HRT & Uterine Bleeding: What Every Woman Needs to Know About Hormone Therapy & Vaginal Estrogen | PYHP 162

In this episode of the Progress Your Health Podcast, Dr. Valorie and Dr. Maki tackle a common yet surprisingly confusing question: When is the best time to test your blood levels if you're using hormone replacement therapy (HRT)? Lisa, a fellow Washingtonian, submitted a thoughtful Ask the Doctor question about testing estradiol and FSH levels when using a trochee or transdermal cream. Should it be 4 to 6 hours after application? Or 10 to 12? And what do the results actually mean? We’ll break down: The ideal timing for blood draws depending on delivery method (trochee, patch,cream) How estrogen and progesterone absorb differently Why testing too soon — or too late — can skew your results How to interpret estradiol and FSH together (and why context is everything) Why the number isn’t the whole story — and how you feel matters most Plus, Dr. Valorie shares insights from her own hormone journey, including rhythmic dosing tips and lab timing mishaps.   If you have a question, please visit our website and click Ask the Doctor a question.   Want more insights like this?  Be sure to subscribe to our newsletter for hormone Q&As, educational guides, and real-world strategies to help you feel like yourself again—especially during perimenopause and menopause. Join the Progress Your Health Newsletter   Stay Connected Instagram: @drvalorie TikTok: @drvaloried Join the Hormone Community: Click here to subscribe   Disclaimer: All content in this blog, including text, images, audio, video, or other formats, was created for informational purposes only. This video, website, and blog aim to promote consumer/public understanding and general knowledge of various health topics. This content is not a substitute for professional medical advice, diagnosis, or treatment. Please consult your healthcare provider with any questions or concerns you may have regarding your condition before undertaking a new healthcare regimen. Never disregard professional medical advice or delay seeking it because of something you have read on this website. If your healthcare provider is not interested in discussing your health concerns regarding this topic, then it is time to find a new doctor.

Is there really an age limit for hormone replacement therapy (HRT)? What if you're in your 70s and still feel better on hormones—but your doctor says it's time to stop? In this episode, we answer a great question from Mary, a 76-year-old woman who's been on HRT for over 20 years. She's dealing with weight gain, breast tenderness, and pressure from her gynecologist to quit hormones altogether. We break it down: Why stopping HRT just because of age isn't always the answer What to consider when switching from a trochee to a cream Why estradiol levels matter more than total estrogen The connection between insulin resistance, weight gain, and hormones How to adjust HRT in your 70s to maintain quality of life without unnecessary risk Whether you're well into postmenopause or just starting HRT, this is a must-listen if you're wondering how long is too long to stay on hormones.   If you have a question, please visit our website and click Ask the Doctor a question.   Want more insights like this?  Be sure to subscribe to our newsletter for hormone Q&As, educational guides, and real-world strategies to help you feel like yourself again—especially during perimenopause and menopause. Join the Progress Your Health Newsletter   Stay Connected Instagram: @drvalorie TikTok: @drvaloried Join the Hormone Community: Click here to subscribe   Disclaimer: All content in this blog, including text, images, audio, video, or other formats, was created for informational purposes only. This video, website, and blog aim to promote consumer/public understanding and general knowledge of various health topics. This content is not a substitute for professional medical advice, diagnosis, or treatment. Please consult your healthcare provider with any questions or concerns you may have regarding your condition before undertaking a new healthcare regimen. Never disregard professional medical advice or delay seeking it because of something you have read on this website. If your healthcare provider is not interested in discussing your health concerns regarding this topic, then it is time to find a new doctor.

