Plant-Based Bioidentical Hormones

Plant-Based Bioidentical Hormones
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Do compounded bioidentical hormones for menopause carry the same risks as conventional hormone replacement drugs, such as Premarin?

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Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

As Martha Rosenberg noted (the author of an excellent book, Born with a Junk Food Deficiency), just as this lithograph tells you everything you need to know about slavery, the fact that electroconvulsive therapy (electroshock treatments) were prescribed for menopause in the United States tells you everything you need to know about Western medicine’s view about aging women.

Here, in this 1946 medical journal ad, amphetamines (speed) was recommended, in conjunction “with such fundamental measures as electric shock and estrogenic therapy.” Doctors could throw in a little thorazine, too, while they’re at it.

Hormone replacement therapy grew to prominence in the 1990s, when millions of women were sold hormones from pregnant mare urine, on the promise that it would prevent age-related diseases. But instead, it may have caused them. Women on hormone replacement therapy suffered increased risk of heart disease, stroke, pulmonary embolism, and invasive breast cancer. They said it would help preserve women’s memory—but may have, in fact, caused dementia, as it shrinks women’s brains.

When the truth got out in 2002, and the number of prescriptions dropped, so did the rates of breast cancer. And, horses got to walk around once again.

Thanks to high-profile celebrity endorsements, though, interest then switched to so-called compounded bioidentical hormones—from plant rather than equine sources, and advertised as not carrying the same risks.

What does the science say? A bunch of new reviews on the subject out from the American College of OB/GYNs, the Mayo Clinic, to the editors-in-chief of the Journal of the International Menopause Society. All concluded that bioidentical hormones, being bioidentical, carried the same risks, benefits, and side effects—which is not a good thing.

And, even worse, when the FDA actually analyzed them to see if the contents matched the label, nearly a third failed the analysis. Even in the same bottle, doses could be all over the place.

Okay, all universally opposed, but, look, how do we know everyone isn’t just in the pocket of the pharmaceutical industry—you know, just doesn’t want the competition?

Well, whenever I’m skeptical, I turn to The Medical Letter on Drugs and Therapeutics, considered to be one of the least-biased sources in medicine. They’re kind of like the Consumer Reports of the drug world, and, in fact, was actually co-founded by the co-founder of the publisher of Consumer Reports, more than 50 years ago.

As they like to brag on their website, The Medical Letter does not accept grants— from any source; donations—from any one; funding—from any entity. They won’t let their work be used for promotional purposes, and they don’t accept any advertising.

They recently reviewed bioidentical hormones, and came to the same conclusion: “There is no acceptable evidence that ‘bioidentical’ hormones are safe or effective. Patients should be discouraged from taking them.”

Please consider volunteering to help out on the site.

Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

As Martha Rosenberg noted (the author of an excellent book, Born with a Junk Food Deficiency), just as this lithograph tells you everything you need to know about slavery, the fact that electroconvulsive therapy (electroshock treatments) were prescribed for menopause in the United States tells you everything you need to know about Western medicine’s view about aging women.

Here, in this 1946 medical journal ad, amphetamines (speed) was recommended, in conjunction “with such fundamental measures as electric shock and estrogenic therapy.” Doctors could throw in a little thorazine, too, while they’re at it.

Hormone replacement therapy grew to prominence in the 1990s, when millions of women were sold hormones from pregnant mare urine, on the promise that it would prevent age-related diseases. But instead, it may have caused them. Women on hormone replacement therapy suffered increased risk of heart disease, stroke, pulmonary embolism, and invasive breast cancer. They said it would help preserve women’s memory—but may have, in fact, caused dementia, as it shrinks women’s brains.

When the truth got out in 2002, and the number of prescriptions dropped, so did the rates of breast cancer. And, horses got to walk around once again.

Thanks to high-profile celebrity endorsements, though, interest then switched to so-called compounded bioidentical hormones—from plant rather than equine sources, and advertised as not carrying the same risks.

What does the science say? A bunch of new reviews on the subject out from the American College of OB/GYNs, the Mayo Clinic, to the editors-in-chief of the Journal of the International Menopause Society. All concluded that bioidentical hormones, being bioidentical, carried the same risks, benefits, and side effects—which is not a good thing.

And, even worse, when the FDA actually analyzed them to see if the contents matched the label, nearly a third failed the analysis. Even in the same bottle, doses could be all over the place.

Okay, all universally opposed, but, look, how do we know everyone isn’t just in the pocket of the pharmaceutical industry—you know, just doesn’t want the competition?

Well, whenever I’m skeptical, I turn to The Medical Letter on Drugs and Therapeutics, considered to be one of the least-biased sources in medicine. They’re kind of like the Consumer Reports of the drug world, and, in fact, was actually co-founded by the co-founder of the publisher of Consumer Reports, more than 50 years ago.

As they like to brag on their website, The Medical Letter does not accept grants— from any source; donations—from any one; funding—from any entity. They won’t let their work be used for promotional purposes, and they don’t accept any advertising.

