Progress Your Health Podcast

  Download the diagram above, click here. Tracy's Question:  Episode 052 – What Biest Ratio is Best for Menopause?  This is such helpful information. I have often wondered who 80:20 is good for and who 50:50 is good for. One thing I'm still confused by is the estrogen weight gain component. You said that estrogen (as well as menopause in general) could be the cause of her weight gain. I can relate. I was very thin my whole life, now 53 and about 30 lbs overweight. But you also said she might benefit from getting her estrogen balanced, and she was not using enough.  If too low a dose made her gain weight, won't an increased dose cause more weight gain? I have heard other podcasts and read articles that in menopause, we gain weight because our estrogen falls. Estrogen seems to be blamed for weight gain, whether it's high or low. Can you help clarify? There's something I'm not understanding. Thank you! Tracy  Short Answer:  Often estrogen has been the scapegoat for weight gain. I'm sure you have heard too much causes weight gain. Too little can pack on the pounds. It can be pretty confusing. So which is it? Is too much estrogen causing my pants to become uncomfortably tight? Or is it too little estrogen that has given me the gut I never had? Well, it's not that simple. Estrogen levels do have a hand in weight gain and weight loss. But it is not the only variable. It really is the combination of the balance of estrogen with other hormones in your body. To name a few main players, progesterone, insulin, and cortisol, as well as enzymes, lipoprotein lipase (LPL), and hormone-sensitive lipase (HSL). Okay, I know that sounds vague and doesn't answer the question. Let's back up a bit and look at what women are saying about estrogen.  As soon as menopause hits, women complain that they are instantly 15-30 lbs heavier. Not because of diet or lifestyle. It's like menopause adds an unwanted 15-30 lbs overnight. Then some women are on hormone replacement therapy, taking estrogen, and are horrified because the HRT caused them to gain 10 lbs in a month. So what is it? Did the lack of estrogen in menopause cause that 20 lb weight gain? Or did that hormone replacement estrogen create rolls that were never there? Well, actually, both are true. Before you throw out your jeans in favor of high-waisted yoga pants, let's learn about the other players in weight gain.  Progesterone will buffer estrogen. Estrogen does like to grow things'. That is why in puberty, you grow breasts and hips. Progesterone helps to balance some of the growth' that estrogen can cause. That is why in perimenopause, when the progesterone drops and the estrogen is running the show, the weight gain begins. That is also why when a woman starts estrogen therapy for menopause but not enough progesterone, there is weight gain. Cortiso

Download the diagram above, click here. Tracy’s Question: Episode 052 – What Biest Ratio is Best for Menopause? This is such helpful information. I have often wondered who 80:20 is good for and who 50:50 is good for. One thing I'm still confused by is the estrogen weight gain component. You said that estrogen […] The post Does Estrogen Cause Weight Gain? | PYHP 123 appeared first on .

  ‘Doc, I really don't feel like myself. I think it's my hormones. Could it be my hormones? Can you test my hormones?'  How many times have I heard new clients tell me this story? They go to see their GP, Gyno, or Internist, asking to have their hormones tested. Only to be told that there is no testing for hormones. Or that it's not necessary to test hormones. Only to leave feeling dismissed, with no answers to why they do not feel well. While I understand that your GP, Gynocologist, and Primary Care Physician are not the jack of all trades,' there are many tests for hormones. There are blood tests, urinary testing, and even saliva testing. The more difficult part of hormone testing is the interpretation. The basic lab values assigned by the labs are very vast, and without experience and training, it can be quite difficult to determine if there is a hormone imbalance.  If you are feeling like you have a hormone imbalance or having symptoms concerning your hormones, below is a list of common hormones to be tested and why. Because blood lab testing is so popular, I am going to stick to blood testing. Later we will have more labs and interpretations for urine and saliva.  To start, blood testing is just a look at one moment in time with respect to your hormone levels. In a menstruating woman, her hormone levels are changing every day. But in a menopausal woman where the ovarian function has ceased, her hormone levels are going to be pretty level day to day. So in a female that is still having her period, I like to try and aim for getting the blood drawn around day 12 and/or day 21. In a 28-day cycle, the estrogen will surge around day 12, and the progesterone will surge on day 21. This can give us better insight into her levels of progesterone and estrogen. In a menopausal woman that has not had a period or has sporadic periods with common menopausal symptoms, I will have her draw her blood any time of the month.  FSH and LH: FSH stands for follicle-stimulating hormone, and LH stands for luteinizing hormone. These are not actually hormones. They are stimulating hormones.' Meaning both the FSH and LH are released from the pituitary gland (in your brain) in response to estrogen and progesterone production. The FSH and LH work in what is called a negative feedback loop.' Meaning if the levels of estrogen and progesterone are high, then the FSH and LH are low. In turn, if the estrogen and progesterone levels are low, then the FSH and LH are high. It is like when you want your husband to take out the garbage. If he doesn't, you might raise your voice until he does. It is the same with all stimulating hormones. If the ovarian production of hormones is low, as in menopause or perimenopause, the FSH and LH levels will look high.  Estradiol and Progesterone: Always test estradiol to get specific results for estrogen levels. Estradiol is much more specific for estrogen levels than simple total estrogens. Ideally, in a menstruating woman having the blood test around day 21 will give you insight if that woman is ovulating. It will so give you insight if there is progesteron

  ‘Doc, I really don't feel like myself. I think it's my hormones. Could it be my hormones? Can you test my hormones?' How many times have I heard new clients tell me this story? They go to see their GP, Gyno, or Internist, asking to have their hormones tested. Only to be told that […] The post What Hormone Tests Should I Get? | PYHP 122 appeared first on .

Michelle's Question: Hi, thank you so much for sharing your knowledge with us!  In March 2022 at 42 years old, I had a total hysterectomy with bilateral salpingo-oophorectomy because of stage 4 endometriosis, grapefruit-sized fibroids, ovarian cysts, and my left ovary adhered to my colon.   I was immediately put on an estradiol patch.  I was recovering and doing well until the beginning of June.  Then I started having hot flashes, 24/7 anxiety, insomnia, and not feeling well every day.   Since March, my dosage has gone from .25, .5, .75, and 1 mg.  But I saw no improvement in my symptoms and have said this was the worse summer of my life.   I am debilitated by it.  After much research, I decided to try bio-identical creams that have estriol, estradiol, progesterone, pregnenolone, and DHEA.   Even though I no longer have a uterus, I know that my body is used to having these hormones and am hoping they help me get through this surgical menopause and be able to function again.  Is this a combo hormone protocol you've ever done for your patients?   If so, should I apply estriol and estradiol in the morning, and progesterone, pregnenolone, and DHEA at night? Short Answer:  Surgical menopause is much different from what you could call your typical menopause. Honestly, there is nothing typical about menopause. Some women breeze through menopause and others have symptoms so severe it can seriously affect their quality of life, not to mention the people around them. And I (Dr. Davidson) can say this honestly, being just shy of 50 and feeling the effects of menopause. But being that I am a hormone doctor, I have some advantages to easing my transition. This is why we do what we do, here at Progress Your Health Inc. We know that hormone imbalance can alter how you feel. From your energy to your sleep, to your libido (or lack of) and more. Hormones can even affect your actual overall health. Menopause is when the ovaries naturally start to decline and then cease producing hormones. Those hormones in particular are estrogen (estradiol) and progesterone. Menopause is a natural part of life. Those ovaries have worked well for a long time and are ready to retire, naturally so. Making that transi

Michelle’s Question: Hi, thank you so much for sharing your knowledge with us! In March 2022 at 42 years old, I had a total hysterectomy with bilateral salpingo-oophorectomy because of stage 4 endometriosis, grapefruit-sized fibroids, ovarian cysts, and my left ovary adhered to my colon. I was immediately put on an estradiol patch. I was […] The post Is Surgical Menopause Worse Than Natural Menopause? | PYHP 121 appeared first on .