In this episode, we’re answering a thoughtful (and very relatable) listener question from Kari,who’s been struggling with unexpected body pain and inflammation after starting hormonetherapy. She wonders if she might be hypersensitive to estrogen—something most doctorsdon’t talk about. Dr. Valorie Davidson and Dr. Robert Maki unpack why this happens and what to do if yoususpect your body is reacting to estrogen differently than expected.   In this episode, we discuss: Why some women experience increased pain, fluid retention, or inflammation onestradiol—especially starting at higher doses too quickly. The importance of starting low and increasing slowly, especially for sensitiveindividuals How Dr. Davidson’s personal experience with estrogen sensitivity helped shape herapproach The role of the liver’s phase 1 and phase 2 detox pathways in clearing estrogenmetabolites Why form, dose, and timing of hormone therapy (cream vs. patch, AM vs. PM) canaffect results What to consider when adjusting your Biest ratio (80:20 vs. 90:10) or RhythmicDosing HRT   ✉️ Here’s Kari’s full question:“I used Biest 80:20 for 3 years and suddenly stopped absorbing. I’m not sure why,but I do know I didn’t always use it the same time every day. From the moment Iwent on hormone therapy I’ve had body pain and thought I had fibromyalgia. Whenmy estrogen dropped due to the absorption issue I realized the body paincompletely went away. I then went on a patch because my doc said we shouldchange the method. Immediate body pain again and even worse. Terrible. I was on0.025 and it was tolerable, but after raising it to 0.05 it got really bad. I think I mayask to go on the compounded cream again—maybe change the site that I apply itand be more consistent. I’m very frustrated because no one talks about a subset ofpeople that are very sensitive to estrogen. They only talk about it making joint paingo away. Do you think I should use 90:10 instead? What would you recommendthat I do? I’m so sad and frustrated.”    If you have a question, please visit our website and click Ask the Doctor a question.   Want more insights like this?  Be sure to subscribe to our newsletter for hormone Q&As, educational guides, and real-world strategies to help you feel like yourself again—especially during perimenopause and menopause. Join the Progress Your Health Newsletter   Stay Connected Instagram: @drvalorie TikTok: @drvaloried Join the Hormone Community: Click here to subscribe   Disclaimer: All content in this blog, including text, images, audio, video, or other formats, was created for informational purposes only. This video, website, and blog aim to promote consumer/public understanding and general knowledge of various health topics. This content is not a substitute for professional medical advice, diagnosis, or treatment. Please consult your healthcare provider with any questions or concerns you may have regarding your condition before undertaking a new healthcare regimen. Ne...

In this episode, Dr. Valorie Davidson and Dr. Robert Maki respond to a great listener question from April, who’s navigating hormone replacement therapy (HRT) while dealing with a history of endometriosis, polyps, and chronic cramps.  April’s experience is all too familiar: spotting, cramping, hormone experimentation, and the frustrating search for symptom relief. So, can women with endometriosis safely use HRT—especially estrogen?  The answer: Yes, but it has to be customized.  �� In this episode, we cover:  Why HRT is absolutely possible for women with endometriosis—but must be individually tailored  The difference between static vs. rhythmic dosing and why rhythmic HRT may be better tolerated for some women  Dr. Davidson’s personal story of having endometriosis, cysts, and polyps—and how she now uses rhythmic dosing herself without flaring  The important role of progesterone in managing endometriosis and minimizing estrogen reactivity  How to approach spotting, cramping, and cyst formation during HRT ● Why estrogen isn’t the enemy—but why it must be dosed thoughtfully  ✉️ Here’s April’s full question:  “Hi—I am a 57-year-old woman in perimenopause. My question is: is it possible for women with endometriosis or adenomyosis to do HRT?  I started oral progesterone 2 years ago, got as high as 300 mg, but didn’t get much symptom resolution. Switched to a progesterone troche—50 mg morning and night. About 3 months ago, I added testosterone (0.25 mg once daily, 5 days/week) and Biest 80/20 (1 ml daily, can go up to 2 ml).  Everything was good for a while, but now the cramping and spotting have returned. I’ve had heavy bleeding as long as I can remember. My main complaint is menstrual cramps throughout the month—not just during my period. I do not have fibroids, but I’ve had many cysts and polyps over the years and have had many ultrasounds and transvaginal ultrasounds because of this.”    If you have a question, please visit our website and click Ask the Doctor a question.   Want more insights like this?  Be sure to subscribe to our newsletter for hormone Q&As, educational guides, and real-world strategies to help you feel like yourself again—especially during perimenopause and menopause. Join the Progress Your Health Newsletter   Stay Connected Instagram: @drvalorie TikTok: @drvaloried Join the Hormone Community:

