Q: My doctor doesn’t know much about natural hormones, but seems willing to help me if I can tell him what I want. I’m 56, menopausal, and still having hot flashes and dryness “down there.” My hormone test says my estrogen and progesterone are low. I got some natural progesterone cream at my health food store, but what type of estrogen is the best?
A: In my practice I’ve found that the estrogen patch does a great job. For example, the 0.025 Vivelle patch delivers a low dose of estradiol (a natural estrogen), and I’ve found that works well for most menopausal women using progesterone to both relieve hot flashes and vaginal dryness. I always start with the lowest dose of estrogen. It’s important that you continue to use the progesterone cream as long as you’re using the estrogen, and that you test your hormones every six months or so to make sure your hormones are balanced. I also recommend taking a five- to seven-day “hormone break” each month. Another good option, especially for doctors who are new to bioidentical hormones, is to have your doctor work with a compounding pharmacy that will make a hormone cream based on your test results.