Progress Your Health Podcast

In this episode of the Progress Your Health Podcast, Dr. Valorie and Dr. Maki tackle a common yet surprisingly confusing question: When is the best time to test your blood levels if you're using hormone replacement therapy (HRT)? Lisa, a fellow Washingtonian, submitted a thoughtful Ask the Doctor question about testing estradiol and FSH levels when using a trochee or transdermal cream. Should it be 4 to 6 hours after application? Or 10 to 12? And what do the results actually mean? We’ll break down: The ideal timing for blood draws depending on delivery method (trochee, patch,cream) How estrogen and progesterone absorb differently Why testing too soon — or too late — can skew your results How to interpret estradiol and FSH together (and why context is everything) Why the number isn’t the whole story — and how you feel matters most Plus, Dr. Valorie shares insights from her own hormone journey, including rhythmic dosing tips and lab timing mishaps.   If you have a question, please visit our website and click Ask the Doctor a question.   Want more insights like this?  Be sure to subscribe to our newsletter for hormone Q&As, educational guides, and real-world strategies to help you feel like yourself again—especially during perimenopause and menopause. Join the Progress Your Health Newsletter   Stay Connected Instagram: @drvalorie TikTok: @drvaloried Join the Hormone Community: Click here to subscribe   Disclaimer: All content in this blog, including text, images, audio, video, or other formats, was created for informational purposes only. This video, website, and blog aim to promote consumer/public understanding and general knowledge of various health topics. This content is not a substitute for professional medical advice, diagnosis, or treatment. Please consult your healthcare provider with any questions or concerns you may have regarding your condition before undertaking a new healthcare regimen. Never disregard professional medical advice or delay seeking it because of something you have read on this website. If your healthcare provider is not interested in discussing your health concerns regarding this topic, then it is time to find a new doctor.

Is there really an age limit for hormone replacement therapy (HRT)? What if you're in your 70s and still feel better on hormones—but your doctor says it's time to stop? In this episode, we answer a great question from Mary, a 76-year-old woman who's been on HRT for over 20 years. She's dealing with weight gain, breast tenderness, and pressure from her gynecologist to quit hormones altogether. We break it down: Why stopping HRT just because of age isn't always the answer What to consider when switching from a trochee to a cream Why estradiol levels matter more than total estrogen The connection between insulin resistance, weight gain, and hormones How to adjust HRT in your 70s to maintain quality of life without unnecessary risk Whether you're well into postmenopause or just starting HRT, this is a must-listen if you're wondering how long is too long to stay on hormones.   If you have a question, please visit our website and click Ask the Doctor a question.   Want more insights like this?  Be sure to subscribe to our newsletter for hormone Q&As, educational guides, and real-world strategies to help you feel like yourself again—especially during perimenopause and menopause. Join the Progress Your Health Newsletter   Stay Connected Instagram: @drvalorie TikTok: @drvaloried Join the Hormone Community: Click here to subscribe   Disclaimer: All content in this blog, including text, images, audio, video, or other formats, was created for informational purposes only. This video, website, and blog aim to promote consumer/public understanding and general knowledge of various health topics. This content is not a substitute for professional medical advice, diagnosis, or treatment. Please consult your healthcare provider with any questions or concerns you may have regarding your condition before undertaking a new healthcare regimen. Never disregard professional medical advice or delay seeking it because of something you have read on this website. If your healthcare provider is not interested in discussing your health concerns regarding this topic, then it is time to find a new doctor.

In this episode, we’re answering a thoughtful (and very relatable) listener question from Kari,who’s been struggling with unexpected body pain and inflammation after starting hormonetherapy. She wonders if she might be hypersensitive to estrogen—something most doctorsdon’t talk about. Dr. Valorie Davidson and Dr. Robert Maki unpack why this happens and what to do if yoususpect your body is reacting to estrogen differently than expected.   In this episode, we discuss: Why some women experience increased pain, fluid retention, or inflammation onestradiol—especially starting at higher doses too quickly. The importance of starting low and increasing slowly, especially for sensitiveindividuals How Dr. Davidson’s personal experience with estrogen sensitivity helped shape herapproach The role of the liver’s phase 1 and phase 2 detox pathways in clearing estrogenmetabolites Why form, dose, and timing of hormone therapy (cream vs. patch, AM vs. PM) canaffect results What to consider when adjusting your Biest ratio (80:20 vs. 90:10) or RhythmicDosing HRT   ✉️ Here’s Kari’s full question:“I used Biest 80:20 for 3 years and suddenly stopped absorbing. I’m not sure why,but I do know I didn’t always use it the same time every day. From the moment Iwent on hormone therapy I’ve had body pain and thought I had fibromyalgia. Whenmy estrogen dropped due to the absorption issue I realized the body paincompletely went away. I then went on a patch because my doc said we shouldchange the method. Immediate body pain again and even worse. Terrible. I was on0.025 and it was tolerable, but after raising it to 0.05 it got really bad. I think I mayask to go on the compounded cream again—maybe change the site that I apply itand be more consistent. I’m very frustrated because no one talks about a subset ofpeople that are very sensitive to estrogen. They only talk about it making joint paingo away. Do you think I should use 90:10 instead? What would you recommendthat I do? I’m so sad and frustrated.”    If you have a question, please visit our website and click Ask the Doctor a question.   Want more insights like this?  Be sure to subscribe to our newsletter for hormone Q&As, educational guides, and real-world strategies to help you feel like yourself again—especially during perimenopause and menopause. Join the Progress Your Health Newsletter   Stay Connected Instagram: @drvalorie TikTok: @drvaloried Join the Hormone Community: Click here to subscribe   Disclaimer: All content in this blog, including text, images, audio, video, or other formats, was created for informational purposes only. This video, website, and blog aim to promote consumer/public understanding and general knowledge of various health topics. This content is not a substitute for professional medical advice, diagnosis, or treatment. Please consult your healthcare provider with any questions or concerns you may have regarding your condition before undertaking a new healthcare regimen. Ne...

