I always said last time I fet young was at 38. Now , ten yrs later , I realize my peri started right after 38. It was so sudden , at 40 I was feeing like 80 .After 45 I started to wish death with passion .The mental struggle was worst than the physical one. I was hating everyone , husband the most , and at 48 I started to look for a divorce lawyer. I suffered 10 yrs from 38-48 😩: suicidal depression, brain fog to embarrassment, joint pains and pain all over my body , irritability, feeling miserable low useless , angry all the time and making my husb life a hell. I’m 49 and been on HRT for 9 months and I am back to myself , all problems gone like magic , I feel betrayed my my own body , manipulated , a marionette on the strings for the past 10 yrs . And no dr would tell me I needed to fix my hormones 😩 .
Thank you for sharing! Like you I have missed that so called ‘window of opportunity’ and I worry it will make things worse 😢 I hope it doesn’t! Are you concerned at all?
Thank you for sharing your story, I can really relate to this. 😪 I am on HRT, and seeing some improvements... but still waiting to really feel myself again. How long after starting HRT did you really start to feel well again? And, are you using testosterone as part of the HRT?
I am a practicing Biote physician and your presentation is excellent. So glad you quoted actual test numbers. I check labs with each pellet dose. Agree with the testosterone values. I tell patients that I will target 100 as a minimum value. I have found about 20% of post menopausal women do better with total testosterone closer to 200. It is really gratifying to have a new patient with testosterone less than 20 and then see them 3 months later over 100 and almost a new person. I too have had a few patients refusing a lower dose of testosterone.
Caused hairloss dramatically as she raised my testosterone from 34 to 134. Massive amount of hair came out. I hope it goes back. I’m in my 60s definitely not worth it. I tend to be sent. I dropped even more weight. It does not work for me I felt fine but my level of 35 no problems no hair loss. Definitely want to the pellet. I’m going back to estradiol and oral progesterone. I was fine with that.
Gosh I wish you were my doctor! My menopause “specialist” didn’t even try to optimize my levels based on my symptoms. She wanted to go straight for the ultrasounds and the painful biopsies because I was having spotting post menopause while newly on HRT. It never occurred to her that perhaps my estrogen was too high. Just listening to videos like these help me realize that I was on the highest dose of estrogen patch available. So, Instead of starting me off at the lowest and working up, she hit me with max estrogen. So I cut my patches in half and the breast tenderness went away and so did a lot of the bloating. I’m giving myself a few months to determine if i need even less.
The problem is not having your progesterone at an appropriate level to oppose your estradiol. Estradiol makes lining grow whereas progesterone keeps it in balance and 'thins' it out. A higher dose of progesterone will help thin out your lining as well as ceasing it for a week causing a 'shed' just like our period during reproductive years. Taking half your patch means your levels won't reach minimum levels for protection against dementia, heart disease, and osteopenia. I would use the entire patch and up your P dose and use it rectally for highest absorption.
This was amazingly informative, detailed and concise. I’ve watched a few channels looking for levels for all the hormones mentioned in this single video! I have an appointment with an endocrinologist shortly so I’m going in very well informed. So grateful to you 🙏🏽❤️💕
I’ve been researching hormone replacement pellets and this is by far the best channel for concise information. I’m 73 and just diagnosed with osteoporosis and have noticed a rapid decline in my skin and muscle tone. I’m looking forward to a healthier life and more energy. Maybe I’ll get back some nice skin and bone density. Thanks for your professional/research based information.
I'm 74 and just started for the same reasons. I have already broken my right ankle twice, my right tibia and right wrist. Later I broke my left wrist. All required plates and screws to repair. Good health to you.
@@denisedecker7330 Oh my! I’m so sorry! I go for my annual bone scan and will know if all the things I’ve done over the past year have helped. Good luck to you!
@@brendafandangle I just bought this book, you might check it out. Preventing and Reversing Osteoporosis, by Alan R. Gaby M.D. - I will just say this, looking at it from a common sense perspective. If HRT can cause new bone growth (and it does), why couldn't that new growth fill in where bone had resorbed?
I am so happy I came to see you this week. Love you and your clinic staff! I just want to thank you for doing this research and then explaining it to us in a way that makes so much sense. Thank you for being an advocate for us menopausal women 🥵🙂
@@KeithFarmer-z3b What studies? If you’re going to post comments in disagreement, you have to produce evidence and more than just oppositional statements. What experience have you had with dosing patients?
@KeithFarmer-z3b as usual, a disgruntled male telling someone to _IGNORE a woman_ discussing female hormonal health issues. Sir, stick to "helping" men and over- prescribing Viagra.
Forget the levels! Treat your symptoms. I suffered from peri all of my forties and told my gyno every year and she always said “ your to young to be going through peri” your levels say your fine. Found a new gyno who specializes in menapause and now I’m educated and on HRT with no testosterone and living my best life. So treat symptoms and forget about the levels. No Dr. will ever make me fell like I’m crazy again. Advocate for yourself because your the only one that knows your body and what your feeling.
As Dr Susan Hardwick had said that in PERI-menopause, estrogen fluctuates as progesterone declines, yet estrogen is also declining slowly (which has been termed estrogen dominance, although it's not the absolute high level of estrogen) and to get a blood level test at a certian time (she says when in the video) to determine your peri stage estrogen level during your monthly cycles. So if it's overall low at that time and fsh is high at that time, then it may benefit to do hrt. I agree Yes treat symptoms first, it's our bodies telling us what we need!
I'm 47 and peri- menopausal my Testosterone levels are 430 and my Estradiol level is 281. I'm trying to fix my mojo and these results make me question if these levels have anything to do with it. I'm working off of my labs from a year ago, I am going to get my blood work done again next week. However my hair loss has decreased I am on really good vitamins however I do feel a whisker growing, only one for me that's one too many. My voice hasn't changed but my sex drive is non existent. It's like an old friend that I want back! My doctor was awful and specialized more in males then females. I'm so grateful to have found you.
If your Estradiol is too high, or too low, it will greatly lower your libido. It sounds like yours is way too high at that level. No need to have your Testosterone or Estradiol that high. Hopefully lowering it will help.
Dr.Susan thank you soooo much for this. Am 69 and was put on HRT 8.5 years. A year ago asked my PCP for a level - she said it wasn’t necessary as I was on a typical dose (and I’d been taking just half the dose originally prescribed) but she agreed and estrogen was 557. She said it was high but would be since I’m supplementing. Got a second opinion from nurse practitioner and she was aghast, said should be no more than 100, preferably 60. I’ve listened to so many podcasts but no one mentioned actual numbers and I didn’t know who to believe. I had no menopausal symptoms and was only taking for osteoporosis, and after a broken femur I got a DEXA after 7 years and it was the same, so had to be the HRT as I get little exercise. I was reluctant to go off it, but have been for a year and have been getting nervous re the bones, good to know I can keep it at 60 and still get bone protection. I feel no different on or off the hormones even with such a wide range. (NP took level after I was off awhile and it was 100) Thanks again!
@@Hibernia2324 I have thought that since mostly no one mentions levels than does it really matter? But then why would Dr. Susan agree with this NP? And seems if there are risks to estrogen than the more of it you have the greater the risk. Thanks for your input.
@@user-xs9835 I saw a doc and he agreed go back on, which I already had. I only take BIEST 1.25 progesterone 50 and testosterone 1mg. He retook labs and estrogen was up to 130, had gotten to 90 off it and suppose would have gotten lower. I’ll ask him to retake in 6 months, curious if it keeps climbing which I assume it will. Weird since that’s a low dose, but did keep my bones from getting worse over 7 years, , unless it was the strontium which I also take.
Oh my gosh!!! I have learned so much after watching 2 of your videos. Please help me, my new Dr. Has told me that she will not right me a prescription for my 12.5 estrogen (yellow) with out explanation. About me, I'm 67, I had a complete hysterectomy at age 34. Now I've had one apointment with her she did blood work. I then got a phone call about the blood work from her personal saying Stop taking your Estrogen!!! My blood work showed I have some heart damage (high enzymes) asked the person how? I've tried this in the past, and it makes me crazy and all kinds of things hot flashed, vivid nightmares, And all the other stuff associated with with draws. She just coldly stated "your too old for that !!" No I'm dealing with Anxiety Nightmares feeling like I'm gonna die With no help. I asked you how do I do this She had no answers just said you're too old to have symptoms. Please help me!!
Find a better doctor who listens to you, collaborates with you in the management of your health. It’s your body, your health and your doctor is a service provider to you. Get the right team around you. Move on from this doctor asap.
Your skin looks amazing! I wish I could see more of your skin. You look younger then 6 months ago. I just found you and only saw a video of yours from 6 months ago.
