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dr. phuli's blog

ENJOYING SEX OVER 50: ESTRIOL, YOUR NEW BEST FRIEND

Monday, April 28th, 2014

If you’re not enjoying sex and want to, if you’re not having mind blowing orgasms like you used to, but your healthy in every other way, I have good news for you. Your return to a full, lush, and exciting sex life is at hand. Read on.

The vagina can be mysterious- particularly in us women over 50.

As you age, estrogen and progesterone are no longer coursing through your veins and vaginal walls at high levels. Eventually the vaginal walls thin and bladder pipes become more easily irritated. Vaginitis, bleeding, itching, urinary frequency and infections can occur. Orgasms, if you’re lucky enough to have them, lose intensity.

There are a plethora of lubricants on the market but none will actually improve the health of your vagina, and prevent infections. For that you need the bioidentical hormone, Estriol.

Estriol is a very weak, naturally occurring form of estrogen that any doctor can prescribe, using a compounding pharmacist. All women, including women who have had a history of breast cancer can use vaginal Estriol safely without increasing risks of cancer.

Estriol should be used instead of vaginal Estradiol (i.e. Premarin, E ring, or Estrace), because it won’t stimulate the lining of the uterus and cause bleeding or fibroids, and it won’t increase breast cancer. It has been prescribed safely for decades by physician’s worldwide.

How do you get some? You will find Estriol over the counter as vaginal/facial creams (yes it lessens wrinkle too!). In general, these over the counter preparations can work but the doses are usually too low. The typical dose is a 1 mg Estriol suppository, prepared by a compounding pharmacy.

Ask your doctor and, if your doctor is clueless, (1) find a compounding pharmacy in your area and ask them about it and which doctors in your area are prescribing it, or (2) ask your doctor to call the compounding pharmacy and prescribe it and (3) refer your doctor to my book, The Natural Hormone Makeover, (I have lots of references in it), or (4) give your doctor this article reference to read, (Menopause 2009: 16: 978-83).

Never heard of a compounding pharmacist? They are pharmacists, trained to prepare individualized medications. They can make creams, lotions, suppositories in what ever dose your doctor recommends. Compounding pharmacists are in all states. You can locate one in your area from this website: http://www.pccarx.com/contact-us/find-a-compounder

I recommend starting with 1 mg Estriol suppositories daily for 7 to 10 days. Once the vagina and sex is comfortable again, then maintain your vaginal lining by inserting a suppository ever 2 to 3 days.

If you start using vaginal Estriol and orgasms are not as intense as they used to be explore DHEA. Have your doctor measure a DHEA-S blood level, (any lab can do this). The level should be over 150 ug/dL. I’ve posted about DHEA before- but it is a hormone made by the adrenal glands and converts into testosterone. DHEA is available over the counter, but should be monitored by your doctor.

The great news is that DHEA can safely be used vaginally to enhance orgasm. I usually prescribe 25 to 50 mg in a vaginal suppository and have women use ½ to a full suppository before sex or once per week. Its thicker than estriol so if it feels uncomfortably messy use less, or ask the compounding pharmacist to make smaller doses and use it more often. Vaginal use won’t raise your blood level so prescribe both vaginal and oral DHEA if a woman has a low DHEA-S blood level. DHEA definitely improves sex drive and vitality if your levels are low.

Don’t be scared to enter the world of bioidenticals vaginally. Educate your doctors and your friends and enjoy sex again!

 

 

 

 

 

 

8 Comments  |  Permalink  |  Posted in Adrenal Hormones, Estrogen, Hormones, Menopause, Natural Hormones, Sex, sex

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DHEA: Four Letters You Want to Know

Wednesday, July 10th, 2013

DHEA is the most abundant hormone in your body, yet few women have ever heard of it. Fewer can pronounce its twenty-two lettered scientific name, Dehydroepiandrosterone.

Think of DHEA as your battery, your reserve fuel. Without DHEA you have trouble activating your thyroid hormone. You can take all the Synthroid, (the most commonly prescribed thyroid medication), in the world, but without enough DHEA your body may not feel any beneficial thyroid effects.

DHEA is made by your adrenal glands. Young men and women have a lot but as we levels fall. When you are busy, chronically stressed and not taking time to refuel, DHEA levels fall faster than normal.

Most doctors just accept low levels as “typical aging,” but do you want to age typically?

DHEA helps an “over 50 woman” regulate cortisol, and make serotonin, estrogen, and testosterone. If your DHEA is low you are at risk for immune problems like frequent colds or autoimmune disease. Low DHEA can also result in bone loss, depression, sexual dysfunction, fatigue, dementia and even heart disease.

Could low DHEA be why you can’t lose weight, can’t sleep at night, or stay awake after lunch?

Ask your doctor to measure DHEA-S in your blood. (DHEA-S is the stable form of DHEA) Most labs can do this and most insurance companies will cover testing.

When your doctor tells you “it’s normal,” ask for the number. You want to keep your DHEA-S level above 150, some suggest aiming as high as 200

DHEA is available in most health food stores, but most doses recommended are too high for most women. Most women need only 2 to 10 mg/day (a typical male dose is 25 to 50 mg/day). If your level goes too high you could develop pimples, facial hair or hair thinning. The 7-keto form of DHEA is less likely to cause these side effects, and is readily available over the counter.

