Hi Dr. Jen, long time follower on twitter/reader and just subscribed, because I've been diagnosed with POI at age 39 after years of irregular periods and now no period for 4 months, plus having symptoms like hot flashes and fatigue. I was wondering if you have any posts on POI and best practices for medication/HRT. I started oestrogel and it helped relieve the symptoms almost immediately but don't know how to determine what the best dose might be, there's so much misinformation online. In the various online communities for POI, it seems a lot of doctors are not aware of how best to treat it and women seem to struggle to get adequately treated and it would be so helpful to be able to share your knowledge with them. I will of course talk with my prescribing doctor about my questions as well. Thank you for your expertise!
Can you please comment on the use of testosterone cream for helping to affect change for a decreased libido in an otherwise healthy, peri menopausal 52 year old. Thank you!
That isn't the first line therapy, so we recommend other things first. I address it in detail in The Menopause Manifesto. I can look at the data again here. Also, highly recommend reading Better Sex Through Mindfulness by Dr. Brotto.
For people searching for a practitioner with appropriate knowledge and having his/her head 'screwed on straight' vis a vis HT, I'd recommend finding a NAMS certified menopause clinician. I realize these people aren't to be found everywhere, but I was able to find one not too far away when I needed to find a new Gyn.
Thank you- I was curious about the difference between oral and transdermal so appreciate this information. My doctor prescribed gabapentin for hot flashes. I'm wondering what dosage you recommend for this since so far I don't see a lot of relief and I have been taking 300MG at night for a couple of months. She also just put me back on the transdermal patch but at a lower dose to see if it helps but doesn't cause migraines like I was experiencing with the 50mcg patch.
Do you know if having a Crohn's disease and being on Humira has any effect on these treatments? Chronic disease and can effect so many things - it makes me wonder if it is impacting menopause as well. (I am 56 and had a hysterectomy MANY years ago. I still have my ovaries however they cannot be seen in any scans - even transvaginal ultrasound.) I appreciate all your information and fights against misinformation. Thank you
This was super helpful! I have a client that is on the transdermal, which doesn’t seem to work, and had questions about the oral version. This is such great information to share with her. Thank you.
I've read it. The author interviewed some good people. I think that it maybe oversells hormones a little and ignores all the other important aspects of health as we age. And the company Alloy isn't where I'd send any of my friends. I'll be writing about them soon.
Hi Dr. Jen, long time follower on twitter/reader and just subscribed, because I've been diagnosed with POI at age 39 after years of irregular periods and now no period for 4 months, plus having symptoms like hot flashes and fatigue. I was wondering if you have any posts on POI and best practices for medication/HRT. I started oestrogel and it helped relieve the symptoms almost immediately but don't know how to determine what the best dose might be, there's so much misinformation online. In the various online communities for POI, it seems a lot of doctors are not aware of how best to treat it and women seem to struggle to get adequately treated and it would be so helpful to be able to share your knowledge with them. I will of course talk with my prescribing doctor about my questions as well. Thank you for your expertise!
Dr Gunter, do you take new patients for your practice?
Can you please comment on the use of testosterone cream for helping to affect change for a decreased libido in an otherwise healthy, peri menopausal 52 year old. Thank you!
That isn't the first line therapy, so we recommend other things first. I address it in detail in The Menopause Manifesto. I can look at the data again here. Also, highly recommend reading Better Sex Through Mindfulness by Dr. Brotto.
Thanks for that info! I've read your book and will check out that section again and look for the other book.
For people searching for a practitioner with appropriate knowledge and having his/her head 'screwed on straight' vis a vis HT, I'd recommend finding a NAMS certified menopause clinician. I realize these people aren't to be found everywhere, but I was able to find one not too far away when I needed to find a new Gyn.
Thank you- I was curious about the difference between oral and transdermal so appreciate this information. My doctor prescribed gabapentin for hot flashes. I'm wondering what dosage you recommend for this since so far I don't see a lot of relief and I have been taking 300MG at night for a couple of months. She also just put me back on the transdermal patch but at a lower dose to see if it helps but doesn't cause migraines like I was experiencing with the 50mcg patch.
Do you know if having a Crohn's disease and being on Humira has any effect on these treatments? Chronic disease and can effect so many things - it makes me wonder if it is impacting menopause as well. (I am 56 and had a hysterectomy MANY years ago. I still have my ovaries however they cannot be seen in any scans - even transvaginal ultrasound.) I appreciate all your information and fights against misinformation. Thank you
For someone with Crohn's transdermal is likely better.
Gabapentin start at 300 mg at night but many people need 300 mg three times a day.
This was super helpful! I have a client that is on the transdermal, which doesn’t seem to work, and had questions about the oral version. This is such great information to share with her. Thank you.
Similarly struggling to find even one Gyn in TX to help. I’m in hormone Hell, had an ablation 10 yrs ago and forgot that doesn’t negate menopause.
https://www.nytimes.com/2023/02/01/magazine/menopause-hot-flashes-hormone-therapy.html
I'm curious to hear thoughts on where this article falls in the continuum of information? Apologies if its behind a paywall.
I've read it. The author interviewed some good people. I think that it maybe oversells hormones a little and ignores all the other important aspects of health as we age. And the company Alloy isn't where I'd send any of my friends. I'll be writing about them soon.