Full Transcript Intro to Low Estradiol Symptoms 0:02 about estradiol and the lubrication. So, 0:02 about estradiol and the lubrication. So, you're talking about the joints, vaginal 0:03 you're talking about the joints, vaginal 0:03 you're talking about the joints, vaginal tissues, dry eye. Dry eye is a big 0:06 tissues, dry eye. Dry eye is a big 0:06 tissues, dry eye. Dry eye is a big symptom of your estrogen being a little 0:08 symptom of your estrogen being a little 0:08 symptom of your estrogen being a little bit too low. A lot of 0:13 How to tell if your estradiol dose is 0:13 How to tell if your estradiol dose is too low. Hi, I'm Dr. Valerie Davidson
Common Menopause Symptoms Beyond Hot Flashes 0:16 too low. Hi, I'm Dr. Valerie Davidson 0:16 too low. Hi, I'm Dr. Valerie Davidson from the Progressive Health podcast. 0:17 from the Progressive Health podcast. 0:17 from the Progressive Health podcast. >> Dr. Mackey from the Progressive Health 0:19 >> Dr. Mackey from the Progressive Health 0:19 >> Dr. Mackey from the Progressive Health podcast. Uh so, let's dive right in. So, 0:21 podcast. Uh so, let's dive right in. So, 0:21 podcast. Uh so, let's dive right in. So, uh what are examples or symptoms that 0:25 uh what are examples or symptoms that 0:25 uh what are examples or symptoms that women would experience if their 0:26 women would experience if their 0:26 women would experience if their estradiol level's too low? 0:28 estradiol level's too low? 0:28 estradiol level's too low? >> Well, obviously, you know, hot flashes 0:29 >> Well, obviously, you know, hot flashes 0:29 >> Well, obviously, you know, hot flashes and night sweats is a trigger. So, we're 0:31 and night sweats is a trigger. So, we're 0:31 and night sweats is a trigger. So, we're going to talk about symptoms and 0:32 going to talk about symptoms and 0:32 going to talk about symptoms and probably dive into a little bit of blood 0:33 probably dive into a little bit of blood 0:33 probably dive into a little bit of blood work in a bit. But, there's so much more 0:36 work in a bit. But, there's so much more 0:36 work in a bit. But, there's so much more to it than just hot flashes and night 0:38 to it than just hot flashes and night 0:38 to it than just hot flashes and night sweats when your estradiol dose is too 0:39 sweats when your estradiol dose is too 0:39 sweats when your estradiol dose is too low. 0:41 low. 0:41 low. >> Certainly, uh
Joint Pain, Headaches, and Migraines 0:42 >> Certainly, uh 0:43 >> Certainly, uh you know, things have changed over the 0:44 you know, things have changed over the 0:44 you know, things have changed over the last number of years, right? Because it 0:45 last number of years, right? Because it 0:45 last number of years, right? Because it used to be uh those women that were 0:47 used to be uh those women that were 0:47 used to be uh those women that were having the hot flashes and night sweats, 0:49 having the hot flashes and night sweats, 0:49 having the hot flashes and night sweats, those would be the ones that were easy 0:51 those would be the ones that were easy 0:51 those would be the ones that were easy to spot, and they were desperate to for 0:53 to spot, and they were desperate to for 0:53 to spot, and they were desperate to for some relief. But, now because there's so 0:55 some relief. But, now because there's so 0:55 some relief. But, now because there's so much more information about um just 0:58 much more information about um just 0:58 much more information about um just menopause in general, 1:00 menopause in general, 1:00 menopause in general, now the reasons why women uh you know, 1:02 now the reasons why women uh you know, 1:02 now the reasons why women uh you know, come in is quite a bit different. 1:04 come in is quite a bit different. 1:04 come in is quite a bit different. >> For example, um we've always talked 1:06 >> For example, um we've always talked 1:06 >> For example, um we've always talked about joint pain or having joint issues. 1:08 about joint pain or having joint issues. 1:08 about joint pain or having joint issues. In fact, I had a patient not that long 1:10 In fact, I had a patient not that long 1:10 In fact, I had a patient not that long ago. I raised up her estradiol level cuz 1:13 ago. I raised up her estradiol level cuz 1:13 ago. I raised up her estradiol level cuz she was getting headaches. That's 1:14 she was getting headaches. That's 1:14 she was getting headaches. That's another symptom of having low estradiol 1:16 another symptom of having low estradiol 1:17 another symptom of having low estradiol is getting headaches, or if you're prone 1:18 is getting headaches, or if you're prone 1:18 is getting headaches, or if you're prone to migraines, getting more migraines. 1:20 to migraines, getting more migraines. 