like to see some studies stating cycling. The HRT is more beneficial!
@@debbiewebster3431No one is studying hormones. I wish!!
@@janinedance102how many days Do you pause with progesteron? Do you pause oestrogen as well?
You just confirmed my thoughts on HRT. My Doc doesn't get it. I'm being under dosed for my doctors' piece of mind at the expense of my health.
may I ask, what dose did the doctor give you?
I think I am too . I was told start with 0.05 mg day estradiol and no progesterone necessary post hysterectomy. I’m going back to debate this and found this info very empowering , thank you Dr Gersch
I’m 67. You don’t believe in daily progesterone when taking estradiol? My hormone doctor has me on those creams for 6 days a week for the last 12 years.
You just described the experience i jad with my doctor. So freaking frustrating. I starete doiig my own research and seekinf out doctoes that have kept with studies on HRT and menopause and keep themselves up-to-date on a regular basis!!
1 ) Find another doctor 2) Do not trust doctors on youtube that advertise tele health services at a coast of over $700.00 for a tele health visit!!! 3) Read educate yourself as much as possible! 4) If you feel a bad vibe with your gyn find another!!! I went through 5 drs and Nps and none of them seemed to have a clue about what they were doing!!!
And finally most important than anything Never pay over 700.00 for someone’s advice. A women can see a doctor and get hrt even if they have money problems or no insurance. Try planned parenthood!!! And listen to Dr. Gersh so far she has been direct not misleading and I don’t see her charging outrageous money for an appt . It looks like her website is straight forward!!! Ladies this menopause thing is a hot topic now with all the baby boomers children generation x getting older. There are more scams out there targeting and misleading terrified women. I know because I was mislead. Then I educated myself and feel a power and knowledge no one can take away.
Heard so much of the brnefits of cyclic HRT but most OBGYN'S provide it durin perimenopuse and shift to continuous once you are post menopause. Thankyou for your insights.
Please train these social media menopause “experts” there’s so much misinformation and poor protocol sharing by MDs in social media. ❤
Watch out for overpriced “doctors” or menopause “experts” needing 900.00 !!
@@gina888warhol1 I had a menopause health coach on UA-cam. I will not say her name she would not talk to me at all or answer any questions unless I gave her $1000. I mean, she would not consider taking payments or any such thing. I felt so bewildered and bereft and was beginning to lose my faith that I was ever gonna feel better. She comes off as somebody who will take you under her wing, but after emailing her that I would like to work with her I told her that I couldn't afford the $1000 but if she could break it up into one or two payments that I could definitely do that. After I emailed that she said she couldn't work with me and also she only works with professional women who are considered neurodivergent high functioning, high IQ type women. I cannot believe that she emailed that to me after following her for several months on UA-cam. She wouldn't answer my next email at all even after I told her I would pay her the thousand dollars she simply said she wouldn't work with me anymore. 😢
This dr has changed my life with her education. My dr put me on cycling after I asked her. It’s like the fountain of youth. 60 & post menopause here and reversing in age
This is amazing. My dr wants me on continuous HRT, but I’d rather go the cyclical route. Go back ten years and tell me that in the future I would actually WANT monthly bleeding. I’d have said you were insane. 😁 Knowledge is power!
Its very different - very light like half - no big deal to me. If you only take 14 days it must be the double dose - 200mg each evening instead of the 100mg - what I was instructed.
@@astralartist4 I'm getting use to the idea. Thank you for your feedback. I did "gladrags" all those years and burnt them when I entered menopause, thinking I'd never need them again!
@@astralartist4200mg transdermal progesterone? I can't tolerate micronized.
Thank you, Dr Gersh. I wonder if you could do a follow up video on the potential impact of long-term cyclical HRT on breast cancer risk. It’s my understanding that the number of menstrual cycles a woman has experienced has been identified as a risk factor for developing breast cancer - the more cycles, the higher the risk. Would cyclical HRT produce the same changes in breast tissues as “cycling” during a woman’s fertile years? Would love to know! 😊
I will!!
@@FeliceGershMD Thank you, Dr Gersh. Looking forward to it!
There would need to be a long-term study in order to prove the benefits of any HRT after menopause. No one is going to fund that unfortunately. Anyone who makes a claim without studies is speculating.
@maryclairehavermd8473
@@lisao3041 Within 30 years, all the women who are now 30 years old, will be using hrt because by everyone will know the benefits. There will be proof.
i love this woman! too many ladies get misinformed during this time of their life!
Yes so much!!!!
