To Testosterone or Not to Testosterone?
There seems to be a lot of controversy around testosterone replacement. It is billed as the solution for low sex drive, building muscle, and improving mood. Yet, not all women notice a difference when they supplement and the guidelines are specific that it’s only indicated for hypoactive sexual desire disorder (HSDD). In fact, the Global Consensus Position Statement on the Use of Testosterone Therapy for Women states “Testosterone therapy, in doses that approximate physiological testosterone concentrations for premenopausal women, exerts a beneficial effect on…
When Is HRT Actually Indicated?
PHEW! There is some serious controversy around this especially as there are the guidelines and then there are clinical experiences or new research articles not yet included in the guidelines. When it comes to estrogen in particular, I want to outline what is recommended and what is FDA approved. Do keep in mind that a guideline is not a law - this piece of advice was given to me by an oncologist (believe it or not). However, it’s a solid place to start if you’re considering hormones. Right now, the Menopause Society...
Is it Perimenopause, a Thyroid Problem, or Both?
Perimenopause is a transitional state of midlife that tends to come with a number of symptoms. According to my friend and researcher, Andrea Donsky at Morphus, there are over 100 signs and symptoms you might experience. Some of those include fatigue, brain fog, weight gain, period changes, digestive changes, and more. It turns out, many of those same symptoms overlap with the symptoms of thyroid problems! This is important to know as it’s estimated that Hashimoto’s and hypothyroidism are way more common in women ages 30-50 years old. In fact, this study states...
Is Perimenopausal Rage Real?
The short answer is yes. Rage can be very real and is more common as women move through the perimenopausal transition. In general, about 40% of women experience mood changes because of the hormone changes (and stress. We can’t forget the extra stress). This can include everything from depression to anxiety, to feeling more introverted and unmotivated to panic attacks. In there, extreme anger or “perimenopausal rage” might also come out. I was having a meeting with another perimenopausal woman who told me the story of when...
My Hormone Interview on The Dhru Purohit Show
I had the opportunity to be on The Dhru Purohit podcast where we talked through all sorts of myths women hear when they hit their 40's and beyond. Listen up or watch the video to learn about what the heck is happening, protein and muscles, mitochondria and hormones, sleep, mood, HRT, and why I love the word, "no" more than ever!
How Do I Know If It’s Time For Progesterone?
Hormone replacement therapy is all over social media - with good reason! Which might leave you wondering, “Is progesterone right for me?” But first, what is progesterone? It’s your “pro-gestation” hormone as it plays a huge role in fertility. However, it also helps you feel calm, sleep better, have easier periods, and reduces PMS. It’s made in the second half of your cycle ONLY after you ovulate (or release the egg). Unfortunately, as we hit perimenopause, we make less and less progesterone. It’s even worse if you’ve gone through menopause or had your ovaries removed!
In the Event of Perimenopause, Put Your Mask On First
How many times have you flown and heard the flight attendant repeat, “In the event of an emergency, put your mask on first before helping others?” I bet it’s a lot and it’s for good reason. If you suddenly lose cabin pressure, how can you help yourself, your family, friends, or those around you if you didn’t put your mask on FIRST!? Turns out, this even applies to you if you’re solidly in mid-life. I would bet that you’ve spent a lot more of your life giving instead of taking, nurturing instead of being nurtured, caring instead of getting care, and thoughtful instead of being thought of...
Do You Need DHEA?
DHEA and DHEA-S are the most abundant steroid hormones floating around in your body! They are considered androgens and are made predominantly by your adrenal glands and your ovaries. DHEA is a “pro-hormone” or “precursor” that goes on to make hormones known as androstenedione and androstenediol. These two “A” hormones can then make testosterone, estrogens, or other downstream androgen hormones. Think of DHEA as being near the top of the funnel for your hormone production!
Explaining Your Progesterone Options
Whether it’s time to start progesterone, you’re considering it, or just wondering about your options, you’re in the right place! Progesterone is a hormone made predominantly in your ovaries after ovulation. It does a lot in the body but it’s primarily known for its positive effects on your uterus and the calming effects on your brain. If you’re not ovulating anymore, or if you’re not ovulating as strongly as you once did, your progesterone levels can decline. Generally speaking, most hormone societies and laboratories say…
Is the Ringing in Your Ears Getting Worse?
The other night I was laying bed and my ears started ringing…again. I’ve been noticing this is happening more like 1-2 times per week instead of once a month. I especially notice it at night when it’s quiet. It doesn’t last long but it’s annoying. Turns out, it’s not an uncommon symptom in perimenopause. I posted on Instagram about it and received a TON of comments and dms from women like you experiencing the SAME THING. Ringing in the ears is called tinnitus. It can sound like ringing, a high pitched beep, shushing, loud white noise, whooshing, buzzing, or a number of other descriptive factors. There are several known causes for it such as…
What Phase Of Perimenopause Am I In?