1:20 to migraines, getting more migraines. But, I ran went ahead and raised up her 1:22 But, I ran went ahead and raised up her 1:22 But, I ran went ahead and raised up her estradiol, and she said, "You know, I 1:24 estradiol, and she said, "You know, I 1:24 estradiol, and she said, "You know, I didn't mention it to you, but my knees 1:26 didn't mention it to you, but my knees 1:26 didn't mention it to you, but my knees got better." The joints in my knees, 1:28 got better." The joints in my knees, 1:28 got better." The joints in my knees, which had been bothering her, got 1:29 which had been bothering her, got 1:29 which had been bothering her, got better. So, it's not just hot flashes 1:31 better. So, it's not just hot flashes 1:31 better. So, it's not just hot flashes and night sweats, which is important. 1:33 and night sweats, which is important. 1:33 and night sweats, which is important. You know, it is important to address 1:34 You know, it is important to address 1:34 You know, it is important to address that. But, we're looking at other 1:36 that. But, we're looking at other 1:36 that. But, we're looking at other aspects of the body, like I said, the 1:37 aspects of the body, like I said, the 1:37 aspects of the body, like I said, the joint issue, headaches, migraines. What 1:40 joint issue, headaches, migraines. What 1:40 joint issue, headaches, migraines. What other symptoms would you say would point 1:42 other symptoms would you say would point 1:42 other symptoms would you say would point towards low um estradiol doses? 1:45 towards low um estradiol doses? 1:45 towards low um estradiol doses? >> Uh certainly, insomnia or not being able 1:48 >> Uh certainly, insomnia or not being able 1:48 >> Uh certainly, insomnia or not being able to fall asleep. Now, the staying asleep
Sleep Problems and Night Anxiety 1:50 to fall asleep. Now, the staying asleep 1:50 to fall asleep. Now, the staying asleep one can be a little bit complicated. Um 1:53 one can be a little bit complicated. Um 1:53 one can be a little bit complicated. Um perimenopausal women and menopausal 1:54 perimenopausal women and menopausal 1:54 perimenopausal women and menopausal women have that problem. But, a classic 1:57 women have that problem. But, a classic 1:57 women have that problem. But, a classic menopausal symptom is like you're just 1:59 menopausal symptom is like you're just 1:59 menopausal symptom is like you're just staring at the ceiling and you can't 2:00 staring at the ceiling and you can't 2:00 staring at the ceiling and you can't turn the brain power off. 2:02 turn the brain power off. 2:02 turn the brain power off. >> Or even just having anxiety at night. 2:05 >> Or even just having anxiety at night. 2:05 >> Or even just having anxiety at night. Like I just had a patient uh the other 2:07 Like I just had a patient uh the other 2:07 Like I just had a patient uh the other week and she was having a tremendous 2:09 week and she was having a tremendous 2:09 week and she was having a tremendous amount of anxiety at night and she would 2:12 amount of anxiety at night and she would 2:12 amount of anxiety at night and she would fall asleep then wake up a couple hours 2:14 fall asleep then wake up a couple hours 2:14 fall asleep then wake up a couple hours later with anxiety not not really hot 2:16 later with anxiety not not really hot 2:16 later with anxiety not not really hot though. And I wanted to make sure that 2:18 though. And I wanted to make sure that 2:18 though. And I wanted to make sure that she did she wasn't hyperthyroid that her 2:20 she did she wasn't hyperthyroid that her 2:20 she did she wasn't hyperthyroid that her thyroid dose wasn't too high. So I had 2:22 thyroid dose wasn't too high. So I had 2:22 thyroid dose wasn't too high. So I had her do some blood work and sure enough 2:23 her do some blood work and sure enough 2:23 her do some blood work and sure enough her estradiol level had went from 89 to 2:26 her estradiol level had went from 89 to 2:26 her estradiol level had went from 89 to 44. And then once we raised up that 2:29 44. And then once we raised up that 2:29 44. And then once we raised up that estrogen at night, raised up the 2:30 estrogen at night, raised up the 2:30 estrogen at night, raised up the estradiol at night and and I did a 2:32 estradiol at night and and I did a 2:32 estradiol at night and and I did a little bit in the morning too cuz we 2:33 little bit in the morning too cuz we 2:33 little bit in the morning too cuz we wanted to level it out. Her waking she's 2:36 wanted to level it out. Her waking she's 2:36 wanted to level it out. Her waking she's been sleeping great. She you know, she 2:38 been sleeping great. She you know, she 2:38 been sleeping great. She you know, she actually has been sleeping like a baby. 2:39 actually has been sleeping like a baby. 2:39 actually has been sleeping like a baby. That's what she said. So that definitely 2:41 That's what she said. So that definitely 2:41 That's what she said. So that definitely is an issue is with the sleep. Any other 2:43 is an issue is with the sleep. Any other 2:43 is an issue is with the sleep. Any other symptoms you can think of with your 2:45 symptoms you can think of with your 2:45 symptoms you can think of with your estradiol dose is too low?