They recently reviewed bioidentical hormones, and came to the same conclusion: “There is no acceptable evidence that ‘bioidentical’ hormones are safe or effective. Patients should be discouraged from taking them.”

Please consider volunteering to help out on the site.

Images thanks to Quadell via Wikimedia Commons; Lameer Witter; Dan & Corina Lecca; Marji Beach of Duchess Horse Sanctuary via flickr; mtholyoke.edujustthismoment, and Bonkers Institute for Nearly Genuine Research.

Images thanks to Dan & Corina Lecca; Lameer Witter; mtholyoke.edu; justthismomentBonkers Institute for Nearly Genuine ResearchQuadell via Wikimedia Commons; and Marji Beach of Duchess Horse Sanctuary via flickr. 

Doctor's Note

Another way to rid ourselves of excess estrogen is in the way nature intended: Relieving Yourself of Excess Estrogen. We can also stop consuming steroid hormones; see Anabolic Steroids in Meat, and Acne & Cancer Connection. For other ways to decrease breast cancer risk, see The Answer to the Pritikin PuzzleBreast Cancer Survival and Soy; and Broccoli Versus Breast Cancer Stem Cells. And check out my new 2018 video Soy Phytoestrogens for Menopause Hot Flashes

For more context, check out my associated blog posts: Stool Size and Breast Cancer RiskMushrooms for Breast Cancer PreventionTreating Breast Pain with Diet; and Are Bioidentical Hormones Safe?

If you haven’t yet, you can subscribe to my videos for free by clicking here.

84 responses to “Plant-Based Bioidentical Hormones

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    1. The reason there is no acceptable evidence that bioidentical hormones are safe for use is because there is no study anywhere of bioidentical hormones. All studies have been done on horse hormones. There is no acceptable evidence that bioidentical hormones are not safe for use either.

      1. Linda,

        There is no lack of well done published long term experiences on the use of various compounded bioidentical hormone. Both in terms of the safety and efficacy.

        Let’s start with this study:The bioidentical hormone debate: are bioidentical hormones (estradiol, estriol, and progesterone) safer or more efficacious than commonly used synthetic versions in hormone replacement therapy? and then Bioidentical, Synthetic, and Animal Based Hormone Replacement Therapies and Risk of Breast Cancer and I could fill this blog with additional studies showing a safer and less risk based reality using BHT.

        For anyone wanting additional info a simple dive into google scholar or use the pubmed search and see the plethora of studies in 2017 alone.

        One of the issues to be considered is that unlike the synthetics there is a very wide variety of combinations, which inevitably leaves us with less than fully evaluated information. Could and should this be a consideration ? I believe that it should not be as every one of our patients is quite different in an array of issues such as hormone receptors, receptor sensitivity, liver function, diet and the list goes on… including exposures, genetics, etc. The overall safe and effectiveness highly suggests that BHT is a much more appropriate use of hormone therapy vs conventional hormone applications.

        Oh and please also see the naysayers and note their funding sources….. I’ve had the “pleasure” of attending some of the educational lectures from the conventional hormone folks. Entertaining and misleading would be words that come to mind.

        My clinical experience has taught me to use the minimum dosing of the bioidentical hormones and find the correct combinations by slow and deliberate changes of the BHT. Often times we land up with very low doses which are not achievable with the synthetics. After watching 30 years of patient satisfaction with this approach and no long term adverse events seen over thousand of doses, I’m sold.

        Dr. Kadish moderator for Dr. Greger

        1. Dr Greger’s video ends by stating there is no study that shows bio-identical hormones are safe to us. It’s good to know that there is evidence that bio-identical hormones are safe to use.
          Also, the two studies you stated are the same study. The first site states ” The authors did not report any potential conflicts of interest. ” . I would not trust that study. What if they used only plant-based women in their ‘no sign of breast cancer’ control group?

        2. I am hoping one of the moderators can help me. I have been plagued with very painful daily headaches for the last year. I am in my early fourties. The headaches came on suddenly and decided to stay. Through numerous doctors visits and treatments I finally found a functional medicine doctor that said they may be hormone induced. I also found Dr. Gregers’ book (which I absolutely love around the same time). My doctor then ran some blood tests and found that my testosterone was extremely low. She recommended getting off my birth control pill and supplementing with bio identical testosterone via troche supplementation. What do you know, the headaches went away… the problem, my appetite went through the roof. I gained ten pounds without blinking an eye. My doctor then said the testosterone might be converting to estrogen causing those levels to rise too high and we may need to supplement with progesterone. I came across this video and now I am so confused about what to do. I stopped taking the testosterone 2 weeks ago because I was worried about the possible side effects. The hunger pains went away but my headaches have come back. So I feel like I am between a rock and a hard place…. Continue to gain weight or live with daily headaches. Can anyone help me?