Start with a low dose, say 5 mg in the morning, on an empty stomach. Use it for a few weeks. You should notice more energy and a better sense of well-being. If not, increase to 10 or 15 mg.

I recommend taking breaks. Use it for a couple of months, then break for a couple of weeks. DHEA can also be used vaginally. Your doctor can write a script for DHEA vaginal suppositories and any compounding pharmacy can make it for you. Most women notice 25 to 50 mg inserted 2 to 3 times per week enhances orgasm and improve vaginal dryness. Think of it as female Viagra.

Don’t be afraid of DHEA. It is an important adrenal hormone, sadly overlooked as we age.

10 Comments  |  Permalink  |  Posted in Adrenal Hormones

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Tuesday, June 18th, 2013

It’s a little known fact but we wear our hormones on our face!

You can get all of the face work and Botox in the world but hormonal health is how to keep your skin looking as young as possible.

Too little hormones will leave you looking (and feeling), tired. Estrogen, testosterone, thyroid, Growth Hormone, melatonin, and the adrenal hormone DHEA (the most abundant hormone in us), keep our skin bright, supple, moist and less wrinkled.

The small creases that crowned my upper lip convinced me to become an anti-aging medical physician. When I was a mere 43 years old I was plucked from the audience as an example of “premature aging.” To my surprise, the lines on my face told the story of what was happening inside…..my thyroid was underactive, my adrenal glands were too stressed to make enough DHEA, my ovaries were not making much estrogen and testosterone, and growth hormone and melatonin were no longer pulsing in me. I was literally drying up.

Here’s a brief list of what happens to your skin and hair when certain hormones are too low:

Low Estrogen: fine lines form around your mouth, your skin and eyes become dry, your hair thins, crow’s feet form, and forehead wrinkles multiply

Low Testosterone: causes facial wrinkles to increase at a faster rate

Low Thyroid: you’ll notice dry, scaly skin, thinning eyebrows- especially the outer brows, your hair becomes brittle and thin, and your face/eyelids can look puffy

DHEA: the plus side of low DHEA is less leg and underarm hair, but with that your skin and hair is depleted of its natural oils, losing sheen and healthy glow

Melatonin: in addition to poor sleep, low melatonin makes you look generally older than your age

Growth Hormone: lack of growth hormone causes your upper lip to thin and makes the jaw line look smaller. It also causes deeper skin wrinkles.

Hormones have been given bad press but it’s time to set the record straight. Did you know that the WHI study which damned hormones did NOT show any increase in breast cancer in women taking only estrogen? Only the women in the WHI study who used synthetic progesterone (Provera) had an increase in cancer.
Despite the safety of natural hormones, the media hype surrounding this 2001 study caused hormone backlash. Millions of women stopped all forms of hormones causing epidemics of bone loss, insomnia, depression, and sexual dysfunction, not to mention a lot of sad skin and bad hair days.

Ask you doctor to measure these hormones:

DHEA-S, for adrenal DHEA
TSH, free T3 and free T4 Thyroid hormones
IgF-1 for growth hormone

Sex hormones such as Estrogen and Testosterone are safe to use if you use bioidentical forms, in a balanced way, (always use progesterone with estrogen). Never eat estrogen, take it by the skin. Melatonin and DHEA are available over the counter in most pharmacies.

European studies have shown that using bioidentical estrogen by skin lotion, balanced with natural progesterone was safe. Educate yourselves and your doctors about safe uses of hormones so that you can look and feel even better after 50.

6 Comments  |  Permalink  |  Posted in Adrenal Hormones, Estrogen, Hormones, Menopause, Natural Hormones, Uncategorized

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Being “hormonal” is a GOOD thing!

Friday, June 15th, 2012

Tired of hearing about how horrible it is to feel “hormonal?” Here’s the good things our hormones are meant to do:

Estrogen gives women curves, energy, sex drives, and bone strength. It lifts the mood, preserves memories, and even gives us our sense of style. Did you know that studies have shown that women low in estrogen dress with less color?

Progesterone balances estrogen. Without enough progesterone women feel bloated and bitchy. Cycles are heavy and irregular. Women who don’t make enough progesterone suffer from insomnia, infertility, breast pain and swelling.

Thyroid hormone ensures that all other hormones work optimally. It controls our mood, mind, temperature, digestion, menstruation, and weight.

Cortisol helps manage stress, fight infections, and gives you energy to do life. It controls appetite, and helps regulate the thyroid.

DHEA gives women their sex drive and sense of vitality. During menopause it makes estrogen and testosterone. Most women over the age of fifty need DHEA support.

Testosterone helps the brain function better and increases the number of orgasms women have. That’s a woman’s greatest sex organ is her brain!

Growth Hormone helps us feel calm during times of strife. It makes us look younger as we age by reducing wrinkles and cellulite. It also strengthens bones and muscles.

Melatonin helps us fall asleep and stay asleep. It is the most powerful antioxidant in our body and maintains a healthy brain as we age.

0 Comments  |  Permalink  |  Posted in Adrenal Hormones, Estrogen, Hormones, Progesterone

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