Full Transcript Why Most Women Quit HRT Too Early 0:00 Most women who 0:01 Most women who stop 0:01 stop 0:01 stop hormone therapy 0:02 hormone therapy 0:02 hormone therapy do so within the first 0:03 do so within the first 0:03 do so within the first month and almost 0:04 month and almost 0:04 month and almost always for the same 0:04 always for the same 0:04 always for the same reason. 0:05 reason. 0:05 reason. No one explained to them what 0:06 No one explained to them what 0:06 No one explained to them what it really 0:07 it really 0:07 it really looks like and what 0:08 looks like and what 0:08 looks like and what time limits exist. 0:09 time limits exist. 0:09 time limits exist. They expect to 0:09 They expect to 0:10 They expect to feel great the very 0:10 feel great the very 0:10 feel great the very next day. 0:11 next day. 0:11 next day. They face a 0:12 They face a 0:12 They face a little 0:12 little 0:12 little difficulty at 0:13 difficulty at 0:13 difficulty at the beginning and give up 0:14 the beginning and give up 0:14 the beginning and give up just before the 0:14 just before the 0:14 just before the 0:16 real effect begins. So 0:16 real effect begins. So in this video, I'm going 0:17 in this video, I'm going 0:17 in this video, I'm going to tell you what's 0:17 to tell you what's 0:17 to tell you what's actually 0:18 actually 0:18 actually happening to your 0:19 happening to your 0:19 happening to your body month by 0:20 body month by 0:20 body month by month during the 0:21 month during the 0:21 month during the first six months of 0:22 first six months of 0:22 first six months of hormone replacement 0:22 hormone replacement 0:22 hormone replacement therapy. So that you 0:24 therapy. So that you 0:24 therapy. So that you know exactly what to expect 0:25 know exactly what to expect and don't give up too 0:26 and don't give up too 0:26 and don't give up too soon. I'm 0:27 soon. I'm 0:27 soon. I'm Dr. Jen, a 0:28 Dr. Jen, a 0:29 dual- 0:30 dual- boarded OB-GYN and 0:30 boarded OB-GYN and 0:30 boarded OB-GYN and integrative 0:31 integrative 0:31 integrative medicine physician, and I've 0:32 medicine physician, and I've 0:32 medicine physician, and I've helped thousands of 0:33 helped thousands of 0:33 helped thousands of women navigate this very 0:34 women navigate this very 0:34 women navigate this very path and stay on 0:35 path and stay on 0:35 path and stay on schedule. This is what 0:36 schedule. This is what 0:36 schedule. This is what no one 0:37 no one 0:37 no one talks about. HRT is 0:38 talks about. HRT is 0:38 talks about. HRT is not an instant 0:39 not an instant 0:39 not an instant switch, it is a 0:39 switch, it is a 0:39 switch, it is a gradual process. 0:41 gradual process. 0:41 gradual process. This really takes
The First 2 Weeks: What to Expect 0:42 This really takes 0:42 This really takes time. Your symptoms will not 0:43 time. Your symptoms will not 0:43 time. Your symptoms will not all go away at once. 0:45 all go away at once. 0:45 all go away at once. They improve in a 0:46 They improve in a 0:46 They improve in a very predictable 0:47 very predictable 0:47 very predictable order, and knowing 0:48 order, and knowing 0:48 order, and knowing that order is the 0:49 that order is the best thing you 0:50 best thing you 0:50 best thing you can do to avoid 0:51 can do to avoid 0:51 can do to avoid giving up too 0:51 giving up too 0:51 giving up too early. Let's start with the 0:53 early. Let's start with the 0:53 early. Let's start with the first two weeks, 0:54 first two weeks, 0:54 first two weeks, because that's when 0:55 because that's when 0:55 because that's when most women 0:55 most women 0:56 most women start to panic 0:57 start to panic . When estrogen 0:58 . When estrogen 0:58 . When estrogen starts circulating, 0:59 starts circulating, 0:59 