Im using testosterone cream and been feeling so much better ....its what works for the individual...also i got my blood drawn 24 hours after using my cream and testosterone at 212 free testosterone at 23 so its not true that it falls to zero an hour after using it. Also cream i feel is safer but again that's my personal preference Im 53 and feel 25
Great information! I honestly wish that those providing hormone replacement therapy were as knowledgeable and understood the nuances of the hormone ranges. Watching a video like this helps me understand better, but it's frustrating because not everybody’s on the same page. In a different video, I heard that pellets do not actually release evenly over time. Another OBGYN doctor discussed this. The company claims that they are released gradually, but they actually spike, go down again, and then go back up. Maybe this is better or worse than creams, but it's still not a consistent dispersal over time.
Excellent video! Thank you! Would love to see a video on treatments for side effects when we are on HRT (Acne with testosterone, namely), and explaining labs like SHBG, DHT, DHEA
My testosterone is at the lowest limit and I have acne. No one can say from what I have acne. I suspect prostaglandins. As when I had Covid I took one week ibuprofen and made no new acne. When I stopped it came back. It’s hard!
This was the most helpful video ever! I shared it. I'm peri and estrogen is 325 so high, breast tenderness. I tool 300mg of progesterone and tenderness is going away. I will get my t3 and testosterone checked
I am 44 years old and found out that I was post menopausal at 41. Although shocking, in hindsight, it explained a lot. I am on 0.075 estradiol patches, 200 mg of Prometrium at night, and 2 mg of compounded testosterone three times per week. I feel fantastic and would actually like to raise my estradiol level if possible, but I do see that my latest blood work came back at 416 pg/ml for total estrogens- I am not experiencing any bleeding, nor any breast tenderness, so this is odd to me considering what was said about blood levels in this video. Estradiol itself is 136 pg/ml Should I be going by total estrogens or by Estradiol? Thank you so much! I love your Content, and I wish that you were local
You're fine. You're younger. You're still use to higher estradiol. Go with how you feel. Look at your estradiol. 136 pg/mL is fine especially if you have no negative symptoms.
I’m 42 and also post menopausal levels, though I still get periods. And these levels have been for a few years- it definitely explains the struggle! I’m glad I switched doctors to someone more informed and look forward to not feeling an alien in my body anymore.
Dr. Smith, Enjoy your information, thank you. I recently discovered you. I think everyone should be treated individually. Different preferences and hormone responses to the pellets. I have taken pellets for years.. And prefer my testosterone at 500. I cannot take estrogen or progesterone as I've had a breast cancer ER+ PR+ Testosterone .. Is a game changer for me. Love your info..
My testosterone is 44, my Dr. told me its high, after listening to this video, it sounds low, which makes more sense, I am having a hard time building muscle. I walk 5 miles 3x a week and go to the gym on other days. What should say to the Dr.
I never realised I should take progesterone in the night. I have been taking it first thing in the morning since I started two days ago. No wonder I dont feel better, I feel so sleepy! Ladies, learn the lesson from me. It is so important to educate yourselves. The pharmacist where I bought my estradiol patches and promethrium told me that I should take the latter in the morning on an empty stomach and she told me to apply the patch on the upper part of my body. I told her that shouldnt the patch be done on the lower body such as my butt or abdomen. Then she went away to check and came back telling me I was right. LOL.
Oh my goodness it is so crazy how people give you misinformation ...progesterone is only absorbed when you have food in your stomach and you definitely don't want to take it during the day because it makes you sleepy -so good for you for asking! and take it at bedtime after dinner, and that way it will absorb and you will feel sleepy at the right time!!
@@drsusan Yikes. The pharmacist told me I have to take the Prometrium on an empty stomach. I did that twice the last two days in the am but after watching your video, I did not take it this morning. I will take it tonight after dinner. Good to know I actually can take with food. She is a young pharmacist and looking back, she definitely did not know what she was instructing about. Thank you Dr Susan.
Oh no! My gynae has me taking the combined oral HRT in the morning with my levothyroxine first thing in the morning on an empty stomach. Does this mean the progestin part of the pill is less or not effective?
@@dabeezkneez8716 Hi, combined oral HRT meaning? Do you take oral estrogen? That is not ideal as oral estrogen passes through the liver and it can increase the chance of blood clots. I can't remember the exact details now but I know the best is patches. About progesterone, I now have another pharmacist tell me that it has to be taken on an empty stomach without chewing at least half hour before food. It is also stated on the label on the box. Also labelled that the progesterone may affect mental alertness and coordination! I am surprised to see that. I want to take it to feel better not get extra issues! So I have written to the company that makes it to get clarification, just waiting for reply. I also notice that the progesterone gives me dizzyness few hours after taking. I experienced that few times so far.Had to lie down for a little bit to recover. Read online that it can do that. Now I will take the progesterone only before bed and avoid taking during the day.
I take oral progesterone at night just before bed.After 4 weeks I now have dizziness from the time I wake up til about noon. I can’t take that form (prometrium). I wanted a lower dose but NP said Prometrium doesn’t come any lower so I’m waiting Cor some to be compounded at 150 mg. She has me on the lowest dos of estrogen. I also take testosterone (mine was in the tank). I can’t wait to see my labs are. I take DIM as well but I am VERY sensitive to estrogen. Other than the sensitivity, I have been feeling more like myself. I wonder how long before DIM starts to snow some promise?
This is so incredibly educational! Thank you so much Dr. Susan 🙏🏻 My testosterone level is 16 including free testosterone and my GYN said it was fine in the “typical” range of 2-50. I don’t feel great and would like to explore pellets. She offered a cream which as you stated is very inconsistent. I would love to schedule an appt with you but I live in Miami, FL. Is there a an option for those of us who don’t live in Houston? 🙏🏻❤️
Hi there yes, that is a very low level of testosterone and you would feel great with it being a little bit higher. I am only licensed to practice in Texas so we'd love to see you if you want to come here or you could check out providers who offer hormone pellets on the biote.com website
Oh my gosh. So much great information. I do HRT, estradiol and progesterone. It's been a life saver. I'm going to check in to testosterone with my Dr. I cannot gain hardly any muscle from working out and have almost zero libido. Thank you!
FSH - pituitary - from brain, to stimulate estrogen production. Low 5 or lower when young fertile. When it gets higher, it will go up to try to make estrogen - when menopausal. Want it to drop by 50 percent if on estrogen. Want it to be between 40-80 if on treatment.
I use test/ cipronate 1.5ml weekly. Estrogen patch , oral progesterone. I did not have a good experience with pellets. I find the injections to be more controlled.
Hi Lynne. I hope you don’t mind me asking about the testosterone shots? This is the first I’m hearing that those as an option. Do you give yourself the shots? I’ll have to ask my dr about them too. Is it working vs pellets? Thank you.
I use pellets also but my doctor had me on way too much testosterone and I got foliculitis really bad and crazy rash and hair loss took me 3 months to figure out I was on too much mine was over 300
The BEST video I have found on this topic. So happy I came across your channel. I subscribed ASAP. I do have a question. In my recent blood work from 02-15-2024 my testosterone (shbg) is 92.7 but my "free testosterone" is 0.86. I was prescribed a compounded cream to apply to either my inner thighs or inner wrists. I am a bit confused. If I start applying this cream how will it know to increase my free testosterone (not even sure what that is) and not my overall testosterone number?
Thank you sooo much! So very thorough and informative. I now feel like I have a foundational knowledge and understanding with which to start my hrt journey 🥰💕
This was very helpful. I’ve been taking HRT for 7 years and never had my blood levels tested. I read that increasing Vitamin D can also increase testosterone levels - are higher levels of vitamin D necessary to make that happen? I also read ashwaganda supplements can increase testosterone .
I've never seen an association between vitamin D and testosterone, but I would be very important for you to check the levels of all of your hormones and your vitamins in my opinion
So informative. Thankyou. I’m on Femoston 1/10 HRT tablets here in Australia. So affordable. In perimenopause and I feel great in every way. Fixed libido too 😊
Hi. My girlfriend is in perimenopause and lost all her libido. How long did you have to be on the pellet before you saw results? She seems down as well and I’m guessing it’s because she doesn’t feel 100% like a woman because of it and feels bad she isn’t interested in me. Same as a man that needs a blue pill. I can only imagine what that feels like. Also, do you have any side affects at all? The pills are for testosterone only, right?
Great information! Thank you for empowering so many of us struggling ladies with knowledge, especially when so many doctors are staying in the dark ages of misinformation from the WHI study. I am currently on .05 Estradiol patch and would like to have my Estradiol tested. I was on low dose birth control but at 54 changed to .05 Estradiol patch twice a week and oral micronized Progesterone. It’s been over 4 months and I now have night sweats, dryness and increased joint pain. Luckily we have a local lab that allows self testing for Estradiol, but I'm not sure when to test. Does anyone have information on what day to test after applying patch? I change my patch every 84 hours at 8am on Wednesday and 8pm Saturday. Thank you in advance for any help or information!