In this episode, Dr. Valorie Davidson and Dr. Robert Maki respond to a great listener question from April, who’s navigating hormone replacement therapy (HRT) while dealing with a history of endometriosis, polyps, and chronic cramps.  April’s experience is all too familiar: spotting, cramping, hormone experimentation, and the frustrating search for symptom relief. So, can women with endometriosis safely use HRT—especially estrogen?  The answer: Yes, but it has to be customized.  �� In this episode, we cover:  Why HRT is absolutely possible for women with endometriosis—but must be individually tailored  The difference between static vs. rhythmic dosing and why rhythmic HRT may be better tolerated for some women  Dr. Davidson’s personal story of having endometriosis, cysts, and polyps—and how she now uses rhythmic dosing herself without flaring  The important role of progesterone in managing endometriosis and minimizing estrogen reactivity  How to approach spotting, cramping, and cyst formation during HRT ● Why estrogen isn’t the enemy—but why it must be dosed thoughtfully  ✉️ Here’s April’s full question:  “Hi—I am a 57-year-old woman in perimenopause. My question is: is it possible for women with endometriosis or adenomyosis to do HRT?  I started oral progesterone 2 years ago, got as high as 300 mg, but didn’t get much symptom resolution. Switched to a progesterone troche—50 mg morning and night. About 3 months ago, I added testosterone (0.25 mg once daily, 5 days/week) and Biest 80/20 (1 ml daily, can go up to 2 ml).  Everything was good for a while, but now the cramping and spotting have returned. I’ve had heavy bleeding as long as I can remember. My main complaint is menstrual cramps throughout the month—not just during my period. I do not have fibroids, but I’ve had many cysts and polyps over the years and have had many ultrasounds and transvaginal ultrasounds because of this.”    If you have a question, please visit our website and click Ask the Doctor a question.   Want more insights like this?  Be sure to subscribe to our newsletter for hormone Q&As, educational guides, and real-world strategies to help you feel like yourself again—especially during perimenopause and menopause. Join the Progress Your Health Newsletter   Stay Connected Instagram: @drvalorie TikTok: @drvaloried Join the Hormone Community:

In this episode, Dr. Valorie Davidson and Dr. Robert Maki dive into a hot topic: Does HormoneReplacement Therapy (HRT) actually slow down aging? While the short answer may surpriseyou, the real conversation is about something even more valuable—your quality of life. Here’s what we cover: How HRT can support energy, strength, and resilience as we age The role of hormones in brain function, memory, and mental clarity Why estrogen and progesterone matter for muscle tone and bone density ❤️ The powerful connection between hormones and cardiovascular health Why HRT isn’t about extending your lifespan—but enhancing how you feel through theyears   Obviously aging is inevitable—but suffering doesn’t have to be. This episode is all about helpingyou feel more like you again, even as your hormones shift.   If you have a question, please visit our website and click Ask the Doctor a question.   Want more insights like this?  Be sure to subscribe to our newsletter for hormone Q&As, educational guides, and real-world strategies to help you feel like yourself again—especially during perimenopause and menopause. Join the Progress Your Health Newsletter   Stay Connected Instagram: @drvalorie TikTok: @drvaloried Join the Hormone Community: Click here to subscribe   Disclaimer: All content in this blog, including text, images, audio, video, or other formats, was created for informational purposes only. This video, website, and blog aim to promote consumer/public understanding and general knowledge of various health topics. This content is not a substitute for professional medical advice, diagnosis, or treatment. Please consult your healthcare provider with any questions or concerns you may have regarding your condition before undertaking a new healthcare regimen. Never disregard professional medical advice or delay seeking it because of something you have read on this website. If your healthcare provider is not interested in discussing your health concerns regarding this topic, then it is time to find a new doctor.

You’ve probably heard “drink your milk for strong bones,” but there’s much more to bone healththan just calcium—and definitely more than just dairy. In this episode, Dr. Valorie and Dr. Makibreas down the key nutrients your body needs to build and maintain bone density as you age,especially during perimenopause and menopause.   From calcium and magnesium to K2, boron, and collagen peptides, we’re covering thesupplements and whole food sources that truly make a difference for your bones. You’ll learnwhich forms of calcium are best absorbed, why magnesium matters for your arteries, howvitamin D and K2 work together, and the underappreciated power of prunes, chia seeds,sardines, and seaweed.   What You’ll Learn: Which forms of calcium are safest and most effective  The synergy between magnesium, vitamin D3, and vitamin K2 How to naturally support your osteoblasts (bone-building cells) Best food sources of key bone nutrients What to avoid if you’re prone to kidney stones or soft tissue calcification The truth about collagen and bone strength   Whether you’re navigating menopause or just want to protect your bones for the long haul, thisepisode offers actionable strategies backed by decades of clinical experience.   Don't miss this podcast to building stronger bones—naturally.   If you have a question, please visit our website and click Ask the Doctor a question.   Want more insights like this?  Be sure to subscribe to our newsletter for hormone Q&As, educational guides, and real-world strategies to help you feel like yourself again—especially during perimenopause and menopause. Join the Progress Your Health Newsletter   Stay Connected Instagram: @drvalorie TikTok: @drvaloried Join the Hormone Community: Click here to subscribe   Disclaimer: All content in this blog, including text, images, audio, video, or other formats, was created for informational purposes only. This video, website, and blog aim to promote consumer/public understanding and general knowledge of various health topics. This content is not a substitute for professional medical advice, diagnosis, or treatment. Please consult your healthcare provider with any questions or concerns you may have regarding your condition before undertaking a new healthcare regimen. Never disregard professional medical advice or delay seeking it because of something you have read on this website. If your healthcare provider is not interested in discussing your health concerns regarding this topic, then it is time to find a new doctor.