          1. As one of the health support volunteers I’m glad to read you’ve found Dr. Greger’s book helpful. sorry to learn of your headaches and while we cannot give medical advice or recommendations, I would encourage you to work with your doctor since you had some initial success with those headaches. Certainly a frank discussion with her about your concerns about testosterone and bioidentical hormones would might help clarify some of your questions and also consideration of consultation with a neurologist about those headaches. I would encourage you to work with your doctor(s) to find a treatment plan that you are comfortable with that addresses the headaches while closely monitoring other symptoms.
            Have you discussed the weight gain and increased appetite with your doctor. Keeping and reviewing a food diary might help, especially if you can identify any changes in food patterns. Certainly being aware of calorie density is important to curb appetite, so if you haven’t you might want to review this video. https://nutritionfacts.org/video/flashback-friday-what-are-the-healthiest-foods/

            I agree it’s frustrating when you try one tactic but then other problems develop, but I hope with some determination working with your doctor you can find a path that leads you to a headache free life without unnecessary weight gain.

        3. I wonder if the opinions are based on the information that some compounded prescriptions are not consistent as stated in this video. But, if one found a trusted Bioidentical lab, that may rule out some of the opinions stated. The big pharmaceutical want to get their hands on everything in order to control and reap profit. So, it is no wonder they have negative comments. As for the independent report, on what did they conclude their opinions? What studies did they perform? Or were they dependent on the same evidence but concluded independently?
          I agree, each individual must be carefully monitored. I feel the same about my thyroid hormone medicine. That too have been best effective for me personally after taking Synthorid for 14 years with little to no effect except in the numbers off the TSH blood work that was too heavily relied upon.
          So, after being on a whole food plant based diet for 17 years and then getting repeat endometrial cancer, I have had to proceed with much caution as well as skepticism. I remain WFPB but I have benefitted from a well qualified MD for BHT that monitors me closely. My CA125 dropped from the progesterone and my after chemo depression was eliminated from the estradiol. Yes, I did chemo when the cancer returned within 6 months to my inguinal lymph nodes and after many alternative treatments, it was so bad I was unable to walk or bear the pain. I have had to to many things I swore I would never do and I don’t feel food is the cure-all. After research I found one comment about WFPB form a well know peer of Dr Gregor. If we start with WFPB we will probably not get cancer. I was in my late 30’s. Now in my mid 60’s. I’m wiser through experience now but not perfect in wisdom.

  1. Dr. John Lee did some excellent work on progesterone therapy for post-menopausal women. Anecdotally he relates amazing reversal of debilitating osteoperosis (sp) in elder women. Are you familiar with his work?

  2. I have been vegan for almost two decades. I have extremely heavy, long, painful periods (since onset of menses) and hypothyroidism and my doctor put me on oral bioidentical progesterone about a year ago. It has been very helpful to me. Are you saying that it is not safe to be taking that?

      1. Thanks Jo, I will look into that. I currently take a B complex that contains B1 and B6, but I don’t know what the amounts are. I also take a green tea extract supplement as I don’t like the taste of green tea (I take it 4 hours apart from my iron supplement). My iron has been low since it was first checked 15 years ago. I was borderline anemic before starting the iron supplements. It’s still chronically low, and I do include vegan sources in my diet (lentils, spinach, quinoa, soy, etc). I do sometimes wonder if red meat might improve my iron status, but I am sickened by the thought of actually eating it.

        1. Hi Veggiegirl,

          Late to your post but I am borderline anemic whether I eat meal or not. I guess we are just the unlucky ones who don’t absorb iron well.

          1. Study in India asked women not to drink tea around their meals and eat one orange after each meal – their iron levels went right up – vit c increases iron absorption..

            1. Thank you Dr. ! I want the world to know that I got breast cancer from bio-identical hormones! Thank you so much for making us all aware that they are harmful! My Dr. Prescribed them for a rare form of epilepsy and they worked but gave me stage 4 breast cancer. I lost my right hand due to brain tumor! Buyer beware! now that I am recovered I am working to get teh word out to other women who seem to think that they’re the answer to menopause.

              1. I’m sorry to hear you became so ill, but relieved for you that you are now in recovery, or have recovered. Please, can you share with us SPECIFICALLY what Bio-Identical hormone you were taking, the name, as much information you can give. And was it Estradiol? Using ESTRIOL instead is supposed to be the safe estrogen to use, and if you get it plant-sourced – not from animal source, not mare’s urine – but plant-sourced, and from a compounding pharmacy, it is not only safe against cancer, but helps protect against heart disease – which is a greater threat to women. ESTRIOL transdermal, used vaginally, or as close to the genitals as possible, is preferred, because then it is minimally introduced into the body, and it is not processed through the liver.

