Progress Your Health Podcast

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Can Estriol Cream Cause Constipation? | PYHP 103 Jan 21, 2021

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Mary’s Question: Hi. I just started estriol cream a couple of weeks ago. I am fifty-three years old and have been told I have PCOS for the past twenty years with a history of absent periods, heavy facial hair growth, and moodiness, and PMS. I have managed my PCOS through diet change, supplementation, and exercise. And I am told I am quite healthy. I began taking the estriol cream for bladder urgency and frequency and for the mucous membrane support for vaginal dryness. Sex had become very painful. I am experiencing some really wonderful positive benefits from the estriol. And in some ways, I realize I have probably been short of this for many many years likely due to the malfunctioning of my ovaries with the PCOS. The skin over my shinbones that has always been flaky no matter how much I moisturize, now, is soft, smooth, and supple for the first time in many years. The skin on my elbows, knees, and heels is softening. And it seems to have helped my skin tremendously. Even my facial hair is coming in much lighter. It seems to be reducing my belly fat in some ways. It is kind of a miracle. And I wish I had known about this years ago. The possible deal-breaker here is that I have become so painfully constipated over the past few weeks. And the estriol cream is the only thing that has changed. I also take bioidentical progesterone in a troche form which I have been taking for about ten years without a problem. The estriol is the only thing that has changed. The only time I can remember being this consistently constipated over a long period of time was during my two pregnancies. Any thoughts? Short Answer: For constipation, the common advice is to drink more water and eat more fiber. However, for some, this does not work. It may seem strange to think that bioidentical hormones could impact digestion, but it is certainly possible for either progesterone or estrogen to cause someone to become constipated. We look at constipation as being a liver issue. Taking hormones can put a slightly extra burden on the detoxification capacity of the liver, which can slow down digestion. PYHP 103 Full Transcript: Download PYHP 103 Transcript Dr. Maki: Hello, everyone. Thank you for joining us for another episode of the Progress Your Health Podcast. I am Dr. Maki. Dr. Davidson: And I am Dr. Davidson. Dr. Maki: So how is your summer going? Dr. Davidson: My summer is going great, although it is already August. So I feel like it is almost over. Dr. Maki: Yes. 2020 has been such a roller coaster. But yes. Weather is good. We are surviving everything. Dr. Davidson: How is your summer going? Dr. Maki: Well, it is a rhetorical question, because I know exactly how your summer has been, because mine has been pretty much the same as yours. So I cannot complain. But you are right. It is going by way too fast. I cannot believe it is already August. But we still have a couple of months of nic

Can You Put Estriol Cream On Your Face? | PYHP 102 Jan 20, 2021

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Allison’s Question: I have opened a hormone wellness practice and came across your blog. You mentioned the application of estrogen cream to the face, neck, and chest to improve skin health. From what I found, it appears that .3% Estriol and .01% Estradiol is typically used. Do you recommend a once-daily application? Can this same dose be applied to the inner and outer labia for improvement of external skin appearance as well as the vaginal entrance to improve vaginal dryness, etcetera? Thank you in advance for any feedback you can provide. Short Answer: We typically only use Estriol cream for the face and the vagina. For the face, we do recommend using estriol daily, usually as a nighttime moisturizer. As for vaginal use, we recommend daily use of estriol cream for the first 1 to 2 weeks depending on the severity of symptoms. After that, we suggest a frequency of 1 to 3 times per week. We don’t use estradiol for vaginal use. The dosage of estriol we typically use for both is is 4 mg/gram, but apply 1/2 gram with each application. PYHP 102 Full Transcript: Download PYHP 102 Transcript Dr. Maki: Hello everyone. Thank you for joining us for another episode of the Progress Your Health Podcast. I am Dr. Maki. Dr. Davidson: And I am Dr. Davidson. Dr. Maki: So I got an email back this morning from the designer. The kind of the first draft of your book cover. It was in my inbox this morning. What do you think about that? Dr. Davidson: I think I am nervous as heck. Dr. Maki: It is good. There are two different versions. I like a couple of things about each one of them. I will show it to you a little bit later, but it just came in right before we sat down to do this. Got to change the color scheme a little bit but so far so good. Dr. Davidson: All right, and the book is on perimenopause. Dr. Maki: This is the middle of summer 2020 so hopefully this will be available on Amazon probably, I am hoping within the next month but there are some other things we want to do prior to that. Maybe by Labor Day, I am thinking and to be conservative and to give ourselves a little bit more time to make sure we have all the things that need to be working, working properly. But we will definitely keep everybody posted.