In this episode, Dr. Valorie Davidson and Dr. Robert Maki break down how to interpret your DEXA scan results—and why it matters, especially for women in perimenopause and menopause. We explain what your T-score and Z-score actually mean, how estrogen and menopause affect your bones, and what you can do to prevent or slow bone loss naturally.   Whether you’re already on HRT or just starting to explore options for protecting your bone health, this episode gives you clear, actionable insights to help you feel strong, confident, and informed.   In this episode, you’ll learn: What a T-score means—and how to understand the risk ranges What a Z-score tells you (and why it’s different from T-score) How menopause and estrogen decline impact bone density The role of HRT in maintaining or improving bone strength How weight-bearing exercise helps preserve bone mass Natural strategies to prevent bone loss (beyond calcium and vitamin D) Real examples of patients’ DEXA scans and how their scores changed over time   Perfect for you if: You’re in your 40s, 50s, or beyond and wondering what your bone scan means—or how to keep your bones strong during the hormonal transition.   If you have a question, please visit our website and click Ask the Doctor a question.   Want more insights like this?  Be sure to subscribe to our newsletter for hormone Q&As, educational guides, and real-world strategies to help you feel like yourself again—especially during perimenopause and menopause. Join the Progress Your Health Newsletter   Stay Connected Instagram: @drvalorie TikTok: @drvaloried Join the Hormone Community: Click here to subscribe   Disclaimer: All content in this blog, including text, images, audio, video, or other formats, was created for informational purposes only. This video, website, and blog aim to promote consumer/public understanding and general knowledge of various health topics. This content is not a substitute for professional medical advice, diagnosis, or treatment. Please consult your healthcare provider with any questions or concerns you may have regarding your condition before undertaking a new healthcare regimen. Never disregard professional medical advice or delay seeking it because of something you have read on this website. If your healthcare provider is not interested in discussing your health concerns regarding this topic, then it is time to find a new doctor.

In this episode of The Progress Your Health Podcast, Dr. Valorie Davidson and Dr. Maki take you behind the scenes and share their own hormone blood test results. Learn how these labs help guide treatment decisions, track progress, and support hormone balance during perimenopause and menopause.   What You’ll Learn: Key labs such as estradiol, testosterone, DHEA-sulfate, pregnenolone, LH, FSH Additional panels like liver enzymes, cholesterol, and comprehensive metabolic profiles How hormone replacement therapy (HRT) is monitored through regular blood work Dr. Valorie’s personal experience with rhythmic HRT dosing during menopause The difference between baseline and follow-up labs   If you have a question, please visit our website and click Ask the Doctor a question.   Want more insights like this?  Be sure to subscribe to our newsletter for hormone Q&As, educational guides, and real-world strategies to help you feel like yourself again—especially during perimenopause and menopause. Join the Progress Your Health Newsletter   Stay Connected Instagram: @drvalorie TikTok: @drvaloried Join the Hormone Community: Click here to subscribe   Disclaimer: All content in this blog, including text, images, audio, video, or other formats, was created for informational purposes only. This video, website, and blog aim to promote consumer/public understanding and general knowledge of various health topics. This content is not a substitute for professional medical advice, diagnosis, or treatment. Please consult your healthcare provider with any questions or concerns you may have regarding your condition before undertaking a new healthcare regimen. Never disregard professional medical advice or delay seeking it because of something you have read on this website. If your healthcare provider is not interested in discussing your health concerns regarding this topic, then it is time to find a new doctor.