                1. When my milk glands became huge (some as large as pecans) overnight, I was terrified. I started researching the life of a tumor. Cancer begins with a single cell gone bad. It takes about 45-55 days to become two. Each doubling takes about the same time so to be detectable by mammogram, it takes about seven to eight years. To be found by self-exam is about two years later. I cannot tell you what a relief it was to learn that. It has also helped me relax because I now understand that if it is going to metastasis, it probably will have already. Therefore, eat a preventive and healing WFPB diet and have a life! Now, if anyone can help explain the mechanism causing DES-exposed women (1945-1972) to almost universally have issues with phytoestrogens, we would all very much appreciate it!

        2. No do not eat red meat!!! Also watch a documentary on Netflix that just came out in 2017 Called What the Health! What an alarming eye opener!!!

            1. My doctors are longevity experts, they are so amazing. The doctor he is 45 looks like he is in his 20’s he is a vegetarian . He has me on an amazing organic vegetarian, protein powder with minerals concentrate, and a scoop of this amazing multi-vitamin I all this in drink daily in lactose free smoothie I also take cold pressed flax seed oil milled flax seed is the key for helping women in perimenopause and menopause is plant based hormones

    1. Dose, vehicle (oral or skin), and age of person all make a huge difference as to safety. I take estradiol and synthetic progesterone via skin patch at low dose and it has totally cured my excessive bleeding. You may want to talk to your doctor about the patch. Good luck. I’m a vegan too, btw.

    2. I have always been anemic. Even the entire time I ate meat. It’s taken a bit to get my iron up since I became vegetarian and now vegan. But I find steeping raw organic stinging nettle dried loose leaf (you could use fresh leaves as well) over night and consuming once I wake up in the morning has helped immensely. My iron levels are perfect now.
      Google nettle infusion (Susan Weed has a infusion that I use) and it is very high in iron plus many other nutrients.

  3. Dr. Greger, I’m wondering about what I should do in regards to my hypothyroidism. I was diagnosed with Graves disease in 2006 and shortly took the radioactive iodine treatment which left my thyroid non-functioning. I have since been taking levothyroxine off and on for several years now. Levothyroxine makes my T4 numbers look good when I get tested but I don’t feel any better when i take it. I have been a vegetarian for many years now and a plant-based vegan for a short time now and am not sure what I should do in regards to my thyroid, as the only time I feel better is when I monitor my diet and eat plant-based. My endocrinologist swears that I need to take the hormone but I really don’t feel any better when I do. Please help. Thank you.

    1. DonnJay,

      First step is to make certain that your evaluation of your thyroid is complete. By this I mean do you have the FreeT3 as well as the FreeT4 lab levels, as a starting point ? Without this information your flying in the dark. Using TSH as an indicator is soooooo old school and inaccurate as to be unacceptable.

      After treating 1000’s of hypothyroid individuals, from all causes, it’s eminently clear that how you feel and not the numbers, within reason, are the key. And if one fails to evaluate all the thyroid aspects why would you expect to get better ? Universally I have needed to use T3 either alone or together with T4 therapy following thyroid irradiation in my patients, coupled with other supportive therapies.

      Please see this site: Mary Shomon – Verywell and start to evaluate your best course of action. You should feel substantially better, within weeks, of starting the correct therapies.

      Look forward to hearing your back to your old self feeling wonderful !

      Dr. Alan Kadish moderator for Dr. Greger

  4. Thank you for this one. My doctor gave me a yam compound that I smeared on for a month. I had horrible results. It did nothing to rid me or night sweats or hot flashes. It did nothing for my mood except worsen it.
    I told him I was afraid of hormones but he said this was harmless. I doesn’t seem harmless to me.

  5. At the age of 35, I had a total abdominal hysterectomy and bilateral salpingo-oophorectomy. I take compounded BHT and thank goodness I do!! I would rather know the risks and take the plant derived hormones over horse piss any day. Without the BHT, I would be in the loony bin with the electroshock therapy!! Women have had to suffer through so much!

    1. Isn’t bht butylated hydorxytoluline, a synthetic antioxidant used for preserving cooking oils? What hormonal effect does it have. I have read that it may antiviral activity since it can disrupt the fatty coat of some species.

  6. I don’t know about the long-term safety of bio-identical hormones- but my girlfriends can tell you from personal experience that they’re effective. They stopped her hot flashes and depression, helped her sex drive and energy and made her skin more youthful- including the skin inside her legs that used to be all dried up.

  7. I also wanted to point out that bio-identical hormones are not identical to the synthetic hormones that big pharma patents and doctors prescribe. They are unpatentable natural substances with well-established effects. It is the synthetic unnatural chemicals derived from horse urine which we have reason to suspect.

    1. Roger T., do you even know what you are talking about? Not ALL bio-identical hormones come from pregnant mares, only Premarin, and perhaps another one that I can’t recall the name of. Many bio-identical hormones are PLANT-SOURCED.

      1. Jane, I hope you noticed, eventually, that nothing Roger T. said contradicted what you said, or vice versa. In fact, reading more carefully, you both probably agree.

