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Bob Mizek-Menopause for men's avatar

Great post. Thank you for sharing this.

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Moorea Maguire's avatar

This is so useful, Denise. Thanks for the time and care you put into it. A couple of weeks ago, I was sitting in the gynecologist's office with beads of sweat forming above my upper lip. "Your symptoms aren't bad, so you don't need HRT," he told me. 🙄

On my last blood test, my estradiol was so low -- less than 10 pg/mL. (?!)

I've been megadosing on magnesium (tried L-threonate as well as bisglycinate) and it hasn't helped my symptoms at all. I've been thinking about trying progesterone for a while.

Did you encounter anything worth sharing about testosterone? I've heard and read that it has multiple benefits.

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Denise Mills's avatar

That's a crappy response on his part. I haven't encountered much on testosterone at this stage, what I have seen has been inconsistent. Note that the OB-GYN in the podcast I mention in the 'resources' section says that people in her profession don't receive much training on menopause. She took it upon herself to get more knowledge after getting breast cancer.

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Moorea Maguire's avatar

Yeah, it's interesting how different gynecologists have wildly different opinions and levels of knowledge on it. Since there's so much research already done, that shouldn't be the case. But I guess the difference is the decision to educate themselves. 🤔

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Andrea Hoffmann's avatar

The explicit warning from Substack was effin hilarious.

Thanks for putting this together!!

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Denise Mills's avatar

Yes, why did it do that! 🤣

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J.P. Boswell's avatar

Thank you for this.

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J.P. Boswell's avatar

Thank you for pointing me in the right direction!

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Denise Mills's avatar

You're very welcome!

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J.P. Boswell's avatar

Did any of the resources you mentioned specifically talk about how to help women during perimenopause who have a high lifetime risk of breast cancer, especially hormone receptor positive breast cancer (and have thus been told by doctors to avoid any hormonal treatments)?

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Denise Mills's avatar

Yes, Dr Jerilynn Prior talks about this in her book, Estrogen's Storm Season (although breast cancer is not the main subject). She is probably one of the best people to listen to about hormone therapy, since many other experts refer back to her work. The podcast I mentioned in the resource section above with Dr Corinne Menn talks in depth about this subject; as a 20-year breast cancer she is very angry about women being denied hormone treatment.

The Centre for Menstrual Cycle and Ovulation Research (CeMCOR) is another good resource; Dr Jerilynn Prior is the founder and scientific director. On this site it states: "The confusion originated with the Women’s Health Initiative documentation of increased breast cancer risk in women randomized to take estrogen with progestin versus placebo. In other words, doctors/scientists/media are mixing up the synthetic progesterone “knock-offs” called “progestins”, with our body’s natural progesterone hormone. Progestins are not progesterone." Source: https://cemcor.ubc.ca/resources/does-taking-progesterone-alone-or-estrogen-increase-womens-risk-breast-cancer/

Personally, as someone whose mother was diagnosed with breast cancer at 49 and died at 50, I would feel safe taking progesterone in perimenopause (but I'd be careful not to take progestins). But I would need to do extra research if I wanted to add a low level of transdermal estrogen after menopause, based on my personal breast cancer risk profile. Definitely arm yourself with lots of research before having a chat with your doctor. I find the good ones are very happy to talk things through.

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Alexis Mera Damen's avatar

This is very useful! Thanks for doing the research and sharing your findings here. I recently started taking Magnesium as I read it could help with sleep... I think it is helping, but it's only been a few months. I've also tried to reduce stress and avoid doing things that stimulate me too much before bed. Before trying all this, I was planning to get my hormones tested; it's still on my list, so it's good to know that I should do that during the peak progesterone phase of my cycle. Thanks again! Love that you're bringing us along on your journey as you learn about this very important topic!

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Denise Mills's avatar

Thanks Alex! I apreciate your kind words and I hope everything works out well for you on your perimenopause journey 😊

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Kathy Parker's avatar

Awesome work, Neesey! I've been on Prometrium for about six months now - absolute game changer.

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Denise Mills's avatar

It's good stuff!

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Maggie Jon's avatar

This is a great article, thanks for sharing! 🙏

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Denise Mills's avatar

Thank you :)

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Sharyn's avatar

Wow, very useful info. Just starting low dose E, and working my way through Lara’s Metabolism Reset book.

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Denise Mills's avatar

I haven't read that one but Hormone Manual is my bible. Lara is fantastic.

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Joans's avatar

Incredibly helpful information- this answers some issues I have in peri, while on a mini pill. Sounds like I just need a switch up - info to arm myself at my next appointment.

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Denise Mills's avatar

Glad it was helpful! Just remember that there’s no progesterone in hormonal birth control. Even though the mini-pill is called "progesterone only" it's actually progestins. https://www.larabriden.com/how-does-birth-control-affect-hormones/

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Moorea Maguire's avatar

Denise, this post is so useful that I keep going back to it. Do you happen to remember your source for the fact that HRT increases breast cancer risk? If not, totally OK.

P.S. In case you're interested to know, I did an experiment with topical progesterone recently. 300 mg/day (yes, lots and lots of goo) for two weeks. Didn't help my sleep or hot flashes. Back to the drawing board.

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Denise Mills's avatar

Hi Moorea! Very happy for you to question anything, it's important to me that I share the right information. I can only see one spot where I mentioned a very slight breast cancer risk, and it's linked to footnote 10: Hormone Repair Manual by Lara Briden, page 142.

With the progesterone, have you thought about trying tablets? I don't know if using stacks of the cream would have the same effect.

I hope you found some answers, not sleeping is awful and while I haven't suffered from hot flashes myself, I've heard how bad they can be!

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Moorea Maguire's avatar

Thanks, Denise :) You're right, and I should have read your post carefully before commenting, ha ha. I'm reading Briden's book now. No, I haven't yet tried tablets of progesterone. I was trying to avoid the cost of a doctor's appointment. 😁 I can't remember if I've already asked you this, but what do you think ultimately cured your insomnia?

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Denise Mills's avatar

I hope you like her book! I DMd you.

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