It sounds like you're describing the Wiley protocol. I've been on it for roughly 30 years and it's been a true godsend for me. I look and feel younger than my age and I'm hoping other people may benefit from it too! Thank you Dr. Gersh.
So encouraging. I'm considering this. Would you mind my asking what your range of E levels are? or how you measure? As I understand, to do cyclic dosing you really have to do transdermal, and for some reason I'm thinking you just couldn't get your levels up very high transdermally. I just started HRT ~9 months ago, 12 yrs post meno, and I'm taking E by injection and my E is around 160, I know not a physiologic level.
Would you mind sharing this protocol?
I am on my third Month. Would you please tell me where you get your scripts filled & from whom? I never want to be with out this if my dr retires
@@thechichichannel3225Dr. Gersh says WP doses are too high.
What are the proper blood levels for estrogen and progesterone?
Thank you!
Ive heard her say she likes estradiol levels around 100. This was from one of her other videos
@@jennysiepka9900 has she mentioned how much should we take to achieve that level ?
Everyone is diff. I use .075 mg estradiol patch and 300 mg oral prog to get me to good physiologic levels. U may need more or less.@@andreiafad
@@jennysiepka9900Wow, that's very low. I’ve been advised 250 - 800 as the range (from hrt docs, and also Dr Louise Newson podcasts). I got my libido back once I reached 300.
@andreiafad It depends on how well the woman absorbs. Start a dose/method (eg, patch, gel, etc). The dose is usually increased incrementally, every 3 months, until symptoms resolve. You can have estrogen levels checked via blood test to see.
I ❤❤love your direct advice. It’s nice to listen to somebody like you who isn’t taking advantage of women by feeding them misinformation half truths and way overpriced 700 and up for a tele-visit!!! There is No reason a woman should ever have to pay over 700.00 for a patient consult!! Thank You for being straight forward and not taking advantage..
Also is starting at 1mg of estradiol patch effective????
I respect each person’s approach.
I have taken my BHRT every day , not cycling, and thankfully, my body has done extremely well these past 9 years since starting in Perimenopause.
Now 57 and post menopause, I still feel great inside and out .
Definitely have to look at each person’s body, health, etc. individually to figure out what works best.
Thank you Dr. G for all your detailed explanations. A joy to listen to you. ❤
I could never cycle,,,my moods are awful with the ups and downs.. Continuous is way better for my mental health
How to even approach a doctor with this is what I’d like to know!
No bleeding again, thankyou. And I love what bleeding means and loved menstrual cycling, but not now. No. I feel gret doing what dr Gersh doesn't like. It's not only about bioidentical hormones. I also eat keto, exercise, dance, enjoy life and feel grateful.
What should estradiol blood tests measure to know you have enough?
I am wondering about this too
I think she had said above 50 -150
@auaticamazon thank you!
I've been told by hrt specialists 250 - 800 range.
This is all great information, but only causes frustration when we can’t find doctors willing to do this and no guidance on how to do this ourselves.
Exactly. What are we supposed to do 😢
I think this dr offers telehealth. Keep looking. I found a GP that will prescibe hrt.
Telemedicine is the way to go!! There are lots of providers who do that!
Im 47 and post menopausal for 2 years. I believe its yway too soon and nobody is listening to me. Having this info i may believe i can go in and speak to my dr more educated to be able to get my point across better. Drs not listening seems to be a growing issue especially with women in my opinion. Only education can fix this. Ive watched a few of ur videos and I appreciate the knowledge ur offering
Indeed in all around the world 🤍🇵🇹
I've heard it said that the pharmaceutical industry educates doctors on prescribing medication and that docs are glorified pill pushers. Their goal is to fit a prescription to a specific symptom. If they don't know the answer, then it's "all in your head" according to them. They don't know the answer A LOT.
I'm almost 60 and I've watched doctors become much, much worse at clinical diagnosis. To the point that they will no longer make a judgement call but instead just order labs. It's ridiculous. They don't treat the body as a unified whole nor do they listen to the patient any longer. To be able to find a doctor who actually listens, looks for answers with the goal of healing the patient is nearing the point of locating white unicorn.
I paid $500 out of pocket for 30 minutes with a functional medicine doctor. He was 11 minutes late and only let me speak for 3 minutes. Then he spent another 5 minutes training a girl on a medical computer in the exam room during my appointment! "Hit F3, no backspace, it's one line up..." All while I'm trying to explain my symptoms. He actually laughed at me at one point before he caught himself. I never went back.
Dr mary claire haver suggests recent studies you can print & give to your dr.