  8. Dr Greger,
    Do you have any information on treatment with single agent bioequivalent progesterone given without estrogen
    treatment? I know there have been some small studies indicating that
    treatment with progesterone alone can help ameliorate symptoms, but
    haven’t seen anything about decreased risk of cancer with progesterone
    alone versus estrogen or estrogen + progesterone. Thanks in advance.

  9. From my understanding of the literature, we just don’t have enough studies in the US of women using strictly bio-identical hormones to say much of anything. We are all an experiment! I think there is more and more evidence, both in Europe and here, that synthetic progesterones (progestins) may have harmful effects. But what is more striking to me is the practice of placing women on a static doses of estrogen, progesterone and testosterone hormones, with no variation in dose with the cyclic rhythm of the month. There is nothing biologically “natural” about this practice. I think it is here that we may be way off the mark. Many women take hormones after menopause for very legitimate reasons that make a significant difference in their quality of life. Hopefully someday we’ll have some decent studies that really look at these issues.

    1. Recent long term studies in France, that looked at women exclusively on bio-identical hormones showed a decrease in strokes. There is also a US study showing lack of hormones has a link to atheriosclerosis. Probably why cardiovascular disease increases after menopause???

      1. The endocrinologist who I consulted with on my hormones told me and this was 2 years ago was that what was coming out in the research was that low hormones after menopause can cause heart disease very rapidly for women. Without HRT I can barely move fatigue, hair loss, bloating, aching bones, dry skin, low intestines, fuzzy brain, poor balance and slow growing nails and hair, and anxiety.

  10. What hormones are we talking about here? Estrogen only? Estrogen plus progesterone? Estrogen plus progestin? Progesterone only? Testosterone? Thyroid hormones?

  11. “Patients should be discouraged from taking them”. Hmmmm…. What about those women who would like to continue enjoying sex, but are concerned about vaginal atrophy? If this were a men’s issue, it wouldn’t even be being discussed, because of course men want to continue having sex. But women should be discouraged from taking bio-identical hormones due to the (not huge) increased risks of certain diseases…

    1. Coconut oil! I was using a bio-ID progesterone and still had horrid atrophy. I desperation I grabbed my virgin coco oil and smeared it in my labia. I also made “pellets” to push up. The next time I saw my gyne she said she would never know my age by my tissues and asked what I was doing. Now I just put a little on externally. She knows tells all her older patients about it.

        1. I found an ice cube tray for very small ice cubes. I fill each spot with liquid coconut oil and keep it in the freezer. Every night I pop one out (or pop them all out into a small container) and just as I go to bed, push one up as far as I can. My gyne will not do an exam now unless I have been faithful for a week! Without the coconut oil internally, I have pain up the middle to my tummy button. I am 66 yo

  12. Dear Dr.Greger, please please answer my question because Ive been wondering forever and my doctor is no help at all.
    I have had higher than normal androstenedione levels since I was 17 (only got tested then, so dont know earlier), I am now 26. I was vegetarian, then became vegan, even tried raw veganism but failed, so now am vegan half-raw half-cooked. I have had back acne since 14-15, hairgrowth on my body is increasing with every year… I have little bumps all over my face but you only see them in certain lighting.Ive been tested for PCOS but they saw nothing. So my question is: what else can this be :S
    I was low in vitamin D and B 12 but am supplementing this daily.
    I am in good shape, exercise, bmi 19.5, oh and female ofcourse. My testosteron is to the high side as well but not too high.

    Thx in Advance

    1. Hi Amanda, Congratulations on the diet sorry to read about your difficulties. Of course there are normal variants between patients and if you are following a good whole plant based diet with Vitamin B12 supplements you should be avoiding many of the dietary and chemical contaminants that contribute to acne and hair growth. In addition to the level of hormones in the body patients cells actually respond differently to the same hormone levels. I would suggest that you continue to be followed by a knowledgeable endocrinologist as there are other conditions other then PCOS that may cause your difficulties. A good dermatologist might have other suggestions both as to the underlying cause and to help treat the acne. Good luck and sorry I couldn’t be of more help.

      1. Hi Amanda, I know this is from a long time ago but I am very similar to you and wondering if you ever figured out a way to heal yourself or deal with the symptoms. I hope your doing well!

  13. What would be recommended, then, for young women who have to have their ovaries removed? I have a BRCA-1 mutation and have been vegan since finding out 2.5 years ago. I am 37 and recommended to get bilateral mastectomy and oophorectomy ASAP, or at least before age 40. This is a really hard thing to go through, and I’d like to know anyone’s advice on what would be the best way to remedy the hormone loss.

  14. Obviously the study did not consider the danger of trying to function on less than 2 hours sleep every night for months/years! I woke up every 90 minutes for years until I discovered bioidentical hormones. A very low dose gives me 8 hours of rejuvenating sleep at night and I’m not giving them up until something else works. Believe me, I’ve tried every other natural insomnia remedy out there.