starts circulating, your body 0:59 your body 0:59 your body readjusts, 1:00 readjusts, 1:00 readjusts, and this 1:01 and this 1:01 and this adaptation process can be 1:02 adaptation process can be 1:02 adaptation process can be a bit tricky. Some 1:03 a bit tricky. Some 1:03 a bit tricky. Some women experience 1:04 women experience 1:05 women experience relief almost 1:06 relief almost 1:06 relief almost immediately, especially with 1:07 immediately, especially with 1:07 immediately, especially with sleep, but others 1:08 sleep, but others 1:08 sleep, but others notice mild 1:09 notice mild 1:09 notice mild side effects like 1:10 side effects like 1:10 side effects like breast tenderness, 1:11 breast tenderness, 1:11 breast tenderness, bloating, occasional 1:12 bloating, occasional 1:12 bloating, occasional 1:14 spotting, and nausea. 1:14 spotting, and nausea. About the same way 1:15 About the same way 1:15 About the same way they felt while 1:16 they felt while 1:16 they felt while taking 1:16 taking 1:16 taking birth control 1:17 birth control 1:17 birth control pills. Here's what I 1:18 pills. Here's what I 1:18 pills. Here's what I want you to know. These 1:19 want you to know. These 1:19 want you to know. These side effects are 1:20 side effects are 1:20 side effects are usually temporary at the beginning 1:21 usually temporary at the beginning 1:21 usually temporary at the beginning and are not a 1:22 and are not a 1:22 and are not a sign that 1:23 sign that 1:23 sign that hormone replacement 1:24 hormone replacement 1:24 hormone replacement therapy is not 1:25 therapy is not 1:25 therapy is not right for you. They 1:26 right for you. They 1:26 right for you. They indicate that 1:27 indicate that 1:27 indicate that your body is 1:28 your body is 1:28 your body is adapting. The 1:29 adapting. The 1:29 adapting. The main mistake is 1:30 main mistake is to stop treatment in the 1:31 to stop treatment in the 1:31 to stop treatment in the second week because of 1:32 second week because of 1:32 second week because of symptoms that would disappear 1:33 symptoms that would disappear 1:33 symptoms that would disappear in the next few 1:34 in the next few 1:34 in the next few weeks, especially by the
Early Side Effects & Why They Happen 1:35 weeks, especially by the 1:35 weeks, especially by the fourth. But if 1:37 fourth. But if 1:37 fourth. But if you feel something 1:38 you feel something 1:38 you feel something serious or worrisome, 1:39 serious or worrisome, 1:39 serious or worrisome, of course, see a 1:40 of course, see a 1:40 of course, see a doctor. However, 1:41 doctor. However, 1:41 doctor. However, difficult first weeks 1:42 difficult first weeks 1:42 difficult first weeks may be the norm. 1:43 may be the norm. 1:44 may be the norm. This does not mean that 1:45 This does not mean that 1:45 This does not mean that hormone replacement 1:45 hormone replacement 1:46 hormone replacement therapy does not work. 1:47 therapy does not work. 1:47 therapy does not work. Mild side effects are 1:48 Mild side effects are 1:48 Mild side effects are usually temporary, 1:49 usually temporary, 1:49 usually temporary, so don't give up. 1:50 so don't give up. 1:50 so don't give up. You will miss 1:51 You will miss 1:51 You will miss the most interesting thing— 1:52 the most interesting thing— positive results 1:53 positive results . Somewhere between the second and 1:54 . Somewhere between the second and 1:54 . Somewhere between the second and eighth weeks, early 1:55 eighth weeks, early 1:55 eighth weeks, early symptoms usually 1:56 symptoms usually 1:56 symptoms usually subside and 1:57 subside and 1:57 subside and true 1:58 true 1:58 true relief begins. 1:59 relief begins. 