In this episode, Dr. Valorie Davidson and Dr. Robert Maki dive into a hot topic: Does HormoneReplacement Therapy (HRT) actually slow down aging? While the short answer may surpriseyou, the real conversation is about something even more valuable—your quality of life. Here’s what we cover: How HRT can support energy, strength, and resilience as we age The role of hormones in brain function, memory, and mental clarity Why estrogen and progesterone matter for muscle tone and bone density ❤️ The powerful connection between hormones and cardiovascular health Why HRT isn’t about extending your lifespan—but enhancing how you feel through theyears   Obviously aging is inevitable—but suffering doesn’t have to be. This episode is all about helpingyou feel more like you again, even as your hormones shift.   If you have a question, please visit our website and click Ask the Doctor a question.   Want more insights like this?  Be sure to subscribe to our newsletter for hormone Q&As, educational guides, and real-world strategies to help you feel like yourself again—especially during perimenopause and menopause. Join the Progress Your Health Newsletter   Stay Connected Instagram: @drvalorie TikTok: @drvaloried Join the Hormone Community: Click here to subscribe   Disclaimer: All content in this blog, including text, images, audio, video, or other formats, was created for informational purposes only. This video, website, and blog aim to promote consumer/public understanding and general knowledge of various health topics. This content is not a substitute for professional medical advice, diagnosis, or treatment. Please consult your healthcare provider with any questions or concerns you may have regarding your condition before undertaking a new healthcare regimen. Never disregard professional medical advice or delay seeking it because of something you have read on this website. If your healthcare provider is not interested in discussing your health concerns regarding this topic, then it is time to find a new doctor.

You’ve probably heard “drink your milk for strong bones,” but there’s much more to bone healththan just calcium—and definitely more than just dairy. In this episode, Dr. Valorie and Dr. Makibreas down the key nutrients your body needs to build and maintain bone density as you age,especially during perimenopause and menopause.   From calcium and magnesium to K2, boron, and collagen peptides, we’re covering thesupplements and whole food sources that truly make a difference for your bones. You’ll learnwhich forms of calcium are best absorbed, why magnesium matters for your arteries, howvitamin D and K2 work together, and the underappreciated power of prunes, chia seeds,sardines, and seaweed.   What You’ll Learn: Which forms of calcium are safest and most effective  The synergy between magnesium, vitamin D3, and vitamin K2 How to naturally support your osteoblasts (bone-building cells) Best food sources of key bone nutrients What to avoid if you’re prone to kidney stones or soft tissue calcification The truth about collagen and bone strength   Whether you’re navigating menopause or just want to protect your bones for the long haul, thisepisode offers actionable strategies backed by decades of clinical experience.   Don't miss this podcast to building stronger bones—naturally.   If you have a question, please visit our website and click Ask the Doctor a question.   Want more insights like this?  Be sure to subscribe to our newsletter for hormone Q&As, educational guides, and real-world strategies to help you feel like yourself again—especially during perimenopause and menopause. Join the Progress Your Health Newsletter   Stay Connected Instagram: @drvalorie TikTok: @drvaloried Join the Hormone Community: Click here to subscribe   Disclaimer: All content in this blog, including text, images, audio, video, or other formats, was created for informational purposes only. This video, website, and blog aim to promote consumer/public understanding and general knowledge of various health topics. This content is not a substitute for professional medical advice, diagnosis, or treatment. Please consult your healthcare provider with any questions or concerns you may have regarding your condition before undertaking a new healthcare regimen. Never disregard professional medical advice or delay seeking it because of something you have read on this website. If your healthcare provider is not interested in discussing your health concerns regarding this topic, then it is time to find a new doctor.

