Hormone replacement therapy
What if all my other hormones are low too, besides estrogen?
Q: I’m 51, and my hormone panel showed that my hormone levels are very low — but
it’s not just estrogen, it’s ALL of them, including some I didn’t even know I had!
But my doctor says all I really need is estrogen and progesterone pills. Since my
testosterone and DHEA levels are low, don’t I need them, too?
A: Testosterone and DHEA can be difficult to obtain from a conventional doctor,
so you may want to wait on these and get the natural estrogen and progesterone first.
We do not usually recommend synthetic testosterone (methyltestosterone) because
it is taken orally, and is not natural or bioidentical. In fact, the brand name
synthetic Estratest has been taken off the market, though generic forms are apparently
still available for “off-label” use.
If really needed for libido, energy, or muscle tone, there are bioidentical testosterone
products that can be considered for women. The female testosterone patch is still
being studied, and seems held up by the FDA for various reasons. Testim gel is FDA-approved
for men only, but again, sometimes prescribed “off-label” for women. Only a pea-
or dime-sized amount is suggested, applied daily to the skin of the thigh, pubis,
or clitoris area.
Alternatively, bioidentical testosterone can be obtained by prescription from a
compounding pharmacy, in the form of a topical cream or gel. You will need to see
a practitioner versed in compounding bioidentical hormones to obtain a prescription.
I suggest only 1–4 mg applied daily for women, starting at the lower dose and slowly
increasing it. (To read more about testosterone, see our articles on low libido
and rekindling desire.)
Likewise, to address your low DHEA levels, we suggest you seek out a practitioner
familiar with compounded hormones, as most conventional practitioners do not subscribe
to its benefits as a form of hormone replacement, and have no experience with it.
You can obtain a list of practitioners from the Natural Woman Institute or the Women’s
International Pharmacy (please note we have no direct knowledge of individuals listed
there). We also have a number of articles on improving adrenal health naturally,
as well as a Personal Program that specifically addresses adrenal imbalance.
Return to:
Our Personal Program is a great place to start
The Personal Program promotes natural hormonal balance with nutritional supplements,
our exclusive endocrine support formula, dietary and lifestyle guidance, and optional
phone consultations with our Nurse–Educators. It is a convenient, at-home
version of what we recommend to all our patients at the clinic.
If you have questions, don't hesitate to call us toll-free at
1-800-798-7902. We're here to listen and help.
We’re always happy to welcome new patients to our medical clinic in Yarmouth,
Maine, for those who can make the trip. Click
here for information about making an appointment.
Related to this article:
References & further reading for FAQ’s about
HRT
Original Publication Date: 03/02/2009
Last Modified:
02/16/2010
Principal Author: Marcy Holmes, NP, Certified Menopause Clinician