My Mammoth Experience With Hormone Replacement Therapy

You won’t want to miss the video at the end.

This post is intended to share my experience- not to give you medical advice. I am not a doctor, nor do I play one on Substack. 

I’ve been doing hormone replacement therapy since before it was cool. 

I started about six or seven years ago with a functional medicine doctor who was not covered by insurance because my regular ob-gyn wouldn't write prescriptions for HRT. 

I was lucky enough to have friends who went by way of “The Pause” before me and I was also fortunate enough to have the resources to pay for all of the retail costs of doctors, supplements, and medications not covered by insurance. 

Let me tell you, it was a whole thing. 

Fortunately, effective treatment options for women in (peri)menopause are starting to turn, and I’m here for it.

HRT is becoming more mainstream. Research now is showing what my doctors back then told me all along - that studies claiming these therapies were not safe have actually been proven wrong and that HRT can have more benefits than risks for most of us. 

So, when a friend recently suggested I check out Dr. Mary Haver’s new book and website, which looks like a complete business for women in The Pause, I was reluctant, mostly because I wasn’t sure I would get much out of it. 

I thought I knew it all.  Rather, I thought I at least knew what I needed to know.

Because I’m, at the very least, curious, I gave it a browse and found more than I expected.  It’s worth checking out if you haven’t already.  She has a lot of good evidence-based information and free resources. I’ve learned a lot about diet, fasting, and optimizing nutrition to help ease symptoms of menopause, which I found very helpful.

Anyhoo, my friend was in the baby stages of exploring HRT, and honestly, I was surprised we hadn’t discussed it before now. I don’t talk about this much, but I would like to -  if doing so can help others. 

So, below, you’ll find my experience with all of it.

Feel free to pass this along if you or someone you know is thinking about going down the road of HRT to treat (peri)menopause symptoms. Be sure to watch the video at the end of this post if you’re having issues in the bedroom. 

The Hormones

I'm on bio-identical hormones, which, from what I’m told, are different from synthetic hormones. I’m not a doctor, of course, but my understanding is that the bio-identical versions are derived from plants and created to mimic the natural hormones made in your body as closely as possible using ‘natural’ ingredients. They were once believed to reduce the risk of certain cancers compared to their synthetic counterparts—I have no idea if this is still true. 

Bio-identical hormones are usually compounded, meaning they are created at the specific dose prescribed by my doctor and purchased at a specialty pharmacy—you’re not getting these at your local Duane Read.

They can be mixed to any strength, which means you can play around with the dose and hone in on the exact amount needed (not too much, not too little) to ease symptoms. 

I have continually played around with dosing over the years and still do sometimes. 

Estrogen

I’m currently on an Estradiol cream that I rub on each morning, but I began therapy with an Estriol/Estradiol combo cream. I know Estrogen also comes in gels and patches, though I’ve not tried these. 

Testosterone

Again, I use a cream version of this and vary my dose based on blood work ordered by my doctor two to three times per year. 

Both creams are dispensed through plastic applicators, which I apply to my arms and legs, depending on the day, because the label clearly states to mix up the application sites.

At one point, I had both the Estrogen and Testosterone in one cream applicator, but I’ve needed to adjust doses recently, so have gone back to separating them. 

I apply these in the morning:

Progesterone

I take a pill version of Progesterone at pretty much the highest level allowed (I think) - 300mg. I take this at night. 

Progesterone helps with sleep and that weird anxiety you get while going through The Pause. When I first began HRT, my doctor told me, ‘This will be your best friend.’ I can attest that it has been. 

Vitamins and Supplements

Once you’re on the HRT train, get ready to travel with your own pharmacy because your doctor will regularly check your blood and want to supplement your vitamin and mineral levels to help your overall health and support your hormones.

Here is a list of what I take regularly or what I take intermittently as needed:

Probiotic

Vitamin D

Zinc

Dim - to help my body process the Estrogen

DHEA

Pregnenolone

Multivitamin

Adrenal Support

Magnesium

If this sounds like a lot, that’s because it is. Honestly, it’s sometimes overwhelming. But it also keeps me balanced, so…

Sexual support

Then there’s the magical hormone that, honestly, everyone of a certain age should be on - not sure how I lived without it. 

**The following video is behind a paywall because much of what we discuss—me in the posts and you in the comments—is personal. We are women going through this together and I want to make sure you all feel safe.