In this episode, Dr. Valorie Davidson and Dr. Robert Maki break down how to interpret your DEXA scan results—and why it matters, especially for women in perimenopause and menopause. We explain what your T-score and Z-score actually mean, how estrogen and menopause affect your bones, and what you can do to prevent or slow bone loss naturally.   Whether you’re already on HRT or just starting to explore options for protecting your bone health, this episode gives you clear, actionable insights to help you feel strong, confident, and informed.   In this episode, you’ll learn: What a T-score means—and how to understand the risk ranges What a Z-score tells you (and why it’s different from T-score) How menopause and estrogen decline impact bone density The role of HRT in maintaining or improving bone strength How weight-bearing exercise helps preserve bone mass Natural strategies to prevent bone loss (beyond calcium and vitamin D) Real examples of patients’ DEXA scans and how their scores changed over time   Perfect for you if: You’re in your 40s, 50s, or beyond and wondering what your bone scan means—or how to keep your bones strong during the hormonal transition.   If you have a question, please visit our website and click Ask the Doctor a question.   Want more insights like this?  Be sure to subscribe to our newsletter for hormone Q&As, educational guides, and real-world strategies to help you feel like yourself again—especially during perimenopause and menopause. Join the Progress Your Health Newsletter   Stay Connected Instagram: @drvalorie TikTok: @drvaloried Join the Hormone Community: Click here to subscribe   Disclaimer: All content in this blog, including text, images, audio, video, or other formats, was created for informational purposes only. This video, website, and blog aim to promote consumer/public understanding and general knowledge of various health topics. This content is not a substitute for professional medical advice, diagnosis, or treatment. Please consult your healthcare provider with any questions or concerns you may have regarding your condition before undertaking a new healthcare regimen. Never disregard professional medical advice or delay seeking it because of something you have read on this website. If your healthcare provider is not interested in discussing your health concerns regarding this topic, then it is time to find a new doctor.

In this episode of The Progress Your Health Podcast, Dr. Valorie Davidson and Dr. Maki take you behind the scenes and share their own hormone blood test results. Learn how these labs help guide treatment decisions, track progress, and support hormone balance during perimenopause and menopause.   What You’ll Learn: Key labs such as estradiol, testosterone, DHEA-sulfate, pregnenolone, LH, FSH Additional panels like liver enzymes, cholesterol, and comprehensive metabolic profiles How hormone replacement therapy (HRT) is monitored through regular blood work Dr. Valorie’s personal experience with rhythmic HRT dosing during menopause The difference between baseline and follow-up labs   If you have a question, please visit our website and click Ask the Doctor a question.   Want more insights like this?  Be sure to subscribe to our newsletter for hormone Q&As, educational guides, and real-world strategies to help you feel like yourself again—especially during perimenopause and menopause. Join the Progress Your Health Newsletter   Stay Connected Instagram: @drvalorie TikTok: @drvaloried Join the Hormone Community: Click here to subscribe   Disclaimer: All content in this blog, including text, images, audio, video, or other formats, was created for informational purposes only. This video, website, and blog aim to promote consumer/public understanding and general knowledge of various health topics. This content is not a substitute for professional medical advice, diagnosis, or treatment. Please consult your healthcare provider with any questions or concerns you may have regarding your condition before undertaking a new healthcare regimen. Never disregard professional medical advice or delay seeking it because of something you have read on this website. If your healthcare provider is not interested in discussing your health concerns regarding this topic, then it is time to find a new doctor.