I tend to break perimenopause into early, mid, and late. I, personally, am somewhere between early and middle perimenopause and here’s why. If you still get your period and have your ovaries, research says approximately 50% of women will experience menstrual abnormalities by age 45.5 years. Women who have experienced ≥3 months of amenorrhea (no period) are highly likely (about 95%) to become postmenopausal within the next 4 years.
What Hormones Am I Taking?
You asked and I’m answering - “Dr. Carrie, are you taking hormones and if so, what ones?” The short answer is YES! I’m taking progesterone. I’m not yet taking estrogens or testosterone. I’m probably going to start DHEA. The long answer is…I am in my mid-40’s pushing into late 40’s. About 2-3 years ago, my sleep started to suck as did my mood prior to my periods. Given all my hormone training, I figured it was time for progesterone. My labs indicated that I did ovulate (release the egg), however the resulting progesterone production was not that great anymore. I began taking…
What Exactly Are Bio (Body) Identical Hormones?
I recently received a great DM on instagram asking me to explain what bio (body) identical hormones are and how they are different from what is the birth control pill or what was looked at in the Women’s Health Initiative study. Bio or body identical are hormone preparations such as estradiol (an estrogen) or progesterone that look exactly like the hormones you have in your body. These are commercially available at your local pharmacy such as the popular estradiol patches or Prometrium (the progesterone pill). Estradiol and progesterone can also be compounded at compounding pharmacies. Progesterone cream is often available over-the-counter as well that is bio (body) identical.
At What Age Should You Stop Your Hormones?
Years ago, I was taught in medical school that women should be on the lowest dose of hormones for the shortest amount of time. For many women, this was a period of 5-10 years then they would stop. I couldn’t understand why they had to stop as many of their symptoms would return! Imagine starting hormones at 45 years old and by 55 years old, giving them up. No surprise when they called reporting insomnia, weight gain, hot flashes, brain fog, mood changes, and more. Plus, increasing the risk for cardiometabolic disease, bone loss, and dementia…
Phantom Smells are Annoying
I had my first phantom smell. Dr. LaKeischa warned me about them as a possibility but I didn’t realize it would temporarily make me feel CRAZY! Not long ago, I was in my bathroom and could smell a sewer smell. I asked my husband to see if he could smell it thinking we needed to fix the drain. Naturally, he couldn’t smell anything. “Smell harder!” I said as he’s sniffing as hard as he can while walking around the bathroom. “No, I don’t smell anything. It doesn’t smell like sewer gases.”
I was confused. It was SO CLEAR that the sewer gas smell was in my bathroom. A few days later while running errands out of my house, it happened again. Immediately I knew it was a phantom smell. <cue annoyed eye roll>
My DUTCH Test Results
I have done a DUTCH Complete test at least every year for about the last 10 years. I used to work there as their Medical Director and definitely had employee perks. However, I don’t work there now and still do the test to keep tabs on my health. Also, no. This is in no way sponsored. You might have done a DUTCH test or have questions about ones you have seen. I thought this might be a nice overview showing you MY results! First, some background on me…
Annoying Intestinal Health Changes in Perimenopause
Here’s an interesting fact: You are more microbial cells than you are human cells in your body! Every time I read or hear that, it blows my mind. You have several microbiomes actually. In your intestines, on your skin, in your mouth and sinuses, and your vagina. Unfortunately, as you head into perimenopause and then menopause, the decline in estradiol really impacts it for the worse! It’s annoying and not fair.
Is It Still Perimenopause Without Hot Flashes?
Recently, I was talking with integrative gynecologist, Dr. LaKeischa MD, on her Hormone Hotties Podcast about metabolic syndrome. This is important to discuss as many women think the main symptoms of perimenopause are hot flashes or night sweats. In fact, I’ve seen some doctors refuse to prescribe any hormones to a woman in perimenopause if she didn’t have hot flashes. This is absurd as there are some 100+ signs and symptoms associated with your hormonal transition, some of which you may NOT feel! This includes metabolic syndrome.
What Hormones Are In What Part Of Your Cycle?
Have you ever wondered if or which of your many hormones shine throughout your cycle? For example, how does your period differ from ovulation? How does that differ from the week before your period that might cause PMS symptoms? And does this change in perimenopause?
The menstrual cycle is normally divided into 2 phases - the follicular phase and the luteal phase.
The day you start your period is counted as day 1 and is the start of the follicular phase.
Your Mental Health and Perimenopause
Feeling moody? Irritable? Depressed? Less interested? More anxious? Less connected? Less confident or lower self worth? And has all of this been happening or worsening since you’ve entered into perimenopause or menopause (even surgical menopause)? In November 2023, Cambridge University Press published an articled titled, “Severe mental illness and the perimenopause.” I’m so grateful that more write-ups like this are happening to educate women! In perimenopause, hormones such as estradiol, progesterone, and testosterone start changing for the worse leaving us with changes in our brain hormones like DHEA, serotonin, oxytocin, GABA, and dopamine. While you might not have heard of some of these hormones before, they play a huge role in your mood!