Hi heather what I love is how each video I’m getting a new learning lesson I’m learning something new that now makes sense and I am understanding this whole journey I’m so grateful that I found you and that you’re teaching everyone and helping all of us that aren’t getting help from regular regular gynecologist that are shutting the door in our face and now I am your patient and I’m so looking forward to getting to talk to you again soon thank you so much for everything that you’re doing keep these videos coming out there great
Hi Heather my wife is 53 and started perimenopause about a year ago, she started loosing hair at quite an alarming rate about three weeks ago, she had blood tests and a checkup and is all good, no thyroid problems or anything like that, how long will the hair loss last and will HRT help?
This video could not have been done at a better time! I have a consult with my menopause specialist on Wednesday, and despite being on 100Estradot, I still have insomnia. Will ask her about the possibility of a different route for estrogen. Thank you so much for your dedication to women around the world! (Also enjoy your podcast!)
Thanks for being so supportive Lara! It truly means a lot. You are doing such good work! A lot of women need to play around with the route and dose for a few months even before finding the right one for them.
@@heatherhirschMD Well I am being switched from patches to oral estrogen ... so of course, I have now watched your OTHER video (Patches vs Oral)! I am binging on your videos tonight!! LOL! THANK YOU!
Wow, this was the most clearly stated video I’ve seen on why HRT may not be working correctly for you. I am someone that cannot absorb the estradiol gel formulation, so if I want to continue with HRT I will be taking it in pill form and see how I do. Thank you for this.
I have referred you to my ob-gyn, PCP and my pelvic floor therapist. I advised them all to refer all their patients to your RU-vid videos and podcast. I just started on HRT as of 4/19/21 and I’m already seeing the benefits. I’m finally feeling hopeful. Thank you for your wealth of knowledge! 💗
I appreciate this channel so much. My heart breaks for the women who in the past have suffered so unnecessarily through peri-menopause and menopause. It's my understanding that there were not many treatment options for our Mothers and Grandmothers, etc., and all the nasty side effects of menopause were just suffered through. Thank you for sharing with us! I had a hysterectomy after the birth of my last child due to PPH (ovaries intact) so I had no clue as to when menopause/peri-menopause would happen for me. Only after I started having severe depression out of the blue (never suffered with this) and did my own research online did I discover the depression was most likely due to dropping estrogen levels. I found a doc and started on BHRT and after one day of treatment, I was my old self again. I'm so glad I didn't go the anti-depression medication route like so many docs apparently prescribe. I kept needing to titrate my dose up (cream) for relief of symptoms. Even though my symptoms have resolved, my E2 levels are only in high 30s with my blood tests. I feel great but wonder if oral would be more beneficial. I've heard that oral route of Estrogen has side effects b/c metabolized by liver???
Thank you for this info! I commented yesterday on Instagram about it being my first day on HRT. I will watch your video on patches vs pills for routes of delivery. I will let things ride for at least a month, but from everything you have said I suspect that 1mg oral estradiol might be a little low for me at 42 (considered post menopause). What I LOVE about you as a doctor is how you discussed how you always get a FULL medical history first- my provider did not so this...just asked a few quick questions. On the surface I appear very fit an healthy, but have had serious health issues. As a military family, we have lived all over the country and I have been consistently told by medical providers that if I had not been so proactive about my health/fitness/nutrition, I would be in very bad shape. I can tell that you are an AMAZING doctor- seriously!! ❤️❤️
Thank you for the very kind and thoughtful message. I know there are amazing women just like you who have had to be very proactive about their health. I think where you are starting is great and time will tell if it is the right dose! You got this girl!
@@heatherhirschMD one more thing- I find it ironic that all this has surfaced because I became a grandmother this year. I’ve laughed and cried quite a bit! 🤯😭😂😭❤️
I’m so thankful for the fact- and evidence based information on this channel! Thank you! 😊 One question: Is the optimal range you give for estradiol in menopause (40-70 pg/ml) also sufficient to protect against osteoporosis and heart disease? Would the low end of this range offer this protection? Thank you in advance.
I am taking prometrium progesterone. I found that it has helped me in loosing the stubborn weight I was holding on to. I was missing periods. Since taking this my life has been awesome sex is amazing again.
