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Linda:
I tried—I started out at, you know, 250 milligrams, which was the strongest they made, took them every day. Now I'm down to 125 twice a week. I cut myself down. My doctor said, "You know, do what you want to do." But I am still—I'm still having hot flashes and hot flashes and night sweats, and how long should this last? I mean, 19 years, should that—is that good for me?

Dr. Northrup:
First of all, it won't hurt you. But are you on 1.25 milligrams of estrogen? Is that what you're on twice a week?

Linda:
Well, it's Premarin.

Dr. Northrup:
Okay.

Linda:
It's a hormone replacement. The whole thing.

Dr. Northrup:
Okay. So you're on that particular type of hormone replacement.

Linda:
Right.

Dr. Northrup:
Are you on any progesterone at all?

Linda:
No. Just the one—one pill.

Dr. Northrup:
Okay. So just the one pill of Premarin.

Linda:
Right.

Dr. Northrup:
And twice a week.

Linda:
I've cut it down to twice a week. But even when I get to like the second or third day, I'm having hot flashes.

Dr. Northrup:
Okay. Now what you could do in your case is you could try one of the other type of transdermal type of hormone replacements where it would be across the skin. It would be a different way of being metabolized than the pill, which goes through the liver. Now, some women do great on what you're on and some don't, but try a different route.

Linda:
I did when I was taking it every day.

Dr. Northrup:
You felt fine when you were taking it every day?

Linda:
Yeah. But 19 years, isn't that too long to be taking it?

Dr. Northrup:
Well, you know, this is—this is why medicine is an art as much as a science because here you are, right? And your quality of life is vastly improved when you're on it, right?

Linda:
Right.

Dr. Northrup:
Okay. And so therefore, statistically, yes, there may be an increased risk. But are your breasts okay?

Linda:
Yes.

Dr. Northrup:
And your uterus is okay?

Linda:
I don't have one.

Dr. Northrup:
Okay. All right. So you don't have to worry about uterine cancer. So that's very good. So what I would do is this. I would say to the pill every day, "I am very grateful for you. You have been very good to me." And then I would work on your lifestyle too. I will tell you, hot flashes are often related to adrenal stress. Cortisol and so on. What's your lifestyle like? Are you sleeping?

Linda:
Sedentary.

Dr. Northrup:
Okay. Okay. I want you to step up the exercise. All right? And I wouldn't worry so much about the estrogen. You might want to change your brand. Talk with your doctor about switching to another brand. Maybe like a spray or something of that nature that you can use as a skin cream. And those are widely available in all pharmacies.

Linda:
Okay.

Dr. Northrup:
And give that a try.

Linda:
Okay. So 19 years is not a long time to be going through this menopause thing?

Dr. Northrup:
A lot of—a lot of women—a lot of women do. Now what you could do, you could go—

Linda:
I'm going to be 90 and still doing this?

Dr. Northrup:
Yeah, but do you look fabulous?

Linda:
Pardon?

Dr. Northrup:
Do you look great?

Linda:
Well, I look okay.

Dr. Northrup:
Yeah. I mean, are you—are you happy with other aspects of your life? Like is your sex life okay? We don't know your last name. Don't worry.

Linda:
It is.

Dr. Northrup:
It's pretty good, right?

Linda:
Wonderful.

Dr. Northrup:
Okay. All right. You know, if it ain't broke, don't fix it. That's what I would say to you.

Linda:
Leave it alone and just take them more often.

Dr. Northrup:
Yeah.

Linda:
Okay.

Dr. Northrup:
That's what I'm thinking, but check it with your doctor every year just the way you do now.

Linda:
I'm doing that next month.

Dr. Northrup:
Perfect.

Linda:
Thank you very much.

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