Laura's Questions: I am on 25 mcg of Levothyroxine for 6 yrs with hypo symptoms, every one! My endocrinologist just took a panel, and the results are the following:  TSH 2.36 uUI/mL        Reference Range = 0.45 to 4.5 uUI/mL  Free T4 1.1 ng/dL         Reference Range = 0.82 to 1.77 ng/dL  Free T3 2.9 pg/mL       Reference Range = 2.0 to 4.4 pg/mL Should we up my dose of Levothyroxine to 50 or should I just switch to Synthroid or Armour? Thanks! Short Answer: We typically don't recommend or prescribe Levothyroxine or Synthroid for our patients. Both of these medications only contain the T4 hormone. This is referred to as T4 Monotherapy. These medications do a good job of lowering the TSH level but do not always help the patient feel better. We like to prescribe thyroid medication that contains both the T4 and T3 hormones. In our experience, our patients tend to feel much better on a combination medication, rather than on a T4-only medication. In our opinion, we feel that sustained-release compounded thyroid medication is the best option most of the time. This type of thyroid medication gives the doctor many dosing options, which is certainly good for the patient and their overall symptom profile. Because this medication is compounded, the T4 and T3 hormones can be changed independently of the other hormone. With a commercial prescription, there are only so many dosing options, and both hormones are affected when raising or lowering the dosage. Also, the sustained-released nature of the medication helps to reduce any unwanted side effects that are common with commercial instant-release thyroid medications. Related Podcast Episode:  PYHP Episode 038 –  Do You Have a Low Free T3 Level?  Check out Dr. Davidson's new book – The Perimenopause Plan Buy the book on Amazon. If you have questions about your thyroid or any other hormone related issue, feel free to contact us. The post Is Armour Thyroid Better Than Levothyroxine? | PYHP 120 appeared first on .

Laura’s Questions: I am on 25 mcg of Levothyroxine for 6 yrs with hypo symptoms, every one! My endocrinologist just took a panel, and the results are the following: TSH 2.36 uUI/mL Reference Range = 0.45 to 4.5 uUI/mL Free T4 1.1 ng/dL Reference Range = 0.82 to 1.77 […] The post Is Armour Thyroid Better Than Levothyroxine? | PYHP 120 appeared first on .

Patient Question: Why am I getting acne in my 40s? Short Answer: Women's hormones are always changing. From puberty to middle age, to when the ovaries cease producing hormones in menopause. When we hit our 40s, our progesterone starts to decline. And our estrogen levels drop slightly as well. But the androgens, which are testosterone and DHEA do not decline. That means that there is less progesterone and estrogen to buffer the effects of the androgens. Testosterone and DHEA are great, useful hormones for a female's body. They help with muscle mass, motivation, ambition, libido, bone density, and stress management to name a few. But in our 40s when estrogen and progesterone start to decline that makes the androgens the ‘leaders of the hormonal pack.' There is no buffer against the negative side effects of androgens. One being, acne. Women in their 40s are usually still getting a period and cycling. So that means that the breakouts and acne are worse anywhere from 7-14 days before their period. That is because women really only make progesterone in the last half of their cycle. Those days being days 14-28.  Because of the decline of progesterone, acne can be quite prominent before a period. But because the estrogen may have declined a bit in our 40s, we are still apt to have breakouts all month long. Because acne in the 40s is from the unopposed androgens, the acne is mostly on the chin and jawline. Although the neck and back are also common in a lot of women in their 40s. And the breakouts are more cystic in nature. They are deep and hard to “pop” (which we all know we should never ever do, and yes, I can't help it either). And cystic acne lasts for weeks. So when one cystic pimple is starting to heal, aggravatingly three more show up. It is very frustrating. In addition too unbalanced androgens, stress, and cortisol levels can exacerbate acne. Women in their 40s are busy. There are family commitments, work, home life, and trying to stay fit is certainly not as easy as it was in our 20 and 30s. Plus the drop in progesterone and estrogen lets the androgens (testosterone and DHEA) make us feel more easily ‘testy.' The stress and unbalanced hormones cause cortisol levels to rise. Which unfortunately also makes the breakouts worse. We really like to use Acnutrol and Inflammatone to help with breakouts. Below are some other episodes where we discuss other issues related to Perimenopause.

Patient Question: Why am I getting acne in my 40s? Short Answer: Women’s hormones are always changing. From puberty to middle age, to when the ovaries cease producing hormones in menopause. When we hit our 40s, our progesterone starts to decline. And our estrogen levels drop slightly as well. But the androgens, which are testosterone and […] The post Why Am I Getting Acne In My 40s? | PYHP 119 appeared first on .

  Listener's Question: Hello, recently my Nurse Practitioner recommended that I should start taking progesterone because she mentioned that I was estrogen dominant. I don't have any real symptoms, so just want to make sure if I even need to take the progesterone. Thanks. Short Answer: If you don't have any direct symptoms, then progesterone would not be necessary. We prescribe progesterone to women of all ages, but usually, they have a symptom profile that justifies the prescription. It is not likely for a woman to be truly estrogen dominant without any noticeable symptoms (fibroids, endometriosis, heavy bleeding, etc). If a cycling woman does her blood work around day 12 of her cycle. The estradiol will be higher, and the progesterone level will typically be less than one (

  Listener’s Question: Hello, recently my Nurse Practitioner recommended that I should start taking progesterone because she mentioned that I was estrogen dominant. I don’t have any real symptoms, so just want to make sure if I even need to take the progesterone. Thanks. Short Answer: If you don’t have any direct symptoms, then progesterone would […] The post When Should A Woman Take Progesterone? | PYHP 118 appeared first on .

                  Sarah's Question: Hi I was diagnosed with ovarian failure at the age of 36. Its been 4 years now, I have been to a few different clinics, trying to figure out what works best for myself. Right now I am using estrogen patches, which do seem to work well, and Prometrium. My main problem that I still face is lack of sleep. The estrogen patches help my mood and sleep some but I have tried a few different progesterone creams and pills, and have not found any improvement in sleep from it. I am wondering what is the brand name of the slow release progesterone you described. Thanks Short Answer:  We almost always use bioidentical sustained-release progesterone from a compounding pharmacy. A typical dose we like to start with for sleep is 100 mg. The commercial form of progesterone available at big box pharmacies is Prometrium, which is an instant release. However, in a situation like Sarah's being diagnosed with Ovarian Failure at 36, we would consider prescribing Rhythmic Dosing to restore her hormones to physiologic levels. This type of dosing protocol is intended to initiate a period in a menopausal woman that still has a uterus. If Sarah still has a uterus, she would also resume menstruating on a monthly basis. Estrogen is what makes a woman a woman. In many cases, the more estrogen a woman has, the better she will feel. The better she will sleep. For more information, below is another episode we did explaining the rationale and how Rhythmic Dosing works. Episode 91: How to Cycle Bioidentical Hormones? One of the best pharmacies we work with for Rhythmic Dosing is Harbor Compounding Pharmacy, located in Costa Mesa, CA. They are PCAB Certified and are currently licensed in 32 states. Feel free to contact us if you have more questions regarding Ovarian Failure or Rhythmic Dosing. The post Can Ovarian Failure Be Treated? | PYHP 117 appeared first on .

                  Sarah's Question: Hi I was diagnosed with ovarian failure at the age of 36. Its been 4 years now, I have been to a few different clinics, trying to figure out what works best for myself. Right now I am using estrogen patches, which do seem […] The post Can Ovarian Failure Be Treated? | PYHP 117 appeared first on .

Megan's Question:  This was great information. I have been 130lbs until I turned 48. Now up to 157. Weight gain all in my stomach, legs, arms, boobs and butt. I have still been working out intensely with weights and cardio and no weight loss . After listening to this is sounds like I should do […]

                      Megan’s Question: This was great information. I have been 130lbs until I turned 48. Now up to 157. Weight gain all in my stomach, legs, arms, boobs and butt. I have still been working out intensely with weights and cardio and no weight loss […] The post How Do I Stop Weight Gain During Perimenopause? | PYHP 116 appeared first on .

