Many times, when a woman is fatigued and experiencing postmenopausal symptoms, practitioners are quick to recommend hormone replacement therapy, referred to as HRT.

This can mitigate the symptoms of menopause and particularly serves as a quick first-line defense against hot flashes, usually the most troubling of all menopausal symptoms.

HRT seeks to bring your estrogen (and sometimes progesterone) levels back up to a higher level, which is what you had when you were more youthful.

Estrogen is typically provided as a prescription called “estradiol.” You can receive prescription hormones via pills, patches, pellets, and creams. Estradiol is one of the three sisters of estrogen; remember, estrogen refers to a combination of estradiol, estriol, and estrone.

Unfortunately, many physicians prescribe the one “sister” by herself, meaning they just give you estradiol and not the other two estrogens. They also do not always give you progesterone with the estrogen medication.

This is a mistake, in my opinion. The estrogen prescribed all by itself is termed “unopposed estrogen.” Despite progesterone’s far-reaching impacts on health, many doctors still wrongly assume its only job is to protect the uterus, and they don’t usually prescribe it with estrogen.

But there are receptors everywhere in your body for progesterone, so you need it whether or not you still have a uterus.

Taking estrogen and/or progesterone doesn’t always help because you might also be deficient in pregnenolone or DHEA, two hormones that are higher up on the chain.

Certain HRT medications come with an increased risk of breast and uterine cancer as well as the small, but potential, risk of heart attack, deep vein thrombosis, and stroke.

HRT medicines are potent drug muggers and are capable of suppressing nearly every mineral in the body, as well as your B vitamins.

Take synthetic HRT long enough and you’ll have even worse fatigue, depression, hypothyroidism, confusion, memory lapses, anxiety, insomnia, and weight gain.

You can choose bioidentical hormone therapy if traditional HRT doesn’t improve your postmenopausal symptoms.

Doing so provides your body with estrogen and progesterone in forms that are biologically identical to what was naturally produced in your youth. That means you experience more of the benefits and fewer side effects.

These therapies are usually created in compounding pharmacies as topical creams, and the dose is customized for you. The dose is determined by the amount that you make, as well as your response.

It’s a trial-and-error thing, so when you start with bioidentical hormones, you should ask the pharmacy if you can purchase just a week or two at a time, so you can test it and be sure that adjustments to the levels of hormones can be made before you buy a 90-day supply.

Oftentimes, the bioidentical hormones used in the cream include some or all of the following: DHEA, testosterone, estriol, estrone, estradiol, and progesterone. Estriol is hardly ever mentioned, but it’s a fun fact that the placenta produces this estrogen in large amounts during pregnancy.

Find a physician in your city that specializes in reading labs and prescribing hormones, rather than just asking your general practitioner for a one-size-fits-all pill.


This information is not intended to diagnose, prevent, or treat your disease. For more information about the author, visit

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