I am sorry. I have tried multiple times to reload it here and I keep getting the same error. I have let Substack know but have not heard back. It is the same worksheet as listed below it though. Sorry again for the inconvenience.
I was someone who had some pretty bad PMS that is now labeled PMDD. Menopause was like getting my SELF back. I’m 77 now and wonder when I read that HRT might be helpful for some of the less desirable outcomes of menopause, like weight gain, low thyroid, vaginal atrophy etc. if it might not improve some of those things at my age. I’m pretty active, going to the gym 3x per week, but wonder if treatment with some form of estrogen might improve the quality of my physical life somewhat also, understanding that it was the progesterone phase of my cycle that was so bad.
At this point systemic estradiol would probably not be a good fit but vaginal estradiol could help with any vaginal dryness or recurring UTIs if those are issues. Certainly, worth a discussion with your doctor though.
My internist is completely ignorant about hrt and menopause. Luckily my (male) gyno ologist is not. Btw menopause can cause constipation. Prunes seem to help; psyllium powder and GERD not a good combo.
Could you discuss the balance of managing estrogen & thyroid. I have struggled for years with hypo/hyperthyroidism. My endocrinologist told me that estrogen & thyroid both jockey for places on the cell. I went off my estradiol patch hoping it would help balance the thyroid. It made a slight impact, but then I lost ground in protective mechanisms that estrogen provided, and exchanged it for low energy, brain fog etc.
That’s such an important topic, Lorna, and a common struggle.
Estrogen and thyroid hormones do interact, but it’s not a simple competition for receptors. Estrogen can affect how thyroid hormone is transported and used, especially by increasing thyroid-binding globulin (TBG), which can make less free thyroid hormone available. But stopping estrogen doesn’t always improve thyroid function, and as you saw, it can come at the cost of brain, bone, and metabolic health.
The key is balance, not sacrifice. For many women, adjusting thyroid medication while staying on appropriate HRT is the better path. A good provider will look at the full picture, symptoms, labs, and how you actually feel, not just numbers on a page.
My mother sailed through menopause, only had a couple hot flashes that weren't a big deal. The only thing she added to a mostly healthy diet was Vit E, full spectrum. Her OB just laughed at her and said it had no bearing. Can't say for sure but she didn't suffer with symptoms. She read about E in Prevention Magazine before it went off the rails. Lived to 93 with most of her brains until the last few months.
What a wonderful story, your mom sounds like she had a strong foundation and great instincts. It’s true some women breeze through menopause, and sometimes those small changes, like adding vitamin E, feel meaningful, even if the science is mixed. I always caution against high-dose vitamin E supplements, but full-spectrum from food (and low-dose blends) can be part of a healthy approach. And Prevention Magazine really did have its golden years!
Georgia, me too. I had my HRT stopped 12 years ago. Then I had good energy and was fit. Now I’m 74, with joint aches and pains, poor sleep, pain with sex. I want my life back, but once you’re older and have been off HRT, it’s been impossible for me to get anyone to prescribe it.
Diane, thank you for sharing this, and you’re absolutely not alone. Many women are told there’s a “cutoff age” for menopausal hormone therapy, but that’s not what the latest research says. While restarting therapy after 60 requires careful evaluation, it can still be considered for symptom relief and quality of life.
Can you please furnish a reference article for HRT for older women? I am 72, and struggling with sleep, weight, joints, despite working out and eating clean. I would like to share the new research with my gynecologist. Thank you!
My name is Aisha I was wondering why they told her no more HRT after a certain age I have had my hormones checked and my progesterone was ok but hardly no estrogen at all so I am reading and learning that it may be more beneficial to take HRT than get a total hysterectomy and possibly avoid taking statins and BP meds
Great question, Aisha! Many were told to stop HRT due to outdated fears, but we now know that for many women, the benefits outweigh the risks, especially for heart, bone, and brain health. Low estrogen can raise your risk for needing statins or BP meds, so you're wise to look into this. Always work with someone trained in menopause care!
So my question is this may be to detailed how does taking estrone or estradiol and there is one more med cause cancer it states that excess cancer risk that is why they stop woman at age 60
I do resistance training 4 times a week I have always participated in some form of exercise throughout my life I have a few fibroids that I have not got removed because I chose not to yep my cycles are heavier in my 30’s to mid 40’s my estrogen level was high then some where in there it plummeted and that’s when I noticed the changes ( I’m thinking the estrogen excess estrogen caused the fibroids to appear) now that I have very estrogen the fibroids didn’t go lol I say all that to say I am thinking of HRT but I was told do not take estrone because that has the highest risk of breast cancer I just want to know if the benefits outweigh the risk
Thank you for sharing your story, and your question. It’s such an important one, and you’re right to be thoughtful about all these factors. Fibroids, fluctuating estrogen, and the type of hormone therapy used can all impact both symptoms and long-term risk.
There has been a lot of confusion over the years, especially around hormone therapy after age 60. What we now understand is that the decision to use hormones, and for how long, really depends on the individual: your health history, current symptoms, personal risk factors, and how the hormones are given (the route and dose matter a lot).
