How to Ask Your Doctor For Bioidentical Hormones

Your doctor can prescribe Natural Bioidentical Estrogen as Estradiol. This is available from any pharmacy as a skin patch or cream. It can also be compounded as a (more concentrated) skin lotion. The more concentrated the cream or lotion the easier and less messy it is to apply.

Bioidentical Progesterone, is available in capsules, known as Prometrium. Oral progesterone should be taken at bedtime because it causes drowsiness. The upside is that it improves sleep and anxiety. Prometrium is made from peanut oil, so don’t use it if you are allergic to peanuts.

Compounding pharmacists can make Bioidentical Progesterone in peanut-free capsules and skin creams. Skin creams will not cause drowsiness and can be used any time of day. Some women need skin creams in the daytime and capsules at bedtime.

Always balance Estradiol with Progesterone, at any age, even if you had a hysterectomy.

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  1. It should also be noted that when taking oral progesterone, the dose the body will receive after passing through the liver is approximately 10-20% of the dose given. ie, 100mg capsules of Prometrium will supply approximately 10-20mg of drug to the tissue level.

    Also, worthy of mentioning, Estriol, one of Wyeth’s biggest drugs in all of Europe, is an extremely effective form of Estrogen for Vaginal Dryness issues. We use Estriol in combination with Estradiol for a more balanced approach (as you know, Estradiol begets Estrone, and vice versa).

    I always look forward to your blogs. Keep up the good work!

    Dr. Trey

  2. I have been taking progrsterone for over ten years. I am now taking 200mg compuonded capsule before bed time and feel that if i don’t take it I cannot sleep. I have tried to lower the dose without much success. Is it safe to take it for so many years?

    1. Luciana White » Yes its very safe long term. The only bad press regarding progesterone is from the syntheitc Progestins. Progestins have been linked to breast cancer.

      Also remember that Progesterone should be balanced with Estrogen, otherwise it can lead to depression. Its great that Progesterone can be used orally or via a skin cream- but please remember that bioidentical Estrogen, E2 or Estradiol, must always be used transdermally via a skincream or lotion, and not taken orally.

  3. I just recently bought your book “The natural hormone makeover” in order to find some valuable answers. I am a 35 year old woman, who exercises daily for at least one hour, eats very clean plant-based foods, no animal products. About five months ago, I started taking compounded Progesterone (40mg on days 1-7, nothing on days 8-11, 20mg, on days 12-21, 40mg on days 22-28). I don’t know why my doctor suggested this odd schedule, but that’s what it is. My problem is that I feel my days are “over”. I have no energy, no desire, bad sleep, no joy whatsoever. A saliva test confirmed that both levels – Estradiol and Progesterone levels – are too low. Now I am debating if I should stop taking Progesterone or if I should talk to my doctor about adding Estradiol. But then again, I am only 35 🙁 Is it “normal” that my estrogen levels decline THAT early. My husband and I still want to have kids eventually. This all becomes very confusing. Thanks much for any advice!!

    1. Heike » I’m sorry that you are feeling this way, and no, your days are not “over.” There is a reason that your levels are too low. I would look at thyroid and adrenal hormones, (TSH, free T3, free T4, reverse T3, salivary cortisol, DHEA-S), as well as RBC magnesium, Western Blot for Lyme, CBC, and because you are vegetarian, iron, ferritin, fasting (quantitative) amino acids, carnitine and B12 (methylmalonic acid). Theses tests can be done by any lab, except the salivary coritsol. You may consider doing the salivary cortisol with neurotransmitters (neuroscience Lab).

      I do not understand why your doctor is using Progesterone in this way and you should ask about this. Good luck and let me know how you do. Phuli

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