Thankyou Dr, replicating natural rhythm makes sense given our bodies have had monthly rythum for 40yrs. I’ menopausal and have been on a minimal, static daily dose of E & P for 5 months and still have a plethora of symptoms (inc brain fog). As women, We need to educate and inform ourselves and listen closely to our bodies. I want optimum health! I want my natural rejuvenation and natural processes to function optimally. Who cares about a couple of days of bleeding, if you’re experiencing extremely severe meno symptoms like I have… I’d be happy to bleed for a fortnight per month!!! I just want to be my normal functioning self again. I’ll check out the course, thankyou 🙏
Thank you so Much Doctor 💝💝New to your Channel
This is so fantastic, Dr. Gersh. I will definitely sign up for your course. I am about to start HRT in perimenopause and have a lot of questions around this. Hopefully your course will help answer these questions.
One question that I would really like to know as well is whether a woman in her 70ies could start HRT if she has never been on HRT before and went into menopause at 54. She has a lot of anxiety and trouble sleeping as well as vaginal dryness but otherwise very healthy, very physically active, healthy body weight, great insulin sensitivity, low APO-B, Coronary Calcium Score of 0, low blood pressure and no medication. Could she potentially benefit from HRT if the HRT is prescribed in the way you normally prescribe to patients?
Thank you so much in advance.
I can’t answer questions about any specific individuals … but as a general statement, I do not concur with the so-called timing hypothesis and strongly believe that even a late start on hormones is good. Early initiation of hormones is best … but if you don’t have any absolute contraindications, the present is the time to start on HRT!
Better late than never … as they say!
Hi DrGersh, what information. Thank you. Been taking HRT for 7 years. Just learned the importance of bleeding necessary and importance of cream instead of pills. Contacting my Doctor to change my Estrogen pill to cream and take progesterone for 14 days. Can you become president of a new Women Initiative?
It’s Eostrogel ( Estradiol , body identical gel ) not a cream 🫶🏼
She says that the best way to get estradiol is a transdermal patch.
@@AS333unoCompounded estradiol is literally a cream.
Dr Gersh…you are such a gift to this world. THANK YOU ❤
I understand cycling the progesterone, you only bring progesterone in on your second half of the cycling ..But the estrodial? Is that continuous? Same levels throughout the month? Or cycling the estrodial also? If yes, when do you bring estrodial in and for how long? How do i cycling an estrodial patch?
My guess is to follow what you would see on a graph over a month
The estrogen dosing is cycled and continuous.
Estradiol is continuous. Progesterone is cycled.
@@Lifes_FrostingThanks for stating this. Ive been looking for this information. Somehow I didn't agree with my doctors assistants not saying both hormones need to be taken for 13 days only.
Makes total sense that Estrogen should be continuous and progesterone only for second half of cycle.
Thank you - great video, Dr Gersh!
What is yr opinion of WILEY PROTOCOL?
I've heard her say the estrogen doses are much too high.
Do you have any studies I can read that discuss the benefit of cyclical progesterone that I can show to my wife’s menopause doctor? Thanks
I am on the highest dose patch 0.1 and 200mg P oral every night. Is that dose of patch enough?? What level of estradiol should I be looking for? If i wanted to cycle how many days would I stop taking progesterone? 7? Thank you for any advice.
No progesterone for the first 14 days of the month. Nightly progesterone for next 14 days the no progesterone for final two or three days of the month. The period/bleeding will start as soon as you stop the progesterone and last a few days. Restart cycle next month.
Where did you see this cycling protocol?
@@pennynichols various lectures and anecdotal information. A woman would adjust for what works for her. Generally 10 - 14 nights of progesterone each month. However some women take a progesterone for 14 days every 3 months.
@@bellaevidencias Thx for the info. When going off progesterone for those 2-3 days do you think it's a good idea to stop the estradiol too before cycle restart?
@@LillTheDancer If you have the flexibility, it will better mimic a natural cycle if you reduce estradiol at the end of the cycle. But your low estrogen symptoms may come back. You can self-adjust your dosage if you take estradiol orally or transdermal. You can better adjust if you take estradiol sublingually.
What if you have had a hysterectomy? Does it still work to do it that way with the estradiol?
This is fascinating !!! I’m curious, is there any evidence? I’d love to read it!! ❤
60’yrs old. Have started my third month of The Wiley protocol. Cycling. Between my chemical free diet, exercise & now the hormones. My body is back to being 30. I am post menopause. My body had turned in to an alien.
If you stop progesterone for 14 days, do you keep your estrodial at the same dose???
