In this episode, we answer a reader question.  This question is from Jen, responding to one of our articles. Jen's question is important because hormone treatment can often come as a prescription.  And it is important to understand our prescriptions and if they are actually going to be beneficial.

Jen's question relates to her current BHRT prescription that her doctor has recently put her on.  She has side effects from her medication. Plus she is not noticing the effectiveness that she was hoping.  

Question From Jenn:
Hi, I stopped cycle four yrs ago- for four weeks now – I'm taking E2/E3/T 1/1/4 (1/4 gr applied morning and 1/4 gr applied at night). If I am receiving 1/2 gram a day, I am receiving .50 mg E2 and .50 mg E3 & 2 mg of Testosterone.

I am getting dull headaches at the back side of head 4 to 5 hrs before the 12 hours app time, but breast tenderness which I hate. I have asked my doc to up to 1.5/1.5 per gram still applying the same quantity (1/2 gram daily)- and request Testosterone in a separate compound. Meaning I will receive .75mg of each E2/E3 a day and hold off on Testosterone to see if headaches are lack of E for sure.

After reading your responses, I wish I would have suggested a different ratio. Perhaps leave the E2 at 1mg/gr. Or drop to .50 and increase the E3 to 2.5 -3.0 mg. E3 might help w/breast tenderness? I take oral 1 mg prog at night. Your thoughts? Is 0.50mg/gr E2 which equates to receiving .25 mg of E2 a day too low, I want the benefits of E2 -hair skin happy, but don't want to feel fat and pregnant.
Thank you in advance for your response and your thoughts. Jenn

One thing we cannot stress enough is there is not a one-size-fits-all for BHRT dosing.  Everyone is unique, and there are many aspects to developing an individualized BHRT plan. In our patient population, everyone's BHRT is based on their personal and family history, health goals, symptoms, as well as lab data.  We then keep continuous follow up with them, because the body is not static.

People's BHRT doses will change over time, whether it is age, change in health goals, stressors, symptoms, etc.  It is important to keep close follow up with the patient to ensure their hormone doses are accurate and working well in their lives. We really like Jenn's message because her situation is common.  She is on BHRT, but it is not quite working for her and alleviate her symptoms.
Also, Jen is experiencing side effects from her prescription dosages. She is getting headaches and breast tenderness which is typical