1:59 relief begins. Most women 2:00 Most women 2:00 Most women initially experience 2:01 initially experience 2:01 initially experience improved sleep 2:02 improved sleep 2:02 improved sleep as their 2:03 as their 2:03 as their hot flashes disappear. This 2:05 hot flashes disappear. This 2:05 hot flashes disappear. This chain then affects 2:06 chain then affects 2:06 chain then affects other things: your 2:07 other things: your 2:07 other things: your mood, patience, and 2:08 mood, patience, and 2:08 mood, patience, and energy. Hot flashes 2:10 energy. Hot flashes 2:10 energy. Hot flashes usually go away 2:11 usually go away 2:11 usually go away pretty quickly, but 2:13 pretty quickly, but 2:13 pretty quickly, but things like " 2:14 things like " 2:14 things like " head fog" or libido 2:15 head fog" or libido 2:15 head fog" or libido take 6 to 8 2:17 take 6 to 8 2:17 take 6 to 8 weeks, and sometimes up to 3 2:18 weeks, and sometimes up to 3 2:18 weeks, and sometimes up to 3 months. If your 2:19 months. If your 2:19 months. If your main symptoms
Weeks 2u20138: When Relief Starts 2:20 main symptoms 2:20 main symptoms have improved significantly, 2:21 have improved significantly, 2:21 have improved significantly, you are on the right 2:22 you are on the right 2:22 you are on the right track. But if they have 2:23 track. But if they have 2:23 track. But if they have hardly changed, 2:24 hardly changed, 2:24 hardly changed, this is not a reason to quit 2:25 this is not a reason to quit 2:25 this is not a reason to quit therapy. You may 2:27 therapy. You may 2:27 therapy. You may want to discuss 2:28 want to discuss 2:28 want to discuss adjusting your 2:29 adjusting your 2:29 adjusting your dose or method of 2:30 dose or method of 2:30 dose or method of hormone administration with your doctor, 2:31 hormone administration with your doctor, 2:31 hormone administration with your doctor, as sometimes an 2:32 as sometimes an 2:32 as sometimes an insufficient dose 2:33 insufficient dose 2:33 insufficient dose can feel like 2:34 can feel like 2:34 can feel like you're not 2:35 you're not 2:35 you're not taking anything. In the second 2:37 taking anything. In the second 2:37 taking anything. In the second and third months, 2:38 and third months, 2:38 and third months, slower symptoms 2:39 slower symptoms 2:39 slower symptoms begin 2:40 begin 2:40 begin to change. The fog in 2:42 to change. The fog in 2:42 to change. The fog in the head dissipates, 2:43 the head dissipates, 2:43 the head dissipates, the mood becomes normal, 2:44 the mood becomes normal, 2:44 the mood becomes normal, and for some, their libido even 2:45 and for some, their libido even 2:45 and for some, their libido even begins to return 2:47 begins to return 2:47 begins to return . Especially 2:49 . Especially 2:49 . Especially if you added 2:50 if you added 2:50 if you added testosterone. One final 2:51 testosterone. One final 2:51 testosterone. One final note: systemic 2:53 note: systemic 2:53 note: systemic estrogen, which acts 2:54 estrogen, which acts 2:54 estrogen, which acts throughout the body, does not 2:55 throughout the body, does not 2:55 throughout the body, does not resolve vaginal 2:56 resolve vaginal 2:56 resolve vaginal or urinary symptoms 2:57 or urinary symptoms 2:57 or urinary symptoms on its own, as these 2:58 on its own, as these 2:58 on its own, as these tissues often 2:59 tissues often 2:59 tissues often require 3:00 require 3:00 require additional 3:00 additional 3:00 additional topical treatment. 3:02 topical treatment. 3:02 topical treatment. So if these symptoms are 3:03 So if these symptoms are 3:03 So if these symptoms are still bothering you 3:04 still bothering you 3:04 still bothering you at this point, that's