@@louisefraser5328 My estradiol cycles, as well. starts at 4 ml, gradually increases, then decreases. i use a calendar to mark the days so that I don't have to think about what day I am on.
What is the optimal physiological level of estradiol and progesterone? How to supplement in perimenopause? How can we distinguish between relative and absolute estradiol dominance by symptomes so that we can better adjust the dosage?
It takes awhile , I take pop only progesterine small dos helps with extreme heavy periods I dont take it that long either , when my hormones are low is when I take it , right after period I'm perimenapause the only thing it's helpful is the heavy periods makes them kinda light , estrogen I do not take it's strange how bc combo had higher amounts than pop or vs versea strange
What about those of us who no longer have a uterus?
I have heard Dr. Gersh point out that progesterone does not only have the function of protecting the uterus. It has many other functions in the body (which makes sense evolutionarily speaking) so one would want to cycle progesterone as well if your goal is optimal health even if you do not have a uterus.
No problem! The uterus is a good marker of the hormonal effects … but is completely unnecessary for giving hormones and the regimen is the same with or without that organ.
@@FeliceGershMD What should the cycle be for us without uterus. I was told 3 wks on and 1 wk off for Progesterone. That's what i'm currently doing.
I tried cyclic HRT and the bleeding was very heavy, even heavier than it was when I had a period. I opted out. I'm currently on 0.05 estrogen patch and 100mg of progesterone daily. what you are saying makes a lot of sense.
So did I! I was on 200mg progesterone two weeks on and two weeks off. I bled like two weeks each month and it was terribly heavy like something was slaughtered inside of me. My iron levels became very low too. It was nothing like a normal period. Ever since I'm taking 100mg progesterone daily, the bleeding stopped. Unfortunately, the nightsweats are back though :-(
@@sabinehoehlmueller3190hello, what did you do to stop the heavy bleeding? I’m experiencing the same thing.
@@carlottataykowski143 some women are incredibly sensitive and will start bleeding without continuous progesterone. Some women need to take it 12 hours apart. In order to prevent bleeding. if you were experience is inconsistent progesterone causes bleeding, you might just have to take it continuously.
I hope you increase that patch dosage because it’s really low.
@@lisao3041 0.05 patch is low? I thought it was standard. I’m on my own because these doctors are clueless. Can you please tell me what’s a good dosage?
It seems estradiol therapy should be started along with progesterone prior to menopause. Does this affect ovarian production of these hormones, when they applied topically?
I'm post menopause and too much HRT aggravated my fibroids, caused polyps to grow in the cervix and uterine lining and caused the lining to get so thick that I had to have a D&C. While I believe in HRT in theory, it doesn't seem to like me.
You did the HRT bio?
Because you probably need more progesterone than estrogen. Estrone the bad estrogens feeds fibroids
Estriol not estradiol drives polyp growth. Is that what you were on?
Can you explain how to do this if the typical prescription dose does not? Doctors just don’t want to prescribe differently than the “normal” dose. Thank you. 😊
As much as having periods sucks, all the evidence shows better health outcomes, breast cardiovascular etc with cyclical than continous progesterone. I will take that.
please cite that evidence.
@@lisao3041
Progesterone goes up 2 weeks after period. She doesn’t need to cite anything.
It’s a fact. The other 2 weeks is low so don’t take progesterone.
Your response doesn’t substantiate her claim.
@@lisao3041 if you're seriously looking for substantiation in youtube comments then I don't know what to tell you.
@@LillTheDancer It's easy to cite a link to a study, even on UA-cam. But I think any rather substantial claim should be able to be justified or it's just wild speculation.
How & how much?! I'm up to 0.1 estradiol & increased my prog to 200/ night. I'm having spotting. I won't tell my doctor because she would immediately order an ultrasound and possibly another painful biopsy! You are verifying what I've been suspecting and trying to figure out all along. Part of the time on my HRT I was feeling great and then I was spending a week or two feeling crappy. I want to cycle but I also was prone in perimenopause to hormonal migraines and want to know how to navigate around that I've never been able to figure out. Trying to get an appointment with you as I am nearby!
I’ve heard other doctors say that having periods increases risks for certain cancers while taking progesterone daily epsiclakh in iud form such as mirena reduces many risks including cancers. I am wondering if you can address that topic Dr Gersh. Thank you for your detailed videos. They’re excellent.
The book “estrogen matters” answers that 😊
This video is amazing! Thank you so much! Unfortunately, many of our doctors are not educated this way
Dr Hersh provides a very convicing and detailed explanation of the necessity in cycle the progesterone. Unfortunately she is not providing the simple way to do this. The people posting comments are trying to help and are also asking the same questions. Not sure why Dr Gersh can't answer. Maybe its in a book she sells. Does anyone know this?