That’s why I wouldn’t want to give a quick answer here. It’s just too nuanced, and you deserve a full conversation with someone who can look at the whole picture with you.
But I will say this: many experts today are more open to continuing or starting hormone therapy after 60 in select women, when the benefits still clearly outweigh the risks. It’s not a one-size-fits-all rule anymore.
I would never have stopped taking estrogen. I’d had a hysterectomy, so it was estrogen alone for HRT. The reason for stopping it was “excess risk of breast cancer” but I wasn’t asked what I wanted to do. In trying to get back on estrogen, I’ve been told that I’ve been without it for so long, that it wouldn’t make a difference anyway.
I just read the other day that estrone is the one that could possibly cause cancer I haven’t found out about the other two yet the estradiol or the estrione I’m not sure of the second spelling
It was for I think Diane but you can answer it also I’m just figuring all this out I didn’t realize perimenopause and or menopause could effect the LDL and BP I didn’t realize how estrogen can impact so much it answers a lot of questions of why some women are taking statins and BP meds instead of balancing their hormones
Oh my, Dr. M, I would buy all of your books, courses, and merch if it would correct the mistakes of "modern medicine" It's too late and the damage is compounded. "When did menopause start?" they ask. The answer is at 40 when they did a TAH and ripped out all hormone producing equipment. What about estrogen replacement therapy and so forth? The doctors were more concerned about their profits and liability insurance than me. They read online or in some journal that hormone therapy increases cancer and they can be sued. I'm left to age and die on my own, with any help. Decade after decade all of those symptoms you list showed up and nobody... I mean, nobody paid attention to me asking at every annual physical, "This isn't right. Can't we do anything?"
Georgia, thank you for sharing this, and I’m so sorry you were dismissed for so long. Surgical menopause at 40 should have come with immediate hormone support. The fear around hormone therapy has hurt too many women, despite strong evidence for its benefits, especially in cases like yours.
Thank you for letting me know! I have tried multiple times to reload this but there is some technical glitch and I have contacted Substack for help. Regardless, it is the same information listed below. I was trying to make it easier to just download like all my other worksheets...ugh! I will let you know when it is working.
This pdf won't download for me today. I've downloaded others from your site today. I checked my pop-up blocker. Something to look into. Thank you!
I am sorry. I have tried multiple times to reload it here and I keep getting the same error. I have let Substack know but have not heard back. It is the same worksheet as listed below it though. Sorry again for the inconvenience.
I was someone who had some pretty bad PMS that is now labeled PMDD. Menopause was like getting my SELF back. I’m 77 now and wonder when I read that HRT might be helpful for some of the less desirable outcomes of menopause, like weight gain, low thyroid, vaginal atrophy etc. if it might not improve some of those things at my age. I’m pretty active, going to the gym 3x per week, but wonder if treatment with some form of estrogen might improve the quality of my physical life somewhat also, understanding that it was the progesterone phase of my cycle that was so bad.
At this point systemic estradiol would probably not be a good fit but vaginal estradiol could help with any vaginal dryness or recurring UTIs if those are issues. Certainly, worth a discussion with your doctor though.
My internist is completely ignorant about hrt and menopause. Luckily my (male) gyno ologist is not. Btw menopause can cause constipation. Prunes seem to help; psyllium powder and GERD not a good combo.
Could you discuss the balance of managing estrogen & thyroid. I have struggled for years with hypo/hyperthyroidism. My endocrinologist told me that estrogen & thyroid both jockey for places on the cell. I went off my estradiol patch hoping it would help balance the thyroid. It made a slight impact, but then I lost ground in protective mechanisms that estrogen provided, and exchanged it for low energy, brain fog etc.
That is all good and helpful information. Thank you!
That’s such an important topic, Lorna, and a common struggle.
Estrogen and thyroid hormones do interact, but it’s not a simple competition for receptors. Estrogen can affect how thyroid hormone is transported and used, especially by increasing thyroid-binding globulin (TBG), which can make less free thyroid hormone available. But stopping estrogen doesn’t always improve thyroid function, and as you saw, it can come at the cost of brain, bone, and metabolic health.
The key is balance, not sacrifice. For many women, adjusting thyroid medication while staying on appropriate HRT is the better path. A good provider will look at the full picture, symptoms, labs, and how you actually feel, not just numbers on a page.
My mother sailed through menopause, only had a couple hot flashes that weren't a big deal. The only thing she added to a mostly healthy diet was Vit E, full spectrum. Her OB just laughed at her and said it had no bearing. Can't say for sure but she didn't suffer with symptoms. She read about E in Prevention Magazine before it went off the rails. Lived to 93 with most of her brains until the last few months.
What a wonderful story, your mom sounds like she had a strong foundation and great instincts. It’s true some women breeze through menopause, and sometimes those small changes, like adding vitamin E, feel meaningful, even if the science is mixed. I always caution against high-dose vitamin E supplements, but full-spectrum from food (and low-dose blends) can be part of a healthy approach. And Prevention Magazine really did have its golden years!