Months 2u20133: Brain Fog, Mood & Libido 3:05 at this point, that's 3:05 at this point, that's to be expected, but 3:07 to be expected, but 3:07 to be expected, but you can add 3:07 you can add 3:10 low-dose vaginal estrogen. Over 3:10 low-dose vaginal estrogen. Over time, you 3:11 time, you 3:11 time, you will need less and less 3:11 will need less and less 3:11 will need less and less vaginal 3:12 vaginal 3:12 vaginal estrogen as your 3:13 estrogen as your 3:13 estrogen as your systemic estrogen levels 3:14 systemic estrogen levels 3:14 systemic estrogen levels 3:16 stabilize. That's 3:16 stabilize. That's why the 6- 3:17 why the 6- 3:17 why the 6- month mark is so important, 3:18 month mark is so important, 3:18 month mark is so important, and it's not just about 3:19 and it's not just about 3:19 and it's not just about how you 3:20 how you 3:20 how you feel. 3:21 feel. 3:21 feel. 3:23 Powerful processes are taking place in your body 3:23 Powerful processes are taking place in your body that you don't 3:24 that you don't 3:24 that you don't necessarily 3:24 necessarily 3:24 necessarily feel physically. And 3:25 feel physically. And 3:25 feel physically. And at the 6-month stage, 3:26 at the 6-month stage, 3:26 at the 6-month stage, almost no one is 3:27 almost no one is 3:27 almost no one is told to make an 3:28 told to make an 3:28 told to make an appointment. I'll talk 3:29 appointment. I'll talk 3:29 appointment. I'll talk about both of these aspects 3:31 about both of these aspects 3:31 about both of these aspects right now. 3:31 right now. 3:31 right now. Stay with me, 3:32 Stay with me, 3:32 Stay with me, because this is what protects 3:33 because this is what protects 3:33 because this is what protects your health in the 3:34 your health in the 3:34 your health in the long 3:35 long 3:35 long run. By 3-6 3:36 run. By 3-6 3:36 run. By 3-6 months, most 3:37 months, most 3:37 months, most women describe the same 3:39 women describe the same 3:39 women describe the same thing, but in different 3:40 thing, but in different 3:40 thing, but in different words. I 3:41 words. I 3:41 words. I feel like myself again. 3:43 feel like myself again. 3:43 feel like myself again. Acute symptoms have 3:44 Acute symptoms have 3:44 Acute symptoms have been mostly 3:45 been mostly 3:45 been mostly brought under control. 3:46 brought under control. 3:46 brought under control. Your sleep and mood 3:47 Your sleep and mood 3:47 Your sleep and mood have improved, and your 3:48 have improved, and your 3:48 have improved, and your body has adapted 3:49 body has adapted 3:49 body has adapted to the new
Months 3u20136: Feeling Like Yourself Again 3:50 to the new 3:50 to the new hormone replacement 3:51 hormone replacement 3:51 hormone replacement therapy. This is where 3:52 therapy. This is where 3:52 therapy. This is where your daily habits 3:53 your daily habits 3:53 your daily habits start to produce 3:54 start to produce 3:54 start to produce real results. 3:56 real results. 3:56 real results. If you have been 3:57 If you have been 3:57 If you have been strength 3:58 strength 3:58 strength training and 3:59 training and 3:59 training and paying attention to 4:00 paying attention to 4:00 paying attention to protein during HRT, 4:01 protein during HRT, 4:01 protein during HRT, you will 4:02 you will 4:02 you will notice real 4:03 notice real 4:03 notice real changes in body composition, 4:04 changes in body composition, 4:04 changes in body composition, weight loss, and 4:05 weight loss, and 4:05 weight loss, and strength gains right now. HRT 4:08 strength gains right now. HRT 4:08 strength gains right now. HRT creates a base, but what 4:09 creates a base, but what 4:09 creates a base, but what you do on that 4:10 you do on that 4:10 you do on that base determines 4:11 base determines 4:11 base determines the results in the 4:12 the results in the 4:12 the results in the months to come. But here's what 4:14 months to come. But here's what 4:14 months to come. But here's what you can't 4:15 you