Too much testosterone cause both of those things in a male pattern- so you can lose hair in a male pattern and grow hair in a male pattern... that would mean facial hair on the top of the lip or chin , and then losing hair at the crown
Pellets peak right after insertion, and are a risk if you don't have the right dose. Sideeffects your stuck with, if thats the case, for 3 months because you cant pull them out. Cream is a 100 time superior, imo, because you can adjust and finetune treatment on a daily basis.
@@LeighClark-zf8oi Just the normal compounded bio identical 2% or 4% testosterone cream is fine. There are indeed more receptors around the labia. Don't use the cream internally, it will burn like crazy because of its high absorption base/ liposomal. For that you MUST use the vaginal cream 0.02% or 0.2mg/ml. Which has a totally different base.
Progesterone has been a lifesaver for me. My anger and brain fog about 8-10 days or so before a cycle was due (although sometimes late in peri) was unbearable and eventually would have cost me relationships and career. Much more leveled out just taking progesterone oral at night 10 days a month when it plummets.
That’s good to hear, what mg of tablets do you take each night please ? Is it 100 or 200mg? Do you also take any estradiol with it? I have been suffering only from insomnia 😢
@@jaykaira9939 100 mg at bedtime and it does make me a little more sleepy. No estrogen for me because I have estrogen dominance (it’s still at levels of someone younger while everything else goes down) which causes the extreme anger. I will likely start testosterone soon though as that’s gone down naturally.
My experience with pellets is not as described. High high at first. Then too low at end. Surprised you didn’t mention my worst side effects with hi T. Road ragey type agitation. Not good. Once it’s in. It’s in. 2 days off of my kind of exercise. Hi cost. Prefer creams
No hair loss, no irritation or mood changes, very calm and even keel, no acne but high testosterone at 87. High insulin sensitivity. Not sure since I'm 1 year post menopause. Total testosterone and free testosterone all in the mid range. This part is consistent with your analysis. I take a DHEA supplement, though. You covered this 😮 Progesterone is low at .1 and Estradiol is less than 15. Hemoglobin A1C is 4.9 low mid-range. I fast 36 hours once per week and stopped my strength training though. Thyroid is optimal. Sleep is great. Trying to solve this.
What is the unit used to calculate the 100-150 optimal range? Does it refer to Total or Free testosterone? I want to be able to compare it to my lab results.
I found this information very helpful. I'm just starting my journey on HRT and it is so difficult finding a provider that has any knowledge about women in menopause. I've discovered that some of my symptoms are from the level of estrogen I'm on is too high. The Dr. I've been seeing increased my progesterone to reduce the symptoms. I believe he should have reduced the estrogen. I've sent him a message with that request and I'll have to see what his response is.
The 100-150 pg/ml might be incorrect, because the ref range for women 18 year old and above is 0.1 - 0.9 ng/ml Which in your case would be 100 - 900 pg/ml. Men ref range is around 2.8 - 8.0 ng/ml.
Yes, I was just looking at those number for her Testosterone. 100-150 ng/dL is what I think she should have stated not 100-150 pg/mL. That's a big difference.
Progesterone micronized in lipophilic cream gets absorbed. Saliva test is used for transdermal route for progesterone. Not blood test. Same with estradiol.
No extra estrogen for peri-menopause. B/c it's fluctuating so much. Can go from day 1- very low (hot flashes etc) to 2 weeks later - very high (breast tenderness etc)
There has been new research out American menopause society - April 2024 which is worth looking at. Most people are saying yes because of all other heath benefits.
Thank you Dr Susan for a very informative video. I am a nurse practitioner working in primary care. One of my patients who is doing HRT pellets asked me a question- her testosterone level is 215 and she feels great however she has very slight clitoral enlargement. Is this side effect permanent or can be modified with a lower dose of testosterone pellet? Or it’s irreversible? She just started this treatment 2-3 months ago and overall feels much better then before. I would greatly appreciate your response and thanks again
I feel better above 100.. But I do take iodine and that keeps breast tenderness almost Nile...and testosterone gives me energy too. She also gave me 200 mg progesterone because I was losing hair. I guess thats why I feel better with Estradiol 100..
What about the difference in levels measured via saliva vs. blood when on HRT! The numbers of very different. Saliva is preferred by many MDs...when using cream...
Dr. Susan Hardwick-Smith When you say T levels that you like being 100-150pg/ml are you taking about total T or Free T, or what? Please clarify. Thank you.
I’ve heard it’s way better to do 24 hour urine test for hormone levels instead of blood test because it fluctuates throughout the day. Also, for some of the hormones you’re not giving the units which makes a big difference if you’re talking about pico grams per millilitres or nanomoles per liter.. please advise
Could you PLEASE Do a video like this for optional levels for those of us that are still menstruating? Its so hard to find info reg HRT and hornones prior to peri or menopause but we have problems too 😓 im 36 and my testosterone, SHBG and estradiol are all too low (very very low).
Dr. Susan, are the testosterone levels you recommend (100-150 ng/dL for most) from blood draws taken 4-6 weeks after inserting the pellets? The BioTE website implies that testosterone levels will go down after 4-6 weeks: "...End organ response to testosterone remains optimal...when testosterone levels at 4-6 weeks after pellet insertion are 150-250 ng/dL. Steady state is subsequently achieved at approximately half of these levels equaling 80-120 ng/dL, which is in the physiologic to slightly supra-physiologic range..." If the levels are 100-150 at 4-6 weeks, they will then decrease to 50-75 ng/dL later in the process, and maybe that's OK?
Thank you for this brilliant video! It really opens our eyes! One question from a non-medicine person: In my blood analysis there is a testosteron number of 1.3 I can't find any unit indication. I am in postmenopause and would like to understand how to convert this number in the unit you are mentioning (pg/ml). Thanks in advance for help.
She confuses the units in this video so it's not helpful. There should absolutely be a unit associated with your number and there should also be a range.
I have a Biote pellet and my testosterone is now 365. What should I do? My provider told me that we will just adjust the dosage next time, but I am worried about side effects.
The good news is it Will wear off over time and it doesn't cause any harm to be high for a short time, but definitely was dosed way too high. I would ask them to give you about half that dose next time -that's a good example of how that dosage calculator is way too aggressive!
Hi there, what was your initial testosterone dosage? I’m experiencing the same with the levels. Thank you in advance. Also, I feel like Dr. Susan is God sent. I came across her video at my most desperate moment.
@amberdaniel6742, how did it go? Mine is around same (389) and I was told they lowered it from the model’s recommendation. I plan to wait until my next blood test before I give them the okay to do another implant. I will also ask for 1/2 the dose.😤 If not, I’m changing doctors.
I am perimenopause and would lose my mind without HRT. Are u not prescribing it to women who are peri-menopausal? I did not finish video so maybe you clear that up later.
I’m post menopausal and have been on an estradiol patch and an oral progesterone. I recently got my estradiol and progesterone back. Both were from a blood test. My estradiol is 69 pg/ml. I’m not sure how that would be converted to the ng/ml measurement. My progesterone is 2.2 ng/ml.
Hi, your information was the best I have heard from anyone. My Dr. Has me on estrogen 0.1 mg and progesterone 10 mg. Is my progesterone to low? Because you mentioned yours is 100mg. I also take ambien so sounds like mine is to low.
@@drsusan I am finding that after starting Prometrium, my sleep got worse somehow. I would wake 2-3 times a night to go to toilet. Usually just once. And I managed to get only 6 hours of sleep with that and wake wide awake. Does Progesterone cause this and does it get better? I am also taking GABA 450mg nightly prescribed by the menopause clinic. Can’t believe my sleep is so trash when both of them are meant to help sleep 😂 On the good side, I am finally feeling better regarding my stiff and achy joints 🥰 and no more dry itchy vagina!!! 👊🏻
I’m 37 & just came off of the combination birth control pill after 21 years. I was prescribed 100mg of Prometrium & my hair immediately began falling out after about 1 week of taking it. Did anyone else have this happen to them? So I discontinued it & now I’m using progesterone cream & of course it doesn’t help me with sleep at all. I’m not sure if it’s helping me at all. I was also prescribed Testosterone cream at 1/4 gram daily which is an extremely low dose but after using it for a little over a month I had grown all kinds of hair on my arms/hands & a lot of vellus hair all over the face including forehead! I was getting acne, losing hair on my hairline which is what T does. My T level was at a 6 when I began the T cream. There’s no way it was too high after only a little over a month on it. I had to discontinue it as well & I’m just suffering. How can I do this to benefit from it but not experience all the negative side effects? I’m scared to death of it now. I also do not have a provider at this moment as I’m looking for a new one. If anyone has any advice I would greatly appreciate it.