Question: I am forty-six years old and a 34A. Now, I'm a 34BC. My breasts hurt at least two weeks out of the month. Swollen, heavy, painful, have to take ibuprofen. It's annoying as hell and it's changed how I view my body. Not to mention, my midsection has changed too. I never wanted large breasts. I know BC cup is not large, but it is to me. And now I need to wear two sports bras to run. And I like to run all the time. And I feel like I did when I was nursing. This totally stinks. Does it get better?  Short Answer: During a woman's 40's, there are many hormonal changes that are happening, which lead to a wide variety of symptoms. Progesterone is declining, and estrogen is still being produced and stress levels can be all over the place. These changes can lead to many unwanted symptoms. Breast tenderness and an increase in cup size is generally related to too little progesterone and proportionally too much estrogen. There is not necessarily an increased amount of estrogen production, but really just a lack of progesterone that leads to many of the symptoms of Perimenopause. PYHP 115 Full Transcript; Download PYHP 115 Transcript Dr. Maki: Hello everyone, thank you for joining us for another episode of the Progress Your Health Podcast. I'm Dr. Maki. Dr. Davidson: And I'm Dr. Davidson. Dr. Maki: So we're back, we're back in the saddle do another podcast. Dr. Davidson: We sure are. Dr. Maki: It's been a little while. We haven't posted any for a little while. We apologize for that. But we've been very busy. We got a new puppy. Dr. Davidson: We did get a new puppy, a poodle puppy. Dr. Maki: Alright. So we've talked about Bob, our little co-pilot. He is having a little bit of a crisis. He's kind of having a crisis with the new puppy. About one minute, it was really funny, we brought her into her first grooming sessions placed here in town called Bailey's and she looked like a little bit of a shaggy mess. And then they just really didn't do much because this is her first one. She's only like four weeks old and she came back from the groomer with a nice blowout. She got her hair done. And Bob was all interested and her name is Vivi, Vivian, one of my relatives. Bob's named after my dad, and Vivi, our new poodle is named after another relative. She was technically my great aunt, but more like my grandmother. So it's Bob and Vivi. She came back from that groomer, a grooming session. And Bob was, he was very… he changed his

Question: I am forty-six years old and a 34A. Now, I’m a 34BC. My breasts hurt at least two weeks out of the month. Swollen, heavy, painful, have to take ibuprofen. It’s annoying as hell and it’s changed how I view my body. Not to mention, my midsection has changed too. I never wanted large […] The post Why Do Breasts Grow During Perimenopause? | PYHP 115 appeared first on .

Patient Question: A patient in her later 40's, who is having a tough time with perimenopausal symptoms, recently asked me which is worse, perimenopause or menopause? Short Answer: After dealing with many patients over the years, it is clear that both Perimenopause and Menopause are difficult and the symptoms can have a significant impact on a women's quality of life. However, there are better treatment options for menopause then for perimenopause. PYHP 114 Full Transcript: Download PYHP 114 Transcript  Dr. Maki: Hello, everyone. Thank you for joining us for another episode of the Progress Your Health Podcast. I'm Dr. Maki. Dr. Davidson: And I'm Dr. Davidson. Dr. Maki: So this morning, we're just going to kind of sort of a question, but this was not actually one that someone answered on the website or wrote to us. This is actually from a patient that I recently saw. She's 46, which is kind of a- I'm sure you would agree, it's kind of like a very common age for our new patients. She's kind of miserable at the moment, has a lot going on, and just does not feel very good. And she actually asked me the question because she hears horror stories about menopause, but she's feeling pretty rotten right now. So she asked the question, “Which is worse, perimenopause or menopause?” So I thought that was a very nice way for us to do an episode around that. Dr. Davidson: Exactly, because we see this all the time, you know, a lot of menopausal females, perimenopause. And sometimes, we kind of overlook a little bit of the differences between the two and how people feel because, you know, everyone's different. Dr. Maki: Yeah. Now, honestly, this is the reason why we're doing the podcast in the first place, because when it comes to some of these female hormone issues in general whether it's PMS, PCOS, perimenopause, menopause, the conventional treatments and approaches are just not very good. Women are kind of left to their own devices. They're not really given a lot of options. We've kind of figured that out over the years, right? There's this big gap in the problems that women are experiencing. Before, it used to be just, “Well, that's just aging and you just have to deal with it.” I don't think that's really acceptable, really, in the 21st century. Dr. Davidson: I think some people still hear that, you know, “It's okay. That's just getting older.” Dr. Maki: Well, yeah. That's easy for the practitioner to say when they're not the o

Patient Question: A patient in her later 40’s, who is having a tough time with perimenopausal symptoms, recently asked me which is worse, perimenopause or menopause? Short Answer: After dealing with many patients over the years, it is clear that both Perimenopause and Menopause are difficult and the symptoms can have a significant impact on a […] The post Which is Worse, Perimenopause or Menopause? | PYHP 114 appeared first on .

Kathy's Question: I tried progesterone 100 mg pill. I felt dizzy and felt like I could not stand upright. Does a cream have the same side effect? I was also prescribed an estrogen patch. Short Question: It is certainly possible that progesterone can cause someone to feel dizzy. It is often prescribed to help with sleep issues and anxiety, but some women claim to feel dizzy or “weird” after taking it. In our experience, this is more common with Prometrium, which is an instant-release form of progesterone. Bioidentical, sustained-release progesterone can still cause some of the same side effects but is typically much better tolerated. Progesterone cream usually does not cause some of the same side effects but is not effective for insomnia or anxiety. There is some research to suggest that progesterone is a vasodilator. This effect could lower blood pressure, which could make someone feel dizzy after taking. PYHP 113 Full Transcript:  Download PYHP 113 Transcript Dr. Maki: Hello everyone. Thank you for joining us for another episode of the Progressional Podcast. I'm Dr. Maki. Dr. Davidson: And I'm Dr. Davidson. Dr. Maki: So, again, we have another question. This one's from Kathy. So, again, in the future, for those of you that are new to the podcast, hopefully we're getting lots of new listeners all the time. If you are an avid listener, you like what we have to say, please give us a review on whatever platform. We are on all the major platforms. I still haven't added our podcast yet, or I have had it added to an Audible or Amazon Music, but that's on the list which I think is cool. But we're on iTunes. We're on Stitcher. We're on Spotify. We're on iHeartRadio. We're on all those different podcast platforms. So, please give us a review. That'd be really nice. So, this question is from Kathy. Once you dive in and give it a whirl. Dr. Davidson: Sure. We always change everybody's name. We always say that on every podcast too. And these questions come from podcast listeners, and also from our website, from our blogs too. Kathy doesn't say on here whether she got this from the podcaster or from reading one of the articles or one of the blog's. So, this is from “Kathy”. I tried progesterone 100mg pill. I felt dizzy and felt like I could not stand upright. Does a cream have the same side effect? I was also prescribed in estrogen patch. Dr. Maki: Yeah, so there's a lot. This is a really simple question, which is nice. Right? It's just a couple of questions and it's fairly similar. We've done a bunch on progesterone. But this one adds a little bit of a different element with the progesterone patch or the estrogen patch. She doesn't specify, but I would assume that if she's getting the estrogen patch, that means she's getting prometrium. We could probably make that as… Would that be a fair assumption to make? Dr. Davidson: Yes, like you said, this is a short question. It seems simple, but it I like it because we can really

Kathy’s Question: I tried progesterone 100 mg pill. I felt dizzy and felt like I could not stand upright. Does a cream have the same side effect? I was also prescribed an estrogen patch. Short Question: It is certainly possible that progesterone can cause someone to feel dizzy. It is often prescribed to help with sleep […] The post Can Progesterone Cause Dizziness? | PYHP 113 appeared first on Progress Your Health.