In this episode, Dr. Maki and Dr. Davidson answer viewer comments from their YouTube channel, providing clarity and insight into hormone replacement therapy (HRT), uterine lining health, and vaginal estrogen options. They also touch on annual gynecological care and share a lighthearted moment with their furry companions. Topics Covered: How to identify uterine lining buildup while on static HRT. Differences between static HRT (no bleeding) and rhythmic HRT (cyclical bleeding). The importance of monitoring uterine lining thickness to prevent cancer risks. The role of transvaginal ultrasounds in checking uterine lining, ovarian cysts, fibroids, and polyps. Why current guidelines for Pap smears have changed, and what they do (and don’t) check. Estriol vs. estradiol: why some doctors prefer estriol for vaginal atrophy and urinary incontinence. How estriol can be a safer alternative for vaginal health and urinary stress incontinence. A shout-out to comments about Vivian, the podcast’s beloved standard poodle, and Bob, the Aussie mix.   Episode Highlights: Why it’s essential to prevent uterine lining thickening on static HRT. The role of transvaginal ultrasounds in annual gynecological exams. How estriol can be a safer alternative for vaginal and urinary health. Viewer questions that sparked meaningful discussions. A fun behind-the-scenes look at the podcast’s four-legged “producers.” Listen now to gain a clearer understanding of HRT, uterine health, and vaginal estrogen safety.   If you have a question, please visit our website and click Ask the Doctor a question.   Want more insights like this?  Be sure to subscribe to our newsletter for hormone Q&As, educational guides, and real-world strategies to help you feel like yourself again—especially during perimenopause and menopause. Join the Progress Your Health Newsletter   Stay Connected Instagram: @drvalorie TikTok: @drvaloried Join the Hormone Community: Click here to subscribe   Disclaimer: All content in this blog, including text, images, audio, video, or other formats, was created for informational purposes only. This video, website, and blog aim to promote consumer/public understanding and general knowledge of various health topics. This content is not a substitute for professional medical advice, diagnosis, or treatment. Please consult your healthcare provider with any questions or concerns you may have regarding your condition before undertaking a new healthcare regimen. Never disregard professional medical advice or delay seeking it because of something you have read on this website. If your healthcare provider is not interested in discussing your health concerns regarding this topic, then it is time to find a new doctor.

In this episode of the Progress Your Health Podcast, we dive deep into why hormonal changes, stress, and nutrient deficiencies contribute to hair loss during menopause and the best ways to support regrowth naturally. What you can do about it.   What You’ll Learn in This Episode: The Hair Growth Cycle & How Menopause Disrupts It The Role of Estrogen, Progesterone & Androgens in Hair Thinning How Thyroid Function & Insulin Resistance Impact Hair Loss Nutritional Deficiencies That Contribute to Hair Shedding The Connection Between Stress, Cortisol, & Scalp Health Best Supplements & Natural Remedies to Regrow Thicker Hair Hormone Therapy (HRT) – Can It Help or Hurt Hair Growth? Key Takeaways: Estrogen & Progesterone Decline: Shortens the hair growth phase & weakens follicles DHT & Androgen Sensitivity: Can cause miniaturization & pattern hair loss Nutrient Deficiencies: Iron, Vitamin D, Zinc, & Omega-3s are crucial for healthy hair Chronic Stress & Cortisol Spikes: Can push hair into the shedding phase Scalp Health & Circulation: Poor blood flow reduces hair follicle nourishment Solutions We Discuss: DHT Blockers: Saw Palmetto, Pumpkin Seed Oil, Spironolactone Best Hair Growth Nutrients: Ferritin (Iron), Vitamin D, Zinc, Biotin, Omega-3s Stress Management Tips: Adaptogens, meditation, & lifestyle shifts HRT & Hair Loss: Understanding the right type of hormone therapy for you   If you have a question, please visit our website and click Ask the Doctor a question.   Want more insights like this?  Be sure to subscribe to our newsletter for hormone Q&As, educational guides, and real-world strategies to help you feel like yourself again—especially during perimenopause and menopause. Join the Progress Your Health Newsletter   Stay Connected Instagram: @drvalorie TikTok: @drvaloried Join the Hormone Community: Click here to subscribe   Disclaimer: All content in this blog, including text, images, audio, video, or other formats, was created for informational purposes only. This video, website, and blog aim to promote consumer/public understanding and general knowledge of various health topics. This content is not a substitute for professional medical advice, diagnosis, or treatment. Please consult your healthcare provider with any questions or concerns you may have regarding your condition before undertaking a new healthcare regimen. Never disregard professional medical advice or delay seeking it because of something you have read on this website. If your healthcare provider is not interested in discussing your health concerns regarding this topic, then it is time to find a new doctor.

One of our listeners: Can you take oral progesterone hormone replacement therapy (HRT) if you already have an IUD? This topic doesn’t have much research or widespread discussion, but it’s a question we hear frequently. Tammy’s situation is common, and we’re here to provide clarity and guidance. Topics Covered: Why might someone take progesterone HRT while using an IUD? Understanding estrogen dominance and its effects The differences between an IUD and oral progesterone Can too much estradiol cause uterine hyperplasia or bleeding? Types of estrogen HRT and how they interact with progesterone The benefits of adding progesterone HRT to your regimen If you’ve ever wondered about balancing hormone therapy with an IUD, this episode will provide practical insights and actionable advice to help you make informed decisions about your health. Tammy’s Question: "Hello! I searched for "can i take progesterone with my IUD". I can't find much, but I found your interview. I am a 53yo female, 8 years into menopause. I started HRT Oct of 2024 (200mg progesterone, 1.0 transdermal estradiol). I felt human again! I started bleeding alot (!!) January 2nd 2024. It lasted for 2 months before I called my doctor. A vaginal US revealed thickening of the uterine lining, with some polyps. I had a D&C with biopsy and placement of IUD in April 2024. I stayed on the patch, my progesterone was reduced to 100mg. I lost my sleep, and I have PMS like symptoms since, just like the time before Menopause. My OB suggested to remove the IUD (it's only been 6 months!) and go back on 200mg. My worry is this: wouldn't i start bleeding again? will my lining react again, and it was a little over $2000 to get all that done. Could i not just take 200mg and keep the IUD? I am trying hard to research this topic. there is very little info out there. Thank you so much for reading this."   This episode is packed with valuable insights to help you navigate HRT options and better understand how they can complement your hormonal health, even with an IUD. If you have a question, please visit our website and click Ask the Doctor a question.   Want more insights like this?  Be sure to subscribe to our newsletter for hormone Q&As, educational guides, and real-world strategies to help you feel like yourself again—especially during perimenopause and menopause. Join the Progress Your Health Newsletter   Stay Connected Instagram: @drvalorie TikTok: @drvaloried Join the Hormone Community: Click here to subscribe   Disclaimer: All content in this blog, including text, images, audio, video, or other formats, was created for informational purposes only. This video, website, and blog aim to promote consumer/public understanding and general knowledge of various health topics. This content is not a substitute for professional medical advice, diagnosis, or treatment. Please consult your healthcare provider with any questions or concerns you may have regarding your condition before undertaking a new healthcare regimen. Never disregard professional medical advice or delay seeking it because of something you have read on this website. If your healthcare provider is not interested in d...