Are there ever exceptions to using creams vs pellets if you have gut issues or possible problems with absorption? Years ago I did progesterone cream at night and found it helpful but I took higher dose (maybe 2 pumps vs 1), and it would immediately help my sleep, but when I tried oral 100mg, I noticed no change. I assumed the systemic oral version just wasn’t absorbed, but sounds like my dose was just too low.. ? (AND, I think they told me to take it in the morning and I had always taken the cream before bed. Hmmm. Perhaps, mystery solved. Haha.). I had long history of progesterone deficiency, prior to menopause. Is there a upper limit? Do certain individuals ever need 300mg or more?
Do you have a view about the Wiley protocol (E&P dosed at diff levels through the month to match a natural cycle, with the intention of starting up your menses again and getting your hormones to a young healthy level). If I’m going to start BHRT it seems trying to be closest to Mother Nature would be best, rather than having the same dose every day ….
i was on est patch 1mg, my levels dropped, it didnt even go up at all, also doc only gave me 25mg prog, T 4mg cream level was very low, it didnt take either
other doc i went to had me on est 1mg pill, T injs biweekly 60mg (my voice does change, enlarge clit, hair loss, totoal T was 223. no prog, he said dont need causes cancer...omg so confused . ur thoughts?
If you have a uterus, you need at least 100 mg of progesterone a day and definitely sounds like you're getting too much testosterone. I can't talk about your particular medical case without seeing you in person but I'd love to see you if you make it to Houston!
Thank you for the great information. Wondering how you feel about the troche’s and if they are tolerated well by the liver? I am on one a day estriol 2.4mg/estradiol 0.6mg/testosterone 2mg all in one troche. I’m not sure why dr split the estriol/estradiol ? I am post menopausal age 65. And also how do you feel about testosterone in a shot form?? First I’ve heard of it is in these comments. I’ve tried pellets but looking for a less expensive way to manage my hormones with good results. Losing muscle tone and low libido are my main concerns. And I work out a lot!
You are on Biest, which is a compounded combination of 2 bioidentical estrogens. The estriol is a weaker estrogen which is shown to be protective against breast cancer and estradiol is the more potent form of estrogen. I also take Biest along with progesterone and testosterone in a troche. If you are losing muscle tone and still have low libido, your testosterone dosage should be raised and if you still have your uterus, you should also be taking progesterone.
TSH - want 1-2. Can be normal but still have low thyroid function. T4 : T3 ratio 14:1. Low thyroid - low energy, cold extremities, hair loss, changes hair, skin, nails, weight gain. *Check FREE T3 - usable, not bound to a protein. Want T3 (2 you feel horrible) (4.5 is metabolism too high - causes heart disease, osteoporosis). WANT 3-3.5!!
I like the pellets. However, if you travel for any length of time, particularly overseas, it's not like you can drop in just anywhere for a pellet refill. Where does that put you? On oral Estrodiol pills and troches until returning to your home base. It would be useful if there was a global network of provider colleagues for such purposes.
I agree that advocating for yourself is the KEY but it’s good to also know that there’s “normal” levels which is what conventional doctors use which has NOTHING to do with optimal health vs. optimal levels which is real prevention and disease control which you won’t find with a GP.
Help! I’ve been overdosed Testosterone for 2 years. Was told 200-300 optimal - BioT provider. Now have male pattern hair loss. Is this permanent? Not doing a next pellet until levels come to the 100-150 range. Very concerned.
I’m on the Biote pellets as well for estrogen and testosterone and also 100 MG’s of progesterone. My provider said they want to keep the testosterone not going over 200. He’s more conservative, but I think it depends on the provider maybe before your next pellet injection, have blood work done maybe you’ll have to skip the testosterone until it starts to come down.
Hi, can you do a video about progesterone and depression? I find that 200 causes me to feel very depressed. Just started the 100 mg but it is still not as good as without.
Should you take combination pellets testosterone and estrogen or separate pellets. Are there areas of body that are more sensitive or receptive to the pellets.
I’m curious how come you don’t mention free testosterone? Some doctors I have listened to say your total could be 200 but if you have a high SHBG it’s binding it all up or most of it and only what’s free and unbound is what’s getting into your tissues. Some women have a total of 200 testosterone with a free of 0.9..and they still have symptoms of low T. Also what I find difficult with pellets and what I see other women say is like me I’m a super fast converter so my level can go from 20 to 347 with one 100 mg testosterone pellet so if lowered to a 50 testosterone pellet now it’s barely going to last me a month and no one can afford to pay 400 dollars multiple times a year or want to be cut that many times.. that’s why I see in my hormone groups on Facebook many women prefer injections they say it keeps them even and if they need a little more they can add a little 1 week or not so much the next they like being in control. I’m just wondering how pellets would work for someone like me who goes through them super fast.. I did them in 2018 and went from total T of around 20 to 347 by my 6 week labs and I was only given a 100 Mg testosterone pellet
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I always said last time I fet young was at 38. Now , ten yrs later , I realize my peri started right after 38. It was so sudden , at 40 I was feeing like 80 .After 45 I started to wish death with passion .The mental struggle was worst than the physical one. I was hating everyone , husband the most , and at 48 I started to look for a divorce lawyer. I suffered 10 yrs from 38-48 😩: suicidal depression, brain fog to embarrassment, joint pains and pain all over my body , irritability, feeling miserable low useless , angry all the time and making my husb life a hell.
I’m 49 and been on HRT for 9 months and I am back to myself , all problems gone like magic , I feel betrayed my my own body , manipulated , a marionette on the strings for the past 10 yrs . And no dr would tell me I needed to fix my hormones 😩 .
Thank you for sharing and happy that you are better ❤️
Thank you for sharing! Like you I have missed that so called ‘window of opportunity’ and I worry it will make things worse 😢 I hope it doesn’t! Are you concerned at all?
Thank you for sharing your story, I can really relate to this. 😪 I am on HRT, and seeing some improvements... but still waiting to really feel myself again. How long after starting HRT did you really start to feel well again? And, are you using testosterone as part of the HRT?
@@sitbytheocean5998 I started feeling better in a couple of months. I take testo too.
Did your marriage survive?
I am a practicing Biote physician and your presentation is excellent. So glad you quoted actual test numbers. I check labs with each pellet dose. Agree with the testosterone values. I tell patients that I will target 100 as a minimum value. I have found about 20% of post menopausal women do better with total testosterone closer to 200. It is really gratifying to have a new patient with testosterone less than 20 and then see them 3 months later over 100 and almost a new person. I too have had a few patients refusing a lower dose of testosterone.
Thank you so much for sharing this!
Caused hairloss dramatically as she raised my testosterone from 34 to 134. Massive amount of hair came out. I hope it goes back. I’m in my 60s definitely not worth it. I tend to be sent. I dropped even more weight. It does not work for me I felt fine but my level of 35 no problems no hair loss. Definitely want to the pellet. I’m going back to estradiol and oral progesterone. I was fine with that.
Gosh I wish you were my doctor! My menopause “specialist” didn’t even try to optimize my levels based on my symptoms. She wanted to go straight for the ultrasounds and the painful biopsies because I was having spotting post menopause while newly on HRT. It never occurred to her that perhaps my estrogen was too high. Just listening to videos like these help me realize that I was on the highest dose of estrogen patch available. So, Instead of starting me off at the lowest and working up, she hit me with max estrogen. So I cut my patches in half and the breast tenderness went away and so did a lot of the bloating. I’m giving myself a few months to determine if i need even less.
What’s the highest dose that they gave you?
@@yvonnesoto5720 the highest estradiol patch is 0.1 mg which isn't high, at all.
The problem is not having your progesterone at an appropriate level to oppose your estradiol. Estradiol makes lining grow whereas progesterone keeps it in balance and 'thins' it out. A higher dose of progesterone will help thin out your lining as well as ceasing it for a week causing a 'shed' just like our period during reproductive years. Taking half your patch means your levels won't reach minimum levels for protection against dementia, heart disease, and osteopenia. I would use the entire patch and up your P dose and use it rectally for highest absorption.
This was amazingly informative, detailed and concise. I’ve watched a few channels looking for levels for all the hormones mentioned in this single video! I have an appointment with an endocrinologist shortly so I’m going in very well informed. So grateful to you 🙏🏽❤️💕
I’ve been researching hormone replacement pellets and this is by far the best channel for concise information. I’m 73 and just diagnosed with osteoporosis and have noticed a rapid decline in my skin and muscle tone. I’m looking forward to a healthier life and more energy. Maybe I’ll get back some nice skin and bone density. Thanks for your professional/research based information.
I'm 74 and just started for the same reasons. I have already broken my right ankle twice, my right tibia and right wrist. Later I broke my left wrist. All required plates and screws to repair.