Brain Fog and Mental Fatigue 2:47 estradiol dose is too low? 2:47 estradiol dose is too low? >> Well, you like you said you mentioned 2:48 >> Well, you like you said you mentioned 2:48 >> Well, you like you said you mentioned joint pain, right? So you think of it as 2:50 joint pain, right? So you think of it as 2:50 joint pain, right? So you think of it as estrogen as being kind of like the 2:51 estrogen as being kind of like the 2:51 estrogen as being kind of like the lubricant for the joints. 2:54 lubricant for the joints. 2:54 lubricant for the joints. Uh so you know, osteoarthritis which is 2:56 Uh so you know, osteoarthritis which is 2:56 Uh so you know, osteoarthritis which is joint pain or just arthritis in general, 2:59 joint pain or just arthritis in general, 2:59 joint pain or just arthritis in general, that's going to tend to go up during 3:01 that's going to tend to go up during 3:01 that's going to tend to go up during menopause. So if you're still having 3:03 menopause. So if you're still having 3:03 menopause. So if you're still having some some joint issues, knees, hips, 3:06 some some joint issues, knees, hips, 3:07 some some joint issues, knees, hips, um 3:07 um 3:07 um shoulders. 3:09 shoulders. 3:09 shoulders. Uh I you know, there's a lot of talk in 3:10 Uh I you know, there's a lot of talk in 3:10 Uh I you know, there's a lot of talk in these days about frozen shoulder and 3:12 these days about frozen shoulder and 3:12 these days about frozen shoulder and menopause. Um so those are all different 3:15 menopause. Um so those are all different 3:15 menopause. Um so those are all different things to think about. Like you said 3:16 things to think about. Like you said 3:16 things to think about. Like you said it's more than just hot flashes and 3:18 it's more than just hot flashes and 3:18 it's more than just hot flashes and night sweats. 3:18 night sweats. 3:18 night sweats. >> And of course we can't forget brain 3:20 >> And of course we can't forget brain 3:20 >> And of course we can't forget brain function. You know, the brain fog, the 3:22 function. You know, the brain fog, the 3:22 function. You know, the brain fog, the words not coming out well, not being 3:24 words not coming out well, not being 3:25 words not coming out well, not being able to retrieve the word from your 3:26 able to retrieve the word from your 3:26 able to retrieve the word from your brain. Like I know that person's name. 3:28 brain. Like I know that person's name. 3:28 brain. Like I know that person's name. I've known them for 20 years. I can't 3:29 I've known them for 20 years. I can't 3:29 I've known them for 20 years. I can't get it out. Or what's the name of the 3:30 get it out. Or what's the name of the 3:30 get it out. Or what's the name of the university I used to go to? Like you 3:32 university I used to go to? Like you 3:32 university I used to go to? Like you just can't get the words out. So that's 3:34 just can't get the words out. So that's 3:34 just can't get the words out. So that's a big one when it comes to having your 3:37 a big one when it comes to having your 3:37 a big one when it comes to having your estradiol dose a little bit too low. 3:39 estradiol dose a little bit too low. 3:39 estradiol dose a little bit too low. Also just kind of the brain power in 3:41 Also just kind of the brain power in 3:41 Also just kind of the brain power in general. Women will find when their 3:43 general. Women will find when their 3:43 general. Women will find when their estradiol dose is too low that they get 3:45 estradiol dose is too low that they get 3:45 estradiol dose is too low that they get tired quicker or cognitively. We always 3:47 tired quicker or cognitively. We always 3:47 tired quicker or cognitively. We always talk about like the mental energy. You 3:49 talk about like the mental energy. You 3:49 talk about like the mental energy. You know, what's your mental energy like? 3:50 know, what's your mental energy like? 3:51 know, what's your mental energy like? They feel like the bandwidth starts to 3:52 They feel like the bandwidth starts to 3:52 They feel like the bandwidth starts to get shorter or they're getting 3:53 get shorter or they're getting 3:53 get shorter or they're getting distracted or their working memory which 3:56 distracted or their working memory which 3:56 distracted or their working memory which is trying to reme- you know, remember 3:57 is trying to reme- you know, remember 3:57 is trying to reme- you know, remember five things at once. Like you go into 3:59 five things at once. Like you go into 3:59 five things at once. Like you go into the grocery store, you want to remember 4:00 the grocery store, you want to remember 4:00 the grocery store, you want to remember the the items on your list is if you 4:03 the the items on your list is if you 4:03 the the items on your list is if you can't remember it, that's your working 4:05 can't remember it, that's your working 4:05 can't remember it, that's your working memory goes down. So, that's a big sign 4:07 memory goes down. So, that's a big sign 4:07 memory goes down. So, that's a big sign when your estradiol dose is too low.