Can I Take Progesterone All Month? PYHP 101 Jan 12, 2021

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Question: Hello. I am forty-five, perimenopausal diagnosed by blood work. I have my uterus and I am taking 200 milligrams of bioidentical progesterone each night orally by capsule. I do not take anything else for hormone balance other than evening primrose oil and some adrenal support. Neither of these is new to my regimen. What is new is the administration of the progesterone orally. Previously, I was using a progesterone cream, 40 milligrams per night. All nights of my cycle, no break. Doc suggested that I needed to be more cyclical with my administration and then I try oral progesterone instead. I am doing this. I go to sleep well but toss and turn a bit more than I used to, then wake up around four thirty-five and cannot sleep any longer. My body temperature seems to be all over the place. At some nights around that same time, I wake up hot, not really a hot flash per se but just hot, but the very next night, I can have on the same bedclothes, sheets, house temperature, et cetera, and will not get hot. She has me doing fourteen days, fourteen to twenty-eight, taking the oral progesterone. My trouble is the fourteen days I have to wait to take it, I have all the trouble sleeping and all the other symptoms while I am waiting for that fourteenth day to come so I can take my oral progesterone. My question, can I take it full-time during my cycle and never take a break or does that go against all medical wisdom and/or would be bad for my body not to have a break? Short Answer: Based on a woman’s physiology, it does make sense to only take progesterone during the second half of the month. Typically, progesterone is produced from ovulation to the period and usually peaks around day 21 of the cycle. However, many women feel better when they take oral progesterone all month long. Oral progesterone helps reduce irritability, reduces anxiousness, and can improve sleep. Because of this, we most often prescribe progesterone to be taken all month long. Sustained Release Oral Progesterone is usually very well tolerated, but sometimes it can change a woman’s cycle. Based on how the cycle changes will determine if the dosage needs to be cycled or not. For example, we might prescribe 50 mg for the first half of the month and then increase to 100 mg during the 2nd half of the month. Then we have our patients stop the progesterone during menstruation. PYHP 101 Full Transcript: Download PYHP 101 Transcript Dr. Maki: Hello, everyone. Thank you for joining us for another episode of the Prog