    1. I have had the opposite happen to me. Been on Bioidenticals for 6 yrs and I still have to take a sleeping pill. But it does help with the hot flashes. Have my blood work done every so they say I am on the right dose but….no sleep without a pill which I don’t want to be on.

    2. Oh gosh, I hear you Pam. When I go off mine, I do NOT sleep. This info scares the crap out of me. And at 60, it’s quality of life that i am interested in, but don’t want to end up with cancer.

    3. Yeah the waking up every two hours before HRT was a whole load of fun. I forgot about that one when I named all the stuff that I have a problem with above without them. I don’t even remember hot flashes those would be great if that is all I had. That would have been a cake walk. My mom was the same way and she had to go on hormone treatment back in the 80s. She said she felt so horrible she went in a demanded estrogen. When I try to go off I actually feel a crawling feeling in my insides.

  15. Your advice, Dr. Greger, is almost always very understandable to me, but I do want to know what you recommend for women who have vaginal atrophy or other issues that bio-identical hormones can help? What is your opinion about a cream? Not a vaginal cream, but a topical cream that is smoothed onto a woman’s inner thighs or inner upper arms, so it bypasses the liver? I would think as a middle-aged man that this issue would affect you as well, so what works for your sexual partner?

  16. Combipatch- Bioidentical estradiol and synthetic progestrone – taken via a patch is fairly safe, especially for women who are still going through menopause, has been a miracle for me. Insomnia, anxiety, hot flashes, excessive bleeding, depression…all controlled from patch. I am a vegan who eats a very balanced diet of whole foods, gets her blood levels checked often, takes supplements, etc. But only the patch worked for me. I also have to stay away from soy, flax and most legumes as they mess with the balance of estrogen and progesterone and cause symptoms. (I get my protein now from veggies, whole-grains and some seeds and nuts, particularly almonds.

    1. I am been seriously thinking about that patch. I have tried it all pills and creams, everything but I can’t get a steady flow of hormones. I did the patch for awhile but for some reason I thought creams would be safer. I did it for awhile but i hate the idea of transferring the cream to others. I used to take birth control pills for years and never had an issue. I want to do natural progesterone but it doesn’t come in a patch

      1. The progesterone in the patch is fairly safe. I did a lot of research on it. It is the variety that does not increase cholesterol. And because it is absorbed through the skin, it is safer. Give it a try. There are two doses, go for the one with the lower progesterone dose first. And then give it a couple of weeks before you decide. It took a week or so for my symptoms to subside after placing the patch on. Good luck!

  17. I had such bad symptoms when I weaned myself off bio-identicle hormones, that I started taking them again….and feel much better. Having a good, compounding pharmacy is important.

  18. Dr. Greger, please advise. I just had a bi-lateral hysterectomy with complete oophorectomy (sp) due to enlarged uterus, large fibroids and a septated ovarian cyst. I was not having any menopause symptoms prior, however I had stopped having periods since a D&C in 2011. I am having severe “hot flashes” with exacerbated asthma to the point of being almost non-functional. Prior to the hysterectomy I had no asthma attacks in 40 years. I’ve also had a pre- cancerous breast mass removed in 2007. That along with a family history of blood clots makes me uncomfortable with synthetic/equine estrogen HRT or ERT. I’ve heard that soy may be effective in regards to estrogen replacement. I’m also concerned about preventing Osteoporosis. Are fortified calcium and Vitamin D such as that added to plant milks safe? What do you suggest? Thank you so much in advance.

    1. Tia: I’m not a doctor and can’t comment on most of your questions. However, I thought you might appreciate a reference to a book about preventing osteoporosis.
      “Building Bone Vitality” by Amy Joy Lanou, Ph.D. and Michael Castleman.
      http://www.amazon.com/Building-Bone-Vitality-Revolutionary-Osteoporosis–Without/dp/0071600191/ref=sr_1_1_title_0_main?s=books&ie=UTF8&qid=1392152304&sr=1-1&keywords=building+bone+vitality

      Dr. Greger would take issue with some of the theories in the book, but I think the overall recommendations and bottom line for the book is valid and helpful.

      Good luck.

      1. Thanks! I’ve read several books, including Suzanne Somers “I’m too young for this”. I’m perusing BHRT as I think this is the healthiest option for both men and women when they experience “the change”. Unfortunately, you really have to dig deep and educate yourself, then insist on a better answer from your doctor! Mine first wanted to give me Premarin, which I refused (see the WHI study if 2002), then I was given the estrogen patch that “works for most people” who apparently are ok with the serious risks. I declined that ad well. I’m getting by with a natural estrogen cream until my BHRT is properly formulated. For that, you have to seek out a compounding pharmacy.

        1. Tia: Good for you for standing up for yourself and what you know would be bad decisions. I think you saved yourself some trouble down the line by doing your research. I don’t know anything about BHRT or issues around supplementing with estrogen, but like you, I do know that Premarin is a bad idea.