Weight Gain and Libido Changes 4:09 when your estradiol dose is too low. 4:09 when your estradiol dose is too low. >> Yeah, I mean those are um you know, 4:11 >> Yeah, I mean those are um you know, 4:11 >> Yeah, I mean those are um you know, those are all sort of at least in our 4:13 those are all sort of at least in our 4:13 those are all sort of at least in our world sort of classic menopausal 4:15 world sort of classic menopausal 4:15 world sort of classic menopausal symptoms. Uh and I think a lot of people 4:17 symptoms. Uh and I think a lot of people 4:17 symptoms. Uh and I think a lot of people are aware of those. Certainly uh it does 4:20 are aware of those. Certainly uh it does 4:20 are aware of those. Certainly uh it does go beyond just um beyond just hot 4:22 go beyond just um beyond just hot 4:22 go beyond just um beyond just hot flashes and night sweats. 4:23 flashes and night sweats. 4:23 flashes and night sweats. >> And of course, I think we're forgetting 4:25 >> And of course, I think we're forgetting 4:25 >> And of course, I think we're forgetting and not touching on the biggest one when 4:27 and not touching on the biggest one when 4:27 and not touching on the biggest one when your estradiol dose is low. Also, on 4:29 your estradiol dose is low. Also, on 4:29 your estradiol dose is low. Also, on another podcast we did with your 4:31 another podcast we did with your 4:31 another podcast we did with your estradiol dose is too high, this is the 4:33 estradiol dose is too high, this is the 4:33 estradiol dose is too high, this is the same thing, weight gain. 4:35 same thing, weight gain. 4:35 same thing, weight gain. >> Oh, sure. Yeah, yeah. Uh well, I mean 4:37 >> Oh, sure. Yeah, yeah. Uh well, I mean 4:37 >> Oh, sure. Yeah, yeah. Uh well, I mean that's just a classic for menopause 4:38 that's just a classic for menopause 4:38 that's just a classic for menopause anyways. Uh 4:40 anyways. Uh 4:40 anyways. Uh not so much if the dose is too much um 4:43 not so much if the dose is too much um 4:43 not so much if the dose is too much um because as we've talked about before, 4:46 because as we've talked about before, 4:46 because as we've talked about before, most of the time, you know, the dose 4:48 most of the time, you know, the dose 4:48 most of the time, you know, the dose usually needs to increase most of the 4:50 usually needs to increase most of the 4:50 usually needs to increase most of the time. 4:50 time. 4:50 time. >> Yeah, cuz we get a lot of questions from 4:52 >> Yeah, cuz we get a lot of questions from 4:52 >> Yeah, cuz we get a lot of questions from people all over the world and they'll be 4:54 people all over the world and they'll be 4:54 people all over the world and they'll be putting their doses down and we'll say, 4:57 putting their doses down and we'll say, 4:57 putting their doses down and we'll say, you know, they they seem like the doses 4:59 you know, they they seem like the doses 4:59 you know, they they seem like the doses are low. I mean, us women, we need the 5:01 are low. I mean, us women, we need the 5:01 are low. I mean, us women, we need the estradiol. Sure, if it's too high, 5:03 estradiol. Sure, if it's too high, 5:03 estradiol. Sure, if it's too high, there's some issues, that's why you want 5:04 there's some issues, that's why you want 5:04 there's some issues, that's why you want to monitor it, you know, and work with 5:06 to monitor it, you know, and work with 5:06 to monitor it, you know, and work with your practitioner. But a lot of times 5:07 your practitioner. But a lot of times 5:07 your practitioner. But a lot of times we'll see these doses are way too low or 5:09 we'll see these doses are way too low or 5:10 we'll see these doses are way too low or whether they're doing an estradiol patch 5:12 whether they're doing an estradiol patch 5:12 whether they're doing an estradiol patch or they're doing a biased or just an 5:14 or they're doing a biased or just an 5:14 or they're doing a biased or just an estradiol transdermal cream or gel, I'll 5:16 estradiol transdermal cream or gel, I'll 5:17 estradiol transdermal cream or gel, I'll notice that the doses are low. And when 5:18 notice that the doses are low. And when 5:18 notice that the doses are low. And when they're low, cuz estrogen helps sort of 5:21 they're low, cuz estrogen helps sort of 5:21 they're low, cuz estrogen helps sort of balance cortisol and buffers cortisol. 5:23 balance cortisol and buffers cortisol. 5:23 balance cortisol and buffers cortisol. We need cortisol, but too much of 5:25 We need cortisol, but too much of 5:25 We need cortisol, but too much of cortisol can be a runaway train and that 5:28 cortisol can be a runaway train and that 5:28 cortisol can be a runaway train and that cortisol will cause the weight gain. So, 5:30 cortisol will cause the weight gain. So, 5:30 cortisol will cause the weight gain. So, when that estradiol drops, it's really 5:32 when that estradiol drops, it's really 5:32 when that estradiol drops, it's really easy to pack on a few pounds even if 5:34 easy to pack on a few pounds even if 5:34 easy to pack on a few pounds even if you're doing everything right. 5:35 you're doing everything right. 