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!
6 Comments | Permalink | Posted in Adrenal Hormones, Estrogen, Hormones, Menopause, Natural Hormones, Sex, sex
Isn’t Your Health is Worth More than Your Car?
Monday, October 21st, 2013
Do you spend more money on your car than on your health? Many of us do. I know because every now and then, when I want to do a specialty test or prescribe a compounded hormone that is not covered by medical insurance, I get push-back. So then I have talk about money and health with my patient. I call this my “you take better care of your car than yourself,” talk.
As your car ages, you will have to pay for new tires, break pads, routine oil changes, etc and you know darn well that when you hit the 50,000 mile mark you’ll spend even more to keep your engine humming.
Your body is no different. You should just expect that at 50, 65, and beyond you are going to need preventive and reconstructive work to keep yourself well tuned, just like those costly 65,000 mile tuneups.
There’s good and bad news. The good news is that we baby boomers are destined to live into triple digits! Most of us will live beyond our 90th birthdays. The bad news is that its going to cost you if you want to enjoy these “bonus” years. You’re going to need preventive treatments and testing to ensure good health. Individualized therapies like natural Bioidentical hormone support, good quality supplements, neurotransmitter evaluations to measure and support serotonin, dopamine and other brain chemicals, genetic panels to help avoid individual weaknesses, and digestive analyses to make sure your bowels and liver detox are working. Such specialty testing may not be entirely covered by your insurance, but for the best older age, it’s worth it. You must plan and budget for high quality preventive care to ensure graceful and enjoyable aging.
It may be time to invest as well in lifestyle changes. Learn to meditate, join a gym, hire a trainer or life coach, get acupuncture or a massage, eat more organic fruits and vegetables.
To stay healthy after 50 means you may have to start spending more money to care for your body than you routinely spend on your car. Here’s my check-list of goals to be addressed for overall good long term health:
Regular bowel movements
Regular physical activity
Prevention of chronic illnesses such as diabetes, heart disease, bone loss, and dementia
In order to address the above list you will need to budget for testing and treatments. The first step is realizing that long-term health is a priority and research how you can best afford to keep yourself as well tuned as your car.
1 Comment | Permalink | Posted in Hormones, Menopause, Natural Hormones
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