Danielle's Question: So, Thank you for this article. I'm having side effects from taking 200 milligrams of oral progesterone. I take forever to wake up and feel really, really groggy. I read where you said that take it early and when I take it early and out in an hour, I can barely keep my eyes open and feel drunk or drugged. So, I usually take it in half an hour before bed. I sleep like a rock but have a hard time coming to the next day. I'm a lightweight when it comes to any medication and always thought that might be due to being clean and sober for 32 years, but I might be wrong. I'm probably just sensitive. So, should I try a hundred milligrams of oral progesterone or change it to a compound? Because currently, I am taking Prometrium. I really love the solid sleep, but it takes hours to wear off in the morning and it seems like I'm just so tired. But I do take thyroid medication and I do have low morning cortisol and take some adrenal glandular as well. So, thank you so much in advance. Short Answer: The commercially available form of progesterone is called Prometrium. It is an instant-release medication and comes in two doses of 100 mg and 200 mg. In our experience with patients, they tend to be strong for women and not well tolerated. It is not surprising that 200 mg is causing next-day fatigue. We typically prescribe 100 mg of bioidentical, sustained-release progesterone. Some women are still sensitive but is usually very well tolerated. PYHP 112 Full Transcript:  Download PYHP 112 Transcript Dr. Maki: Hello everyone. Thank you for joining us for another episode of the Progress Your Health Podcast, I'm Dr. Maki. Dr. Davidson: And I'm Dr. Davidson. Dr. Maki: So this morning we're going to just kind of dive right in. Of course, as we always do we have a lot of listener questions. So, for the future or for those that are listening, if you're new to the podcast you can always send us an e-mail at help@progressyourhealth.com, help@progressyourhealth.com. That is if you want to keep it somewhat private and discreet. We always change everybody's name. So, there's no question about who is sending in the question. You know, we do get sometimes some sensitive female issues. And I'm sure people wouldn't want that to be kind of public knowledge. So, like I said, we do try to protect everybody's privacy as much as possible and we love the questions because that means we know people are listening. And you know, it gives us kind of an unlimited amount of topics that we can discuss in the podcast. So, Dr. Davidson won't you just kind of dive in and let's go through Danielle's question. Dr. Davidson: Sure. Sure. So this question is from Danielle, but just on a quick little side note is we love all the questions. So, if you have any concerns, please write into us. But at the same time if it's maybe not exactly like a lot of the questions were doing or pertaining to. You can probably hear our little pup in the background. He always gets a little more, I don't know. When we do the podcast he gets a little more rambunctious or something.

Danielle’s Question: So, Thank you for this article. I’m having side effects from taking 200 milligrams of oral progesterone. I take forever to wake up and feel really, really groggy. I read where you said that take it early and when I take it early and out in an hour, I can barely keep my […] The post Can 200 mg Prometrium Make You Tired? | PYHP 112 appeared first on Progress Your Health.

Amanda's Question: I'm 41. I have regular periods every 35 days. I have some anxiety, tiredness, stress, but I do work a lot. I don't have trouble sleeping, but my doctor checked my serum progesterone level, and at day 21, it was .5. She said it was low. She had prescribed me oral 200 milligrams a day of compounded progesterone. I work at a job that requires 24-hour shifts twice a week. I'm trying to verse myself in information about this replacement therapy and if this is the right way for me to take progesterone therapy. She told me to just not take it on the days that I work, but I'm concerned with things that I read about replacement therapy and increased mood issues and anxiety. I don't think I could deal with those any worse than I have than what I have. Can you please tell me if I'm on the right path as I'm scared to begin this therapy? Thanks, Amanda. Short Answer: When women enter their early to mid 40's, they typically stop ovulating, but continue to have periods. This lack of ovulation usually causes a significant drop in progesterone levels and can lead to many unwanted symptoms of perimenopause. Taking oral, bioidentical, sustained-release progesterone is a simple, but effective way to help deal with many of the unwanted symptoms. We typically start a patient on 100 mg of sustained-release Progesterone and they can increase to 200 mg later if needed. Some women may even need to cycle the progesterone dose. For example, taking 100 mg (1 capsule) from Day 1 to Day 13 of the cycle and then increase to 200 mg (2 capsules), from Day 14 back to the period. PYHP 111 Full Transcript: Download PYHP 111 Transcript Dr. Maki: Hello everyone. Thank you for joining us for another episode of the Progress You Health podcast. I'm Dr. Maki. Dr. Davidson: And I'm Dr. Davidson. Dr. Maki: We mentioned in the last couple of times on the podcast, you actually have a book coming out, The Perimenopause Plan. It should be out probably within the next, I would say, probably the next couple of weeks to the next month or so. Dr. Davidson: Depending on when we post this podcast. It's all written. It's just having a little bit of issue trying to make it look pretty- the design process. Dr. Maki: Yeah. It should be fun. We're excited about. It's going to be published in Amazon as an e-book. Perimenopause is something that we deal with all the time and it was definitely a- I know you like to write. You've always been the writer. That's always been your forte for the most part so we're definitely excited about that. We'll keep you up to date on that. Now, diving in, we have again more questions. We just have lots and lots of them. So, hopefully, if everyone keeps sending us emails with their questions that I'm assuming that the questions that we're answering, people are finding some value or enjoying the questions because we just keep getting more of those. So, hopefully, it's not getting stale or we don't want to be boring

Amanda’s Question: I’m 41. I have regular periods every 35 days. I have some anxiety, tiredness, stress, but I do work a lot. I don’t have trouble sleeping, but my doctor checked my serum progesterone level, and at day 21, it was .5. She said it was low. She had prescribed me oral 200 milligrams […] The post Does Progesterone Help With Perimenopause? | PYHP 111 appeared first on Progress Your Health.

Tammy's Question: Hi. Recently, I read your article about estriol. I'm currently using a Biest Progesterone Vaginal Cream, but it's compounded, and it's expensive. I could use an estradiol patch and Prometrium and this therapy could be much more affordable. Would I expect a big change in that? Short Answer: First off, we don't recommend using Biest for vaginal use. We use Estriol only for vaginal use, especially if a woman still has a uterus to minimize any spotting or bleeding issues. Switching to an Estradiol Patch and Prometrium will not produce the same results, and could cause some unwanted side effects. Using Estriol is best for vaginal dryness and pain with intercourse. For more information: read the article about the difference between Biest vs Estradiol. PYHP 110 Full Transcript:  Download PYHP 110 Transcript Dr. Maki: Hello, everyone. Thank you for joining us in another episode of the Progress Your Health Podcast. I'm Dr. Maki. Dr. Davidson: And I'm Dr. Davidson. Dr. Maki: So we're back in the swing of things. We're just going to dive right back in. Now, this time, we have a question from Tammy. This is relatively pretty short, but you and I have actually had a couple of recent experiences with the estradiol patch. Let's just dive right in, and why don't you go ahead and read the question. Dr. Davidson: Like we've said in our other podcast, we want to say that we always change everybody's names. We get lots of email questions from people, so we're really trying to get to as many of them as we can. So we really love that you are sending in those questions, but know that we do change any personal information and all that jazz. Okay. So this one is from “Tammy”. Hi. Recently, I read your article about estriol. I'm currently using a Biest Progesterone Vaginal Cream, but it's compounded, and it's expensive. I could use an estradiol patch and prometrium and this therapy could be much more affordable. Would I expect a big change in that? Dr. Maki: Yeah, right. So her question, she's using right now a compounded by Biest Progesterone Vaginal Cream which based on our last episode and we are not sure about the Biest Vaginal part. We'll segue back into that a little bit just as a refresher. So her question is, can she switch completely the types of prescriptions to the estradiol patch, also called the Vivelle patch? Dr. Davidson: Or CombiPatch. There are a few different names. Now, they have the generic. So Vivelle was around, but now they have generic. So just estradiol patch. Dr. Maki: They are all still basically estradiol. It comes in a couple of different which seems like – and this is what we're going to talk about – which seems like a relatively low dose .025, .05, .075, and then, of course, Prometrium. Prometrium is commercially available progesterone, instant release progesterone. That's something key that we'll get to in a second. So tell me your thoughts, Dr. Davidson. Dr. Davidson: Well, she's using it as a vaginal cream and she's using a Biest. We don̵

Tammy’s Question: Hi. Recently, I read your article about estriol. I’m currently using a Biest Progesterone Vaginal Cream, but it’s compounded, and it’s expensive. I could use an estradiol patch and Prometrium and this therapy could be much more affordable. Would I expect a big change in that? Short Answer: First off, we don’t recommend using […] The post Biest vs Estradiol Patch for Vaginal Dryness | PYHP 110 appeared first on Progress Your Health.

