Hormone Resources for women
Hormones for men — see bottom of page
Sometime between 35 and 63, women begin menopause. They lose all of their progesterone and most of their estrogen. This can be a very rocky time for many women, and they don’t understand that this industry was set back tremendously by the completely flawed Women’s Health Initiative report in 2002 that said HRT causes breast cancer. This study used synthetic oral estrogen, which no one has used for 20 years, and synthetic progesterone, which again no one uses. Plus, the original scientists behind the study reanalyzed their work and retracted their claims several years later, though that was not front-page news.
Every book on menopause published in the last 15 years has told the story of the WHI disaster and listed the hundreds of studies since that show the benefits of replacing estrogen:
Symptom Relief: Reduces hot flashes (up to 80%), night sweats, vaginal dryness (50–60% prevalence), reduces brain fog, mood swings, improves sleep, energy, and quality of life overall
Bone Health: Lowers osteoporosis risk (50%) and fracture risk by 24–34%
Heart Health: Supports cardiovascular health if started early, potentially reducing heart disease risk
Supports building muscle and reducing the risk of falls
Protects against Alzheimer’s
Reduces urinary infections, which can be fatal
Protects the uterus
prevents endometrial cancer
Improves energy, sex drive, vaginal wall thickness, lubrication, arousal, intercourse, and orgasms.
There are similar benefits for progesterone and testosterone for women. Every woman can benefit from some form of hormone replacement therapy as soon as she starts to see symptoms of perimenopause. My philosophy is that you want as much of all three hormones that will benefit you without negative side effects, and sometimes that amount will be zero for some people. Plus, your body will change over time, and so should your prescription. Here’s the new FDA director talking about how this is changing …
Every woman is different and has her own needs. Yet because of the WHI disaster, there is a serious gap in the number of qualified urologists who can spend time with each woman to help get her mix of hormones and delivery methods right for her. You can read more about the benefits of HRT on my blog. Here, I’m going to list doctors and websites that can help you get the right doctor and the right solution.
Guidelines for choosing a doctor
I recommend urologists over endocrinologists, because urologists are more likely to specialize in sex hormones, and too many endocrinologists are statistically illiterate. Any endocrinologist who is prescribing Fosamax, Boniva, or Prolia for bone density is a quack.
I also recommend hormone sex-specific specialists. There are many online everything doctors like HIMS.com and Alloy Health that are selling anything anyone wants to order. The best urologists are not going to work for a place like that. If a website offers weight-loss drugs, stop-smoking drugs, eyelash-growing drugs, and others, it’s a sign they are just online marketers. Stick with specialists. I would even say that any online company that offers both male and female hormone treatments is not the best for either.
In-person urologists
Please tell me if you know others who should be added to this list, many of these doctors have long waiting lists …
Dr Rachel Rubin, Bethesda MD
Dr Vonda Wright, Orlando FL
Dr Kelly Casperson, Bellingham WA
Dr Mark Olsen, Springdale, AZ
Find in-person doctors
Dr Mary Claire Haver’s list of doctors
The International Society for the Study of Women’s Sexual Health directory
Menopause.org — I’m mixed on this group, because they recommend drugs for osteoporosis, which means they are out of date. But you could use their directory of doctors to see if you can find a good one.
Menopause Mandate — they want many more doctors trained to help women going through menopause. Their site has many resources.
Online doctors
Online doctors are a great option, because you can easily send them your blood-test results and they can prescribe patches to start. They are generally more available than a local clinic, so they can work with you more frequently in the first six months, which is when you need the most help. Once you have it dialed in, you may want to switch to pellets or rings, but at the beginning you want to use patches for most flexibility. These are some specialty online clinics I recommend:
Online pharmacies
You can get your Rx filled by online pharmacies that specialize in women’s hormone and menopause products.
Books
Estrogen Matters — a look at the history and development of hormone science, how it went wrong, and where we are today.
The New Menopause — a smart guide to getting the right treatment at any age.
Hormones for men
First, some basics:
Testosterone-replacement therapy will shut down your own supply, which means you likely won’t be fathering any children while on TRT. In some cases, it has been reversed, but I wouldn’t count on that.
Testosterone will make you feel like a lion initially. The problems come later. For many men, their body naturally makes estrogen as a response, and that leads to female characteristics like breast growth, less hair, etc.
There are many application options. Many men use creams, which are a good way to start. Realize that cream on your hands can get onto children or spouse and cause problems. Good idea to use gloves when applying creams.
Common risks include Acne, oily skin, fluid retention, sleep apnea, increased red blood cell count (polycythemia).
Serious risks include potential prostate enlargement, increased prostate cancer risk (controversial), cardiovascular risks possibly. Certainly infertility.
There are two approaches to testosterone replacement therapy for men:
Only if deficient, to make up the deficiency. This is what a Scientific American article recommends.
If you’re past having children, try it and see if you like it, but work with a good doctor, not a hack.
For either option, I recommend finding a local, in-person doctor. The online doctors are simply too eager to prescribe. The good news is that with creams, it’s very easy to experiment without a big commitment, so you can use creams for years and see how it goes. Many men on creams are very happy with their results.
Summary
In my view, women should have a good reason not to go on HRT, and men should have a good reason to go on TRT. But men — you can always try creams for a year or so and stop if you feel you’re heading in the wrong direction.
