Patients are required by law to follow up for an appointment every 12 months or as directed by their doctor.
Dr. Hohenwarter offers a 50 / 50 mixture (equal amounts) of E2 and E3 gels / topical ethanol solutions. Weaker and gentler estriol (E3) is not necessary for the benefits of estrogen replacement but may decrease cancer risk and provide unique actions and benefits. Estradiol (E2), the strongest of the three and the one responsible for most of the proven benefits of HRT is in EquEst or compounded singly. E2 is metabolized (broken down) via a pathway that makes Estriol so women will still have Estriol with Estradiol alone therapy. Higher levels of E3 have been shown in studies to be protective against breast cancer. Importantly many foods, and herbs can influence estrogen metabolism so as to decrease the risk of cancer.
During perimenopause and menopause, women's estrogen levels drop as their ovaries age making bio-identical hormone replacement necessary to maintain optimal health.
Estrogen
Know what symptoms to look for!
For much of your life, estrogen fluctuates up and down. This occurs within the monthly cycle and also within the general framework of a lifetime. The degree and pattern of fluctuations are totally unique to you. So, too, are the ways your body reacts to the episodes of deficiencies and excesses created by the fluctuations. Deficiency-related responses are much more common then responses resulting from excess. Following are symptoms of both deficiency and excess, along with typical comments from my patients.
Common Signs of Estrogen Deficiency
- Mental fogginess
- Forgetfulness
- Depression
- Minor anxiety
- Mood change
- Difficulty falling asleep
- Hot flashes
- Night sweats
- Temperature swings
- Day-long fatigue
- Reduced stamina
- Decreased sense of sexuality and sensuality
- Lessened self image and attention to appearance
- Dry eyes, skin, and vagina
- Loss of skin radiance
- Sense of normalcy only during second week of cycle
- Sagging breasts and loss of fullness
- Pain with sexual activity
- Weight gain, with increasing lack of concern about it
- Increased back and joint pain
- Episodes of rapid heartbeat, with or without anxiety
- Headaches and migraines
- Gastrointestinal discomfort
Some of the above reactions occur nearly simultaneously whenever the level of estrogen falls. Most notable are hot flashes, inability to sleep, mental fogginess, and emotional instability. The surprising news is that the symptoms improve very quickly as well, often within a half hour to an hour and a half after giving the body what it is missing: estrogen.
Common Signs of Excess Estrogen
- Breast tenderness or pain, occurring mainly in the central area, including the nipple
- Increase in breast size EX. swollen breasts
- Water retention EX. swollen fingers and legs
- Headaches
- Weight Gain
- Impatient, snappy behavior, but with clear mind
- Pelvic cramps with or without uterine bleeding
- Nausea (less frequently)
Use as directed by Dr. Hohenwarter
Female patients who are prone to headaches and continue to have hot flashes and night sweats on Estrogen replacement have found that if they take DIM (Indole-3-Carbinol / Diindolylmethane (DIM)complex) at the same time they take their EquEst, they NO longer have hot flashes, sweats and headaches.
This may be due to I3C and DIM increasing C2 Hydroxylation of the estrogen in favor of C4 and C16 Hydroxylation which also decreases breast cancer risk.
If you are continuing to have these menopause symptoms while on Bio-Identical Estrogen therapy, try taking DIM Advantage by Thorne Research.
Estrogen replacement is not recommended in women with a history of the following conditions: breast or uterine cancer, phlebitis and blood clots, gall bladder disease, uterine fibroma, and liver disease.
SIDE EFFECTS may include, but are not limited to:
- increased body fat,
- fluid retention,
- uterine bleeding,
- depression,
- headaches,
- impaired glucose tolerance,
- aggravation of migraines
Female patients who are prone to headaches and continue to have hot flashes and nightsweats on Estrogen replacement have found that if they take DIM (Indole-3-Carbinol / Diindolylmethane (DIM)complex) at the same time they take their EquEst, they NO longer have hot flashes, sweats and headaches.
This may be due to I3C and DIM increasing C2 Hydroxylation of the estrogen in favor of C4 and C16 Hydroxylation which also decreases breast cancer risk.
If you are continuing to have these menopause symptoms while on Bio-Identical Estrogen therapy, try taking DIM Advantage by Thorne Research.