Kate's Question: Hi, I've been doing extensive research and I came across your site. I don't know if you're still responding to email questions or not, but I thought I'd give it a try. I just completed my first year of no periods. Dryness, I have the beginning of atrophy, is really my only issue. But I was given 50/50 ratio Biest, one gram a day. I do that vaginally as an insertion for two weeks, and then I reduce it to two times a week after that. I don't do any progesterone, but this is what my experience has been. After the first full week, I started bleeding. After the second week, it became heavier bleeding. So then they put me on it for a third week and I was supposed to drop down my Biest 50/50, but I continued bleeding. So, I do feel great. And now it's week four, and the bleeding is starting to taper and I'm loving this but worried about the bleeding. So just wondering your about your thoughts. Thank you, Kate. Short Answer: With our patients, we don't use Estradiol vagainlly in order to minimize any unwanted spotting or bleeding. We only use Estriol for vaginal use as it is a “weaker” hormone and less likely to cause any bleeding issues. PYHP 109 Full Transcript:  Download PYHP 109 Transcript Dr. Maki: Hello everyone, thank you for joining us for another episode of the Progress Your Health Podcast. I'm Dr. Maki… Dr. Davidson: And I'm Dr. Davidson. Dr. Maki: So we have a lot of questions to do. We have, it seems like we just keep getting more and more and more. So we really apologize that we're not able to keep up with is as many of them as they keep coming. I think it's a good thing. Alright, we have an unlimited amount of content to talk about. We are gonna dive in. This is Kate's question. We are changing everybody's name just to keep it, you know, just to keep it you know. So no one's, there's no identifying information. So if you did submit a question, we might have answered it or we were probably going to answer it but the name might be different so you might have to actually pay extra attention to the podcast. So Dr. Davidson won't you go ahead and we'll just dive in. Dr. Davidson: All right, let's dive in. So this question is from Kate. So, ‘Hi, I've been doing extensive research and I came across your site. I don't know if you're still responding to email questions or not, but I thought I'd give it a try,' and this is why we do get a lot of email questions. We get a lot of, lot of questions on the website, but we want to do them for everybody to listen because it actually all this really applies to a lot of people. So, okay, just to continue with Kate here, ‘So I just completely…' Dr. Maki: Oh sorry, that's the copilot. Our co-host Bob is playing with his antlers, deer antlers. So sorry about that. Dr. Davidson: And he loves to talk and make lots of noise.

Kate’s Question: Hi, I’ve been doing extensive research and I came across your site. I don’t know if you’re still responding to email questions or not, but I thought I’d give it a try. I just completed my first year of no periods. Dryness, I have the beginning of atrophy, is really my only issue. […] The post Does Estradiol Work for Vaginal Dryness? | PYHP 109 appeared first on Progress Your Health.

Anne's Question: Since moving to the high desert, I have to use very large doses of Bio HRT or bioidentical hormone cream, and it is still not getting blood levels up to where my doctor would like. I tried switching to the patch and the level dropped to less than half. This is all giving me terrible symptoms and impacting my quality of life. I am worried the high doses are harming me somehow. Can I just rub some DMSO on the skin prior to applying the cream or will that help? Short Answer: This is somewhat of a complicated question to answer because it is based on the type of BHRT a woman is using. We do have different blood level targets for women using static dosing vs women who are using rhythmic dosing. When prescribing BHRT for a patient, we have some very general blood levels that we are trying to reach, but the woman's subjective response is a much better indicator for dosing. How she feels is much more important than her blood level of Estradiol. In regards to DMSO, we don't typically use or recommend this for women, but we do add DMSO to testosterone cream for men because they have more body hair. PYHP 108 Full Transcript:  Download PYHP 108 Transcript Dr. Maki: Hello, everyone. Thanks for joining us for another episode of the Progress Your Health Podcast. I am Dr. Maki. Dr. Davidson: And I am Dr. Davidson. Dr. Maki: Of course, this is audio so nobody can see anything but you and I are getting ready and we were having a little problem with our boom mic stand. It was not sitting at the table. You are getting a little impatient with me and then you end up fixing it which was great. As we are just starting, our dog, Bob is at my feet right now and he is upside down, chewing on like a little bone. Dr. Davidson: It is so cute. It is so cute. Dr. Maki: I am trying to stay focused on doing the podcast and he is upside down with a little bone in his mouth. It is too cute. We are back into podcasting land. We have a ton of questions to get to. We are just going to do it. I think we kind of for a while we were kind of doing a few questions per episode. I think it is a little bit better, a little more focus by doing just one question per episode. It is also easier to figure out a title for it, that is more specific to what the question is about. This one is from Anne. So why not you go ahead and read the question. Dr. Davidson: Now he just got up and you shake it around. All right. This question is from Anne. Of course like we always say, we change everybody's names and any kind of pertinent information just for privacy protection. We kind of renamed her Anne. From Anne. Since moving to the high desert, I have to use very large doses of Bio HRT or bioidentical hormone cream, and it is still not getting blood levels up to where my doctor would like. I tried switching to the patch and the level dropped to less than half. This is all giving me terrible symptoms and impacting my quality of life. I am worried the high doses are harming me somehow. Can I just rub some DMSO on the skin prior to applying the cream or will that help? Dr. Maki: Yeah. This comes up a lot, people are worried about absorption. DMSO is one of the rhythmic dosing protocols we use for men. We do add… The compounding pharmacy we use doe

Anne’s Question: Since moving to the high desert, I have to use very large doses of Bio HRT or bioidentical hormone cream, and it is still not getting blood levels up to where my doctor would like. I tried switching to the patch and the level dropped to less than half. This is all giving […] The post What Should Estradiol Level Be On BHRT? | PYHP 108 appeared first on Progress Your Health.

Carrie's Question: I am currently taking, .25ml's Biest which is 1.25mg, 70/30 ratio per gram. I apply it to the labia and vaginal area at night, every night. About how long do I have to wait for it to absorb before having intercourse? I am getting conflicting reports. My doctor says I do not have to wait at all, as it will not affect my husband but the pharmacist says, it will affect my husband and not have sex for several hours after application. Thank you. Short Answer: Carrie is taking a very low dose of Biest. However, she is applying the estrogen cream vaginally, so in theory, her partner could absorb some estrogen during intercourse, but Carrie's applied dose is only about .30 mg. This small amount of Biest is barely enough to affect Carrie, let alone her husband. If the male partner is worried about the estrogen, simply skip applying the cream until after intercourse. If the Biest cream is being used to help with pain and discomfort during intercourse apply about an hour or so before activity. For vaginal use, we typically only recommend Estriol cream and not Biest, which has both Estradiol and Estriol. PYHP 107 Full Transcript: Download PYHP 107 Transcript Dr. Maki: Hello everyone. Thank you for joining us for another episode of the Progressional Podcast. I am Dr. Maki. Dr. Davidson: And I am Dr. Davidson. Dr. Maki: Well again, we are trying to do our best to get back in the swing of things back in podcasting land. It actually feels pretty good. On the last podcast, we talked a little bit about the book that you have coming out. I would just mention it real fast up for perimenopause plans, going to be available on Amazon. We will keep you up to date when that comes out. If you have any questions, just in general. You can always send us an email at help@progressionhealth.com. We are going to do another question today again because we took some time off over the summer. We got a whole slew of questions for us to do, this one does come up quite often. Why do not we just dive into it? This question is from Carrie. Dr. Davidson: We always change everybody's names and personal information just for privacy, but this is a really good question. We are going to break it up a little bit, give the general answer to it. And then I am going to get probably a little nitpicky on it because I like the math part. But, this is from Carrie. “I am currently taking, .25ml's biased[?] which is 1.25mg, 70/30 ratio per gram. I apply it to the labia and vaginal area at night, every night. About how long do I have to wait for it to absorb before having intercourse? I am getting conflicting reports. My doctor says I do not have to wait at all, is it will not affect my husband but the pharmacist says, it will. And she capitalizes ‘WILL', which will affect my husband and not have sex for several hours after application.” Thank you. She is wondering which way should she go? Dr. Maki: This one comes up a lot and I guarantee you that the husband is worried about the estrogen, right? Men are always worried about little estrogen, It is probably more of his concern, he is more of, what about that estrogen? He does not want to grow boobs or something. To be honest, every man is worried about that, but I do not think it is really that big of a deal. She might not want to apply it vaginally and hav

Carrie’s Question: I am currently taking, .25ml’s Biest which is 1.25mg, 70/30 ratio per gram. I apply it to the labia and vaginal area at night, every night. About how long do I have to wait for it to absorb before having intercourse? I am getting conflicting reports. My doctor says I do not have […] The post Does Estrogen Cream Affect Male Partner? | PYHP 107 appeared first on Progress Your Health.

