It takes a very well-trained doctor to customize estrogen dosages to each woman.
Estradiol, is the essential, necessary hormone of women, sometimes called the “female hormone”. It is produced in the ovary prior to menopause and is the primary feminizing hormone women make. A normal blood level for cycling, fertile women is betwee 60-250 pg/dl. The perfect blood level for each woman is unique, and controlled by genetics, age, health, and amount of exercise the woman does.
After menopause estradiol is no longer secreted from the ovary, and the ovary dies and shrinks. The ceasing of estradiol secretion from the ovary triggers the two stimulatory hormones, FSH and LH to rise. LH and FSH are responsible for the symptoms a woman experiences secondary to a lack of estradiol: hot flashes, night sweats, a dry vagina, painful intercourse, vaginal infections, bladder infections, weight gain, insomnia, thinning hair, thinning skin, inability to think and arthritis. At the time of menopause, the LH and FSH are rising and causing most of these symptoms. I view LH and FSH as the check engine light that tells a woman that she needs to age in a healthy way and to maintain quality of life for the following 40-50 years. Without it aging is speedy and diseases accumulate.
After menopause it is important to get a woman to the blood level of estradiol where her symptoms of estrogen deprivation are gone!
With many franchised hormone pellets offices springing up all over I think it is important to know 2 major things about taking estrogen:
- Every woman is unique and needs a customized dose of estrogen to bring them back to feel like they did at 35.
- It takes a very well-trained doctor to customize estrogen dosages to each woman, and formulas or the “same size fits all” never works.
So why am I talking about this?
I am speaking about a hormone pellet practice that treats menopausal women with estradiol pellets. I spend a lot of time determining an Estradiol dose for each new patient, and even then, there is a little trial and error involved. Trying a dose of Estradiol pellet and talking to a woman about her symptoms (are hot flashes gone, is intercourse now comfortable?) and having the time to answer questions in a consultation is necessary to get a woman on the right estradiol dose!
You need to be aware of the nuances of hormone replacement. We are not all the same, different genetics and different body types, different races, not to mention diets, lifestyle choices and diseases. The type of estrogen, the delivery system for the estrogen and the dose must be determined by a skilled hormone specialist. Everyone else has a smaller repertoire of choices and doses. You deserve to receive the accurate, unique dose of estradiol.
Estrogens are not the same either…the biggest differences are:
- What they are made of
- The delivery method
- Dosage
- How often you have to take it
Bio-identical hormones are made from yams, Premarin is made from horse urine! Other estradiol products are made from chemicals in a pharmaceutical company. I always choose bio-identical as it is the most effective and with the least amount of side effects.
Delivery method that I choose is pellet because it is most like the ovaries. The estradiol is delivered to the blood directly, with being broken down by the liver before it is available to work.
Transdermal, creams and patches must go through the skin and most of the good estradiol is changed into the aging estrogen, estrone, that makes women gain weight and feel badly, instead of better.
Oral delivery changes the pellets into other chemicals by the stomach acid and liver breakdown. The factors that affect which estradiol is best for your unique include:
- Your premenopausal estradiol levels
- Your testosterone level
- Your genetic makeup
- The receptor sites located on all your cells
- Your activity (more requires a higher dose)
- Speed of liver breakdown of your estrogen
Replacing estradiol with a pill, patch, cream usually requires much trial and error and often you don’t feel completely better because there are some parts of your genetic makeup we don’t have a test for.
Think of estradiol as a plug, and your receptor sites are the receptacle. If you have the wrong plug for the receptacle you can’t plug in and the way you feel based on your dose is blunted….
Replacing estradiol with pellets when in the hands of a skilled hormone specialist is the best method. 95% of my patients feel completely better after the second dose (4 months).
Replacing Estradiol with a pellet requires knowing:
- What the perfect target blood level is for an individual patient
- The dose of an estradiol pellet to get to that level and keep it there for 4 months.
- The weight and body fat of a patient determines how much estradiol a woman needs…bigger (taller) and fatter women need more than smaller and thinner women)
- The factors that cause pellets to dissolve in the fat faster or slower than is usual-exercise, amount of fat, genetic activity of the fat
- Amount of exercise a week
- Other hormones that can affect the estradiol blood level
- The medications that affect the breakdown of estrogen in the liver
- Genetic mutations that can cause high and low estradiol levels
Those are the factors a doctor can learn to determine the first dose of estradiol.
There are some factors we can’t measure that affect how a woman feels on estradiol.
- How easily estradiol sticks to a woman’s receptor sites- genetically determined. Some women take a small amount of E2 and it is enough because their receptors attach easily to the estrogen.
- How fast the liver will break down estradiol. Alcohol, multiple drugs and smoking increase the rate of breakdown..but we can’t know how fast!
It is my experience that women need their hormone, testosterone, replaced with estradiol.
At BioBalance we replace both in menopausal women and they feel better in 2-3 weeks and ideal in 4 weeks. Please don’t waste your time training a doctor through trial and error. Come to a doctor who has experience with pellets and who can give you the unique dose that you need to be healthy and happy.
This Health cast was written and presented by Dr. Kathy Maupin, M.D., Bio-identical Hormone Replacement Expert and Author. www.BioBalanceHealth.com • (314) 993-0963. Please subscribe to our YouTube channel and please check “ Like “. Follow us on Facebook and Instagram at BioBalanceHealth.