5:35 you're doing everything right. >> Yeah, I mean that's one of those things 5:37 >> Yeah, I mean that's one of those things 5:37 >> Yeah, I mean that's one of those things we've seen over the years where, you 5:38 we've seen over the years where, you 5:38 we've seen over the years where, you know, that that and the hot flashes and 5:40 know, that that and the hot flashes and 5:40 know, that that and the hot flashes and night sweats used to be and sort of 5:42 night sweats used to be and sort of 5:42 night sweats used to be and sort of still is at least the weight gain 5:44 still is at least the weight gain 5:44 still is at least the weight gain anyways are the main reasons that 5:46 anyways are the main reasons that 5:46 anyways are the main reasons that motivates someone to change it because 5:48 motivates someone to change it because 5:48 motivates someone to change it because lifestyle doesn't change, diet doesn't 5:50 lifestyle doesn't change, diet doesn't 5:50 lifestyle doesn't change, diet doesn't change, all of a sudden now they've put 5:51 change, all of a sudden now they've put 5:51 change, all of a sudden now they've put on, you know, 10 to 20 lb in a 5:53 on, you know, 10 to 20 lb in a 5:53 on, you know, 10 to 20 lb in a relatively short amount of time. 5:55 relatively short amount of time. 5:55 relatively short amount of time. >> And then of course libido is a big one. 5:58 >> And then of course libido is a big one. 5:58 >> And then of course libido is a big one. I know testosterone's important for 5:59 I know testosterone's important for 5:59 I know testosterone's important for libido, especially for men and for women 6:02 libido, especially for men and for women 6:02 libido, especially for men and for women also, but really the estradiol is 6:04 also, but really the estradiol is 6:04 also, but really the estradiol is probably the big game player when it 6:06 probably the big game player when it 6:06 probably the big game player when it comes to female libido. 6:08 comes to female libido. 6:08 comes to female libido. >> Yeah, I mean uh 6:10 >> Yeah, I mean uh 6:10 >> Yeah, I mean uh testosterone is what sort of drives uh 6:12 testosterone is what sort of drives uh 6:12 testosterone is what sort of drives uh men uh and estradiol is what sort of 6:15 men uh and estradiol is what sort of 6:15 men uh and estradiol is what sort of drives women in that respect. So, you 6:17 drives women in that respect. So, you 6:17 drives women in that respect. So, you can't you can't ignore the estradiol if 6:20 can't you can't ignore the estradiol if 6:20 can't you can't ignore the estradiol if there's any libido issues. 6:22 there's any libido issues. 6:22 there's any libido issues. >> And when that estradiol's low, it's like 6:24 >> And when that estradiol's low, it's like 6:24 >> And when that estradiol's low, it's like the sex isn't on the brain. That's what 6:26 the sex isn't on the brain. That's what 6:26 the sex isn't on the brain. That's what women will say is I'm I'm not even 6:28 women will say is I'm I'm not even 6:28 women will say is I'm I'm not even initiating, it's not my partner, it's 6:30 initiating, it's not my partner, it's 6:30 initiating, it's not my partner, it's just not on my brain. And then that of 6:32 just not on my brain. And then that of 6:32 just not on my brain. And then that of course, like I was mentioning about 6:33 course, like I was mentioning about 6:33 course, like I was mentioning about cortisol, so when that estrogen's low, 6:35 cortisol, so when that estrogen's low, 6:35 cortisol, so when that estrogen's low, that cortisol can kind of go, you know, 6:37 that cortisol can kind of go, you know, 6:37 that cortisol can kind of go, you know, it's not being buffered. And cortisol, 6:39 it's not being buffered. And cortisol, 6:39 it's not being buffered. And cortisol, high cortisol, is terrible for a libido. 6:42 high cortisol, is terrible for a libido. 6:42 high cortisol, is terrible for a libido. Like that'll just turn the sex drive 6:43 Like that'll just turn the sex drive 6:43 Like that'll just turn the sex drive right off. So, you're thinking about, 6:45 right off. So, you're thinking about, 6:45 right off. So, you're thinking about, you know, libido on the brain, but also 6:47 you know, libido on the brain, but also 6:47 you know, libido on the brain, but also down south if that if that estradiol 6:50 down south if that if that estradiol 6:50 down south if that if that estradiol level is too low, you can have the 6:51 level is too low, you can have the 6:52 level is too low, you can have the vaginal atrophy or what they call it
Vaginal Atrophy and GSM 6:54 vaginal atrophy or what they call it 6:54 vaginal atrophy or what they call it now, GSM. 6:55 now, GSM. 6:55 now, GSM. >> Now, GSM, uh I mean that's honestly 6:57 >> Now, GSM, uh I mean that's honestly 6:57 >> Now, GSM, uh I mean that's honestly there's lots of things that that could 6:59 there's lots of things that that could 6:59 there's lots of things that that could be a whole separate episode 7:02 be a whole separate episode 7:02 be a whole separate episode uh talking about estradiol and or just 7:05 uh talking about estradiol and or just 7:05 uh talking about estradiol and or just estrogen in general and the GSM 7:07 estrogen in general and the GSM 7:07 estrogen in general and the GSM symptoms. Uh this is one where you might 7:09 symptoms. Uh this is one where you might 7:10 symptoms. Uh this is one where you might need two prescriptions. You might need 7:12 need two prescriptions. You might need 7:12 need two prescriptions. You might need one for your menopausal symptoms and 7:15 one for your menopausal symptoms and 7:15 one for your menopausal symptoms and then need a separate one for your GSM 7:18 then need a separate one for your GSM 7:18 then need a separate one for your GSM symptoms. 7:18 symptoms. 7:18 symptoms. >> Yeah, we'll we'll definitely circle back 7:20 >> Yeah, we'll we'll definitely circle back 7:20 >> Yeah, we'll we'll definitely circle back and do another one on that cuz I do 7:22 and do another one on that cuz I do 7:22 and do another one on that cuz I do often find that you might need a little 7:24 often find that you might need a little 7:24 often find that you might need a little bit of like an estriol vaginally, which 7:26 bit of like an estriol vaginally, which 7:26 bit of like an estriol vaginally, which works really good, but we'll we'll talk 7:27 works really good, but we'll we'll talk 7:27 works really good, but we'll we'll talk about that on a different podcast. When