The Wiley Protocol. Be sure to use a progesterone cream that your body can absorb. I don't use the standard 20% cream. 5% works.
@@bluejean-1968what?!
She does this with everything. She wants to sell her book and for ppl to pay to work with her
@@bluejean-1968Tell me more about the 5% cream. I use Wiley, but always used 20%.
@@SS-dp7ltshe is not selling a book. The method of delivery of hormones is based upon the Wiley Protocol. It is a rhythmic dosing schedule of hormone application in the form of creams.
The one gift of menopause is no more bleeding! I couldn't imagine starting with the hassle of periods all over again. Would rather put up with the lingering vasomotor symptoms I have, as annoying as they are 😰 ... and doing everything else I can to live a healthy lifestyle.
I hope more doctors become well informed as it relates to this topic. Can someone tell me how soon after starting the Cyclic HRT will the period bleeding start?
Could start the first month.
Thank you for your thorough explaination. Im currently using progesterone in cream form from a holistic dr. Coco March. I wasn’t comfortable with adding estradiol cream but now I understand it. Just need to find a good dr with intergrative background medicine. I hope more good drs that care step up. Thank you again. 😊
Thank you Dr Gersh, this information is so vital for women! If I haven’t gotten my period in six months, how do I figure out the timing of my cycle to know when to take estradiol and when to take progesterone?
Take estradiol every day of the month. Take progesterone days 14-28. Period should start day 29, 30, 31. Repeat cycle.
Thank you very much!! Please speak in details how to mimic the cycle. And for the “period time” you recommended to stop all hormones and restart after with a small dose ?
Yes. That is my question too. I want to understand exactly how the cyclic theory works out in day to day so I can have the conversation with a local doctor.
@@melissalovelady5459Wiley protocol
I was on continuous first 3 months and just asked my doc to change to cyclical. He said to take the HRT from Day 13 to Day 25 of cycle.
@@SPower-yl9ww Thanks for sharing this information. How soon after will you start bleeding?
That is my question also. Is it Estradiol for 2 weeks, then Progesterone for 2 week, then nothing for a time until the bleeding is over?
Can anyone explain as to why women on HRT who bleed are such a scary stuff for doctors? Why all the scans and biopsies? In an endometrium buildup simply a cause for stopping progesterone and letting a woman bleed ?
Or, is it more complex than that?
I’m so glad I found you! I want to inform myself in what’s to come for me! I’m 48 and still have monthly cycles but I want to know ahead of time how to help and support my health. I’m still confused in what to do but I’ll keep listening to you!
I was on the Wiley protocol for twelve years, and it worked great for me until it didn’t. During the last two years I’d developed fibroids and my periods got so heavy that I became anemic. My Wiley practitioner, who is not a gynecologist, tried to adjust the dose throughout that time, but in the end I had to quit it. My gynecologist basically told me the fibroids were no big deal and blamed the hormones. After I changed gynecologists I got an Estradiol patch and progesterone caps, which works well for me. I also had a hysterectomy. I’ll never go without hormones.
Hello, are you now no longer cycling the progesterone? Thanks 🙏🏻
I wish we had someone ike you in India. This is amazing information
See also, Dr Louise Newson podcasts. Very informative.
I’m getting AFUL terrible pains during perking doing cyclical. It’s so bad I can’t cope with the pain I thought I was having a miscarriage.
I’m going to try Continous now to see what happens. It’s supposed to be better here in the UK they are saying that it’s better
I was trying to do cyclical as well but now I’ve only about a few days in an I’m already have bad uterine cramps and haven’t started the progesterone it’s disappointing but the cramps are massive I believe I’ll have to go back to continuous.
So I have recently found a hormone doctor for BIHT that wants to precribe progesterone & estradial statically not in a cycle as I would prefer. So are there any recent studies that I can share with him to support the claim for the cycle method and it's benefits for longevity? Thank You for these videos.
Your talks are so incredibly informative! Much appreciated Can you give any feedback on your opinion of loestro fe in perimenopause?
Oral contraceptives are not a favorite but sometimes need to be used to control uncontrollable bleeding. Of course they also are contraceptives.
But as a general rule, I prefer human identical hormones over endocrine disruptors!