What is a Common Biest Starting Dose? | PYHP 100 Aug 07, 2020

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Alexis Question: Hi there, this forum is fabulous. Thank you. I am so confused with dosing. How much is one gram of Biet in mL – milliliters. So confusing. I use a one mL syringe. One mL is a lot of cream. It is an eighty-twenty ratio and I will split the dose. Reading that your recommended starting dose is three milligrams, how much exactly is that in cream in terms of milliliters or MLs? That cannot be three MLs, that would be three syringes. Sorry to be daft. I have tried to find the answer on Google but nothing is making sense to me. Maybe that is why I need bioidentical hormones. Anyway, Help. Thank you, Alexis. Short Answer: 1 gram is equal to 1 mL. A BHRT prescription can be written in either mg/gram or mg/mL. For example, when we call in prescriptions to a compounding pharmacy, let’s say the Biest prescription is 3 mg/gram with an 80/20 ratio. This is the same as 3 mg/mL with an 80/20 ratio. The instruction we give the patient is to apply 1/2 gram, twice per day. If the patient is using a Topi-Click device, 1/2 gram is equal to 2 clicks. We like to have the patient apply 1/2 gram because they have to apply much less cream to the skin. We always recommend women apply their Biest to the inner thigh. We don’t recommend applying Biest to the arms, forearms, wrists, abdomen, or vaginally. If the patient is having any vaginal dryness, then we will provide separate Estriol (E3) prescription that can be used vaginally. We don’t like to have patients apply Estradiol (E2) vaginally, especially if they still have a uterus. PYHP 100 Full Transcript: Download PYHP 100 Transcript Dr. Maki: Hello, everyone. Thank you for joining us for another episode of the Progress Your Health Podcast. I am Dr. Maki. Dr. Davidson: And I am Dr. Davidson. Dr. Maki: So it is the middle of summer, enjoying some beautiful weather. Dr. Davidson: Gorgeous. Dr. Maki: It is a little hard to get into the podcast room and actually sit down and record some of these. You know, summer gets a little distracting. But nonetheless, we are here. Actually, some questions came in recently that were really good. Good in the fact that they are the ones that come up a lot and we figured that these would be good to talk about. Dr. Davidson: It would be helpful to the listeners. Should we just go ahead and start reading the question? Dr. Maki: Yeah, let us dive into this. What is the name of the first one? Dr. Davidson: Yeah. We always change the names of the questions, you know, just to respect the privacy of our Progress Your Health community. So this one, we changed to Alexis. Dr. Maki: Why is it Andrea and then you said, Alexis? Dr. Davidson: I like the name, Alexis. But I like the name Andrea too, but I like Alexis. Dr. Maki: Yeah. Okay. Alright. This person, we will call her Alexis. Dr. Davidson: Alexis. So do you want me to read it? Dr. Maki: Go ahead. Dr. Davidson: So again, this is from Alexis. “Hi there, this forum is fabulous. Thank you.” Well, thank you right back. “I am so confused with dosing. How much is one gram of bias in ml- milliliters. So confusing. I use a one-ml

What Are Symptoms of Thyroid Problems in Females? | PYHP 099 Jul 30, 2020

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Question: What are symptoms of thyroid problems in females? Short Answer: There is a wide variety of thyroid symptoms in women. Some of the more common are fatigue, weight gain, constipation, and dry skin. Based on our experience, we have noticed many other hypothyroid related symptoms as well. These symptoms include heavy periods, infertility, anxiety, low libido, hair loss and low mood. PYHP 099 Full Transcript: Download PYHP 099 Transcript Dr. Maki: Hello everyone. Thank you for joining us for another episode of the Progress Your Health Podcast. I am Dr. Maki Dr. Davidson: And I am Dr. Davidson. Dr. Maki: So it is officially a little bit past the beginning of summer in Washington, although looking out the window right now, it certainly does not look like summer. It is raining kind of heavy right now. Dr. Davidson: I would say even though it is supposed to be summer, it seems like spring has officially started because it is really beautiful with the little deer out and the flowers are blooming, and I think it will clear up a little bit later. Dr. Maki: Yes, you know that I sent you the picture you saw but for the listeners, I was sitting here, you were upstairs and I was looking out the window and I saw a female deer and then she just took a picture of it. You know, that is great. A deer walks through the yard all the time and then she moved and there is a little, literally like a little fawn, a little Bambi right next to her and kind of following along and she hit the little white spots on the side and there. Eating little weeds in the yard and they walked over to the little garden over there and ate some things out of the garden. Dr. Davidson: I was so happy to see that picture because I saw that little fawn a couple. I think a couple of weeks ago right after it was just born with its mom walking through the driveway and then I did not see them again and well, little baby still. Okay, so it is really neat to see him or her a little bit bigger with those little white spots on the bum. Dr. Maki: Yes, right. That was that was nice. You know, we do not see the deer hardly at all winter long and then it seems like June, I remember where we lived. Now we moved in here lack last year and June came literally like June first I will send, the deer came almost every day. We are having deer come through the yard and sure enough, here is June again. I do not know where they go. Dr. Davidson: Only because we do not cover up our garden beds. So we basically are growing a garden to feed deer. [laughing] Which is fine. Dr. Maki: That is okay. Dr. Davidson: They need to it. Dr. Maki: That is all right. Make sure the little one gets the gets a meal here and here and there. So on today’s episode, we are going to talk about thyroid. This is a question, this is actually a specific question from somebody

