Hello, I live not far from Phila, and am trying to find a good physician that will listen to me as well as wean me off of premarin and set a plan to achieve my goals. Is it true that you would go directly from premarin to a basic (not sure about the technical terminology) dosage of bioidenticals --- I am confused -- how long do you need to wait after you are off of premarin to get a good valid test result from the three tests Dr Northrup refers to. Any recommendations for doctor, advice on what I should ask and more importantly insist.

Do you recommend DIM with BHRT? I am currently waiting for my lab results and then I will be meeting with a compounding pharmacist. The pharmacist has much more experience with BHRT than the physician. What questions should I be asking the pharmacist? Who decides which medications, dosages, etc Is it possible to do any background checks on the pharmacy/pharmacist? I have a background myself in medicine (RN). I want to make sure I am making the best educated decision for me. I'm usually the one helping others, but now I need help. I also scheduled an appt with a physician listed in Suzanne Somers book. I'm not sure if I should get a second opinion. I have been suffering for 4 years and I want my old self back for myself and for my family. Thank you for any info/suggestions you can provide.

you can go directly from taking Premarin to taking compounded hormones. In regards to blood testing, it would probably be good to get a blood test now while you are on the Premarin to see what your levels are at. Then, we typically have patients get blood work done 3 months after starting the compounded hormones to see what levels have changed. It is important to know that you must look at both your symptoms and blood levels to decide what to change or start. We also recommend to patients that were originally on premarin and want to switch, to start taking milk thistle (an over the counter herbal supplement). It works in the liver to eliminate metabolites of the Premarin and therefore have a quicker stabilization of levels. As far as finding a physician, I would start with your regular ob/gyn, unless they are unwilling already to write for hormones. Our theory for hormone supplementation is the lowest dose of medications for the least amount of time. We want you to be comfortable without having side effects, and we also always support a the effectiveness of a good diet and sufficient exercise. If your physician sees you willing to make a lifestyle change, they may be more willing to try prescribing for hormones for the time being.

I think it is a great idea you are meeting with a pharmacist to discuss hormone replacement therapy. Often times, physicians are not familiar with hormones and writing for them, and pharmacists have the time and resources to research and offer suggestions. It is important for you to include both the physician and the pharmacist in planning a regimen for yourself. It will probably be up to the pharmacist to decide the dosages/medications/etc, but it is the physicians authority to decide to prescribe for what the pharmacist recommends. It is possible to do research on the pharmacy, but I would just ask the pharmacy/pharmacist if they could provide adequate informaiton about the products and resources they use. Typically, they will have that information readily available. Hope this answers some of your questions!

Dear Jennrx,

Just read your blog on Oprah. I am looking for a ob/gyn or doctor in greater Philly area who can look at all my menopausal issues and get me onto bioidentical hormones. But I hope it can be someone in the Keystone HMO network of physicians. I have a list of network providers, but don't know which ones will prescribe bioidenticals or not. Can you help me?

SVB

Hi. I am a 53 year old man and I was wondering if you know of a medical doctor who has experience in Bio-Identical Hormone Replacement. I live in the Bucks County area. I am experiencing Andropause and my main concerns are elevated Estrogen/lowered Testosterone, thyroid issue (low T4) and low DHEA level. Your help is greatly appreciated.

Kind Regards,

Matt Bain

Hi Matt, if you are willing to travel for one appointment to Houston you can then do follow ups over the phone. Google Hotze Health & Wellness Center. If you are not willing to travel you may still google them and click on men's health for more information about bioidenticals for men. Possibly someone in your area has info on a good doctor near you and will answer you as well. I live in Texas, so I do not know about doctors in your area.

Hello. I am a 38 year old female who has been hormonally imbalanced my entire life, and I have suffered terribly. Now I suspect that I am perimenopausal and would very much like to speak with you and a physician who will listen to me. Please contact me at your earliest convienence. I live in the Philadelphia metropolitan area and am open to a little travel to put an end to my suffering. I have Keystone Health Plan East insurance. Please give me more information about you and any doctors you may know who take my insurance and are willing to consider working with me to finally balance my hormonal levels.

Thanks so much,

K. G.

I am very interested in starting bioidentical replacement hormone therapy with a phsician in the Philadelphia area. Would you be able to recommend one? Thank you.

I put a link from my blog (private message me if you would like the blog address, I am not allowed to post it) to a site called Women to Women (Google it to find the address), it has a pretty extensive list of doctors by zip code who practice hormone therapy. I don't think the site does any checking of credentials, protocols, etc, but at least it's a start.

Sorry, everyone, I shouldn't type when I'm tired, the website to Google is Women in Balance, not women to women-----my bad. I'm going to shut the computer down now so I dont screw up any more!

Any recommendations for compounding pharmacies or physicians? I live in Bucks County, PA. Thank you. Betty

To find a doctor in your area, do an Internet Seach for compounding pharmacy in your area, and then call a couple of them for doctor referrals Since most BHRT is compounded, they know how is prescribing BHRT by the prescriptions they fill. If you ned further assistance, email me at holyhormones@gmail.com.

PLEASE HELP! I'm sitting here half in tears as I write you! As my wonderful primary care doctor explained to me. It is no longer simply a set of blood tests that proves a woman is going through the change. I had a partial (uterus removed) hysterectomy way back in 1999. Approximately 3 years ago these "symptoms" started. She's been diligent about doing the tests for me but they've always come back normal. Whatever the heck normal is these days. Yet recently she has explained to me that new research and studies have shown that the tests alone don't always show everything. And boy is she right. From my female parts down I'm on fire. My upper half is freezing most of the time. The rest of the time I want to be sitting in the freezer. I'm on crying jags and the next minute I want to laugh my head off. I haven't drank in near 30 years but tried that in small amounts for two nights and realized hang overs are NOT what I want to solve my problems. I do not want synthetic hormones and was actually told when I had my uterus removed that they would never be a good idea because I had the surgery due to cancer stage one. It was just the beginnings as they had caught it in time. But that coupled with fibromyalgia, severe pernicious anemia and osteoarthritis have me with a much lowered immune system. I am interested in bioidentical hormone replacement but don't know where to start. I am on permanent SSI so I am on Medicare with Molina Options as my Insurance plan. I live in New Mexico. Usually I am very good about investigating and finding out where to go and what to do about things but I am at a real loss here. I don't know how to find a compound pharmacy in my area. What I do know is I have a husband who is a saint and doesn't want to leave my side for fear he may come home to find I've done some severe act of madness. Either I find something to help me or I concoct a way to have my ovaries removed and bypass this "change" thing. Because I refuse to go through the next 20 years of life having no control over what happens to me. PLEASE give me any references, ideas or any other help you can from your end of the country.

Thank you SOOOO much!

Sign me: going mad in the land of "enchangement"

Oh, how I wish I had the right words to make you feel better, but I don't. I've been crying lately, too. I had some idea of what was going to happen to my body, let alone my va-jay-jay,once I hit menopause but I surely wasn't told by my mom all that would happen and I'm so sad. Unlike your husband, I don't think mine will be as loyal.

I didn't /don't have any cancer but so many women in my family have and I'm terrified of hormones and I want to go the bio route as you do. I got a few tips reading here but I have so many other questions. My biggest being, will it help with this awful dryness and painful intercourse? I want to feel like a functioning woman again, and I'm at my wits end. I wish Doctor Oz would give us the skinny on these bio hormones. I'd feel better hearing him speak about them.

OPRAH? Are you listening? Can you do a show on this? PLEASE?! Or if he has, can someone direct me info?