          1. Thea, Do have thoughts on MACA for menopause? and if so can you comment on its safety ( cancer risk)…Much Thanks..I think someone else on this tread asked a similar question…..

            1. citrus1: I like how you worded your question, re: “…thoughts…” I often have thoughts. ;-) In don’t always have the concrete info I wish I would have.
              .
              As for maca, my thoughts are: I’ve heard of maca and even had a doctor recommend it to me once (though not for reasons of menopause). However, this same doctor had recommended licorice, because he had been unaware of the potential danger of licorice. So, I’m pretty sure the doctor was not aware if there was any research, positive or negative, specific to maca.
              .
              A dog trainer who I particularly like once said something to the effect of: If something has the power to effect change, it has the power to hurt as well as help, or both. So, I think it is especially wise of you to ask what the downside to maca might be. I don’t know the answer. I hope that one of our medical moderators or research-wise community members will answer that question. In the meantime, my thought it (lame as it is) is to be cautious.
              .
              What do you think?

      2. Its important to use the terms “claim” or “hypothesis” in statements such as the above. In science a theory is an explanation for a phenomenon in the physical universe that is supported with an overwhelming and substantial amount of evidence to support a hypothesis and none to refute it. Old science teachers never stop trying to grow scientifically literate minds. So our choice of words is critical.

  19. The way to not need prescription HRT or compounded bio-identical hormones adjusted to your personal physiological needs is to eat at least 2 tablespoons of ground flax seeds in something good and tasty every day for the rest of your life, and pumpkin seeds, avocados and olives and be as green vegetarian as you can possibly be. Don’t consume any oils except very small amounts of extra virgin olive oil and coconut oil for baking or sautéing, everyday oil competes with omega 3. Drink water as your primary beverage with unsweetened electrolye salts added. Take bathes with lots of Himalayan salt crystals, get alkaline. Don’t ever eat anything #GMO. Check me out on twitter.com/rivkafreeman where I try to teach nutrition therapy.

    1. Really Rivka? That very mild food-based protocol certainly does not work fro everyone. I was eating 3-4 tablespoons of ground flax seeds, and eating raw pumpkin seeds by the handful, using minimal oil, and when I did, it was virgin coconut oil, and I have always been someone who drinks 8-10 glasses of pure, filtered water a day. I also avoid GMO products. The only thing I did not do was “bathe in Himalayan salt”, but I do use Himalayan salt in my food. It did not affect my post menopausal misery in the least, did nothing for me. Some of us need something stronger.

  20. Thank you for these videos, they are so inspirational and eye opening….it is so great to discover all of this wonderful insight. I’ve also found this video helpful because I have recently considered trying bioidentical hormones because i am finding the ones I am on seem to be causing some depression.

    I feel curious what is the best treatment for premature ovarian failure ?

    I am 34 and I had menopause at 26 and I have only just been put on an estrogen patch a month ago after a hospital admission however, because I have had heart issues in the past i am really interested to discover the best treatment so that I can protect the health of my heart in the future.

    This site has been helping me in many ways in terms of changing my diet to a plant based one and taking responsibility to improve my health ,overcome a food addiction and turn many things around for the better…11 months ago…I had some paralysis in my left side and now i am walking around and living life again. It is amazing what good nutrition and self care can do. So I am immensely grateful for the information that is here. This site is so helpful , it gives us the freedom to make well informed decisions based on science and it is also great for motivation and inspiration to stay on track with these great nutritional principles.. This information save lives.,. Thank you. :-)

  21. Try armour thyroid or Nature-Thyroid. It gives you t3 and t4 and is by prescription. You of course can get it
    online without one. Do your own research, ask your doctor. It may change your life!!!!!! It has mine and millions of others.

  22. I am wondering about maca powder for menopause and andropausefor. I am a almost 3 year whole plant,no oil vegan and still have to fight hot flashes and insomnia to some extend. How long will it take until my body gets used to the maca and my sleeping gets better? I would love to hear your insides!Thank you.

  23. I am 53 years old and went into menopause 2 years ago and started terrible hot flashes 1 year ago… But what is more troubling than that is I’ve had consistent painful intercourse. Western med docs prescribed Premarin (which I refused to take) and then Estradiol + Progesterone. I am wondering if you know of a natural way. This has been very upsetting to me. I have been vegan for 4 years.

    1. I am a year and half late, Karen. I read this discussion before you posted. I mentioned in a prior post that virgin coconut oil is my atrophy cure and my doctors are all amazed when I tell them that is all I use, prescribing it to all their postmen ladies. I live in the Philippines and our oil is just that: oil. liquid. When I visit the US or the mountains here, I have it in a small container that I slip into hot water as I begin my shower/bath. Enough is melted to apply externally. I also found an ice cube tray for very small ice cubes. I fill each spot with liquid coconut oil and keep it in the freezer. Every night I pop one out (or pop them all out into a small container) and just as I go to bed, push one up as far as I can. My gyne will not do an exam now unless I have been faithful for a week! Without the coconut oil internally, I have pain up the middle to my tummy button. BTW, it also makes a great lubricant….