Good health to you.
I had osteo. Did Prolia for awhile, Garden of life Bone system, Agical, now i'm in osteopenia making progress.
Dr. Barbie Taylor ( who I also follow and respect)said Hrt will not correct osteoporosis but prevent it. Can you confirm this please.
@@denisedecker7330 Oh my! I’m so sorry! I go for my annual bone scan and will know if all the things I’ve done over the past year have helped. Good luck to you!
@@brendafandangle I just bought this book, you might check it out. Preventing and Reversing Osteoporosis, by Alan R. Gaby M.D. - I will just say this, looking at it from a common sense perspective. If HRT can cause new bone growth (and it does), why couldn't that new growth fill in where bone had resorbed?
I am so happy I came to see you this week. Love you and your clinic staff! I just want to thank you for doing this research and then explaining it to us in a way that makes so much sense. Thank you for being an advocate for us menopausal women 🥵🙂
@@paulohlsson27what are you contributing to this topic. I’d suggest you stop these random reply’s, it’s creepy.
I’m an MD and even I learned some pearls
Ty dr. Hardwick
don't listen to her. Even her units are wrong. And there are studies showing what the minimum E2 levels should be to prevent osteoporosis.
@@KeithFarmer-z3b
What studies? If you’re going to post comments in disagreement, you have to produce evidence and more than just oppositional statements. What experience have you had with dosing patients?
@KeithFarmer-z3b
as usual, a disgruntled male telling someone to _IGNORE a woman_ discussing female hormonal health issues. Sir, stick to "helping" men and over- prescribing Viagra.
What is the name of the plant-based bioidentical testosterone that I would ask my doctor for because I don't think my doctor's have a clue.
@@KeithFarmer-z3bI read that article it's easy to find.
I so appreciate your presence and how you are educating me in a way that no one else has!
Purrrrrrfectly stated! I am tired of UTIs…having a temp yuk! Antibiotics. Yuk. Thankful for your UTI information ❤
Vaginal estrogen cream stopped my UTI's. Vaginal atrophy was my problem. I'm post menopausal.
Forget the levels! Treat your symptoms. I suffered from peri all of my forties and told my gyno every year and she always said “ your to young to be going through peri” your levels say your fine. Found a new gyno who specializes in menapause and now I’m educated and on HRT with no testosterone and living my best life. So treat symptoms and forget about the levels. No Dr. will ever make me fell like I’m crazy again. Advocate for yourself because your the only one that knows your body and what your feeling.
😊❤
As Dr Susan Hardwick had said that in PERI-menopause, estrogen fluctuates as progesterone declines, yet estrogen is also declining slowly (which has been termed estrogen dominance, although it's not the absolute high level of estrogen) and to get a blood level test at a certian time (she says when in the video) to determine your peri stage estrogen level during your monthly cycles. So if it's overall low at that time and fsh is high at that time, then it may benefit to do hrt. I agree Yes treat symptoms first, it's our bodies telling us what we need!
Yes. Key word is advocate.
Would you mind telling us what your symptoms were?
Thank you I needed to see this post cause I was about to get frustrated again.
I'm 47 and peri- menopausal my Testosterone levels are 430 and my Estradiol level is 281. I'm trying to fix my mojo and these results make me question if these levels have anything to do with it. I'm working off of my labs from a year ago, I am going to get my blood work done again next week. However my hair loss has decreased I am on really good vitamins however I do feel a whisker growing, only one for me that's one too many. My voice hasn't changed but my sex drive is non existent. It's like an old friend that I want back! My doctor was awful and specialized more in males then females. I'm so grateful to have found you.
If your Estradiol is too high, or too low, it will greatly lower your libido. It sounds like yours is way too high at that level. No need to have your Testosterone or Estradiol that high. Hopefully lowering it will help.
@@chaddavis6411 Wow so mine is too high? Thank you for your response. I'm going to see what I can do about that.
ive never seen someones test level so high to be honest.....
Very high!!! Or I’m depleted or completely in the negative!
Fantastic video. Great info! Great, clear presentation! Thank you!!!🙏
Dr.Susan thank you soooo much for this. Am 69 and was put on HRT 8.5 years. A year ago asked my PCP for a level - she said it wasn’t necessary as I was on a typical dose (and I’d been taking just half the dose originally prescribed) but she agreed and estrogen was 557. She said it was high but would be since I’m supplementing. Got a second opinion from nurse practitioner and she was aghast, said should be no more than 100, preferably 60. I’ve listened to so many podcasts but no one mentioned actual numbers and I didn’t know who to believe. I had no menopausal symptoms and was only taking for osteoporosis, and after a broken femur I got a DEXA after 7 years and it was the same, so had to be the HRT as I get little exercise. I was reluctant to go off it, but have been for a year and have been getting nervous re the bones, good to know I can keep it at 60 and still get bone protection. I feel no different on or off the hormones even with such a wide range. (NP took level after I was off awhile and it was 100) Thanks again!
There are no established levels for these hormones. No one should be aghast.
@@Hibernia2324 I have thought that since mostly no one mentions levels than does it really matter? But then why would Dr. Susan agree with this NP? And seems if there are risks to estrogen than the more of it you have the greater the risk. Thanks for your input.
@@Candleflower42 Office visit + blood work.
Science-based docs go by symptoms, which also don't correlate with low levels for everyone.
What is your daily estrogen dosage now?
@@user-xs9835 I saw a doc and he agreed go back on, which I already had. I only take BIEST 1.25 progesterone 50 and testosterone 1mg. He retook labs and estrogen was up to 130, had gotten to 90 off it and suppose would have gotten lower. I’ll ask him to retake in 6 months, curious if it keeps climbing which I assume it will. Weird since that’s a low dose, but did keep my bones from getting worse over 7 years, , unless it was the strontium which I also take.
What an amazing video. Subscribed!!!
Oh my gosh!!! I have learned so much after watching 2 of your videos. Please help me, my new Dr. Has told me that she will not right me a prescription for my 12.5 estrogen (yellow) with out explanation. About me, I'm 67, I had a complete hysterectomy at age 34. Now I've had one apointment with her she did blood work. I then got a phone call about the blood work from her personal saying Stop taking your Estrogen!!! My blood work showed I have some heart damage (high enzymes) asked the person how? I've tried this in the past, and it makes me crazy and all kinds of things hot flashed, vivid nightmares, And all the other stuff associated with with draws. She just coldly stated "your too old for
that !!" No I'm dealing with Anxiety Nightmares feeling like I'm gonna die With no help. I asked you how do I do this She had no answers just said you're too old to have symptoms. Please help me!!
Get a different doctor. Stop playing the victim and stand up for yourself!!!
Find a better doctor who listens to you, collaborates with you in the management of your health. It’s your body, your health and your doctor is a service provider to you. Get the right team around you. Move on from this doctor asap.
I don't know if you found someone good, but look for a chiropractor/functional medicine dr. THEY will help you!
You can also get the hormones you need from Alloy online. They treat menopause with doctor prescribed medicine.
What a rude disgraceful "physician". I hope you've switched and have found the help you needed since last year.
Your skin looks amazing! I wish I could see more of your skin. You look younger then 6 months ago. I just found you and only saw a video of yours from 6 months ago.
Im using testosterone cream and been feeling so much better ....its what works for the individual...also i got my blood drawn 24 hours after using my cream and testosterone at 212 free testosterone at 23 so its not true that it falls to zero an hour after using it. Also cream i feel is safer but again that's my personal preference
Im 53 and feel 25
Great information! I honestly wish that those providing hormone replacement therapy were as knowledgeable and understood the nuances of the hormone ranges. Watching a video like this helps me understand better, but it's frustrating because not everybody’s on the same page. In a different video, I heard that pellets do not actually release evenly over time. Another OBGYN doctor discussed this. The company claims that they are released gradually, but they actually spike, go down again, and then go back up. Maybe this is better or worse than creams, but it's still not a consistent dispersal over time.
Excellent video! Thank you! Would love to see a video on treatments for side effects when we are on HRT (Acne with testosterone, namely), and explaining labs like SHBG, DHT, DHEA
My testosterone is at the lowest limit and I have acne. No one can say from what I have acne. I suspect prostaglandins. As when I had Covid I took one week ibuprofen and made no new acne. When I stopped it came back. It’s hard!
This was soooo clear and helpful! Thank you!