I am 77 and have been on oral estradiol since age 43. I've never had any problems. I have tried estradiol patches because multiple GYNs insisted. Patch was insufficient. Am back on oral estradiol BUT multiple GYNs have told me they will no longer prescribe ! One told me that it will soon be illegal to prescribe oral estrogen for "older women" !!!! She also said that HRT should not be for life !!! I feel like I'm suddenly back in the dark ages. I am not in your area of the country. PLEASE HELP !
If you can't find a local nurse practitioner, MD, etc...Go online and find a telehealth doctor to help you. There are now a lot of HRT doctors that provide Rx's for HRT that are either mailed to you (you would have to direct-pay) or they will send Rx to your local pharmacy. Try Dr. Shawn Tassone (out of TX) My Alloy, etc.
I had an iud 2 days ago, the progesterone tab didn't agree with me. I was on divigel changed to a higher dose of estrogen estradiol. I hope this helps because I have no change on the others. After 2 months, actually, my PMS and heart palpitations have been bad as ever. Definitely not a high enough dose by the sound. Plus im 40 in my research it says the younger the higher dose is needed.
I’m 42. I started on hrt 1mg duet tablet about a month ago. Since then I have plummeted. I have been very ill, tired, sleeping like I’m in a coma for hours, I’ve had to take time off work, my mood is the lowest it’s ever been, I’m angry, irrritable and so far I have had 3 periods in between taking these pills. My doctor has suggested increasing it with no blood checks or anything. Uk gps are not very well up on women’s issues
Can you talk about the estrodial patches and how they leave red marks that don’t go away and itch! Not sure if its because the adhesive and the fact that my pharmacy only gives me generics… getting good results with the medication except for that.
I love everything about this channel ! Especially this particular video as I just started a new hrt but 4 days later no relief from hot flashes, in fact im having more. Not sleeping well either. I'm on 0.05 estradiol patch and 100 mg progesterone. I would love to have the progesterone as an IUD as I don't do progesterone well but my Dr won't do it for menopause. I wish you were in my area. Thanks for all the information though.
There is NO reason you can't get an IUD. I would ask to be referred. Some women will have more hot flashes for the first few weeks (sort of like setting your system off) but then totally gets better. Keep at it! you got this! Thanks for the wonderful message :)
I just found this and you Tok Tok channel. I am really enjoying learning more about this season of my life. Now, to lose the perfectly timed 15 extra menopause and pandemic pounds......ugh!
I know Premarin works for a lot of women and its been around for decades. BUT... it is Hell on Earth for horses and their fouls. Premarin stands for "pregnant mare". The horses live their lives strapped to a contraption in a stall that captures their urine after being artificially inseminated. Their female fouls are often kept to replace other Premarin horses and the males are sold to be raised for food in other countries. They are of course separated at birth which is another cruelty. I want to encourage women to try bio-identical first and hopefully it will work for you.
I am on bio identical estrogen gel(.75) and progesterone (200mg) and getting relief from hot flashes but still suffer from a little anxiety and terrible insomnia 😞
So hard. Try adding 250 - 500 mg of over the counter magnesium at bedtime. you could try increasing the progesterone to 300 mg if your doctor is okay with that.
@@heatherhirschMD Thank you Dr. H. I already take Mag Glycinate 220mg. I can try increasing it if my doc concurs. I have also played around with increasing my Prometrium from 100mg po q HS to 200mg. My issue is I wake with insomnia after about 4 hours of sleep and cannot fall back asleep.
I have yet to embark on any from of HRT, and am trying to learn about it all, so I can ask the right questions when I get to the gyn who'll be prescribing and monitoring. I feel my body has aged literally decades over the past 3 or 4, and it's devastated me, body and soul. I have also been living under the shadow of male pattern hair loss for the past 4-5 years. I am not emerging from menopause 7 years in to it, nor is the hair loss desisting. Apart from feeling l like an 80 yr old woman at 48, I'm scared I'll go bald, as my hair is getting very sparse at the sides. Is there an optimal combination that would specifically address this, or anything I should stay away from?
You won’t emerge from menopause; instead, you will be in a menopausal state for the rest of your life. Some symptoms may get better with time; whereas, others may show up later and lead to long term risks without HRT.
I’ve been having oral estrogen for almost 10 years now. I recently got tested, and my levels are very low. I have no idea why they have stopped working, and I’m trying to find out. I have added transdermal with a higher oral dosage, and there has been a small difference, but can’t be very sure
Ok...but ...bare with me...I don't have hot flashes, my personal hell is digestive issues ( constant constipation), water retention ( I go up and down 7 pounds for no reason) and very painful breasts, as well as insomnia. HRT has aggravated my symptoms. I'm afraid of going higher and making it worse, I simply could not deal with it, my mental health is starting to deteriorate that would be the end of me.
