Estrogen for Perimenopause and Menopause
In this blog, I’m going to share my experience and my opinion on Estrogen Pills, Vs. Creams Vs. Patches and the benefits you gain by supplementing with Estrogen for Perimenopause and Menopause symptoms.
There are three types of estrogen we produce as women's during our lives.
Estrone (E1) - is the primary form of estrogen that your body makes after menopause. It's the weakest type of estrogen and is produced in the adrenal glands, fatty tissue and ovaries.
Estradiol (E2) - is the primary form of estrogen in your body during your reproductive years. It's the most potent form of estrogen.
Estriol (E3) - is the primary form of estrogen during pregnancy
Bioidentical Estrogen for Hormone Replacement
If you’ve been researching and studying Hormone Replacement Therapy, you’ve likely heard of Bioidentical Hormone Replacement Therapy. That’s a lot of long words, let me help break them down for you.
"Bioidentical" refers to substances that have the same chemical structure as those found naturally in the body. In the context of hormone therapy, bioidentical hormones are synthetic hormones that are chemically identical to the hormones produced by the body's endocrine system.
Hormone replacement therapy (HRT) is a medical treatment that involves administering hormones to replace those that are no longer being produced or are produced in insufficient amounts by the body. It is primarily used to alleviate symptoms associated with menopause in women, such as hot flashes, night sweats, and mood swings.
How do you know if the HRT you are considering is Bioidentical? Well, you need to look at the ingredients on the label or ask what you are being prescribed? We as women have several different kinds of Estrogen in us. The one that we need to replace for perimenopause and menopause is Estradiol. So, if the HRT you are considering has Estradiol as the main ingredient, then it’s considered Bioidentical. Bioidentical Estrogen can be a pill, patch or a cream
My Hormone Replacement Journey
When I first started HRT back in 2019, my original “diet” doctor put me on an Estrogen/Progesterone Troche. A Troche is a pill that melts under your tongue and then absorbs into your body. I had read some papers on the different formulations of Estradiol, so after a few years, when I switched from getting my HRT from a local doc (who really wasn’t so local – 45 min drive), I wanted to see if I could find an online HRT provider who would prescribe an Estradiol cream. That’s when I found Winona.
If you’ve been looking at online HRT providers, you’ve likely come across them. During my initial communications with Winona, my HRT Specialist and I landed on prescribing for me their Estradiol / Progesterone Cream and then their DHEA pills. It was about $74 per month. I used these two products for several months and although I felt okay, I was still curious about my hormone levels and if I was getting the right amount of Estrogen and Progesterone.
After my first 3-month prescription from Winona, I switched to a company call Joi Women’s Wellness. They require blood work and labs before they’ll prescribe HRT. I went to their website, choose the lab panel I was interested in and paid for it. They immediately sent me lab orders to visit a nearby Lab corp. Within a week Lab corp had sent my blood results to both me and Joi Women’s Wellness. I then scheduled my 1:1 consultation with one of their clinicians. I met with Brooke, and she pointed out that even though I was on an HRT Cream of Estradiol and Progesterone, my levels were still pretty low. After a few minutes of conversation, we decided together, that I would switch to an estradiol patch and take the progesterone as a tablet, 100mg.
The estradiol patch was the .050 dosage. We also decided that I would start taking testosterone as an injection. Three months later when it was time for me to be tested again, now my estrogen was through roof and was way too high, my progesterone was still low, and my testosterone was also low. So, we tweaked my meds again. Keep in mind, we would not have known any of this, had it not been for lab work. We went to the .025 estrogen patch, so half the dose of the first prescription, we doubled the progesterone tablet to 200 mg and she suggested that rather than doing my testosterone injection once a week, to up to 2X’s per week.
Three months later I was tested again and now my estrogen was on the low side again. My Progesterone was good and so was testosterone. So, we went for the patch between the .025 and .050 dosage and today I’m on the .0375 dose, 200 mg of progesterone and I cycle the testosterone throughout the year, mainly due to cost.
Estradiol, Patch Vs. Pill Vs. Cream- Which is better?
That will likely depend on each of us as individuals. Since I didn't feel like the cream absorbed well and was proven by my low estradiol numbers in my bloodwork, I personally lean toward the patch as being more effective.
What I have learned, is that you may have to tweak your formulas and dosages a few times before you get it just right. Many HRT specialists and docs use the evidence-based medicine approach and don't require blood work or labs, unless you want them. For years, this worked for me, but I finally got to a point where I wanted to know what my levels were.
Estrogen Patch Costs
I’ve always gotten my patches at the local CVS pharmacy. I used my medical insurance that I get as a benefit from my full-time employer. I’ve paid as much as $96 (that was August 2024) for a 3-month supply and I’ve paid $31 (in November 2024) for a 3-month supply. I can’t speak to why there was such a different to the costs, as that is still a mystery I’ve yet to figure out. If you know the answer, please share.
Benefits of HRT Estradiol Patch
For me, this is the laundry list of the benefits I have noticed and seen since starting HRT back in 2019.
No more night sweats
Not as irritable
No hot-flashes AND
I was finally able to shed some weight along with using Semaglutide for about 6 months
Well, there you have it, my thoughts on Estradiol and whether the pill, patch or cream is better. I’ve included links to Winona and also to Joi Women’s Wellness throughout this blog, if you want to check them out.
Winona is simple and doesn’t require a 1:1 consult or a start-up fee. Joi does require labs for hormone testing and includes the 1:1 consult fee in the lab costs. I’d go this route if you have interest in knowing your blood hormone levels.
Want to research other online Hormone Replacement Providers, see the links below and be sure to use coupon codes if I've noted them. All of these providers offer bioidentical estrogen patches and creams.
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