Joy's Question: Is the Vivelle patch good to use? My gyno prescribed it for hot flashes, vaginal burning, vaginal itching, and mood issues during ovulation before my period. I have not tried it yet, though. Short Answer: Some women do fine with the Vivelle patch. However, in our experience, many women do not tolerate the patch very well, or it does not provide full relief of menopausal symptoms. The key to this question is the fact that Joy was prescribed the patch, but is still having a regular period. We don't agree with using the patch for women who are still menstruating. There are some better options that we discuss in this episode. PYHP 106 Full Transcript Download PYHP 106 Transcript Dr. Maki: Hello, everyone. Thank you for joining us for another episode of the Progress Your Health podcast. I am Dr. Maki. Dr. Davidson: And I am Dr. Davidson. Dr. Maki: Well, we are back. It has been a little bit of a hiatus. We had a really amazing summer, right? You know, summer is always a fun time. So we took a little bit of time off on the podcast, but now the weather has changed a little bit. We are into fall, the perfect time to kind of get back into the podcasting routine. Dr. Davidson: Definitely. Ready to hit the ground running. Although fall was really beautiful here with the leaves changing. So yeah, it is good. I am definitely ready to get back into the podcasting seat. Dr. Maki: For some reason, when it was really nice out and the sun was shining every day, it was really difficult to come and sit down and do a podcast. It was really challenging, but nonetheless, we kind of decided ahead of time that we were going to do that anyways. But now we have lots of questions that people have reached out to us with. So we have just a tremendous– [laughter] in some ways, we probably should not have taken that time off because now we have so much work to do, but this is good. These are legitimate questions that people are asking us, and we feel that without coming up with topics of our own, this makes it so relevant when people ask us question because we get to hear our listeners. We get to hear our readers for the blog post. We get to hear what problems they are actually dealing with. And I think that is really valuable because now we have a chance to sit down, kind of discuss them, give everybody our opinion. So that one person really is helping a lot of people because now we are giving our answer to that very specific question to lots and lots of people. Dr. Davidson: Exactly. When you write in or email us with your question, know that you are not alone. The question you have, trust me, we have heard it over and over and over again so it is really great to get it from a reader or listener's perspective, and then when we can apply it to the masses, it helps everyone. Dr. Maki: Yeah, right. So we are going to dive in this question. Now, we are changing everybody's name just to keep it so there is no question about identity or anything like that. So the name that we are going to give is not the actual name of the person, but nonetheless– Dr. Davidson: Just for protection, anything that looks like it would be something that– we would just change even if it is descriptions

Joy’s Question: Is the Vivelle patch good to use? My gyno prescribed it for hot flashes, vaginal burning, vaginal itching, and mood issues during ovulation before my period. I have not tried it yet, though. Short Answer: Some women do fine with the Vivelle patch. However, in our experience, many women do not tolerate the patch […] The post Is an Estrogen Patch Good to Use? | PYHP 106 appeared first on Progress Your Health.

Mary's Question: I am 58 years old and lost my thyroid to cancer eight years ago. I am finding it impossible to lose weight and have thinning hair near my hairline and no eyebrows. I started Bi-est cream, 50/50 ratio, 2.5 milligrams; progesterone, a 175 milligrams; and testosterone, 1 mg. About a year ago, it was lower doses and then went up to those as recently my doctor had me using it twice a day, the cream, and then the progesterone, one pill at night, because my levels have shown that my progesterone is 7, estradiol less than 5, – that means it is not even in the bloodstream – free testosterone is 1.2, total testosterone is 6 . I am so afraid I am going to gain weight more or more hair loss from some of the things I have read. Please give me your opinion. I also take Tirosint and Cytomel for my thyroid. Do I have to worry about any medication interactions? Please help. Mary. Short Answer: Typically, bioidentical hormone replacement therapy (BHRT) is not going to cause consistent weight gain. When starting BHRT, there might be slight water retention, but should not lead to consistent weight gain over time. If weight gain continues once on BHRT, pay attention to insulin status and stress level. For more information on our approach, you can download our Keto Carb Cycling Program. PYHP 105 Full Transcript:  Download PYHP 105 Transcript Dr. Maki: Hello, everyone. Thank you for joining us for another episode of Progres Your Health Podcast. I am Dr. Maki. Dr. Davidson: And I am Dr. Davidson. Dr. Maki: So what are we going to do later today? Dr. Davidson: I do not know. Hopefully, get to go, maybe, for a hike or a long walk. Dr. Maki: Yeah. Weather is good. It is August in Western Washington. Beautiful. It does not get too hot here. You know, we still have some patience in the Southwest. When I am getting ready to talk to them I look at the weather app and I see those triple digits: hundred and five, hundred and nine, hundred and ten and I have to say, it makes me cringe a little bit. Dr. Davidson: I remember living in the Southwest and, August, I could not wait for August to be over with, like, come on, let us get to September. Let us get to the middle of September. And now I am like, I just want August to last forever. Please go slow go slow. [laughs] Dr. Maki: Yeah. It is amazing how much of a contrast in you and I in the summertime. So June, July, August– it seems like, in the Southwest, Labor Day is when everything starts to change. You can feel it. Like you wake up one of those mornings and it is like, “Oh, okay. Summer is just– Dr. Davidson: It is still pretty warm, but at least you are on the tail end. Dr. Maki: Yeah, but you can start to feel like it starts to, you know, you get rid of some of those hundred and ten degree days and it will be in the upper 90s, maybe a hundred, and then it starts to gradually trickle down. But I remember you and I used to

Mary’s Question: I am 58 years old and lost my thyroid to cancer eight years ago. I am finding it impossible to lose weight and have thinning hair near my hairline and no eyebrows. I started Bi-est cream, 50/50 ratio, 2.5 milligrams; progesterone, a 175 milligrams; and testosterone, 1 mg. About a year ago, it […] The post Can BHRT Cause Weight Gain? | PYHP 105 appeared first on Progress Your Health.

Monica's Question: Hi, I have been prescribed testosterone cream and I have been advised to apply it to my inner thigh. I was wondering, in doing so, will this reverse the results of my laser hair removal on my bikini line? As per you stated that someone had a similar experience to this. Should I apply it there or should I apply in another area? Thank you.  Short Answer: Applying testosterone cream to the mid-inner thigh should not affect the bikini line. However, the hair in the area of where the testosterone cream is applied will get darker. There is no real way to avoid the hair from darkening. Switching thighs can help, but it will probably still darken in both areas. PYHP 104 Full Transcript:  Download PYHP 104 Transcript Dr. Maki: Hello, everyone. Thank you for joining us for another episode of the Progress Your Health podcast. I am Dr. Maki. Dr. Davidson: And I am Dr. Davidson.  Dr. Maki: So summer is moving along very quickly I cannot even believe it is almost the middle of August already.  Dr. Davidson: I know summertime is so fun in Washington.  Dr. Maki: We have got rain in the last couple of mornings which actually has been– We had quite a bit of rain in June at least it seemed like July was really nice and now the last couple mornings we had a really nice stretch with no rain at all. And now it was kind of nice actually with a little bit of drizzle in the morning. We have got this jungle in the back of our house. I know that you kind of went back there with little clippers and trying to– We have this little trail that leads up to another trail and you are back there a couple of days ago trying to clean up the trail.  Dr. Davidson: Exactly. We have a beautiful trail up there and it is funny because I always laugh with my patients that summertime. It is almost, even though it is beautiful, it seems like it is harder to exercise and eat well because it is almost like you are just having too much summertime fun. Where the holidays, you can be a little bit more diligent because the holidays are one day but it seems like summertime fun. So we have been trying to rain it in and do some more exercise and eating a little cleaner

Monica’s Question: Hi, I have been prescribed testosterone cream and I have been advised to apply it to my inner thigh. I was wondering, in doing so, will this reverse the results of my laser hair removal on my bikini line? As per you stated that someone had a similar experience to this. Should I […] The post Where Do I Apply Testosterone Cream As A Woman? | PYHP 104 appeared first on Progress Your Health.