Hi im 37 years old n i think I'm going through perimenopause I don't be having energy some days now I started itchiness n dryness down below n I took a midstream analog n 2 pink lines pop up n it was Saturday when I took the test so Monday I called my doctor so I go Monday on the 21
Is the oral route more beneficial to your skin and hair vs transdermal? Ive been on Evamist for about 6 weeks now and I haven’t seen the benefits I hoped for. My skin is dry and itchy and my hair is dry and brittle. Nails are still breaking a lot. TIA
I was great until my pharmacy changed progesterone brands. Within a few weeks I had what I know now as estrogen dominance and then crashed a week or two after that - anxiety, weight gain, depression, back ache, cramps, super heavy low uterus. ACK! Have you ever heard that some manufacturers may work for you while others not?
Question: If you were typically estrogen dominant and for people like me, who gain a lot of weight on HRT is there not another base that can be used other than wild yam and soy?
This has been my question for months. I’ve learned micronized may be better. Wondering if you went this route? Provera is not helping me. Still have insomnia.
Thank you so much for the wonderful information you share with us !!! I’m 49 and taking Viorele (low dose birth control pill) plus 1 mg estradiol. Everything is good, except for the night sweats 🥵 I wake up hot and sweaty in the middle of the night. My ob had suggested for me to stay on these 2 pills till age 55 then switch to HRT. But I’m wondering now ? Does the night sweats mean I need more estrogen ?
K I got to tell you this ! I called my doctor and asked him if it would be k to add progesterone to what I’m already taking and he said it wouldn’t hurt, so he prescribed 200 mg progesterone and told me I could even take 2 at night. Well let me tell you, I was experiencing anxiety since last summer and I don’t want to speak too soon since I’ve only take it for a few days but I think it’s gone ! I wake up not feeling that heaviness in my chest and the flutters in my heart throughout the day ! I’m so excited !! Why nobody tells you progesterone can help with anxiety ?!
Hi yes I am a black 40 year old transgender woman I have been on hormones since the age of 18 but for the past three and a half years I have noticed my hormones have not been working is it possible you can give me any tips or help me in some type of way because I have been really depressed and stressed out not wanting to leave my home because of the way I have been looking sometime I even be scared thinking that I want to take my life because I'm not fitting in and passing in society like I used to when I was in my twenties and thirties please help me if you can
I started on oral progesterone 100mg after being on the topical cream. I am still on the bi-est 2mg/ml 2 clicks twice per day. The oral progesterone I felt more anxiety and PVC’s. The doctor decreased it to 25 mg to slowly titration up. Started on the 50mg and felt anxious again with headaches. Have you seen this before?
Dr can you tell me if Femring is better than the ups and downs of patches (if you have that) ? Also what about a clot risk with Femring ? I see a lot of women like it. Do you have to be concerned with your make partner's exposure? Thx !
I had joint pain during my peri, had rheumatoid arthritis diagnosis, tried many meds for that, stopped having my period and went into menopause and the hormones gave me a brief reprieve, sadly pain is back and I need to adjust my HRT to higher dose
I took oral birth control for 30 years and it caused a pre-cancerous tumor on my liver. The pill gave me the most beautiful skin and hair. I didn’t know it was hurting my liver! As soon as I stopped the pill, I lost a lot of hair and my skin started breaking out. I am working with my gyn to do an estrogen that does not hurt my liver. It’s amazing that an MRI can catch specific problems and causes like this! My gyn advises that only a pellet or a patch doesn’t go through the liver…. My liver tests 6 month later after stopping the pill were completely clear. I just started the pellet about a month ago. There are 3 levels and they started me from 0. I asked for starter dose and they said no, you need the medium dose pellet. I feel it’s too much testosterone because I’m very flashy/angry. Not normal for me.