In this episode of the Progress Your Health Podcast, we answer another insightful question from one of our favorite listeners, Victoria. She’s curious about the effects of taking bioidentical progesterone continuously throughout the cycle during perimenopause. Specifically, Victoria wonders if taking progesterone all month long would disrupt estrogen production during the first half of the cycle. Join us as we explore the hormonal shifts in perimenopause and how continuous progesterone use might affect estrogen levels. Topics Covered in This Episode: How hormones fluctuate throughout a woman’s menstrual cycle. Do women in perimenopause still experience hormonal cycling? Key hormonal changes that occur during perimenopause. Does taking progesterone influence estrogen production? The differences between premenopause, perimenopause, and menopause hormones.   Victoria’s Question "Hi again! I submitted a question about a week ago, but I’ve been thinking about something I didn’t ask the first time. In short: if you give a perimenopausal woman progesterone during the first part of her cycle (e.g., starting a 100mg capsule on day 6), wouldn’t that dampen estrogen production in the first half of the cycle? Would this be counterproductive? Or is that dose low enough that estrogen production remains the same with or without the progesterone? Thanks so much!"   What You’ll Learn This episode is perfect for women in perimenopause or anyone curious about hormone replacement therapy. You'll gain a better understanding of: The delicate balance of estrogen and progesterone in the menstrual cycle. How perimenopause changes hormone production. Whether continuous progesterone use might be beneficial or disruptive during this transitional phase. Have a Question for Us? We’d love to hear from you! Visit our website and click on Ask the Doctor to submit your questions. Your question might be featured in a future episode! Don’t Miss an Episode Subscribe, rate, and review the Progress Your Health Podcast to stay up-to-date on the latest tips and insights for hormonal health.   Want more insights like this?  Be sure to subscribe to our newsletter for hormone Q&As, educational guides, and real-world strategies to help you feel like yourself again—especially during perimenopause and menopause. Join the Progress Your Health Newsletter   Stay Connected Instagram: @drvalorie TikTok: @drvaloried Join the Hormone Community: Click here to subscribe   Disclaimer: All content in this blog, including text, images, audio, video, or other formats, was created for informational purposes only. This video, website, and blog aim to promote consumer/public understanding and general knowledge of various health topics. This content is not a substitute for professional medical advice, diagnosis, or treatment. Please consult your healthcare provider with any questions or concerns you may have regarding your condition before undertaking a new healthcare regimen. Never disregard professional medical advice or delay seeking it because of so...

In this episode of the Progress Your Health Podcast, we dive into an important listener question from Amanda, a 57-year-old who is navigating uterine bleeding while on hormone replacement therapy (HRT). Amanda is using a transdermal estrogen cream and a separate progesterone cream but is experiencing bleeding every three weeks. She’s concerned about the safety of her uterus, the risks of endometrial hyperproliferation, and how to balance her hormones without reducing the benefits of estrogen. We explore the root causes of uterine bleeding during menopause and share practical tips for balancing estrogen and progesterone to reduce bleeding, protect the uterus, and maximize the benefits of HRT. If you’re on HRT and struggling with similar issues, this episode is packed with insights tailored for you. What You'll Learn in This Episode: What hormones can trigger bleeding during menopause How HRT supports muscles, reduces inflammation, and improves bladder control. Understanding the 12-month rule for menopause diagnosis. Comparing oral progesterone and transdermal creams: Which is best for you? What is Biest, and how do you determine the right dosing and ratios? Strategies to balance estrogen and progesterone to stop bleeding. Rhythmic vs. static HRT approaches Why This Episode is a Must-Listen Whether you’re newly navigating menopause, adjusting to HRT, or dealing with side effects like uterine bleeding, this episode provides clear, actionable advice to help you make informed decisions about your hormonal health. Amanda’s Question: "Hello, thank you for your informative content. I’m using 80:20 biest 2x a day taking off Sunday plus 30 mg transdermal progesterone for the last 6 months and am doing pretty well. My numbers look good, no breast tenderness, muscles feel better, bladder stronger etc., however, I am having light bleeding for a few days every 3 weeks or so. I’m not yet menopausal but close as before hormones I did go 5 months without a period. I want to avoid any hyperplasia and am slightly concerned however I don’t think i can lower my dose of biest without negative side effects. Any advice would be helpful! I’m 57 years old. Thank you"   If you have a question, please visit our website and click Ask the Doctor a question. Don’t forget to subscribe, rate, and review the podcast to stay updated on the latest episodes!   Want more insights like this?  Be sure to subscribe to our newsletter for hormone Q&As, educational guides, and real-world strategies to help you feel like yourself again—especially during perimenopause and menopause. Join the Progress Your Health Newsletter   Stay Connected Instagram: @drvalorie TikTok: @drvaloried Join the Hormone Community: Click here to subscribe   Disclaimer: All content in this blog, including text, images, audio, video, or other formats,was created for informational purposes only. This video, website, and blog aim topromote consumer/public understanding and general knowledge of various healthtopics. This content is not a substitute for professional medical advice, diagnosis, ortreatment. Please consult yo...