Mary's Question: Hi. I just started estriol cream a couple of weeks ago. I am fifty-three years old and have been told I have PCOS for the past twenty years with a history of absent periods, heavy facial hair growth, and moodiness, and PMS. I have managed my PCOS through diet change, supplementation, and exercise. And I am told I am quite healthy. I began taking the estriol cream for bladder urgency and frequency and for the mucous membrane support for vaginal dryness. Sex had become very painful. I am experiencing some really wonderful positive benefits from the estriol. And in some ways, I realize I have probably been short of this for many many years likely due to the malfunctioning of my ovaries with the PCOS. The skin over my shinbones that has always been flaky no matter how much I moisturize, now, is soft, smooth, and supple for the first time in many years. The skin on my elbows, knees, and heels is softening. And it seems to have helped my skin tremendously. Even my facial hair is coming in much lighter. It seems to be reducing my belly fat in some ways. It is kind of a miracle. And I wish I had known about this years ago. The possible deal-breaker here is that I have become so painfully constipated over the past few weeks. And the estriol cream is the only thing that has changed. I also take bioidentical progesterone in a troche form which I have been taking for about ten years without a problem. The estriol is the only thing that has changed. The only time I can remember being this consistently constipated over a long period of time was during my two pregnancies. Any thoughts? Short Answer: For constipation, the common advice is to drink more water and eat more fiber. However, for some, this does not work. It may seem strange to think that bioidentical hormones could impact digestion, but it is certainly possible for either progesterone or estrogen to cause someone to become constipated. We look at constipation as being a liver issue. Taking hormones can put a slightly extra burden on the detoxification capacity of the liver, which can slow down digestion. PYHP 103 Full Transcript:  Download PYHP 103 Transcript Dr. Maki: Hello, everyone. Thank you for joining us for another episode of the Progress Your Health Podcast. I am Dr. Maki. Dr. Davidson: And I am Dr. Davidson.  Dr. Maki: So how is your summer going?  Dr. Davidson: My summer is going great, although it is already August. So I feel like it is almost over.  Dr. Maki: Yes. 2020 has been such a roller coaster. But yes. Weather is good. We are surviving everything.  Dr. Davidson: How is your summer going?  Dr. Maki: Well, it is a rhetorical question, because I know exactly how your summer has been, because mine has been pretty much the same as yours. So I cannot complain. But you are right. It is going by way too fast. I cannot believe it is already August. But we still have a couple of months of nic

Mary’s Question: Hi. I just started estriol cream a couple of weeks ago. I am fifty-three years old and have been told I have PCOS for the past twenty years with a history of absent periods, heavy facial hair growth, and moodiness, and PMS. I have managed my PCOS through diet change, supplementation, and exercise. […] The post Can Estriol Cream Cause Constipation? | PYHP 103 appeared first on Progress Your Health.

Allison's Question: I have opened a hormone wellness practice and came across your blog. You mentioned the application of estrogen cream to the face, neck, and chest to improve skin health. From what I found, it appears that .3% Estriol and .01% Estradiol is typically used. Do you recommend a once-daily application? Can this same dose be applied to the inner and outer labia for improvement of external skin appearance as well as the vaginal entrance to improve vaginal dryness, etcetera? Thank you in advance for any feedback you can provide. Short Answer: We typically only use Estriol cream for the face and the vagina. For the face, we do recommend using estriol daily, usually as a nighttime moisturizer. As for vaginal use, we recommend daily use of estriol cream for the first 1 to 2 weeks depending on the severity of symptoms. After that, we suggest a frequency of 1 to 3 times per week. We don't use estradiol for vaginal use. The dosage of estriol we typically use for both is is 4 mg/gram, but apply 1/2 gram with each application. PYHP 102 Full Transcript:  Download PYHP 102 Transcript Dr. Maki: Hello everyone. Thank you for joining us for another episode of the Progress Your Health Podcast. I am Dr. Maki. Dr. Davidson: And I am Dr. Davidson.  Dr. Maki: So I got an email back this morning from the designer. The kind of the first draft of your book cover. It was in my inbox this morning. What do you think about that?  Dr. Davidson: I think I am nervous as heck.  Dr. Maki: It is good. There are two different versions. I like a couple of things about each one of them. I will show it to you a little bit later, but it just came in right before we sat down to do this. Got to change the color scheme a little bit but so far so good.  Dr. Davidson: All right, and the book is on perimenopause.  Dr. Maki: This is the middle of summer 2020 so hopefully this will be available on Amazon probably, I am hoping within the next month but there are some other things we want to do prior to that. Maybe by Labor Day, I am thinking and to be conservative and to give ourselves a little bit more time to make sure we have all the things that need to be working, working properly. But we will definitely keep everybody posted.

Allison’s Question: I have opened a hormone wellness practice and came across your blog. You mentioned the application of estrogen cream to the face, neck, and chest to improve skin health. From what I found, it appears that .3% Estriol and .01% Estradiol is typically used. Do you recommend a once-daily application? Can this same […] The post Can You Put Estriol Cream On Your Face? | PYHP 102 appeared first on Progress Your Health.

Question: Hello. I am forty-five, perimenopausal diagnosed by blood work. I have my uterus and I am taking 200 milligrams of bioidentical progesterone each night orally by capsule. I do not take anything else for hormone balance other than evening primrose oil and some adrenal support. Neither of these is new to my regimen. What is new is the administration of the progesterone orally. Previously, I was using a progesterone cream, 40 milligrams per night. All nights of my cycle, no break. Doc suggested that I needed to be more cyclical with my administration and then I try oral progesterone instead. I am doing this. I go to sleep well but toss and turn a bit more than I used to, then wake up around four thirty-five and cannot sleep any longer. My body temperature seems to be all over the place. At some nights around that same time, I wake up hot, not really a hot flash per se but just hot, but the very next night, I can have on the same bedclothes, sheets, house temperature, et cetera, and will not get hot. She has me doing fourteen days, fourteen to twenty-eight, taking the oral progesterone. My trouble is the fourteen days I have to wait to take it, I have all the trouble sleeping and all the other symptoms while I am waiting for that fourteenth day to come so I can take my oral progesterone. My question, can I take it full-time during my cycle and never take a break or does that go against all medical wisdom and/or would be bad for my body not to have a break? Short Answer: Based on a woman's physiology, it does make sense to only take progesterone during the second half of the month. Typically, progesterone is produced from ovulation to the period and usually peaks around day 21 of the cycle. However, many women feel better when they take oral progesterone all month long. Oral progesterone helps reduce irritability, reduces anxiousness, and can improve sleep. Because of this, we most often prescribe progesterone to be taken all month long. Sustained Release Oral Progesterone is usually very well tolerated, but sometimes it can change a woman's cycle. Based on how the cycle changes will determine if the dosage needs to be cycled or not. For example, we might prescribe 50 mg for the first half of the month and then increase to 100 mg during the 2nd half of the month. Then we have our patients stop the progesterone during menstruation. PYHP 101 Full Transcript:  Download PYHP 101 Transcript Dr. Maki: Hello, everyone. Thank you for joining us for another episode of the Prog

Question: Hello. I am forty-five, perimenopausal diagnosed by blood work. I have my uterus and I am taking 200 milligrams of bioidentical progesterone each night orally by capsule. I do not take anything else for hormone balance other than evening primrose oil and some adrenal support. Neither of these is new to my regimen. What […] The post Can I Take Progesterone All Month? PYHP 101 appeared first on Progress Your Health.