Thank you for your explanation of cycling. I do that… estradiol daily and progesterone every four months for 5 days/100 mg progesterone vaginally when I go to sleep. I have a vaginal bleed about 5-7 days later. I’ve been doing this for about 25 years. At 70 years of age I may cut back on estradiol due to aging changes at 70. But will continue but at a lower dose. I’ll seek out a doctor that will help me with this change. I’ve subscribed to your channel. Many thanks😊.
Hello I am glad to hear that I take progesterone 100 mg every other day for about 3 years now I am starting to believe now I have to go and get a biopsy I am very nervous
So you only have to take progesterone for five days out of four months? I’m on estrogen and progesterone, but I cannot and do not take the amount of progesterone that they give me because I cannot tolerate it, I would love to know I can only take it every four months!
Yes 100 mg insert into the vaginal before you go to sleep for 5 days in a row. About 5-7 days a period. For me it lasts about 4-5 days. No side effects from the progesterone. About 20 years ago I tried progesterone orally and I felt hot and sleepy. This is not acceptable because I work full time. I’m close to 70 years old and still work full time because I want to. Progesterone daily made me feel awful so this regimen I presently follow works with hardly any side effects. Just a menstrual bleed. Eat plenty of protein and veggies to balance your hormones and carbs with fiber. Mini meals works best for best. I learned all this from retired gynecologist Dr. Larrian Gillespie. She wrote books like the Goddess Diet and the Menopause Diet. Maybe it’s on Amazon. Take care.
@@liznaber880wow Thought I was the only one who can't tolerate progesterone. I've been taking rstradiol for about fifteen years. Have tried progesterone in every form and always brings back the tortuous night hot flashes. Because I do not take progesterone I have had seven D&Cs for uterine lining build up in 15 yrs.
. I discovered vaginal progesterone for 5-6 days causes a bleed.
Unfortunately, the bleed is so heavy that the last one I just had I was going through a super tampon every 45 minutes. I was up four times one night to change.
I like the idea of continuing to do this, but the bleed is so intense!
My doctor told me to stop HRT bc my bleeding was causing my uterus lining to get too thick. It’s so confusing!!
Check levels of progesterone
did you stop your hrt as dr suggested? How is it going?
Good question. Did you try the cyclical process Dr Gersh suggests?
I had to have a hysterescopy prior to my Obgyn prescribing hormones because of my uterus lining was too thick (7mm). After he confirmed that there wasn't cancer, he gave me the prescription for estriol, progesterone and testosterone.
Can a woman over 70 safely begin HRT? Unfortunately, I did not get this information after menopause. Now I have osteoporosis and very low energy with no explanation.
Yes you can. I am 68 and just started 4 weeks ago . Find a doc who is north American menopause society member . Lots of misinformation everywhere
How much does it cost?
Yes! Watch Dr Louise newson podcasts on youtube to get well-informed about this. There is no upper age limit to commence HRT. 😊
@@malabikakulkarni7241why would I contact a doctor from Nams? Do they practice like this Dr? I'm very curious.
Dr Louise newsome
So what IS enough?? What is the optimal amount of Estradiol?
Thank you. 😊 Are you suggesting taking Estrodial all month transdermally and using the progesterone only one week per month during menopause as if the body never changed? Also, How much would be a physiological amount of Estrodial?
If a 53-year-old takes an average of how many mg of estradiol per day for BHRT, will bleeding occur? I don't speak English, I barely understood the video. Best regards
Thank you making this video. I was just started on Estradiol patch and Progesterone. I am post menopausal. Have a womb and recently diagnosed osteoporosis.
My insurer won’t pay for progesterone! How do you get yours paid or do you self pay? If so, what are you paying monthly.
@@leenickshramko1100 I have bcbs. it's like $25 for both. testosterone is not covered, of course, and is $100 a month.
@@leenickshramko1100I just looked it up. You can get 90 tablets of oral progesterone at Mark Cuban’s online pharmacy costplusdrugs for about 30 bucks.
Of course they'll pay for HRT if it's prescribed for their standard reasons. Why do you think they'd pay for the estradiol but not the progesterone? Unless you have no uterus.
@@leenickshramko1100
Find a Nature Path . But HRT is covered through insurance.
This makes so much sense! I’m so glad I watched this video. Thank you!
Is this ok for cancer survivors?
Sew Avron Bluming podcasts.
Thank you for explaining hormones so i can finally understand!
I hope Dr. Gersh answers this - I am trying cyclic progesterone. I stopped taking it on day 15-30 with no bleeding happening. Resumed progesterone and 10 days later while on the progesterone, got a period. Now what? Do I stop again on day 15? I thought if I’m going to bleed it will be 1-3 days after stopping the progesterone. I use a .1 patch and 200 mg of micronized progesterone
You need to be using 100mg Progesterone vaginally at night.
