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...
Sep 02, 2021
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 m...
Aug 30, 2021
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 i...
Aug 23, 2021
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 ver...
Aug 19, 2021
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...
Aug 18, 2021
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 pr...
Feb 17, 2021
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 th...
Jan 28, 2021
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 painfu...
Jan 21, 2021
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...
Jan 20, 2021
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 sug...
Jan 12, 2021
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 o...
Aug 07, 2020
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 fo...
Jul 30, 2020
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 2...
Jul 02, 2020
Question: What supplements are good for Perimenopause? Short Answer: The conventional treatment options for Perimenopause are limited. Most often, women are offered birth control and other habit forming medications. None of those options are very effective in providing women relief of their symptoms. PYHP 097 Full Transcript: Download 097 Transcript Dr. Maki: Hello everybody. Thank you for joining us for another episode of the Progress Your Health podcast. I am Dr. Maki. Dr. Davidson: And I am D...
Jun 26, 2020
Question: Why Is Perimenopause so awful? Short Answer: We work with a good number of women in their 40’s and most of them do complain about how difficult Perimenopause is for them. As female hormones begin to decline, but stress levels are high it can cause a wide variety of symptoms. The most common perimenopausal symptoms are weight gain, irritability, and insomnia. PYHP 096 Full Transcript: Download PYHP 096 Transcript Dr. Davidson: Thank you for joining us for another episode of the Progress...
Jun 25, 2020
Question: What is Oxytocin Used For? Short Answer: The hormone oxytocin is available by prescription from compounding pharmacies. The most common uses for oxytocin is to enhance female libido and mood. Also, research has shown that oxytocin may also be helpful in weight loss. More research is needed to better understand how oxytocin can be used as an effective therapy for obesity. PYHP 095 Full Transcript: Download PYHP 095 Transcript Dr. Maki: Hello everyone. Thank you for joining us for anothe...
Jun 19, 2020
Question: What is LDN Used For? Short Answer: There are many possible uses for Low Dose Naltrexone (LDN). The common use for LDN is autoimmune diseases but has also been used in many immune system-related conditions, including cancer. PYHP 094 Full Transcript: Download 094 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 today, we are going to do not really an ac...
Jun 18, 2020
Linda’s Question: Hello, Dr. Maki. I hope you are well. I eat perfectly. I a small amount of organic food daily. No alcohol. No smoking. I bike forty miles a week. I am a 51-year-old postmenopausal woman at five foot eight. I am now 25 pounds overweight at 154 pounds. I cannot lose one pound. My TSH was 1.6 free T4, 1.1 free T3, 2.6 reverse T3, eleven had very low sex hormones. Hence, probably the postmenopausal part, recently began one milligram of biest troche daily and 50 mg capsule of proges...
Jun 12, 2020
Question: A question we get all the time from patients and podcast listeners is if they should take their thyroid medication before a blood test. Short Answer: There is not a simple answer to this question. It depends on the patient and their situation. For new patients, we typically want them to take their medication in the morning 3 to 6 hours before a blood test. This is especially true if we have made a recent medication change. If a patient skips their medication the morning of the blood te...
Jun 04, 2020
Question: How to cycle bioidentical hormones? Short Answer: When it comes to BHRT dosing, the two main options is static dosing and rhythmic dosing. Static dosing is by far the most common, but depending on the patient’s symptoms and goals, rhythmic dosing might be a better option. We like to use rhythmic dosing with testosterone for men almost exclusively. We are not fans of injectable testosterone or hormone pellet implants. PYHP 091 Full Transcript: Download PYHP 091 Transcrip t Dr. Maki: Hel...
Jun 03, 2020
Jennifer’s Question: Hi there! Thank you for this forum! My sister is using the Mirena. I would like to recommend she starts BHRT as she is 49 and has perimenopause symptoms. Is she able to take Prometrium and stay on the Mirena? Thank you in advance Short Answer: The Mirena IUD contains 52 mg of levonorgestrel, which is a synthetic form of progesterone. This is often recommended for women in their mid to late 40’s to control some of the symptoms of perimenopause. The IUD is fine for pregnancy p...
