Ask Dr. Rosensweet: Hormones – “Should I Get the Lowest Dose for the Shortest Period of Time?”

Should I Get the Lowest Dose of Hormones for the Shortest Period of Time?

Dr. Rosensweet: No. There is zero science backing this popular misconception. When 90% of women went off their hormones after 2002, so many of them had major life-disruptive symptoms. Many realized that they’d rather take what they thought was a risk (wrong!) and be treated. So the statement, “lowest dose for shortest time” somehow became popular. This is so far from what is best practice of medicine. 

A woman’s body needs, in menopause, at least a certain minimal dose of estrogen capable of protecting her vagina and bones. That amount is known, and is to be respected. A woman can be treated with a dose minimal enough to alleviate many of the disruptive symptoms of menopause. Yet, in 50% of women who achieve this alleviation, when tested, fall shy of sufficient dosage to protect bones and vagina, at a minimum. Good medicine aims for optimal dosage levels. Yes, for most women this is less than the amount needed for a young woman to menstruate and be fertile. And, we care about that upper limit, and for most women, keep it below the amount that would stimulate breast glandular proliferation (an amount that occurs monthly in every young menstruating woman. Good medicine knows these numbers, and confirms them by state of the art hormone testing: 24 hour urine assessment. Optimal dose is not the lowest dose…and, for most –not all–women, that range for women in menopause is just shy of what is healthy for a young menstruating woman.

How Long Should I Take Hormones?

 Dr. Rosensweet: How long? Ask a man who is on hormone replenishment treatment with testosterone, a man who lost all erectile function and had it return with treatment, how long he would like to take his testosterone? Or suggest he stop it in a few years. Hilarious! Such men know full well they will not stop until it’s time to leave Earth. Ask women on hormone replenishment therapy how long they think their body would like to take these hormones? This is not rocket surgery…they all get it. Don’t stop!  Just for an example, a woman who had some bone loss early in menopause with no treatment, and was able to restore reasonable bone strength with hormone treatment, should she stop hormone treatment, will begin to rapidly lose bone again! This is also true for other benefits: rapid loss!

Dr. Rosensweet’s Conclusion on Hormones

 Dr. Rosensweet: I’m an elder physician specializing in this work for over 30 years. Ask me how my women patients would respond if I told them, at any age, that we are stopping hormonal treatment. Well I wouldn’t suggest this, and wouldn’t dream of facing an uproar. Ask me–I am on testosterone–if I think it is a good idea for me to stop taking my testosterone! Hah. Are you kidding me! I wouldn’t dream of it, and, for many reasons!

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