@@jessicahitchens6926 why
I am 72 y and take 3mg estradiol patch 2 time a week and 14 days 200 progesterone orally. 10 days later while on progesterone got a period for 5 days. I continued taking the progesterone for these 5 days. I started with HRT 2 months ago. In the first month no period but it happens in the second month.
Can someone please explain exactly how to cycle? Do you continue estrogen for the whole 28 days with 12 days of progesterone or do you totally stop both for a number of days?? 🙏😊
Look up a graph of a menstrual cycle. Use progesterone for last 2 weeks
Thank you 🙏
@@daniellebilson2612can you share the graph you found? Did you figure out how much estrogen to use each day?
@daniellebilson2612 Estradiol is continuous. Progesterone is taken the last 12-14 days of the cycle.
I was recently prescribed HRT and the Dr gave me both options. He said if I choose cycling. It's Estrogen day 1-25, progesterone only days 15-25. Then wait for a bleed. First day of bleeding starts over again as day 1. I just started though and so far I had opted for the continuous protocol. I'm considering switching it up to cyclic now though.
Thank you for informing us women. You give vital information. However no where in the video do you tell how much estrodial and progesterone us women should be taking cyclically. For me it would be very beneficial to have this information so I can advocate for myself. My gynecologist is very conservative as regards hormones. Her only focus is alleviating symptoms which can be done with a small amount.
@tela1653 Optimal amount varies from woman to woman. I was able to achieve a period with .075 transdermal estradiol patch and 200 mg of Progesterone - both bio-identical. Others may be able to achieve this with less some may need more. It took me a few months to get here as my practitioner wanted to start me out with low levels and adjust up. I just finished my first cycle with a period and I feel so much better. My inflammation, joint & muscle pain is subsiding. Other symptoms like hot flashes have completely disappeared. Breast fullness, collagen and muscle/strength that I lost has returned. I'm thrilled that I found Dr. Gersh when I did.
@@Lifes_Frostingare u working with her?
I take progesterine only birth control, i use it when i have to but not that long nor not that many mg , it does help with heavy heavy periods,
I love your approach to adjust hrt close to nature. I would like to know if you also favour a small E2 break, or continuous E2 alongside cyclical p4.
I need to find out what optimal dosing is.
I've had night sweats & hot flashes for at least 10 years 😢😢😢
@SusanAnnePowerOfTruth Go get HRT and end suffering. Don't wait, RUN!!! They will go away very quickly with the right dosing.
Is it ok to be on cyclic HRT if there is a small uterine fibroid? Isn’t the cycle going to stimulate the fibroid to grow?
I'm cycling my progesterone and am having worse pms than I ever did before and I think I'd probably be better off w consistent progesterone. thoughts?
Love the content and information…So where does one start? Since we are mimicking the cycle, do I stop taking all HRT temporarily and start over say the first of the month..? And how do I know what doses for each.
Can I request something from my MD, who by the way is an OB not Menopause specialist… perhaps thats the answer. A specialist.
Did I miss something? Examples of low doses please!
16:28 should estrogen be cycled as well?
Yes. Read Theresa Wiley's book.
What is the name of her book?
T. S. Wiley , was on Dave Asprey #508
71 y.o. In good health except for osteoporosis despite HRT use for 19 years and Prolia injections for 7 years. Now thinking that the daily .5mgs of estradiol is completely
inadequate . I take prometrium tablets 14 days a month. Would like to switch to a patch with a higher dose of estradiol. Its hard to get the MD to let me stay on hormones due to my age. Its very frustrating.Im more concerned about breaking a hip than cancer at this point. Uterine ultrasound shows no problem.
Ok so I've watched quite a number of your videos and Dr. Havers (thanks both!!)...but...WHAT amounts of estradial and progesterone should we be taking? Im utterly confused, and have no idea what to ask/tell my doctor! Thanks.
Start low and titrate up until you have symptom relief. Patches start as low as 14mcg. That’s what I’m doing right now. Prometrium 100mg cyclical.
I’ve been trying to figure out how much estrodial! No one says it so frustrating! Doctors don’t know anything! Aggggg
@@jamiesouza 3 months ago I started on Lenzetto estradiol spray, 2x1.5 mg each day, plus progesterone tablets at night. Works fantastic! Hope that helps!