This was the most helpful video ever! I shared it. I'm peri and estrogen is 325 so high, breast tenderness. I tool 300mg of progesterone and tenderness is going away. I will get my t3 and testosterone checked
I am 44 years old and found out that I was post menopausal at 41. Although shocking, in hindsight, it explained a lot. I am on 0.075 estradiol patches, 200 mg of Prometrium at night, and 2 mg of compounded testosterone three times per week. I feel fantastic and would actually like to raise my estradiol level if possible, but I do see that my latest blood work came back at 416 pg/ml for total estrogens- I am not experiencing any bleeding, nor any breast tenderness, so this is odd to me considering what was said about blood levels in this video. Estradiol itself is 136 pg/ml
Should I be going by total estrogens or by Estradiol? Thank you so much! I love your Content, and I wish that you were local
You're fine. You're younger. You're still use to higher estradiol. Go with how you feel. Look at your estradiol. 136 pg/mL is fine especially if you have no negative symptoms.
I’m 42 and also post menopausal levels, though I still get periods. And these levels have been for a few years- it definitely explains the struggle! I’m glad I switched doctors to someone more informed and look forward to not feeling an alien in my body anymore.
Dr. Smith,
Enjoy your information, thank you. I recently discovered you.
I think everyone should be treated individually. Different preferences and hormone responses to the pellets.
I have taken pellets for years.. And prefer my testosterone at 500. I cannot take estrogen or progesterone as I've had a breast cancer ER+ PR+
Testosterone .. Is a game changer for me. Love your info..
My testosterone is 44, my Dr. told me its high, after listening to this video, it sounds low, which makes more sense, I am having a hard time building muscle. I walk 5 miles 3x a week and go to the gym on other days. What should say to the Dr.
Awesome explanation
I never realised I should take progesterone in the night. I have been taking it first thing in the morning since I started two days ago. No wonder I dont feel better, I feel so sleepy! Ladies, learn the lesson from me. It is so important to educate yourselves. The pharmacist where I bought my estradiol patches and promethrium told me that I should take the latter in the morning on an empty stomach and she told me to apply the patch on the upper part of my body. I told her that shouldnt the patch be done on the lower body such as my butt or abdomen. Then she went away to check and came back telling me I was right. LOL.
Oh my goodness it is so crazy how people give you misinformation ...progesterone is only absorbed when you have food in your stomach and you definitely don't want to take it during the day because it makes you sleepy -so good for you for asking! and take it at bedtime after dinner, and that way it will absorb and you will feel sleepy at the right time!!
@@drsusan Yikes. The pharmacist told me I have to take the Prometrium on an empty stomach. I did that twice the last two days in the am but after watching your video, I did not take it this morning. I will take it tonight after dinner. Good to know I actually can take with food. She is a young pharmacist and looking back, she definitely did not know what she was instructing about. Thank you Dr Susan.
Oh no! My gynae has me taking the combined oral HRT in the morning with my levothyroxine first thing in the morning on an empty stomach. Does this mean the progestin part of the pill is less or not effective?
@@dabeezkneez8716 Hi, combined oral HRT meaning? Do you take oral estrogen? That is not ideal as oral estrogen passes through the liver and it can increase the chance of blood clots. I can't remember the exact details now but I know the best is patches. About progesterone, I now have another pharmacist tell me that it has to be taken on an empty stomach without chewing at least half hour before food. It is also stated on the label on the box. Also labelled that the progesterone may affect mental alertness and coordination! I am surprised to see that. I want to take it to feel better not get extra issues! So I have written to the company that makes it to get clarification, just waiting for reply. I also notice that the progesterone gives me dizzyness few hours after taking. I experienced that few times so far.Had to lie down for a little bit to recover. Read online that it can do that. Now I will take the progesterone only before bed and avoid taking during the day.
I take oral progesterone at night just before bed.After 4 weeks I now have dizziness from the time I wake up til about noon. I can’t take that form (prometrium). I wanted a lower dose but NP said Prometrium doesn’t come any lower so I’m waiting Cor some to be compounded at 150 mg. She has me on the lowest dos of estrogen. I also take testosterone (mine was in the tank). I can’t wait to see my labs are. I take DIM as well but I am VERY sensitive to estrogen. Other than the sensitivity, I have been feeling more like myself. I wonder how long before DIM starts to snow some promise?
This is so incredibly educational! Thank you so much Dr. Susan 🙏🏻 My testosterone level is 16 including free testosterone and my GYN said it was fine in the “typical” range of 2-50. I don’t feel great and would like to explore pellets. She offered a cream which as you stated is very inconsistent. I would love to schedule an appt with you but I live in Miami, FL. Is there a an option for those of us who don’t live in Houston? 🙏🏻❤️
Hi there yes, that is a very low level of testosterone and you would feel great with it being a little bit higher. I am only licensed to practice in Texas so we'd love to see you if you want to come here or you could check out providers who offer hormone pellets on the biote.com website
Very good!I love your videos.
My T level was non-detectable before taking the gel. I'm now at 82. The levels my practitioner used showed normal ranging from 40-120
What a great informative video! Thank You! Learned a bunch.
Oh my gosh. So much great information. I do HRT, estradiol and progesterone. It's been a life saver. I'm going to check in to testosterone with my Dr. I cannot gain hardly any muscle from working out and have almost zero libido. Thank you!
Look into dhea and ashwagandah as well.
@@ctdali Not sure I would take DHEA while simultaneously taking estradiol as DHEA converts to both Testosterone and estradiol.
FSH - pituitary - from brain, to stimulate estrogen production. Low 5 or lower when young fertile. When it gets higher, it will go up to try to make estrogen - when menopausal. Want it to drop by 50 percent if on estrogen. Want it to be between 40-80 if on treatment.
So much information!! Thank u
Thank you for this video. It really went in depth and helped me to understand more of the changes I'm experiencing.
I use test/ cipronate 1.5ml weekly. Estrogen patch , oral progesterone. I did not have a good experience with pellets. I find the injections to be more controlled.
Hi Lynne. I hope you don’t mind me asking about the testosterone shots? This is the first I’m hearing that those as an option. Do you give yourself the shots? I’ll have to ask my dr about them too. Is it working vs pellets? Thank you.
I use pellets also but my doctor had me on way too much testosterone and I got foliculitis really bad and crazy rash and hair loss took me 3 months to figure out I was on too much mine was over 300
Thank you for the amazing detailed and clear information.
The BEST video I have found on this topic. So happy I came across your channel. I subscribed ASAP. I do have a question. In my recent blood work from 02-15-2024 my testosterone (shbg) is 92.7 but my "free testosterone" is 0.86. I was prescribed a compounded cream to apply to either my inner thighs or inner wrists. I am a bit confused. If I start applying this cream how will it know to increase my free testosterone (not even sure what that is) and not my overall testosterone number?
Thank you sooo much! So very thorough and informative. I now feel like I have a foundational knowledge and understanding with which to start my hrt journey 🥰💕
Can you educate the doctors?
This was very helpful. I’ve been taking HRT for 7 years and never had my blood levels tested. I read that increasing Vitamin D can also increase testosterone levels - are higher levels of vitamin D necessary to make that happen? I also read ashwaganda supplements can increase testosterone .
I've never seen an association between vitamin D and testosterone, but I would be very important for you to check the levels of all of your hormones and your vitamins in my opinion
@@drsusanm
So informative. Thankyou. I’m on Femoston 1/10 HRT tablets here in Australia. So affordable. In perimenopause and I feel great in every way. Fixed libido too 😊
Hi. My girlfriend is in perimenopause and lost all her libido. How long did you have to be on the pellet before you saw results? She seems down as well and I’m guessing it’s because she doesn’t feel 100% like a woman because of it and feels bad she isn’t interested in me. Same as a man that needs a blue pill. I can only imagine what that feels like. Also, do you have any side affects at all? The pills are for testosterone only, right?
Great information! Thank you for empowering so many of us struggling ladies with knowledge, especially when so many doctors are staying in the dark ages of misinformation from the WHI study. I am currently on .05 Estradiol patch and would like to have my Estradiol tested. I was on low dose birth control but at 54 changed to .05 Estradiol patch twice a week and oral micronized Progesterone. It’s been over 4 months and I now have night sweats, dryness and increased joint pain. Luckily we have a local lab that allows self testing for Estradiol, but I'm not sure when to test. Does anyone have information on what day to test after applying patch? I change my patch every 84 hours at 8am on Wednesday and 8pm Saturday. Thank you in advance for any help or information!
What about taking DHEA supplement?😊
I feel best with my T around 400. No SE
Please explain how too much testosterone can cause hair growth AND hair loss? Thx
Too much testosterone cause both of those things in a male pattern- so you can lose hair in a male pattern and grow hair in a male pattern... that would mean facial hair on the top of the lip or chin , and then losing hair at the crown
Hair loss on head, hair growth on face and arms etc
@@drsusanwhat is the name of the plant-based bio-identical testosterone tablet
Pellets peak right after insertion, and are a risk if you don't have the right dose.
Sideeffects your stuck with, if thats the case, for 3 months because you cant pull them out.
