Spotting or Bleeding on HRT? How to Adjust Estrogen, Progesterone & Testosterone in Menopause | PYHP 185

Estrogen dips can trigger migraines—especially in perimenopause. Here’s how to spot it and what helps. Dr. Valerie Davidson and Dr. Robert Maki explain why sudden drops in estradiol can spark headaches/migraines in cycling women, perimenopause, and menopause, plus what to do if HRT dosing (patch vs BiEst vs rhythmic) is making things worse. They also cover DIM (diindolylmethane)—when it helps vs when it can exacerbate low-estrogen symptoms, and supportive options like magnesium glycinate, B-complex, Vitamin D, and blood sugar balance. What you’ll learn ● How luteal-phase and ovulation-time estrogen drops trigger migraines ● Why perimenopause creates spike-and-crash estradiol patterns (and

Should you use estradiol cream on your face? Dr. Valerie Davidson and Dr. Robert Maki explain why estriol (E3) is a gentler, safer alternative for wrinkles, melasma, vaginal health, and hormone balance during perimenopause and menopause. They share the risks of estradiol absorption, why it can throw off your HRT program, and why estriol is often the better choice—for both skin care and vaginal tissues. You’ll also learn about systemic vs local hormone use, melasma risk, and the real-world challenge of getting access to estriol. If you have a question, please visit our website and click Ask the Doctor a

If you’ve ever wondered which blood tests actually matter for women’s hormones and longevity, this episode is your roadmap. Dr. Valorie Davidson and Dr. Robert Maki walk through real labs—from CBC/CMP to cholesterol, estradiol/FSH/LH, DHEA, testosterone, insulin, and apolipoprotein B (ApoB). You’ll learn how to spot insulin resistance (TG/HDL ratio), why ApoB beats total cholesterol for risk, how liver markers (AST/ALT/GGT) fit in, and how rhythmic dosing can mimic the natural ovarian cycle. We also cover hs-CRP vs ESR, vitamin D ranges, pregnenolone, and why individualized care wins over one-size-fits-all. What you’ll learn: ● How to read CBC/CMP for nutrition,

Are you experiencing bleeding or spotting while on hormone replacement therapy (HRT)? In this episode, Dr. Valorie Davidson and Dr. Robert Maki from Progress Your Health dive deep into one of the most common — and frustrating — concerns women face on HRT: when and how to adjust estrogen, progesterone, or testosterone. Using a real-world patient example (shared with permission and anonymized), we break down: ● Why some women continue bleeding on HRT despite progesterone support ● The role of estradiol sensitivity and early heavy periods in predicting uterine response ● Static vs rhythmic dosing for estrogen — and how

Can you use rhythmic-dosing HRT after a uterine (endometrial) ablation? In this episode, Dr. Valorie Davidson and Dr. Robert Maki explain why—and how to do it safely. Can you do rhythmic dosing HRT after a uterine (endometrial) ablation? Short answer: yes—and in this episode Dr. Valorie Davidson and Dr. Robert Maki explains why. We unpack how rhythmic dosing works post-ablation, what to expect if you don’t bleed, how estrogen and progesterone balance drives symptoms, and why individualized monitoring (including occasional ultrasounds) can give peace of mind. If you’ve worried that higher physiologic estradiol might “recreate old problems,” we cover how

Surgical menopause happens fast—especially if both ovaries are removed  (oophorectomy). In this episode, Dr. Valorie Davidson and Dr. Robert Maki explain how surgical menopause differs from “natural” menopause, why symptoms can arrive abruptly, and how to think about HRT options (rhythmic vs static), bone density, brain health, and long-term prevention. If you’ve had your ovaries removed—or you’re facing that decision—this is for you. What you’ll learn: ● Surgical vs “natural” menopause: why timing and symptom intensity differ ● Oophorectomy, hysterectomy & endometriosis: when and why surgery happens ● Symptom timelines after ovary removal (often within weeks) and what that means

Are you stuck in the in-between—not fully in perimenopause, but not quite in menopause either? In this episode, Dr. Valorie Davidson and Dr. Robert Maki from Progress Your Health dive deep into the gray area of women’s health that often gets overlooked. We cover: ✅ The most common in-betweener symptoms (hot flashes, brain fog, low libido, weight gain, hair & skin changes, sleep problems). ✅ Why the in-between phase is often the most challenging and overlooked in women’s health. ✅ How HRT (Hormone Replacement Therapy) and bioidentical hormones may help—and when to be cautious with estrogen. ✅ Lifestyle, supplementation, and

In this episode, Dr. Valorie Davidson and Dr. Robert Maki from Progress Your Health respond to a powerful listener comment about estradiol levels and hormone replacement therapy (HRT). Many women feel dismissed when it comes to their hormone care—and this conversation gets right to the heart of it. We cover: ● Why some women feel terrible when their estradiol drops below 60—and why that number matters for hot flashes, sleep, energy, and exercise tolerance. ● The link between estrogen decline and rising cholesterol, cardiovascular risk, osteoporosis, dementia, and metabolic health. ● Static dosing vs. rhythmic dosing of estrogen—why it matters

Should You Aim for the Minimum or Optimal HRT Dose? Should women on hormone replacement therapy (HRT) use the minimum dose to manage symptoms—or aim for an optimal dose to support long-term bone, brain, and heart health? This is a common and important question. In this episode of the Progress Your Health Podcast, Dr. Valorie Davidson and Dr. Robert Maki break it down in a clear, practical way. Static vs. Rhythmic Hormone Dosing Not all hormone dosing approaches are the same. In this episode, we explain the key differences between static dosing and rhythmic (cyclical) dosing, and why this distinction

Exciting Announcement! We’re launching the Progress Your Hormones Community today—a space designed to empower women with expert guidance and support for navigating perimenopause and menopause. Get access to live office hours, hormone hot seats, lab interpretation, and more! If you have a question, please visit our website and click Ask the Doctor a question. Join the Progress Your Hormones Community Stay Connected Instagram: @drvalorie TikTok: @drvaloried 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.