Thank You for being direct about this!!❤❤
I love Dr Gersh!! I have learned so much! I took the course and followed the instructions exactly. I had the worst mood swings of my life. I was depressed, weepy, and irrational. The cramps were so intense and the "period" lasted two weeks. I powered through for three months. I almost ended up in divorce court. I had horrible PMDD when I was in my reproductive years. The treatment was birth control pills without taking the inert pills. That worked for me but I only did it for a few years. When I stopped the PMDD came roaring back. So my question is how does a woman who can not handle the hormone drop each month proceed? I am currently using a static regime with a very high dose of estrogen and I am joyful and energetic. Do I just stick with that? Or maybe try the cyclic regime less often?
What is your dose of oestrodial. I take .05 but want to go up to 1 and my doctor won't go there 😕
What about estriol creams?
Very informative and enlightening. Thank you for this great resource.
DrGersh, in my earlier notes I chose to remain in blissful ignorance, but now some deep questions are knowing at me 🤔 As this is a HUGE topic I’ve decided to make a video, and let you know when posted. 😉
I invite others to check it out and comment ❤
Can you do a video on HRT with IUD
Is it important to take oral progesterone for health benefits if you have the IUD?
Fantastic explanation! Thank you so much!
Thank you, Dr Gersh. Would you also recommend cycling estradiol and progesterone for someone without a uterus? I appreciate all the information you are kindly imparting.
How do you know what your physiologic levels are?
Test with a blood test
Estradiol goal - over 50
More info in my course!
@@FeliceGershMD Estradiol blood level of 50 is enough? I would have thought it would need to be higher to cycle? Question what do you think about Estradiol injections? Thank you!
@@FeliceGershMDover 50? What are units? Is that same for Canadians?
What about for these people who are on cyclical HRT BUT no bleeding? Does this mean the progesterone is not enough?
I just started cycling progesterone and would also like to know the answer on this..
@ylqinsun389 I believe both have to be in the right amounts to achieve a period. For me it took .075 estradiol patch and 200 mg Progesterone. Some women may need less, some more.
@@Lifes_Frosting Hi, How soon after when you started the HRT did you have a period?
So it's safe to cycle off and still be on Estradiol? I'm confused because Progesterone is supposed to protect our uterus while taking Estradiol. I'm post menopause and want to do this. Hope someone will answer please. Thank you! I love learning from you!
@AnnieSimmons1 Estradiol is continuous. Progesterone is cycled - taken last 12-14 days of the month. Both have to be at optimal levels to achieve a period. This can take some time to find the right levels for you.
Should you always start HRT even if you have no menopause symptoms?
Yes because you can’t see osteoporosis developing. It also has benefits of heart health protection and preventing dementia. I didn’t really have symptoms, but it’s best to start BHRT.
this is great information but would be the "accurate" amount of estradiol ..I just started on BHRT and have been given 0.5 which I think is th minimal and 200mg of Progesterone? Thank you!!
How do you cycle though? Did I miss that? And what if you’ve had a hysterectomy; how do you know when your estradiol levels are optimal?
Thank you! Very informative. What would be considered a physiological dose?
What about surgical menopause? Bilateral oophorectomy here
Thank you so much, for this invaluable information!!
I love this woman, Tracy, Marshall Bell
So what/ how much is the physiological amoun??? I am 72 and I just convinced my doctor to prescribe estrogen because I have insulin resistant, diabetes, osteoporosis, etc., and he prescribed 1 mg. of Estradiol in tablet form (and also micronized progesterone capsules for daily use). So now I’m wondering if the estrogen is going to do anything.
I love this Dr❤
You're amazing. What day should I start progesterone? What day should I stop. I prefer to take this path on Hrt. I'm post menopause. Thank you.
Dr said everything but did not say how much is the intake of estradiol and when we stop it to get progesteronr
I wished I knew if this only applies with menopausal women with an uterus. I am 74 and just started a cream with E P and T.
I have a very simple question. I hope someone will clarify. I understand the cycling off the progesterone for 2 weeks per month. Should we also lower our estradiol at that time or should we stay on a static high dose? My concern is without progesterone for 2 weeks our uterine lining will become to thick because of the high dose of estradiol.
@pennynichols I take transdermal estradiol in patch form - 2X weekly every week - so on it all the time. Progesterone last 12-14 days of the cycle. You will need to have dosing high enough to have a period. The period sheds the uterine lining. This takes some time to find the right levels. Most physicians only give the lowest amounts to resolve unwanted symptoms of perimenopause/menopause like hot flashes.
Is there a free source of dosing information for oneself? Have no idea if what I’m taking is sufficient or how to cycle. Don’t live in CA. Am disabled and low income. HRT is so important I think.