In this episode, we address a question from "Victoria" (name changed for privacy), who is experiencing prolonged bleeding while undergoing hormone replacement therapy (HRT). Victoria is in perimenopause and is taking compounded T4/T3 thyroid medication and progesterone. Despite normal test results, she often has bleeding that lasts up to 14 days, and her menstrual cycles are becoming shorter. These symptoms are quite common during perimenopause or when HRT is not properly balanced. Additionally, Victoria is dealing with joint pain and inflammation and wonders if these issues could be related to her hormones. Topics Discussed: The relationship between perimenopause and HRT Causes of prolonged periods during perimenopause Managing menopausal bleeding with HRT Understanding estrogen dominance Is estrogen therapy suitable for perimenopausal women who are still menstruating? Optimal timing for progesterone HRT: continuous vs. cyclical use The connection between hormones, inflammation, and joint pain   Victoria’s Question: "Hi! Your podcast is awesome, thanks for making it available! I turned 50 four months ago. Still menstruating monthly - every 27-28 days (with one exception - see below). Generally feeling good - no hot flashes or night sweats that I can tell, sleeping 7-9 hours a night (might wake up once or twice on occasion but generally able to go back to sleep quickly). My brain is working fairly well and my mood is good. No vaginal dryness or libido issues so far. For reference, my mum had her very last period four months after she turned 54, and she has never ever had hot flashes (in case that's useful). For the last two years I have been taking 100mg bio-identical progesterone from day 14 (sometimes I might start it on day 12 or 13 of my cycle if I feel PMS-like symptoms). I have also been taking 1,5 grain compounded thyroid for the last two years. I can honestly say the progesterone and the thyroid medication saved me from a lot of suffering I had started to experience 6 months before I started taking them: I had just turned 48 and I started to gain weight, couldn't sleep, felt depressed and brain-fogged. After starting the progesterone capsule and the compounded thyroid medication I gradually returned to feeling normal again. Lately I have even managed to lose some of the weight I put on. My issues right now: My period, although still regular, is characterized by long bleeding. I can easily bleed for up to 14 days. Granted, the bleeding will lighten up after day 5 or 6 but it will continue for at least as many days, albeit light. And to cap it all, this month I finished bleeding on day 14 and started bleeding again on day 19 (this is the first time my cycle is that short for as long as I can remember). I do yearly vaginal ultrasound - all normal. My last one was in June this year. Questions: Could I manage the bleeding by starting the progesterone earlier in my cycle? If so, on which day? Or do I need to start adding a bit of biest into my regiment? My doctor suggested that I could introduce 2.5mg biest (80/20 ratio) from day 5 to day 25 of my cycle, but I am unclear on how this could solve the bleeding issues. Lastly, I am experiencing some joint pain and joint inflammation lately, and I keep reading that this could be a (peri)menopausal symptom. Could adding a bit of biest help the joint pain? Oh, my skin is also drying up and sometimes breaking out a bit, and I guess that's also related to the change of hormones. It's the bleeding and the joint paint though that I am mostly bothered about. I already have l...

In this episode, we dive into the important topic of HRT (Hormone Replacement Therapy) dosing. Our discussion is inspired by a question from Leah, a 56-year-old listener who is healthy, fit, and navigating menopause. Leah has been experiencing significant anxiety and wonders if her current estrogen dose might be too low.  What You’ll Learn in This Episode  The difference between static vs. rhythmic HRT dosing and how they impact symptoms.  Various HRT applications, including estradiol patches, transdermal/transvaginal creams, and oral HRT options.  Key hormones involved in HRT: estradiol, estriol, testosterone, progesterone, and cortisol.  Why anxiety is a common and often overlooked symptom of menopause—and how HRT can help.    Let’s Read Leah’s Question:  "Hello there! After 6 months of deep diving I found your site! I feel like no one here in Vancouver has a full hold on how to treat me. Your information has been so invaluable, but now I’m worried I’m not being cared for properly.  I’m 56, fit, work out regularly at moderate intensity with muscle training, normal weight, healthy my entire life-no menopause issues till March.  I was a week away from a big gig and suddenly got this weird, crippling anxiety. It started with a massive hot flash upon waking one morning, then this feeling like I had just missed being in a car accident … like a fright- for no reason. It was bad enough the first week that I didn’t want to drive. It settled to about 30% and so was able to function. But it recurs at this level now and it’s been 8 months. Its the most uncomfortable feeling, and little things bring it on, like getting ready to go out and always first thing when I wake up.  I started with an obgyne who put me on .05 estradot patch with 100 mg progesterone. Hot flashes went away but nothing else. Went up to .075, no change. Also started on 2 mg testosterone ordered perivaginally.  Then I went to see a naturopath. Did a DUTCH. Test, my hormone levels looked as if I wasn’t taking anything! Also adrenals were fatigued and low cortisol.Basically everything really low but progesterone ok.  My naturopath put me on 50:50 bi-est 2.0 mg vaginally applied. Progesterone 40 mg transdermal and staying on the oral progesterone. No change after 3 weeks. I feel like I need more hormones. My naturopath says she never gives more than 3 mg testosterone because it can raise cholesterol but all the research shows 5 mg starting dose?  I also asked her about vaginal application of biest and systemic concerns and she said because it was 50:50 the estriol would help regulate the estradiol.  After listening to all your podcasts and reading your case studies, I’m feeling like there’s so much contradicting info and I don’t want to apply it vaginally. I feel like my dose is too low, did I mention in addition to this weird anxiety, I’m also getting little hot flashes again?  I want to enjoy my life and feel like me again. This ins...