What Diet Is Best For Perimenopause? | PYHP 098 Jul 02, 2020

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Question: What diet is best for Perimenopause? Short Answer: One of the most common complaints we get from women in perimenopause is unexplained weight gain. Their lifestyles have not changed in years, but all of a sudden, their weight keeps increasing. And if they try to lose the weight, their efforts fall short and often gain more weight in the process. An observation we see quite often is that many women are still tyring to “eat less and exercise more.” This might have worked when they were 25, but for women in their 40’s, this weight loss approach often seemed to backfire. Women in their 40’s typically have a good deal of stress already, so trying to exercise the weight off only adds to their stress. This makes the weight loss process very frustrating, if not seem impossible. Click the link to download our Keto Carb Cycling Program. PYHP 098 Full Transcript: Download PYHP 098 Transcript Dr. Maki: Everyone thank you for joining us for another episode of the Progress Your Health podcast. I am Dr. Maki. Dr. Davidson: And I am Dr. Davidson. Dr. Maki: So on this one, we are just going to dive right in, and we of course have a lot to talk about. We cannot not talk about perimenopause or menopause without discussing diet and weight loss at least to some extent. Would you agree with that? Dr. Davidson: Absolutely when women, hit their 40s, they especially perimenopause and menopause. They always say it is like I put on 10, 12 pounds overnight like it, just where did it come from and they will point right to their stomach. I have had women, I love them dearly they will even grab their stomach and say, “I have never had a belly before where did this gut come from?” And things are different, of course, we all know obviously from when we are twenty, to when we are forty, to when we are sixty, we are always changing but it definitely comes from the change in hormones. Dr. Maki: Yes, right and believe me that is very complicated and you and I, we have been doing this a long time and we certainly do not have all the answers when it comes to diet and weight loss and especially perimenopausal weight loss or menopausal weight loss for that matter. But the purpose of this episode is to kind of just shed some light on some of the observations that we have noticed and in some ways what does not work for people, we do know some of those things. Everyone is still trying to follow the same advice eat less, exercise more all the time. They are just trying to basically starve themselves and exercise a bunch and that strategy right there and we will kind of dive into that, what that strategy looks like little bit more specifically but that strategy clearly does not work. And in some cases that actually make their situation worse, they actually gain more weight. They are exercising five, six days a week and their weight is going up. Dr. Davidson: Yes, you will see that I mean granted I was a child of the 80s. I remember the 80s and the 90s, if you were going to go on a diet, you

What Supplements Are Good For Perimenopause? | PYHP 097 Jun 26, 2020

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Question: What supplements are good for Perimenopause? Short Answer: The conventional treatment options for Perimenopause are limited. Most often, women are offered birth control and other habit forming medications. None of those options are very effective in providing women relief of their symptoms. PYHP 097 Full Transcript: Download 097 Transcript Dr. Maki: Hello everybody. Thank you for joining us for another episode of the Progress Your Health podcast. I am Dr. Maki. Dr. Davidson: And I am Dr. Davidson. Dr. Maki: So on this episode, we are going to continue our talk about perimenopause. We are going to talk about some of the supplementation that we use in helping people deal with some of the symptoms of perimenopausal. Dr. Davidson: Exactly. We have talked about perimenopause many times in other podcasts and blog posts as well. Like we always say, there is really not a lot of answers out there, especially conventionally. The last thing you want to do is take habit-forming or ineffective medications, but at the same time, we also want to have some help so we can kind of transition and feel good during this time of perimenopause. Dr. Maki: Yes, right. Now conventionally, like we talked about the past, really, the only options for this window, this demographic, this ten-year span, ten-plus years span for women. Dr. Davidson: Possibly. Dr. Maki: Yes, right. Let us say from forty to fifty, if we just kept it to that, but I think there is an overlap into the late thirties and even the early fifties. So we are looking at a really good solid decade. In some ways, a really highly productive time frame for women where they need to be on their game. They have lots of things, are juggling lots of different parts of their lives and we hear it all the time. Women get to this certain point and all of a sudden, their bodies just stop cooperating. They cannot sleep. They have anxiety. They are irritable. They are gaining weight. They have all these things that are happening that they have never really experienced at that point. They really do not know what is going on. They go to their gynecologist. They go to their primary care doctor and no one really has any answers to be able to help them. Dr. Davidson: Yes. Like you were saying, probably the most common medication is birth control pills, which the last thing you want to do is be in your forties taking birth control pills. So, that is kind of frowned upon. I mean antidepressants, a lot of doctors will offer perimenopausal females antidepressants. And they will say, “Well, I am not depressed. Sure, I do not feel well. I am irritable. I am not sleeping. I have a lot of brain fog. My short-term memory is not right.” They have a lot of these symptoms but it is not necessarily a disease. So, a lot of conventional practitioners do feel like their hands are tied. Even like anti-anxiety medications are extremely habit-forming. The last thing you want to do is put somebody on some kind of prescripti