Georgia, me too. I had my HRT stopped 12 years ago. Then I had good energy and was fit. Now I’m 74, with joint aches and pains, poor sleep, pain with sex. I want my life back, but once you’re older and have been off HRT, it’s been impossible for me to get anyone to prescribe it.
Diane, thank you for sharing this, and you’re absolutely not alone. Many women are told there’s a “cutoff age” for menopausal hormone therapy, but that’s not what the latest research says. While restarting therapy after 60 requires careful evaluation, it can still be considered for symptom relief and quality of life.
Can you please furnish a reference article for HRT for older women? I am 72, and struggling with sleep, weight, joints, despite working out and eating clean. I would like to share the new research with my gynecologist. Thank you!
Here you go. It is a conversation. Not everyone is a good candidate but absolutely should be considered. https://www.tandfonline.com/doi/pdf/10.1080/09513590.2025.2468957
My name is Aisha I was wondering why they told her no more HRT after a certain age I have had my hormones checked and my progesterone was ok but hardly no estrogen at all so I am reading and learning that it may be more beneficial to take HRT than get a total hysterectomy and possibly avoid taking statins and BP meds
Great question, Aisha! Many were told to stop HRT due to outdated fears, but we now know that for many women, the benefits outweigh the risks, especially for heart, bone, and brain health. Low estrogen can raise your risk for needing statins or BP meds, so you're wise to look into this. Always work with someone trained in menopause care!
So my question is this may be to detailed how does taking estrone or estradiol and there is one more med cause cancer it states that excess cancer risk that is why they stop woman at age 60
I do resistance training 4 times a week I have always participated in some form of exercise throughout my life I have a few fibroids that I have not got removed because I chose not to yep my cycles are heavier in my 30’s to mid 40’s my estrogen level was high then some where in there it plummeted and that’s when I noticed the changes ( I’m thinking the estrogen excess estrogen caused the fibroids to appear) now that I have very estrogen the fibroids didn’t go lol I say all that to say I am thinking of HRT but I was told do not take estrone because that has the highest risk of breast cancer I just want to know if the benefits outweigh the risk
Thank you for sharing your story, and your question. It’s such an important one, and you’re right to be thoughtful about all these factors. Fibroids, fluctuating estrogen, and the type of hormone therapy used can all impact both symptoms and long-term risk.
There has been a lot of confusion over the years, especially around hormone therapy after age 60. What we now understand is that the decision to use hormones, and for how long, really depends on the individual: your health history, current symptoms, personal risk factors, and how the hormones are given (the route and dose matter a lot).
That’s why I wouldn’t want to give a quick answer here. It’s just too nuanced, and you deserve a full conversation with someone who can look at the whole picture with you.
But I will say this: many experts today are more open to continuing or starting hormone therapy after 60 in select women, when the benefits still clearly outweigh the risks. It’s not a one-size-fits-all rule anymore.
Why I wonder they won’t put you back on HRT
This is a wealth of info for me I’m dealing with this rite now if you had to do it all over again tell me what would you do
I would never have stopped taking estrogen. I’d had a hysterectomy, so it was estrogen alone for HRT. The reason for stopping it was “excess risk of breast cancer” but I wasn’t asked what I wanted to do. In trying to get back on estrogen, I’ve been told that I’ve been without it for so long, that it wouldn’t make a difference anyway.
I just read the other day that estrone is the one that could possibly cause cancer I haven’t found out about the other two yet the estradiol or the estrione I’m not sure of the second spelling
Who is the question for?
It was for I think Diane but you can answer it also I’m just figuring all this out I didn’t realize perimenopause and or menopause could effect the LDL and BP I didn’t realize how estrogen can impact so much it answers a lot of questions of why some women are taking statins and BP meds instead of balancing their hormones
Oh my, Dr. M, I would buy all of your books, courses, and merch if it would correct the mistakes of "modern medicine" It's too late and the damage is compounded. "When did menopause start?" they ask. The answer is at 40 when they did a TAH and ripped out all hormone producing equipment. What about estrogen replacement therapy and so forth? The doctors were more concerned about their profits and liability insurance than me. They read online or in some journal that hormone therapy increases cancer and they can be sued. I'm left to age and die on my own, with any help. Decade after decade all of those symptoms you list showed up and nobody... I mean, nobody paid attention to me asking at every annual physical, "This isn't right. Can't we do anything?"
Georgia, thank you for sharing this, and I’m so sorry you were dismissed for so long. Surgical menopause at 40 should have come with immediate hormone support. The fear around hormone therapy has hurt too many women, despite strong evidence for its benefits, especially in cases like yours.
This is so helpful! Thank you!!
You are most welcome!
Thank you for letting me know! I have tried multiple times to reload this but there is some technical glitch and I have contacted Substack for help. Regardless, it is the same information listed below. I was trying to make it easier to just download like all my other worksheets...ugh! I will let you know when it is working.
Ah, thank you! It was quite the journey!