Alexis Question:  Hi there, this forum is fabulous. Thank you. I am so confused with dosing. How much is one gram of Biet in mL – milliliters. So confusing. I use a one mL syringe. One mL is a lot of cream. It is an eighty-twenty ratio and I will split the dose. Reading that your recommended starting dose is three milligrams, how much exactly is that in cream in terms of milliliters or MLs? That cannot be three MLs, that would be three syringes. Sorry to be daft. I have tried to find the answer on Google but nothing is making sense to me. Maybe that is why I need bioidentical hormones. Anyway, Help. Thank you, Alexis. Short Answer:  1 gram is equal to 1 mL. A BHRT prescription can be written in either mg/gram or mg/mL. For example, when we call in prescriptions to a compounding pharmacy, let's say the Biest prescription is 3 mg/gram with an 80/20 ratio. This is the same as 3 mg/mL with an 80/20 ratio. The instruction we give the patient is to apply 1/2 gram, twice per day. If the patient is using a Topi-Click device, 1/2 gram is equal to 2 clicks. We like to have the patient apply 1/2 gram because they have to apply much less cream to the skin. We always recommend women apply their Biest to the inner thigh. We don't recommend applying Biest to the arms, forearms, wrists, abdomen, or vaginally. If the patient is having any vaginal dryness, then we will provide separate Estriol (E3) prescription that can be used vaginally. We don't like to have patients apply Estradiol (E2) vaginally, especially if they still have a uterus. PYHP 100 Full Transcript: Download PYHP 100 Transcript Dr. Maki: Hello, everyone. Thank you for joining us for another episode of the Progress Your Health Podcast. I am Dr. Maki. Dr. Davidson: And I am Dr. Davidson. Dr. Maki: So it is the middle of summer, enjoying some beautiful weather. Dr. Davidson: Gorgeous. Dr. Maki: It is a little hard to get into the podcast room and actually sit down and record some of these. You know, summer gets a little distracting. But nonetheless, we are here. Actually, some questions came in recently that were really good. Good in the fact that they are the ones that come up a lot and we figured that these would be good to talk about. Dr. Davidson: It would be helpful to the listeners. Should we just go ahead and start reading the question? Dr. Maki: Yeah, let us dive into this. What is the name of the first one? Dr. Davidson: Yeah. We always change the names of the questions, you know, just to respect the privacy of our Progress Your Health community. So this one, we changed to Alexis. Dr. Maki: Why is it Andrea and then you said, Alexis? Dr. Davidson: I like the name, Alexis. But I like the name Andrea too, but I like Alexis. Dr. Maki: Yeah. Okay. Alright. This person, we will call her Alexis. Dr. Davidson: Alexis. So do you want me to read it? Dr. Maki: Go ahead. Dr. Davidson: So again, this is from Alexis. “Hi there, this forum is fabulous. Thank you.” Well, thank you right back. “I am so confused with dosing. How much is one gram of bias in ml- milliliters. So confusing. I use a one-ml

Alexis Question: Hi there, this forum is fabulous. Thank you. I am so confused with dosing. How much is one gram of Biet in mL – milliliters. So confusing. I use a one mL syringe. One mL is a lot of cream. It is an eighty-twenty ratio and I will split the dose. Reading that […] The post What is a Common Biest Starting Dose? | PYHP 100 appeared first on Progress Your Health.

Question: What are symptoms of thyroid problems in females? Short Answer: There is a wide variety of thyroid symptoms in women. Some of the more common are fatigue, weight gain, constipation, and dry skin. Based on our experience, we have noticed many other hypothyroid related symptoms as well. These symptoms include heavy periods, infertility, anxiety, low libido, hair loss and low mood. PYHP 099 Full Transcript:  Download PYHP 099 Transcript Dr. Maki: Hello everyone. Thank you for joining us for another episode of the Progress Your Health Podcast. I am Dr. Maki Dr. Davidson: And I am Dr. Davidson.  Dr. Maki: So it is officially a little bit past the beginning of summer in Washington, although looking out the window right now, it certainly does not look like summer. It is raining kind of heavy right now.  Dr. Davidson: I would say even though it is supposed to be summer, it seems like spring has officially started because it is really beautiful with the little deer out and the flowers are blooming, and I think it will clear up a little bit later.  Dr. Maki: Yes, you know that I sent you the picture you saw but for the listeners, I was sitting here, you were upstairs and I was looking out the window and I saw a female deer and then she just took a picture of it. You know, that is great. A deer walks through the yard all the time and then she moved and there is a little, literally like a little fawn, a little Bambi right next to her and kind of following along and she hit the little white spots on the side and there. Eating little weeds in the yard and they walked over to the little garden over there and ate some things out of the garden.  Dr. Davidson: I was so happy to see that picture because I saw that little fawn a couple. I think a couple of weeks ago right after it was just born with its mom walking through the driveway and then I did not see them again and well, little baby still. Okay, so it is really neat to see him or her a little bit bigger with those little white spots on the bum.  Dr. Maki: Yes, right. That was that was nice. You know, we do not see the deer hardly at all winter long and then it seems like June, I remember where we lived. Now we moved in here lack last year and June came literally like June first I will send, the deer came almost every day. We are having deer come through the yard and sure enough, here is June again. I do not know where they go. Dr. Davidson: Only because we do not cover up our garden beds. So we basically are growing a garden to feed deer. [laughing] Which is fine.  Dr. Maki: That is okay.  Dr. Davidson: They need to it.  Dr. Maki: That is all right. Make sure the little one gets the gets a meal here and here and there. So on today's episode, we are going to talk about thyroid. This is a question, this is actually a specific question from somebody

Question: What are symptoms of thyroid problems in females? Short Answer: There is a wide variety of thyroid symptoms in women. Some of the more common are fatigue, weight gain, constipation, and dry skin. Based on our experience, we have noticed many other hypothyroid related symptoms as well. These symptoms include heavy periods, infertility, anxiety, low […] The post What Are Symptoms of Thyroid Problems in Females? | PYHP 099 appeared first on Progress Your Health.

Question:  What diet is best for Perimenopause? Short Answer:  One of the most common complaints we get from women in perimenopause is unexplained weight gain. Their lifestyles have not changed in years, but all of a sudden, their weight keeps increasing. And if they try to lose the weight, their efforts fall short and often gain more weight in the process. An observation we see quite often is that many women are still tyring to “eat less and exercise more.” This might have worked when they were 25, but for women in their 40's, this weight loss approach often seemed to backfire. Women in their 40's typically have a good deal of stress already, so trying to exercise the weight off only adds to their stress. This makes the weight loss process very frustrating, if not seem impossible. Click the link to download our Keto Carb Cycling Program. PYHP 098 Full Transcript:  Download PYHP 098 Transcript Dr. Maki: Everyone thank you for joining us for another episode of the Progress Your Health podcast. I am Dr. Maki. Dr. Davidson: And I am Dr. Davidson.  Dr. Maki: So on this one, we are just going to dive right in, and we of course have a lot to talk about. We cannot not talk about perimenopause or menopause without discussing diet and weight loss at least to some extent. Would you agree with that? Dr. Davidson: Absolutely when women, hit their 40s, they especially perimenopause and menopause. They always say it is like I put on 10, 12 pounds overnight like it, just where did it come from and they will point right to their stomach. I have had women, I love them dearly they will even grab their stomach and say, “I have never had a belly before where did this gut come from?” And things are different, of course, we all know obviously from when we are twenty, to when we are forty, to when we are sixty, we are always changing but it definitely comes from the change in hormones.  Dr. Maki: Yes, right and believe me that is very complicated and you and I, we have been doing this a long time and we certainly do not have all the answers when it comes to diet and weight loss and especially perimenopausal weight loss or menopausal weight loss for that matter. But the purpose of this episode is to kind of just shed some light on some of the observations that we have noticed and in some ways what does not work for people, we do know some of those things. Everyone is still trying to follow the same advice eat less, exercise more all the time. They are just trying to basically starve themselves and exercise a bunch and that strategy right there and we will kind of dive into that, what that strategy looks like little bit more specifically but that strategy clearly does not work. And in some cases that actually make their situation worse, they actually gain more weight. They are exercising five, six days a week and their weight is going up.  Dr. Davidson: Yes, you will see that I mean granted I was a child of the 80s. I remember the 80s and the 90s, if you were going to go on a diet, you