Dry Eye and Other Low Estrogen Signs 7:29 about that on a different podcast. When 7:29 about that on a different podcast. When you're thinking about estradiol and the 7:31 you're thinking about estradiol and the 7:31 you're thinking about estradiol and the lubrication, so you're talking about the 7:33 lubrication, so you're talking about the 7:33 lubrication, so you're talking about the joints, the vaginal tissues, dry eye. 7:35 joints, the vaginal tissues, dry eye. 7:35 joints, the vaginal tissues, dry eye. Dry eye is a big symptom of your 7:38 Dry eye is a big symptom of your 7:38 Dry eye is a big symptom of your estrogen being a little bit too low. A 7:39 estrogen being a little bit too low. A 7:39 estrogen being a little bit too low. A lot lot women will be like, my vision 7:41 lot lot women will be like, my vision 7:41 lot lot women will be like, my vision was fine, I was great." Of course, you 7:43 was fine, I was great." Of course, you 7:43 was fine, I was great." Of course, you know, after a while you need the 7:45 know, after a while you need the 7:45 know, after a while you need the readers, but you know, that's 7:46 readers, but you know, that's 7:46 readers, but you know, that's inevitable. But they'll say, "Oh, I went 7:48 inevitable. But they'll say, "Oh, I went 7:48 inevitable. But they'll say, "Oh, I went to my eye doctor and they said I have 7:49 to my eye doctor and they said I have 7:49 to my eye doctor and they said I have dry eye. What I have dry eye?" You know, 7:51 dry eye. What I have dry eye?" You know, 7:51 dry eye. What I have dry eye?" You know, yeah, you know, it happens when that 7:52 yeah, you know, it happens when that 7:52 yeah, you know, it happens when that estrogen's too low. 7:53 estrogen's too low. 7:53 estrogen's too low. >> Yeah, it's one of those things that um 7:55 >> Yeah, it's one of those things that um 7:55 >> Yeah, it's one of those things that um you know, is almost like a I wouldn't 7:57 you know, is almost like a I wouldn't 7:57 you know, is almost like a I wouldn't say classic, but becoming much more 7:59 say classic, but becoming much more 7:59 say classic, but becoming much more common to have to use drops and 8:01 common to have to use drops and 8:01 common to have to use drops and everything when that estrogen drops off. 8:03 everything when that estrogen drops off. 8:03 everything when that estrogen drops off. >> So, those are some of the most common 8:05 >> So, those are some of the most common 8:05 >> So, those are some of the most common symptoms that we'll see with the low
Testing, Dosing, and Individualized HRT 8:07 symptoms that we'll see with the low 8:07 symptoms that we'll see with the low estrogen. I'm sure there's We could talk 8:09 estrogen. I'm sure there's We could talk 8:09 estrogen. I'm sure there's We could talk probably for hours about this. So, 8:11 probably for hours about this. So, 8:11 probably for hours about this. So, definitely and I'm sure a lot of you 8:12 definitely and I'm sure a lot of you 8:12 definitely and I'm sure a lot of you will have some comments on that. But one 8:14 will have some comments on that. But one 8:14 will have some comments on that. But one thing when you're looking at that 8:16 thing when you're looking at that 8:16 thing when you're looking at that estradiol level being too low is you're 8:18 estradiol level being too low is you're 8:18 estradiol level being too low is you're thinking whether we're doing a static 8:19 thinking whether we're doing a static 8:19 thinking whether we're doing a static dosing or rhythmic dosing. So, rhythmic 8:21 dosing or rhythmic dosing. So, rhythmic 8:21 dosing or rhythmic dosing. So, rhythmic dosing is looking at the you're 8:24 dosing is looking at the you're 8:24 dosing is looking at the you're basically recreating the ovarian 28-day 8:27 basically recreating the ovarian 28-day 8:27 basically recreating the ovarian 28-day cycle by doing varying amounts of 8:30 cycle by doing varying amounts of 8:30 cycle by doing varying amounts of estradiol throughout the 28 days and 8:32 estradiol throughout the 28 days and 8:32 estradiol throughout the 28 days and then adding in that progesterone on day 8:33 then adding in that progesterone on day 8:33 then adding in that progesterone on day 14. So, I love to test with the rhythmic 8:36 14. So, I love to test with the rhythmic 8:36 14. So, I love to test with the rhythmic dosing on day 12 or day 21. That's a 8:39 dosing on day 12 or day 21. That's a 8:39 dosing on day 12 or day 21. That's a good time to test to check for those 8:40 good time to test to check for those 8:41 good time to test to check for those levels. When you're doing rhythmic 8:42 levels. When you're doing rhythmic 8:42 levels. When you're doing rhythmic dosing, you can really bump up the 8:45 dosing, you can really bump up the 8:45 dosing, you can really bump up the estradiol levels. Like you can 8:46 estradiol levels. Like you can 8:46 estradiol levels. Like you can sometimes, you know, I'll keep them 8:48 sometimes, you know, I'll keep them 8:48 sometimes, you know, I'll keep them easily at 150 and when you're going to 8:51 easily at 150 and when you're going to 8:51 easily at 150 and when you're going to um what is that? Picograms per 8:52 um what is that? Picograms per 8:52 um what is that? Picograms per milliliter. 8:53 milliliter. 