In this episode, we discuss a listener’s question regarding her hormone replacement therapy, testosterone dosing, and vaginal dryness. In this podcast, we discuss: Vaginal dryness and menopause Testosterone for women Testosterone injections, pellets, and transdermal cream hormone therapy for women Estrogen, estradiol, estriol, and biest hormone treatments Hormone testing for menopause   Question:"Hi! I am 52 currently on Cypionate 200mg/1ml 0.06 injection once a week, Progesterone 200mg orally, and Biest 50:50 1mg a day. I came off of pellets to this regime now. I was doing fine until the past 3 months. I all of a sudden got back my vaginal dryness pretty bad. My testosterone had gotten pretty high 334 from my normal 219 because the compounding pharmacy gave me Depo-Testosterone instead of my normal Cypionate. I know the depo is just brand name but it really through everything off. I have stopped the depo and have been on the Cypionate now for the past month. With that said I am still having vaginal dryness. Do you think it could have been due to being Testosterone dominate? Do you think I need to up my Biest Cream? I do use and have used the Estridol vagina cream for years and it's not helping. I tried one night doing one and half pumps of my Biest cream and the next day I had more discharge. Any help is greatly appreciated!"   If you have a question, please visit our website and click Ask the Doctor a question.   Want more insights like this?  Be sure to subscribe to our newsletter for hormone Q&As, educational guides, and real-world strategies to help you feel like yourself again—especially during perimenopause and menopause. Join the Progress Your Health Newsletter   Stay Connected Instagram: @drvalorie TikTok: @drvaloried Join the Hormone Community: Click here to subscribe   Disclaimer: All content in this blog, including text, images, audio, video, or other formats, was created for informational purposes only. This video, website, and blog aim to promote consumer/public understanding and general knowledge of various health topics. This content is not a substitute for professional medical advice, diagnosis, or treatment. Please consult your healthcare provider with any questions or concerns you may have regarding your condition before undertaking a new healthcare regimen. Never disregard professional medical advice or delay seeking it because of something you have read on this website. If your healthcare provider is not interested in discussing your health concerns regarding this topic, then it is time to find a new doctor.

In this episode, we discuss a listener’s question about estrogen cream causing nausea. ‘Betty’ is a practitioner with a client that is having severe nausea as a reaction to her biest/estrogen cream. While her client has experienced much improvement with her hormone therapy, she is having a lot of issues with nausea and vomiting. In this podcast, we discuss: What types of hormone therapy can cause nausea Why is HRT causing you to feel sick Estrogen therapy for vaginal dryness Blood work for menopause Blood work for hormone levels How HRT dosing is very individualized to each person   Let’s read Betty’s question:"I have a patient with a history of hysterectomy who retains one ovary. She is currently on Biest cream 50/50, 1 mg daily. She is also on progesterone 100-200 mg orally HS. She initially did well: improved vaginal moisture, great sex and mood. Now she is experiencing debilitating N/V, which she did when taking synthetic estrogen from her gyn. Should I just have her maybe 0.5mg vaginally 3x/week? I have never had any patients experience this. BTW, she was not on progesterone when she was taking the synthetic estrogen so that's why we think it's the estrogen. Thanks."   If you have a question, please visit our website and click Ask the Doctor a question.   Want more insights like this?  Be sure to subscribe to our newsletter for hormone Q&As, educational guides, and real-world strategies to help you feel like yourself again—especially during perimenopause and menopause. Join the Progress Your Health Newsletter   Stay Connected Instagram: @drvalorie TikTok: @drvaloried Join the Hormone Community: Click here to subscribe   Disclaimer: All content in this blog, including text, images, audio, video, or other formats,was created for informational purposes only. This video, website, and blog aim topromote consumer/public understanding and general knowledge of various healthtopics. This content is not a substitute for professional medical advice, diagnosis, ortreatment. Please consult your healthcare provider with any questions or concerns youmay have regarding your condition before undertaking a new healthcare regimen.Never disregard professional medical advice or delay seeking it because of somethingyou have read on this website. If your healthcare provider is not interested indiscussing your health concerns regarding this topic, then it is time to find a new doctor.

