Spice Up Your Life: Fall 2009

Letter from the Editor

Women are complex. We know that. So fixing hormones is likewise a complex process of trial and error. When there were just a few patients on bio-identical hormones it was relatively easy to call and see how you were doing on a monthly basis. Unfortunately now I have to rely on you letting me know how you are doing and if changes need to be made.

I thought I would let you know some Pearls about Natural Hormones and perhaps you and I can help you feel the best possible sooner than later.

  • Basically hormonal treatment comes in either a cream or a lozenge. The lozenge comes in a variety of flavors if you order from Jolley's Pharmacy in SLC: : mint, pina colada, tangerine, chocolate mint, orange marshmallow, raspberry, chocolate, lemon, and green apple.
  • Medicine Shoppe in Rexburg is a compounding pharmacy and can compound the cream and lozenges, but you do not have the variety of lozenge flavors here.
  • I know some of you have stopped using the lozenge or cream and that is ok. I myself quit. I had started on the hormones to decrease my risk for osteoporosis. When I found I wasn't getting any better, I said, I am not going to take this. One of my nurses also quit because she couldn't tell she was any different on the hormones. We reformulated her RX and I am back on mine also. Call if you would like to restart or have any questions.
Rule #1: FIX PROGESTERONE FIRST-often that is all that needs to be added.

Rule #2: DHEA converts to Testosterone. If you are not sleeping well, maybe your testosterone is too high or you may be taking too much DHEA or maybe you are taking the PM dose too close to bedtime. Testosterone is stimulating.

Rule #3: If you have been on oral estrogen or a combination of estrogen and progesterone prior to taking natural hormones, then you will need a higher dose of estrogen for 3-6 months and then we can slowly taper you down back, hopefully without an increase in hot flashes.

Rule #4: If you are still having a menstrual cycle, then usually we will just give Progesterone and dose it ½ each day on days 1-13 and ½ twice a day on days 14-28.

Rule #5: If you have sleep issues, the progesterone will help and you can also take oral Progesterone 150mg at night.

Rule #6: If your nipples become tender after treatment, it is likely too much Progesterone.

Rule #7: If your breast is tender, it is likely too much Estrogen.

Rule #8: You should see a change in your sleeping and hot flashes the first week of treatment, but it may take 4-6 weeks to get total effect, then alterations can be changed.

Rule #9: If Estrogen is in cream formulation: apply on the inner and outer thighs NOARMS.

Rule #10: It is always a good idea to retest at least in one year. If you have been using lozenges, retest with Blood Spot only the hormones they have been using. The cost will be less.

Rule #11: If you have been using cream, retest with saliva test, again only the hormones you have been using. Thus it will cost significantly less.

Rule #12: If you have testosterone or DHEA in your formulation I can only give you an initial RX for 6 months. I am happy to refill it once for another 6 months and then we should retest.