can't 4:15 you can't feel. 4:17 feel. 4:17 feel. Meanwhile, estrogen quietly 4:18 Meanwhile, estrogen quietly 4:18 Meanwhile, estrogen quietly slows 4:19 slows 4:19 slows bone loss, which 4:21 bone loss, which 4:21 bone loss, which accelerates during 4:22 accelerates during 4:22 accelerates during menopause and 4:23 menopause and 4:23 menopause and premenopause. This 4:25 premenopause. This 4:25 premenopause. This helps 4:25 helps 4:25 helps protect against 4:26 protect against 4:26 protect against fractures that could 4:28 fractures that could 4:28 fractures that could occur years later. 4:29 occur years later. 4:29 occur years later. If you start taking it at 4:30 If you start taking it at 4:31 If you start taking it at the beginning of premenopause 4:32 the beginning of premenopause , it also has a positive 4:33 , it also has a positive 4:33 , it also has a positive effect on 4:34 effect on 4:34 effect on heart health and metabolism. 4:35 heart health and metabolism. 4:35 heart health and metabolism. You won't feel these 4:36 You won't feel these 4:36 You won't feel these changes every day, but they 4:37 changes every day, but they 4:37 changes every day, but they may be more 4:38 may be more 4:38 may be more important to 4:39 important to 4:39 important to your future 4:40 your future 4:40 your future than relieving 4:41 than relieving 4:41 than relieving the symptoms you're 4:42 the symptoms you're 4:42 the symptoms you're experiencing today. 4:43 experiencing today. 4:43 experiencing today. That's why 6 months 4:44 That's why 6 months is a checkpoint,
The Hidden Benefits: Bone, Heart & Metabolic Health 4:45 is a checkpoint, 4:45 is a checkpoint, not a finish line. This is the 4:47 not a finish line. This is the 4:47 not a finish line. This is the time to meet with 4:48 time to meet with 4:48 time to meet with your doctor, discuss 4:49 your doctor, discuss 4:49 your doctor, discuss what's working, and 4:50 what's working, and 4:50 what's working, and adjust what's 4:51 adjust what's 4:51 adjust what's left: change your 4:53 left: change your 4:53 left: change your dose, add 4:53 dose, add 4:53 dose, add vaginal estrogen, 4:55 vaginal estrogen, 4:55 vaginal estrogen, or evaluate the 4:55 or evaluate the 4:55 or evaluate the feasibility of taking 4:57 feasibility of taking 4:57 feasibility of taking testosterone. It's been 4:59 testosterone. It's been 4:59 testosterone. It's been 6 months and although you 5:00 6 months and although you 5:00 6 months and although you feel much 5:01 feel much 5:01 feel much better, you're still not 5:02 better, you're still not 5:02 better, you're still not fully 5:03 fully 5:03 fully adjusted. So, 5:04 adjusted. So, 5:04 adjusted. So, let's look at the 5:05 let's look at the 5:05 let's look at the order of changes when you 5:06 order of changes when you 5:06 order of changes when you start 5:07 start 5:07 start hormone replacement therapy. 5:08 hormone replacement therapy. 5:08 hormone replacement therapy. First, you will notice 5:09 First, you will notice 5:09 First, you will notice that your sleep and hot flashes 5:10 that your sleep and hot flashes 5:10 that your sleep and hot flashes disappear within 5:11 disappear within 5:11 disappear within a few weeks. 5:12 a few weeks. 5:12 a few weeks. Next comes 5:13 Next comes 5:13 Next comes improved mood 5:14 improved mood 5:14 improved mood and energy levels. " 5:15 and energy levels. " Head fog" and 5:15 Head fog" and 5:15 Head fog" and libido take 5:16 libido take 5:16 libido take a little longer, up to 5:18 a little longer, up to 5:18 a little longer, up to 6 months. Vaginal 5:19 6 months. Vaginal 5:19 6 months. Vaginal and urinary symptoms 5:20 and urinary symptoms 5:20 and urinary symptoms may be 5:20 may be 5:20 may be slow to resolve, especially 5:21 slow to resolve, especially 5:21 slow to resolve, especially if you don't 5:22 if you don't 5:22 if you don't use 5:22 use 5:22 use topical remedies. But 5:23 topical remedies. But 5:23 topical remedies. But bone protection 5:24 bone protection 5:24 bone protection occurs