In this episode, Dr. Maki and Dr. Davidson answer viewer comments from their YouTube channel, providing clarity and insight into hormone replacement therapy (HRT), uterine lining health, and vaginal estrogen options. They also touch on annual gynecological care and share a lighthearted moment with their furry companions. Topics Covered: How to identify uterine lining buildup while on static HRT. Differences between static HRT (no bleeding) and rhythmic HRT (cyclical bleeding). The importance of monitoring uterine lining thickness to prevent cancer risks. The role of transvaginal ultrasounds in checking uterine lining, ovarian cysts, fibroids, and polyps. Why current guidelines for Pap smears have changed, and what they do (and don’t) check. Estriol vs. estradiol: why some doctors prefer estriol for vaginal atrophy and urinary incontinence. How estriol can be a safer alternative for vaginal health and urinary stress incontinence. A shout-out to comments about Vivian, the podcast’s beloved standard poodle, and Bob, the Aussie mix.   Episode Highlights: Why it’s essential to prevent uterine lining thickening on static HRT. The role of transvaginal ultrasounds in annual gynecological exams. How estriol can be a safer alternative for vaginal and urinary health. Viewer questions that sparked meaningful discussions. A fun behind-the-scenes look at the podcast’s four-legged “producers.” Listen now to gain a clearer understanding of HRT, uterine health, and vaginal estrogen safety.   If you have a question, please visit our website and click Ask the Doctor a question.   Want more insights like this?  Be sure to subscribe to our newsletter for hormone Q&As, educational guides, and real-world strategies to help you feel like yourself again—especially during perimenopause and menopause. Join the Progress Your Health Newsletter   Stay Connected Instagram: @drvalorie TikTok: @drvaloried Join the Hormone Community: Click here to subscribe   Disclaimer: All content in this blog, including text, images, audio, video, or other formats, was created for informational purposes only. This video, website, and blog aim to promote consumer/public understanding and general knowledge of various health topics. This content is not a substitute for professional medical advice, diagnosis, or treatment. Please consult your healthcare provider with any questions or concerns you may have regarding your condition before undertaking a new healthcare regimen. Never disregard professional medical advice or delay seeking it because of something you have read on this website. If your healthcare provider is not interested in discussing your health concerns regarding this topic, then it is time to find a new doctor.

In this episode of the Progress Your Health Podcast, we dive deep into why hormonal changes, stress, and nutrient deficiencies contribute to hair loss during menopause and the best ways to support regrowth naturally. What you can do about it.   What You’ll Learn in This Episode: The Hair Growth Cycle & How Menopause Disrupts It The Role of Estrogen, Progesterone & Androgens in Hair Thinning How Thyroid Function & Insulin Resistance Impact Hair Loss Nutritional Deficiencies That Contribute to Hair Shedding The Connection Between Stress, Cortisol, & Scalp Health Best Supplements & Natural Remedies to Regrow Thicker Hair Hormone Therapy (HRT) – Can It Help or Hurt Hair Growth? Key Takeaways: Estrogen & Progesterone Decline: Shortens the hair growth phase & weakens follicles DHT & Androgen Sensitivity: Can cause miniaturization & pattern hair loss Nutrient Deficiencies: Iron, Vitamin D, Zinc, & Omega-3s are crucial for healthy hair Chronic Stress & Cortisol Spikes: Can push hair into the shedding phase Scalp Health & Circulation: Poor blood flow reduces hair follicle nourishment Solutions We Discuss: DHT Blockers: Saw Palmetto, Pumpkin Seed Oil, Spironolactone Best Hair Growth Nutrients: Ferritin (Iron), Vitamin D, Zinc, Biotin, Omega-3s Stress Management Tips: Adaptogens, meditation, & lifestyle shifts HRT & Hair Loss: Understanding the right type of hormone therapy for you   If you have a question, please visit our website and click Ask the Doctor a question.   Want more insights like this?  Be sure to subscribe to our newsletter for hormone Q&As, educational guides, and real-world strategies to help you feel like yourself again—especially during perimenopause and menopause. Join the Progress Your Health Newsletter   Stay Connected Instagram: @drvalorie TikTok: @drvaloried Join the Hormone Community: Click here to subscribe   Disclaimer: All content in this blog, including text, images, audio, video, or other formats, was created for informational purposes only. This video, website, and blog aim to promote consumer/public understanding and general knowledge of various health topics. This content is not a substitute for professional medical advice, diagnosis, or treatment. Please consult your healthcare provider with any questions or concerns you may have regarding your condition before undertaking a new healthcare regimen. Never disregard professional medical advice or delay seeking it because of something you have read on this website. If your healthcare provider is not interested in discussing your health concerns regarding this topic, then it is time to find a new doctor.