Have you had more hair loss and acne with the testosterone pellet? I was booked for pellets, but didn't do it because (this channel )Dr.Hirsch says she doesn't recommend it. I had no idea there were doctors against the pellets, I didn't think I had to research something my GYN suggested. I kinda feel like I was left in the dark. Can you let us know how you are doing now with the pellet(s), did U do both Estrogen & Testosterone, Thx
This video is so timely for me. I am on bhrt and have been doing well. I had an appt last month to go over lab work and my dr and I felt a little tweaking of my estrogen was in order. I feel like I now have a belly bloat and my breasts feel a little tender. I wonder if it’s too much estrogen or do I need to give my body more time to adjust. Thx for the info
The patch, gel etc worked, I didn't absorb anything. And I've been in the oral tablet isn't working either. My bloods were 134 pmol/l. I'm only 45 but feel awful
I started hrt therapy at 29 bc I am was having none stop bleeding and low progesterone. So they added progesterone and estrogen orally now I am not having no cycle at all she added provera to take after progesterone if i had not got a cycle still never have and just been going back and fourth 14 days estrogen/ 14 days progesterone 10 days provera if no cycle I have took it consistently for 1 year I’ve talked to my doctor but she don’t wanna up my dose any more My uterine lining has not thickened according to ultrasound any in the past year by ideas ?
Have been on HRT for15 days, one tablet and 1pump of gel. I have been menaporse for 3 years had my last period at 51. I am not sure when I will feel any different but as I type I feel exactly the same with the same symptoms., If I don’t sleep soon I think I will go mad, dry eyes , lost libido, fog brain, feeling low and flat. This is just a few of the things I have put up with for 5 years Any help or advice would be appreciated.
@@heatherhirschMD Have had my first full night of sleep, I can hardly believe it. My bedding and pillow still in the same place in the morning, normally every pillow and the duvet look like I have had a fight. Thank you so much for your comment. Long may it continue and improve.
Can I use Estrogen patches continuously and only take the progesterone every three months? I get migraines from the progesterone so I don't want to take it every cycle. I still have regular cycles.
I am 44. I had a hysterectomy last year but kept my ovaries. I was also on birth control pills for 24 years prior to my surgery. About 3 months after my hysterectomy I started having vaginal irritation and dryness and frequency. Soon after I had anxiety, sleep problems, migraines. I started on HRT 3 months ago. All my symptoms resolved except all my vaginal issues. It got better for a short period of time but then came back full force. I just increase my estrogen. Oh I also use vaginal estrogen with DHEA. How long can it take for the vaginal estrogen to resolve? I’m miserable!
I get my vaginal estrogen off Amazon but I use the one that is 2mg estriol only. DHEA turns to testosterone which is not helpful to my bladder as far as I know not harmful either. I stopped all progesterone when I found out that it does cause incontinence. Vaginal estrogen has been proven to fix the tissue issues that cause incontinence. So I use the pure estrogen one only.
Do you treat transgender? I have use gel, pills , pills under tongue and now injection of estradiol valerate. Every time I started a new route I felt the initial effects but then after a few days it would stop working. My doctor says. I have to be realistic 🤦♀️ I just think my body is not absorbing right even tho when I do blood work it shows high estrogen levels. That’s crazy
I've been on estrodial now for 12 weeks. Ive had 3 blood tests. The initial showed my estrogen levels at 17. The next was 15. The 3rd >15. It's not working. And they've only increased my dose once to 4 clicks. I pay $300/mo. I am so frustrated with this company. Also on my DNA health report it shows estrogen resistant. I don't know if that has anything to do with it. Neither does this Dr I'm being treated by.
I would recommend finding a Doctor Who knows how to prescribe FDA approved hormone therapy the compounded stuff that you’re getting is way too expensive and not working at all so try getting on estradiol the Esterdale patch or even oil primer and it’s gonna work significantly better
Way too much talking. Needs to be succinct. Good points but I’m skipping because too much distraction. If so much talking have quick slides with talking points.
What do you make of the current kickback by doctors, insisting that the HRT doses are too high, and it's got to be the lowest dose for the shortest time? This is doctors speaking now in the media, in journals, now, today, 2024,, not old stuff. What's going on? 🤔xx
That happened to me with my first encounter with HRT. They are going by that study, that faulty, misinterpreted study. HRT hadn't even given me any relief yet, and they were discussing taking me off of it. "Thirty days in, thirty days out." I bawled, I had bad insomnia and they wanted to do WHAT? Doctors like Mary Claire Haver explain that fallacy. I found a provider nearer to my home who understands and is all for me taking it as long as it is needed without any worries. So there are 2 schools of thought and you have to search out the ones you align with. I know it's a headache to do, but it's worth it.