Cream is a 100 time superior, imo, because you can adjust and finetune treatment on a daily basis.
Is that what you’re currently using? How long you been on it? I’m considering cream.
Labial cream (mucous membranes) seems to be better absorbed than cream applied to the skin.
@@LeighClark-zf8oi The main thing is, you need liposomal cream and find the most thin skin on your body and apply it.
@@LeighClark-zf8oi Just the normal compounded bio identical 2% or 4% testosterone cream is fine.
There are indeed more receptors around the labia. Don't use the cream internally, it will burn like crazy because of its high absorption base/ liposomal. For that you MUST use the vaginal cream 0.02% or 0.2mg/ml. Which has a totally different base.
Progesterone has been a lifesaver for me. My anger and brain fog about 8-10 days or so before a cycle was due (although sometimes late in peri) was unbearable and eventually would have cost me relationships and career. Much more leveled out just taking progesterone oral at night 10 days a month when it plummets.
That’s good to hear, what mg of tablets do you take each night please ? Is it 100 or 200mg? Do you also take any estradiol with it? I have been suffering only from insomnia 😢
@@jaykaira9939 100 mg at bedtime and it does make me a little more sleepy. No estrogen for me because I have estrogen dominance (it’s still at levels of someone younger while everything else goes down) which causes the extreme anger. I will likely start testosterone soon though as that’s gone down naturally.
My experience with pellets is not as described. High high at first. Then too low at end. Surprised you didn’t mention my worst side effects with hi T. Road ragey type agitation. Not good. Once it’s in. It’s in. 2 days off of my kind of exercise. Hi cost. Prefer creams
Your pellets were not dosed right obviously
No hair loss, no irritation or mood changes, very calm and even keel, no acne but high testosterone at 87. High insulin sensitivity. Not sure since I'm 1 year post menopause. Total testosterone and free testosterone all in the mid range. This part is consistent with your analysis. I take a DHEA supplement, though. You covered this 😮 Progesterone is low at .1 and Estradiol is less than 15. Hemoglobin A1C is 4.9 low mid-range. I fast 36 hours once per week and stopped my strength training though. Thyroid is optimal. Sleep is great. Trying to solve this.
Dhea increases your testosterone,also estrogen..❤
The pellet stacking makes so much sense , thank you.
Have you been checked for ovarian cysts?
@@amymasreliez8957 DHEA increases testosterone.
What is the unit used to calculate the 100-150 optimal range? Does it refer to Total or Free testosterone? I want to be able to compare it to my lab results.
Crazy that nobody answered this
The screen showed 100 - 150 pg/ml
Really appreciate your information. Never heard it before.
I found this information very helpful. I'm just starting my journey on HRT and it is so difficult finding a provider that has any knowledge about women in menopause. I've discovered that some of my symptoms are from the level of estrogen I'm on is too high. The Dr. I've been seeing increased my progesterone to reduce the symptoms. I believe he should have reduced the estrogen. I've sent him a message with that request and I'll have to see what his response is.
Thank you for all this wisdom. You mentioned an enzyme that helps with T3 conversion. What enzyme is this?? Thank you
Loved this video!! Thanks so much! ❤
The 100-150 pg/ml might be incorrect, because the ref range for women 18 year old and above is 0.1 - 0.9 ng/ml
Which in your case would be 100 - 900 pg/ml.
Men ref range is around 2.8 - 8.0 ng/ml.
Yes, I was just looking at those number for her Testosterone. 100-150 ng/dL is what I think she should have stated not 100-150 pg/mL. That's a big difference.
When I was in peri, progesterone cream was very helpful. In meno, I had to switch to prometrium.
Progesterone micronized in lipophilic cream gets absorbed.
Saliva test is used for transdermal route for progesterone. Not blood test. Same with estradiol.
No extra estrogen for peri-menopause. B/c it's fluctuating so much. Can go from day 1- very low (hot flashes etc) to 2 weeks later - very high (breast tenderness etc)
I'm Very happy to have found this video. My question is whether I should be taking the Progesterone with no uterus. Thank you.
She said you can in another video. Taken at night only for sleep 😊
There has been new research out American menopause society - April 2024 which is worth looking at. Most people are saying yes because of all other heath benefits.
Thank you Dr Susan for a very informative video. I am a nurse practitioner working in primary care. One of my patients who is doing HRT pellets asked me a question- her testosterone level is 215 and she feels great however she has very slight clitoral enlargement. Is this side effect permanent or can be modified with a lower dose of testosterone pellet? Or it’s irreversible? She just started this treatment 2-3 months ago and overall feels much better then before. I would greatly appreciate your response and thanks again
Do thyroid hormones affect estrogen, testosterone levels and vice versa? I recently started taking thyroid meds and have been on HRT for 20 years.
Dr. Susan can you do a video for perimenopausal women who have lots of horrible symptoms and want to do HRT in order to be symptom free?
There's a video on my channel you can watch to learn all about perimenopause and HRT th-cam.com/video/24V352fnFog/w-d-xo.html
@@drsusan 27:43
I feel better above 100.. But I do take iodine and that keeps breast tenderness almost Nile...and testosterone gives me energy too. She also gave me 200 mg progesterone because I was losing hair. I guess thats why I feel better with Estradiol 100..
What about the difference in levels measured via saliva vs. blood when on HRT! The numbers of very different. Saliva is preferred by many MDs...when using cream...
Saliva is the preferred testing methods for topical creams. Blood results are not accurate on creams
I am not a fan of creams as I mentioned, and I also think salivary testing is not necessary in my opinion. Blood levels are just fine.
I just started at 62 . Estrodiol patch .025. The cream gave me infections. Sounds funny,, but can you put the cream in other places for benifits?
Can you put estrodiol in skin like wrist?
My Wife’s (48) testosterone just tested at 17 total. Her Dr “that’s perfect”. She needs a new Dr.
My testosterone is 44 the Dr. says its too high. I may have to find another Dr.
omg she totally needs a new dr!! my level is 170 on BHRT and i feel amazing!!
@@jennysiepka9900My T is
Mine was 16 and doc said it was low!
@@bmcdonald7303I agree.
Dr. Susan Hardwick-Smith When you say T levels that you like being 100-150pg/ml are you taking about total T or Free T, or what? Please clarify. Thank you.
Cortisol - 6x in 24 hour period for cortisol curve. High in morn, low at night. Stress.
I’ve heard it’s way better to do 24 hour urine test for hormone levels instead of blood test because it fluctuates throughout the day. Also, for some of the hormones you’re not giving the units which makes a big difference if you’re talking about pico grams per millilitres or nanomoles per liter.. please advise
She has the units on the screen when she talks about it for testosterone.
Could you PLEASE Do a video like this for optional levels for those of us that are still menstruating? Its so hard to find info reg HRT and hornones prior to peri or menopause but we have problems too 😓 im 36 and my testosterone, SHBG and estradiol are all too low (very very low).
Dr. Susan, are the testosterone levels you recommend (100-150 ng/dL for most) from blood draws taken 4-6 weeks after inserting the pellets? The BioTE website implies that testosterone levels will go down after 4-6 weeks: "...End organ response to testosterone remains optimal...when testosterone levels at 4-6 weeks after pellet insertion are 150-250 ng/dL. Steady state is subsequently achieved at approximately half of these levels equaling 80-120 ng/dL, which is in the physiologic to slightly supra-physiologic range..." If the levels are 100-150 at 4-6 weeks, they will then decrease to 50-75 ng/dL later in the process, and maybe that's OK?
Biote is the worst method for testosterone replacement to many peaks and valleys. I do twice weekly injections
Thank you for this brilliant video! It really opens our eyes! One question from a non-medicine person: In my blood analysis there is a testosteron number of 1.3
I can't find any unit indication.
I am in postmenopause and would like to understand how to convert this number in the unit you are mentioning (pg/ml). Thanks in advance for help.
She confuses the units in this video so it's not helpful. There should absolutely be a unit associated with your number and there should also be a range.
Amazing video. Thank you!
I have a Biote pellet and my testosterone is now 365. What should I do? My provider told me that we will just adjust the dosage next time, but I am worried about side effects.
The good news is it Will wear off over time and it doesn't cause any harm to be high for a short time, but definitely was dosed way too high. I would ask them to give you about half that dose next time -that's a good example of how that dosage calculator is way too aggressive!
Hi there, what was your initial testosterone dosage? I’m experiencing the same with the levels. Thank you in advance. Also, I feel like Dr. Susan is God sent. I came across her video at my most desperate moment.
@amberdaniel6742, how did it go?
Mine is around same (389) and I was told they lowered it from the model’s recommendation. I plan to wait until my next blood test before I give them the okay to do another implant. I will also ask for 1/2 the dose.😤 If not, I’m changing doctors.