What to Review at the 6-Month Mark 5:25 occurs 5:25 occurs throughout 5:26 throughout 5:26 throughout this time. Now that 5:27 this time. Now that 5:27 this time. Now that you know this procedure, 5:28 you know this procedure, 5:28 you know this procedure, you can stop 5:29 you can stop 5:29 you can stop panicking. Not everything 5:30 panicking. Not everything 5:30 panicking. Not everything gets fixed 5:30 gets fixed 5:30 gets fixed instantly. Everyone is 5:31 instantly. Everyone is 5:32 instantly. Everyone is different, 5:32 different, 5:32 different, so use 5:33 so use 5:33 so use this as a roadmap 5:34 this as a roadmap 5:34 this as a roadmap and discuss your 5:35 and discuss your 5:35 and discuss your progress with your doctor. 5:36 progress with your doctor. 5:37 progress with your doctor. So, if you 5:37 So, if you 5:37 So, if you remember just 5:38 remember just 5:38 remember just one thing: HRT is a process, 5:40 one thing: HRT is a process, 5:40 one thing: HRT is a process, not a switch. The first 5:41 not a switch. The first 5:41 not a switch. The first 2 weeks can be 5:42 2 weeks can be 5:42 2 weeks can be challenging, real 5:43 challenging, real 5:43 challenging, real relief usually 5:44 relief usually 5:44 relief usually comes by the eighth 5:44 comes by the eighth 5:44 comes by the eighth week, and the 6-month 5:45 week, and the 6-month 5:45 week, and the 6-month mark is a time for 5:46 mark is a time for 5:46 mark is a time for reassessment and 5:47 reassessment and 5:47 reassessment and optimization, not 5:48 optimization, not 5:48 optimization, not expecting 5:48 expecting 5:48 expecting perfection. Don't 5:49 perfection. Don't 5:49 perfection. Don't evaluate hormone 5:50 evaluate hormone 5:50 evaluate hormone therapy week by 5:51 therapy week by 5:51 therapy week by week, because that 5:52 week, because that 5:52 week, because that takes time. 5:53 takes time. 5:53 takes time. Evaluate it by the 5:54 Evaluate it by the 5:54 Evaluate it by the overall trend 5:55 overall trend , the time it took 5:56 , the time it took 5:56 , the time it took to act, and whether there is 5:57 to act, and whether there is 5:57 to act, and whether there is improvement during 5:58 improvement during 5:58 improvement during that period. If
HRT Is a Curve, Not a Switch I am talking about this one 6:00 that period. If 6:00 that period. If you have been on treatment for several 6:01 you have been on treatment for several 6:01 you have been on treatment for several months and are not 6:01 months and are not 6:01 months and are not getting 6:02 getting 6:02 getting the expected 6:03 the expected 6:03 the expected relief, often the 6:04 relief, often the 6:04 relief, often the problem is not the 6:05 problem is not the 6:05 problem is not the hormone itself. Perhaps it's a matter of 6:06 hormone itself. Perhaps it's a matter of 6:06 hormone itself. Perhaps it's a matter of dosage 6:07 dosage 6:07 dosage or duration. 6:08 or duration. 6:08 or duration. For example, a patch or 6:10 For example, a patch or 6:10 For example, a patch or gel, etc. I already 6:12 gel, etc. I already 6:12 gel, etc. I already covered this in a 6:12 covered this in a 6:12 covered this in a previous video: 6:13 previous video: 6:14 previous video: estrogen patch 6:15 estrogen patch 6:15 estrogen patch vs. gel. So, I'll 6:16 vs. gel. So, I'll 6:16 vs. gel. So, I'll put it right 6:17 put it right 6:17 put it right here. Check it out 6:18 here. Check it out , and see you in the 6:19 , and see you in the 6:19 , and see you in the next video.
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