May 22, 2020
Laura’s Question: Dear. Dr. Maki, I read your article about progesterone cream versus oral format. I have used the cream with some satisfaction but not one hundred percent happy. My sleep has been my main complaint for the last six to eight months. I’m 44 years old, still menstruating with a lot of menopausal symptoms. Recently, I found a doctor in the Netherlands who did blood tests on me. She put me on oral progesterone and transdermal testosterone. The testosterone seems a little too high, on...
May 21, 2020
Donna’s Question: Hello. I’m 62 years old with a uterus. Recently my nurse practitioner switched me from 6% progesterone cream to Prometrium capsules. The amount of cream I was using was 1/4 teaspoon two weeks out of the month. She also added in the Intrarosa vaginal inserts instead of the estradiol cream for vaginal discomfort. I do not have many symptoms other than occasional sleepless nights and occasional hot flashes. My question is are the Prometrium capsules safe? And is the cream safer th...
May 15, 2020
Lilly’s Question: Dear Dr. Davidson, I’m writing to say how illuminating your article on Estriol was for me. Especially your metaphorical descriptions of the actions of the 3 types of estrogens. I have a question, if I may. I am 49-years-old, I just entered menopause and started taking Botanical Phytoestrogens to help with the once a day hot flash. It helped for a month and then the flashes increased to several times a day. I then took Estriol, 5 milligrams and it helped. But since then that fla...
May 14, 2020
Nathalie’s Question: Hello Dr Maki, I am 45 full menopause and currently on biest 80:20 (0.5 mg) and progesterone 200 since July 2018. I was also given testosterone injection at the time and by Oct 2018 I was losing hair so we stopped that and no longer take it. I have been gaining weight steadily and even though we try to increase my estrogen slowly, I get too many side effects (constipation, weight gain, horrible bloating, hair loss-diagnosed with androgenic alopecia). My Thyroid is in normal ...
May 01, 2020
Monica’s Question: Hi, Thank you for providing such great information regarding BHRT, this has been a great resource and one of the best sites I have visited. My question is: I am currently going through peri-menopause; while back in July my hormones levels tanked and I started having terrible problems with hot flashes and night sweats, after about 3 mos in and no period blood test confirmed my levels are very low. I decided to go with BHRT cream and within a week I could tell a huge difference....
Apr 30, 2020
Marisa’s Question: Dr. Davidson and Dr. Maki, I truly appreciate what you are doing to share your information with the public!! You are helping many people learn more about their body!! I wasn’t sure the best place to ask this question or where you may answer it, but I found your podcast after I have been digging into how to repair adrenals. I was elated once I found your Podcast #69 Adrenals affecting sleep. The Ghost, defined me to a tee and I wanted to learn more on how to get better from my ...
Apr 23, 2020
Maria’s Question: Hello, I’ve been reading the articles on BHRT, and I have questions. Does the body or will the body develop tolerance to hormones? Whether progesterone, testosterone or estrogens, will I eventually have to increase my dose to get the same effect, progesterone for sleep, estrogen for hot flashes, testosterone for energy and libido… Thank you very much. Short Answer: There are many factors that go into a BHRT dosage for a patient. This includes age, gender, lifestyle, stress leve...
Apr 22, 2020
Staci’s Question: Hello, Dr. D, I was on Biest, 80:20 ratio. One mg/mL. I take one click, which is a quarter gram per day. I have been taking that for two and a half months to come about sleep disturbances, low libido, and hot flushes. I also take 100 mg of progesterone capsules at night. After the two and a half months, my breasts were so dense, tender and sore that I had to stop, to get some of the estrogen out of my body. I still get my period intermittently, so I don’t think I’m quite finish...
Apr 15, 2020
Heidi’s Question: Hi, I’m a 48 year old female who has struggled with PCOS my whole life. I’ve taken 200 milligrams of oral progesterone for several years now. I also take 45 milligrams of Armour Thyroid, and my TSH is 3.87, and my free T3 is 3.22. I’ve had symptoms of: hair loss, dry eyes, vaginal dryness, very low sex drive, and irritability. I just had a saliva test done which revealed very low estradiol levels, and low DHEA along with borderline low testosterone. The practitioner I have, put...
Apr 14, 2020