      1. That’s very interesting. I’d read that women should avoid coconut oil as a lubricant. I can’t remember the reason, but it seems so natural that I’d love to try it with my partner. (Works good externally for men.) Can you give me any links to more info?

  24. Is there any research on the effects of testosterone treatment on trans individuals? What would you recommend to those who are looking to block estrogen and increase the testosterone levels in their bodies?

    1. lots of grass fed, organic, halal or kosher red meat. there are some really good videos on youtube for transitioning trans individuals. I stumbled across them when I was looking up HRT.

  25. Hey, I have questions about PCOS and what recommendations you have? I am about 20 lbs overweight and following the eating and exercise guidelines that your book says to without success in the weight loss area. Everything else feels great, my energy is up and I am feeling good. If anyone has healed themselves please comment!

    1. Megan: Joseph, one of the previous staff people at NutrtionFacts wrote a wonderful page on PCOS here: http://nutritionfacts.org/questions/what-does-the-research-say-about-dietary-interventions-on-women-with-pcos/
      .
      In addition to that information, I thought I would address your question about losing weight. As Dr. Greger says, losing weight is about understanding calorie density/energy density. I copied below some information that I often share with people who ask about losing weight. I hope it helps.
      *****************
      The nice thing about your situation is that you already understand half the battle. I’m guessing from your post that you already understand about the importance of a whole plant food diet and have at least a sense of how to implement it. That’s half the learning curve. The other half is understanding the concept of calorie density and how to apply it to weight loss so that you don’t get hungry and you still get all the nutrients you need.
      .
      Dr. Greger covers calorie density (http://nutritionfacts.org/video/eating-more-to-weigh-less/ ), but not in enough detail in my opinion for someone who wants to apply it for the first time. Doug Lisle, one of the experts in the Forks Over Knives documentary, gives a great ‘calorie density 101’ talk officially called: How To Lose Weight Without Losing Your Mind. I have watched the following talk from Doug Lisle several times and think very highly of it. And it’s free!!! And it’s entertaining! https://www.youtube.com/watch?v=xAdqLB6bTuQ
      .
      As good as Doug Lisle’s talk is, it pretty much just gives you a solid understanding of the concept, but not enough practical information in my opinion. For starting to get the practical information, I recommend a talk from Jeff Novick,Calorie Density: “How to Eat More, Weigh Less, and Live Longer,” http://www.jeffnovick.com/RD/Calorie_Density.html If talks aren’t your thing, the following article from Jeff covers a lot of the same information: http://www.jeffnovick.com/RD/Articles/Entries/2012/5/20_A_Common_Sense_Approach_To_Sound_Nutrition.html
      Be sure to pay attention to the charts.
      .
      Chef AJ tells people who want to lose weight to eat “left of the red line”, where I believe the red line is on a diagram of hers representing is about 650 (or so) calories per pound. And “left of the red line” is all the whole plant foods which are below 650 calories per pound. The above article from Jeff Novick gives you a good sense of which foods are “left of the red line” by food category. But if you want to look up the calorie density of specific foods, you can find many foods on the following site: http://nutritiondata.self.com/ Most foods on that site have the option of choose an ‘ounce’ as a size. Then you can multiply by 16 to get the calories per pound.
      .
      It would be perfectly respectable if you are one of those people who are just not interested in the theory. You just want to dive right in and want straight how-to information. If you would rather not think about any of that (or start with the theory and then move onto this step), I have one more suggestion that Dr. Greger also recommends in his book, How Not To Die. Consider going through the free program from PCRM (Physician’s Committee For Responsible Medicine) called 21 Day Kickstart. The program will “hold your hand” for 21 days, including meal plans, recipes, videos, inspirational messages, and a forum (moderated by a very respected RD) where you can ask questions.
      http://www.pcrm.org/kickstartHome/
      (Click the green “Register Now” button.)
      At the end of the program, you will have a very good practical knowledge about how to eat with healthy and “low” (normal for most people) calorie density.
      .
      Another recommendation that Dr. Greger and I share is to get Jeff Novick’s Fast Food videos for tasty, affordable, fast and healthy calorie density recipes. Also, on-line and free is a YouTube series of recipes/cooking shows called something like Chef AJ and The Dietician. I know that Chef AJ will not steer you wrong in terms of weight loss and providing accurate nutrition information.
      .
      How’s that for some tips? If you give these ideas a try, please report back and let us know how it went.

  26. Thanks for vid.
    All I know is that I was initially on Synthroid and felt absolutely horrible.
    When I switched doctors, and got on Armour thyroid, I felt great, and have ever since. Numbers are amazing now and have been able to lose weight. Menopausal, TAH 3 years ago.

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