The short and quick answer to your question is yes we do. One of the main treatments would be the utilization of micronized progesterone and in high doses if needed up to 4x per day in some instances.Originally Posted by Eric Schexnayder
Keith
✓ Member
Dr. Nichols, thank you for taking time to appear on the show and sharing all this information with us.
I have a question if you'll take it. Have you had any clinical experience with postpartum females suffering from behavioral disorder symptoms? Specifically obsessive-compulsive disorder (more on the "O" part of the spectrum) and general anxiety disorder. Does hormone optimization therapy help manage symptoms of these conditions?
Member
The short and quick answer to your question is yes we do. One of the main treatments would be the utilization of micronized progesterone and in high doses if needed up to 4x per day in some instances.
Keith
✓ Member
Much appreciated, thank you.
Member
Cholesterol and women on testosterone
Hi Doctor Nichols, after listening to your podcast my 66 year old wife sought testosterone (she's already on progesterone and estradiol). They required a blood test which came back cholesterol 273, (HDL 64; LDL 180). She is not on any cholestorol med. Doc says no to testosterone due to elevated numbers. I've seen studies which say connection of testosterone and cholesterol in women is inconclusive. Your thoughts? Thanks!
Member
I literally hear things like this every day and it just makes me want to cut my throat with a butter knife. Testosterone reduces and prevents insulin resistance. Testosterone prevent type two diabetes and has been shown in randomized controlled trials to reverse type two diabetes. Some men when they utilize injections it can have a negative affect on their HDL cholesterol but will have a positive effect on all other lipid parameters. The testosterone cream which women use will not have a negative effect on any lipid parameters. Testosterone will help your wife lose both visceral and subcutaneous body fat and will improve her insulin resistance as we all become insulin resistant with age if we don't mean an adequate diet, exercise regimen, and hormone optimization. Let me include an article about women and testosterone, and about how they get the shaft.
https://www.liebertpub.com/doi/10.1089/andro.2021.0005
https://www.liebertpub.com/doi/10.1089/andro.2021.0030
Keith
TMPHBITEU
Get a better doctor, one who is actually familiar with the literature.
Member
Gentleman, thank you on behalf of my wife. Mike
Member
Quick follow up. After talking directly to her doctor (rather than the PA), my wife got a px for a sublingual for testosterone and estradiol. Compounding pharmacy is making it, but still making us jump through hoops and warning that "this is a controlled substance.".....probably easier to get oxy than this. We pick up this week and will update.
TMPHBITEU
Sublingual testosterone?
Member
I'm not surprised when I read this because I literally hear this several times every week.
The best most effective way to take estradiol is an oral tablet. It will provide a woman with the greatest amount of cardiovascular protection. It will have the greatest impact on improving her lipid profile. It has never been shown in any randomized controlled trials to cause heart attacks, strokes, or blood clots. That was oral Premarin, not oral estradiol. It's not only getting estradiol but it's also getting it in sufficient amounts to provide protection, and that's gonna be somewhere around 75 to 100.
Progesterone absolutely needs to be given orally, and for it a sublingual troche gives the best levels. It can be given as an oral capsule but can cause drowsiness in a lot of women. For women that need a lot of progesterone we will give the oral troches during the day and a capsule at night. You also want to follow progesterone levels and depending on the lab they're typically going to be in the range of 10 to 20 when optimal.
As far as testosterone goes you can give it orally but it will not raise levels very much at all. Once again, what your wife is going to get is what a lot of men get. A little bit of testosterone but not enough to make a significant impact on their overall health. The easiest way for your wife to obtain testosterone in the most efficacious way is simply a transdermal cream applied peri vaginally once a day. When optimizing females, their free testosterone is usually going to be somewhere around 3 to 6 ng/dlL which would correlate to a total testosterone in the hundreds. Your physician will never allow your wife to have those type of levels, but that's what it's going to take to decrease her visceral and subcutaneous body fat, increase lean muscle mass, reverse her insulin resistance, and improve her lipid profile etc...
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