In this episode, we discuss Connie’s question about her hormone levels in menopause. Hormone therapy should be tailored to the individual and not just blood work levels. We discuss how labwork can be important in determining hormone dosing. But it is only one part of working with hormone replacement. It is not wise to just depend on blood work to treat a client. It is taking in the whole picture, including their health history, family history, health goals and intention with hormone replacement. Blood work and lab values are an essential part of creating optimal hormone levels, but not the only consideration. We discuss: Optimal hormone levels in menopause How to tailor hormone replacement to each individual When and how to take estrogen and progesterone HRT How important is lifestyle in aging well Lifestyle changes for menopause What is HRT static dosing What is rhythmic hormone replacement therapy Connie’s Question: "Hi Dr. Maki and Dr. Davidson, Really appreciate your podcast andlisten to all of them. My age is 56 and I went on BHRT about 3 years ago, while notquite in menopause. My plan was to be proactive before the levels tanked, but it didcreate some issues with uterine buildup. That was addressed and all ok, but still tryingto find a perfect balance. I am in menopause now, based on blood levels and my goal isto be at optimum levels of hormone replacement in order to protect bones, heart andbrain. My current compounded cream of Estradiol is 1 mg and Testosterone 0.5mg.Progesterone compounded capsule is 225mg (a bit higher due to my lining build up inthe past). Last labs showed Estradiol at 51.2 and FSH at 70. Labs were run abouthalfway after applying my hrt, which I apply at night. Wanting estradiol to be higher andfsh lower and realizing blood work with creams is maybe hard to pinpoint accurately, butdo you think staying with these doses is optimal? Can the numbers get better with thesame static dosing or is this the best range I will get? Not really interested in having aperiod what with the bleeding concern before, but does it make sense to not takeprogesterone every night, maybe every other? Would that help or hinder things? Thankyou for any information!" If you have a question, please visit our website and click Ask the Doctor a question.   Want more insights like this?  Be sure to subscribe to our newsletter for hormone Q&As, educational guides, and real-world strategies to help you feel like yourself again—especially during perimenopause and menopause. Join the Progress Your Health Newsletter   Stay Connected Instagram: @drvalorie TikTok: @drvaloried Join the Hormone Community: Click here to subscribe   Disclaimer: All content in this blog, including text, images, audio, video, or other formats, was created for informational purposes only. This video, website, and blog aim to promote consumer/public understanding and general knowledge of various health topics. This content is not a substitute for professional medical advice, diagnosis, or ...

In this episode, we discuss progesterone capsules vs cream. We get many listener questions about what type of progesterone to use. Wondering should they take oral progesterone or topical cream progesterone when taking estrogen HRT. Not only is this important for symptom relief in menopause. It is also important as a healthy safety issue for women taking biest/estrogen/estradiol hormone therapy. This discussion will address: The difference between progesterone orally and cream. Different types of progesterone, such as creams, gels, troches, capsules, tablets, and sublingual. How does progesterone protect again uterine cancer when taking estrogen HRT? Progesterone capsules help with sleep. What about cream? Can progesterone cream protect the uterus when taking estradiol? Can progesterone delay periods? Can progesterone help with help with heavy periods? If you have a question, please visit our website and click Ask the Doctor a question.   Want more insights like this?  Be sure to subscribe to our newsletter for hormone Q&As, educational guides, and real-world strategies to help you feel like yourself again—especially during perimenopause and menopause. Join the Progress Your Health Newsletter   Stay Connected Instagram: @drvalorie TikTok: @drvaloried Join the Hormone Community: Click here to subscribe   Disclaimer: All content in this blog, including text, images, audio, video, or other formats, was created for informational purposes only. This video, website, and blog aim to promote consumer/public understanding and general knowledge of various health topics. This content is not a substitute for professional medical advice, diagnosis, or treatment. Please consult your healthcare provider with any questions or concerns you may have regarding your condition before undertaking a new healthcare regimen. Never disregard professional medical advice or delay seeking it because of something you have read on this website. If your healthcare provider is not interested in discussing your health concerns regarding this topic, then it is time to find a new doctor.

Our listener, Jackie, wants to know if she can take estrogen even though she is in her late 30’s and has not started menopause. She wants something to help with weight loss, hair regrowth after pregnancy, improving mood, and help with libido. In this episode, we talk about: Risks from taking estrogen before menopause When to start estrogen hormone replacement The difference between estradiol and estriol How to balance hormones in perimenopause Using testosterone therapy for women and libido DHEA and perimenopause How estrogen might not be the right fit for someone in perimenopause. What a women in perimenopause can do to help with hormone balancing. Jackie’s Question:"I am concerned that if I use estrogen cream, such as estriol, that I will gain weight and lose hair. I have seen conflicting accounts to whether this is true, and some say that it helps regrow hair and helps with weight loss. I have not started menopause yet, (I'm almost 40) and want something to help me stay youthful, lose weight and grow my hair which started thinning very badly and continues since pregnancy, help protect bone density, improve mood and memory, and get my libido back. Is estrogen cream a good fit for me? Thanks!" If you have a question, please visit our website and click Ask the Doctor a question.   Want more insights like this?  Be sure to subscribe to our newsletter for hormone Q&As, educational guides, and real-world strategies to help you feel like yourself again—especially during perimenopause and menopause. Join the Progress Your Health Newsletter   Stay Connected Instagram: @drvalorie TikTok: @drvaloried Join the Hormone Community: Click here to subscribe   Disclaimer: All content in this blog, including text, images, audio, video, or other formats, was created for informational purposes only. This video, website, and blog aim to promote consumer/public understanding and general knowledge of various health topics. This content is not a substitute for professional medical advice, diagnosis, or treatment. Please consult your healthcare provider with any questions or concerns you may have regarding your condition before undertaking a new healthcare regimen. Never disregard professional medical advice or delay seeking it because of something you have read on this website. If your healthcare provider is not interested in discussing your health concerns regarding this topic, then it is time to find a new doctor.