That was sooo helpful! 🙏🙏🙏💖
I am perimenopause and would lose my mind without HRT. Are u not prescribing it to women who are peri-menopausal? I did not finish video so maybe you clear that up later.
What about for someone with fibroids?
I’m post menopausal and have been on an estradiol patch and an oral progesterone. I recently got my estradiol and progesterone back. Both were from a blood test.
My estradiol is 69 pg/ml. I’m not sure how that would be converted to the ng/ml measurement.
My progesterone is 2.2 ng/ml.
Hi, your information was the best I have heard from anyone. My Dr. Has me on estrogen 0.1 mg and progesterone 10 mg. Is my progesterone to low? Because you mentioned yours is 100mg. I also take ambien so sounds like mine is to low.
Wow that sounds very low for the progesterone. Do you still have an uterus? 100mg is better to protect the uterus lining from problems.
If you have a uterus, you need to be on at least 100 mg of progesterone a day
@@drsusan I am finding that after starting Prometrium, my sleep got worse somehow. I would wake 2-3 times a night to go to toilet. Usually just once. And I managed to get only 6 hours of sleep with that and wake wide awake. Does Progesterone cause this and does it get better? I am also taking GABA 450mg nightly prescribed by the menopause clinic. Can’t believe my sleep is so trash when both of them are meant to help sleep 😂 On the good side, I am finally feeling better regarding my stiff and achy joints 🥰 and no more dry itchy vagina!!! 👊🏻
@@wem-c9fFor some people, GABA does the opposite effect of what it IS supposed to do (To calm you down). Stop the GABA a few days and see.
@@jennybadl7840 been off since months ago. Thank you.
I’m 37 & just came off of the combination birth control pill after 21 years. I was prescribed 100mg of Prometrium & my hair immediately began falling out after about 1 week of taking it. Did anyone else have this happen to them? So I discontinued it & now I’m using progesterone cream & of course it doesn’t help me with sleep at all. I’m not sure if it’s helping me at all. I was also prescribed Testosterone cream at 1/4 gram daily which is an extremely low dose but after using it for a little over a month I had grown all kinds of hair on my arms/hands & a lot of vellus hair all over the face including forehead! I was getting acne, losing hair on my hairline which is what T does. My T level was at a 6 when I began the T cream. There’s no way it was too high after only a little over a month on it. I had to discontinue it as well & I’m just suffering. How can I do this to benefit from it but not experience all the negative side effects? I’m scared to death of it now. I also do not have a provider at this moment as I’m looking for a new one. If anyone has any advice I would greatly appreciate it.
Are there ever exceptions to using creams vs pellets if you have gut issues or possible problems with absorption? Years ago I did progesterone cream at night and found it helpful but I took higher dose (maybe 2 pumps vs 1), and it would immediately help my sleep, but when I tried oral 100mg, I noticed no change. I assumed the systemic oral version just wasn’t absorbed, but sounds like my dose was just too low.. ? (AND, I think they told me to take it in the morning and I had always taken the cream before bed. Hmmm. Perhaps, mystery solved. Haha.). I had long history of progesterone deficiency, prior to menopause. Is there a upper limit? Do certain individuals ever need 300mg or more?
I am having the same problem right now. Pill 100mg didn't work so trying 150mg cream tomorrow. It's much more expensive though.
I take 200 progesterone. I was taking orally, but now as a suppository. Does help with sleep.
Creams can transfer to pets etc.
You said 150 pg/ml on captions. Wouldn't if be 150 ng/dc?
It's strange that you don't mention progesterone for osteoporosis prevention. I read that it activates osteoblasts that put calsium back into bone.
Do you have a view about the Wiley protocol (E&P dosed at diff levels through the month to match a natural cycle, with the intention of starting up your menses again and getting your hormones to a young healthy level). If I’m going to start BHRT it seems trying to be closest to Mother Nature would be best, rather than having the same dose every day ….
I’m in Southern California, where can I go to get this excellent care?
Look for a functional med dr
i was on est patch 1mg, my levels dropped, it didnt even go up at all, also doc only gave me 25mg prog, T 4mg cream level was very low, it didnt take either
other doc i went to had me on est 1mg pill, T injs biweekly 60mg (my voice does change, enlarge clit, hair loss, totoal T was 223. no prog, he said dont need causes cancer...omg so confused . ur thoughts?
one time tot T was 500, mayb i was tested soon after inj, i dont recall. when on T cream, it was like 19, completely nose dive
If you have a uterus, you need at least 100 mg of progesterone a day and definitely sounds like you're getting too much testosterone. I can't talk about your particular medical case without seeing you in person but I'd love to see you if you make it to Houston!
ty
what causes weight gain, not enough estradiol? mine less than 15. now takn 1mg est pill, prog 12.5 (is this too low dosage? Tot T 164, by injs?
Thank you for the great information. Wondering how you feel about the troche’s and if they are tolerated well by the liver? I am on one a day estriol 2.4mg/estradiol 0.6mg/testosterone 2mg all in one troche. I’m not sure why dr split the estriol/estradiol ? I am post menopausal age 65. And also how do you feel about testosterone in a shot form?? First I’ve heard of it is in these comments. I’ve tried pellets but looking for a less expensive way to manage my hormones with good results. Losing muscle tone and low libido are my main concerns. And I work out a lot!
Change practitioners. Mine cost about 300 including visit every three -four months.
You are on Biest, which is a compounded combination of 2 bioidentical estrogens. The estriol is a weaker estrogen which is shown to be protective against breast cancer and estradiol is the more potent form of estrogen. I also take Biest along with progesterone and testosterone in a troche. If you are losing muscle tone and still have low libido, your testosterone dosage should be raised and if you still have your uterus, you should also be taking progesterone.
TSH - want 1-2. Can be normal but still have low thyroid function. T4 : T3 ratio 14:1. Low thyroid - low energy, cold extremities, hair loss, changes hair, skin, nails, weight gain. *Check FREE T3 - usable, not bound to a protein. Want T3 (2 you feel horrible) (4.5 is metabolism too high - causes heart disease, osteoporosis). WANT 3-3.5!!
My FSH was undetectable. I’m on HRT. My hormone specialist asked me to get a refer to endo but my HMO is denying.
My hormone doctor always does periodic bloodwork on me to check my levels.
Your skin looks great buy the way.
Great info🎉
I like the pellets. However, if you travel for any length of time, particularly overseas, it's not like you can drop in just anywhere for a pellet refill. Where does that put you? On oral Estrodiol pills and troches until returning to your home base. It would be useful if there was a global network of provider colleagues for such purposes.
I agree that advocating for yourself is the KEY but it’s good to also know that there’s “normal” levels which is what conventional doctors use which has NOTHING to do with optimal health vs. optimal levels which is real prevention and disease control which you won’t find with a GP.
Excellent information …
Help! I’ve been overdosed Testosterone for 2 years. Was told 200-300 optimal - BioT provider.
Now have male pattern hair loss. Is this permanent? Not doing a next pellet until levels come to the 100-150 range. Very concerned.
I’m on the Biote pellets as well for estrogen and testosterone and also 100 MG’s of progesterone. My provider said they want to keep the testosterone not going over 200. He’s more conservative, but I think it depends on the provider maybe before your next pellet injection, have blood work done maybe you’ll have to skip the testosterone until it starts to come down.
Hi, can you do a video about progesterone and depression? I find that 200 causes me to feel very depressed. Just started the 100 mg but it is still not as good as without.
I take 400 and feel great. Dropped to 200 and dealt with depression
What do you think about Dutch testing?
I think it's expensive and unnecessary and modern blood testing can give you all the information that you need
Should you take combination pellets testosterone and estrogen or separate pellets. Are there areas of body that are more sensitive or receptive to the pellets.
They are two pellets. One in after the other, injected together.
I’m curious how come you don’t mention free testosterone? Some doctors I have listened to say your total could be 200 but if you have a high SHBG it’s binding it all up or most of it and only what’s free and unbound is what’s getting into your tissues. Some women have a total of 200 testosterone with a free of 0.9..and they still have symptoms of low T.
Also what I find difficult with pellets and what I see other women say is like me I’m a super fast converter so my level can go from 20 to 347 with one 100 mg testosterone pellet so if lowered to a 50 testosterone pellet now it’s barely going to last me a month and no one can afford to pay 400 dollars multiple times a year or want to be cut that many times.. that’s why I see in my hormone groups on Facebook many women prefer injections they say it keeps them even and if they need a little more they can add a little 1 week or not so much the next they like being in control. I’m just wondering how pellets would work for someone like me who goes through them super fast.. I did them in 2018 and went from total T of around 20 to 347 by my 6 week labs and I was only given a 100 Mg testosterone pellet
Hi jennifer. What hormone groups are you on on FB? I am also a fast converter with pellets. Have you tried the injections yet?