8:53 milliliter. When you're getting closer into like day 8:55 When you're getting closer into like day 8:55 When you're getting closer into like day 12 when the estradiol levels in nature 8:58 12 when the estradiol levels in nature 8:58 12 when the estradiol levels in nature go up at really high, you can get that 8:59 go up at really high, you can get that 8:59 go up at really high, you can get that up from 250 to 450 and then it comes 9:02 up from 250 to 450 and then it comes 9:02 up from 250 to 450 and then it comes back down. So, the rhythmic dosing is 9:04 back down. So, the rhythmic dosing is 9:04 back down. So, the rhythmic dosing is different when you're checking for high 9:05 different when you're checking for high 9:05 different when you're checking for high estrogen as opposed to the static 9:07 estrogen as opposed to the static 9:07 estrogen as opposed to the static dosing. That gets a little bit more 9:09 dosing. That gets a little bit more 9:09 dosing. That gets a little bit more tricky, which static dosing is taking 9:11 tricky, which static dosing is taking 9:11 tricky, which static dosing is taking the same dose every single day and not 9:13 the same dose every single day and not 9:13 the same dose every single day and not without any deviation. 9:15 without any deviation. 9:15 without any deviation. >> Yeah, and that's where there's, you 9:16 >> Yeah, and that's where there's, you 9:16 >> Yeah, and that's where there's, you know, their philosophies between those 9:18 know, their philosophies between those 9:18 know, their philosophies between those two different dosing strategies are just 9:20 two different dosing strategies are just 9:20 two different dosing strategies are just completely different. So, they have to 9:22 completely different. So, they have to 9:22 completely different. So, they have to be evaluated different, that be 9:23 be evaluated different, that be 9:23 be evaluated different, that be monitored different, you know, because 9:24 monitored different, you know, because 9:24 monitored different, you know, because they're really technically not the same 9:26 they're really technically not the same 9:26 they're really technically not the same thing. 9:26 thing. 9:26 thing. >> Mhm. 9:27 >> Mhm. 9:27 >> Mhm. >> Um but um you know, depending on the 9:29 >> Um but um you know, depending on the 9:30 >> Um but um you know, depending on the woman, depending on the situation, 9:32 woman, depending on the situation, 9:32 woman, depending on the situation, you know, there's a there's a way to 9:34 you know, there's a there's a way to 9:34 you know, there's a there's a way to customize and you know, pick a solution 9:37 customize and you know, pick a solution 9:37 customize and you know, pick a solution that's going to help them with whatever 9:38 that's going to help them with whatever 9:38 that's going to help them with whatever they're dealing with. 9:39 they're dealing with. 9:39 they're dealing with. >> Yeah, I mean, just to kind of, you know, 9:41 >> Yeah, I mean, just to kind of, you know, 9:41 >> Yeah, I mean, just to kind of, you know, every practitioner has their own 9:42 every practitioner has their own 9:42 every practitioner has their own philosophy and their own way of, you 9:44 philosophy and their own way of, you 9:44 philosophy and their own way of, you know, treating and doing HRT, and that's 9:47 know, treating and doing HRT, and that's 9:47 know, treating and doing HRT, and that's totally cool. I I will say when 9:49 totally cool. I I will say when 9:49 totally cool. I I will say when someone's doing a static dose, I don't 9:51 someone's doing a static dose, I don't 9:51 someone's doing a static dose, I don't like to have that estradiol level too 9:54 like to have that estradiol level too 9:54 like to have that estradiol level too much higher than like 120 pg/mL. 9:57 much higher than like 120 pg/mL. 9:57 much higher than like 120 pg/mL. Most Most women feel really good when 9:59 Most Most women feel really good when 9:59 Most Most women feel really good when it's around 60 to 80. Like, 80 is like a 10:02 it's around 60 to 80. Like, 80 is like a 10:02 it's around 60 to 80. Like, 80 is like a really good number, maybe even a little 10:03 really good number, maybe even a little 10:03 really good number, maybe even a little shy of 100. They feel really good. Of 10:06 shy of 100. They feel really good. Of 10:06 shy of 100. They feel really good. Of course, if it's too low, in the 30s and 10:08 course, if it's too low, in the 30s and 10:08 course, if it's too low, in the 30s and the 40s, they may not feel they may have 10:10 the 40s, they may not feel they may have 10:10 the 40s, they may not feel they may have some of these symptoms that we're 10:11 some of these symptoms that we're 10:11 some of these symptoms that we're talking about 10:12 talking about 10:12 talking about >> Right. 10:12 >> Right. 10:12 >> Right. >> um for determining if their estradiol 10:14 >> um for determining if their estradiol 10:14 >> um for determining if their estradiol level is too low or their dosing is too 10:16 level is too low or their dosing is too 10:16 level is too low or their dosing is too low. Now, 10:18 low. Now, 10:18 low. Now, there's always caveats. I have some 10:19 there's always caveats. I have some 10:19 there's always caveats. I have some women that feel fantastic with it, you 10:21 women that feel fantastic with it, you 10:21 women that feel fantastic with it, you know, with it at 30 pg/mL, 10:23 know, with it at 30 pg/mL, 10:23 know, with it at 30 pg/mL, where others feel great at 80 when 10:25 where others feel great at 80 when 10:25 where others feel great at 80 when you're doing a static dose. So, there is 10:27 you're doing a static dose. So, there is 10:27 you're doing a static dose. So, there is that individual sort of variation that 10:29 that individual sort of variation that 10:29 that individual sort of variation that you're going to tailor that HRT to. 10:31 you're going to tailor that HRT to. 10:31 you're going to tailor that HRT to. >> Now, we've never really been big fans of 10:33 >> Now, we've never really been big fans of 10:33 >> Now, we've never really been big fans of chasing a number. Like, getting a number 10:36 chasing a number. Like, getting a number 10:36 chasing a number. Like, getting a number up up to a certain amount. If she's at a 10:38 up up to a certain amount. If she's at a 10:38 up up to a certain amount. If she's at a lower amount and her 10:40 lower amount and her 10:40 lower amount and her um her testing says, you know, that it's 10:42 um her testing says, you know, that it's 10:42 um her testing says, you know, that it's lower, there's no reason to change it as 10:44 lower, there's no reason to change it as 10:44 lower, there's no reason to change it as long as she's feeling good because 10:46 long as she's feeling good because 10:46 long as she's feeling good because eventually, if you keep trying to raise 10:48 eventually, if you keep trying to raise 10:48 eventually, if you keep trying to raise the dose to hit a certain target, it's 10:51 the dose to hit a certain target, it's 10:51 the dose to hit a certain target, it's going to create some other problems at 10:52 going to create some other problems at 10:52 going to create some other problems at some point. At least At least 10:53 some point. At least At least 10:53 some point. At least At least potentially. 10:54 potentially. 10:54 potentially. >> Oh, absolutely. Absolutely. You don't 10:56 >> Oh, absolutely. Absolutely. You don't 10:56 >> Oh, absolutely. Absolutely. You don't want to chase the number. It's It's nice 10:57 want to chase the number. It's It's nice 10:57 want to chase the number. It's It's nice to have that objective data. Now, when 10:59 to have that objective data. Now, when 10:59 to have that objective data. Now, when you're thinking, you know, I know what 11:01 you're thinking, you know, I know what 11:01 you're thinking, you know, I know what you're thinking. You're thinking 11:02 you're thinking. You're thinking 11:02 you're thinking. You're thinking long-term. Well, what about my brain, my 11:03 long-term. Well, what about my brain, my 11:03 long-term. Well, what about my brain, my bones, my heart if my estrogen's staying 11:05 bones, my heart if my estrogen's staying 11:05 bones, my heart if my estrogen's staying too low, too consistently? And there's 11:08 too low, too consistently? And there's 11:08 too low, too consistently? And there's so many other factors that we would work 11:09 so many other factors that we would work 11:09 so many other factors that we would work on. So, if somebody felt really good 11:11 on. So, if somebody felt really good 11:11 on. So, if somebody felt really good with their estradiol level being, you 11:12 with their estradiol level being, you 11:12 with their estradiol level being, you know, 40 pg/mL, 11:15 know, 40 pg/mL, 11:15 know, 40 pg/mL, then I'd say, "Okay, well, let's keep 11:17 then I'd say, "Okay, well, let's keep 11:17 then I'd say, "Okay, well, let's keep Let's keep you where you feel good, and 11:19 Let's keep you where you feel good, and 11:19 Let's keep you where you feel good, and then we'll work on the bone density with 11:20 then we'll work on the bone density with 11:20 then we'll work on the bone density with lifestyle and supplementation and 11:22 lifestyle and supplementation and 11:22 lifestyle and supplementation and nutrition." So, there's so many aspects 11:23 nutrition." So, there's so many aspects 11:23 nutrition." So, there's so many aspects to that. But, I know for this one, it 11:25 to that. But, I know for this one, it 11:25 to that. But, I know for this one, it was about if your estradiol level was 11:27 was about if your estradiol level was 11:27 was about if your estradiol level was too low. 11:28 too low. 11:28 too low. >> Right. Uh so, if you want to see the 11:30 >> Right. Uh so, if you want to see the 11:30 >> Right. Uh so, if you want to see the other video we did, there should be up 11:31 other video we did, there should be up 11:31 other video we did, there should be up here, uh and the uh 11:34 here, uh and the uh 11:34 here, uh and the uh upper part of the 11:35 upper part of the 11:35 upper part of the >> Which feather video? 11:36 >> Which feather video? 11:36 >> Which feather video? >> Uh the one about estradiol being too 11:38 >> Uh the one about estradiol being too 11:38 >> Uh the one about estradiol being too high. 11:39 high. 11:39 high. We also did a progesterone being um too 11:42 We also did a progesterone being um too 11:42 We also did a progesterone being um too low and too high. So, there's a few that 11:44 low and too high. So, there's a few that 11:44 low and too high. So, there's a few that you can choose from. Um cuz sometimes, 11:47 you can choose from. Um cuz sometimes, 11:47 you can choose from. Um cuz sometimes, to be honest, when it comes to HRT, um 11:49 to be honest, when it comes to HRT, um 11:49 to be honest, when it comes to HRT, um uh 11:50 uh 11:50 uh high estrogen, low estrogen, high 11:52 high estrogen, low estrogen, high 11:52 high estrogen, low estrogen, high progesterone, low low progesterone, the 11:55 progesterone, low low progesterone, the 11:55 progesterone, low low progesterone, the the response you can get can be a little 11:57 the response you can get can be a little 11:57 the response you can get can be a little bit paradoxical sometimes. Um so, check 12:00 bit paradoxical sometimes. Um so, check 12:00 bit paradoxical sometimes. Um so, check those other videos out. 12:02 those other videos out. 12:02 those other videos out. Uh until next time, I'm Dr. Mackey. 12:03 Uh until next time, I'm Dr. Mackey. 12:03 Uh until next time, I'm Dr. Mackey. >> And I'm Dr. Valerie. 12:04 >> And I'm Dr. Valerie. 12:04 >> And I'm Dr. Valerie. >> Take care. Bye-bye.
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