Why Is Perimenopause So Awful? | PYHP 096 Jun 25, 2020

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Question: Why Is Perimenopause so awful? Short Answer: We work with a good number of women in their 40’s and most of them do complain about how difficult Perimenopause is for them. As female hormones begin to decline, but stress levels are high it can cause a wide variety of symptoms. The most common perimenopausal symptoms are weight gain, irritability, and insomnia. PYHP 096 Full Transcript: Download PYHP 096 Transcript Dr. Davidson: Thank you for joining us for another episode of the Progress Your Health Podcast. I am Dr. Valerie Davidson and I am here joined with my co-host, Dr. Maki. Dr. Maki: Good morning. How are you today? Dr. Davidson: I am doing great. Thanks. Dr. Maki: We are experiencing a little bit of almost a torrential downpour this morning. Looking out the window, it is, unfortunately, raining a little bit too hard. Dr. Davidson: But it is not that cold. So June, June in Washington, Western Washington. What do you expect? Dr. Maki: Hopefully the sun will come out later this afternoon. So in this episode, I think that we are going to answer a question but it is not an actual specific question. We actually wrote a blog post a while ago. Why is perimenopause so horrible? So we are just kind of playing off that a little bit. That is a blog, this is going to be a podcast, obviously. Why is perimenopause so awful. The same idea, just a little bit of a different title. As of the last few years, I think, the perimenopausal demographic, women in their late thirties to early fifties is probably the majority of the people that we see on a regular basis. Dr. Davidson: I think you know with perimenopause, it is a little bit of an under-represented, I guess, demographic because it is, you know, it is not menopause but it is not your typical PMS. It is somewhere right in between. So a lot of times women sort of getting blown off and perimenopause is exactly what it sounds like before menopause. It can happen, you know as late as you are in your late thirties and it can last even you know, thirty or early fifties depending on how a female’s ovaries are performing, and when they decide to retire or work part-time or work full time. Dr. Maki: And their stress level. Dr. Davidson: And their stress level exactly but I always kind of you know, I do not want to make it so negative. You know, why is perimenopause so awful or so horrible. It is not a negative thing but a lot of women will say that to me like, “This is really awful, what do I do? I cannot stand it. Nobody else can stand to be around me.” But it really has to do with those hormone imbalances. So working on those hormones is completely different in perimenopause than it is with menopause. Dr. Maki: Yeah, right. Conventionally, in the medical community, no one is really equipped or prepared to deal with it. Given a woman in her late forties birth control to deal with her menstr

What Is Oxytocin Used For? | PYHP 095 Jun 19, 2020

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Question: What is Oxytocin Used For? Short Answer: The hormone oxytocin is available by prescription from compounding pharmacies. The most common uses for oxytocin is to enhance female libido and mood. Also, research has shown that oxytocin may also be helpful in weight loss. More research is needed to better understand how oxytocin can be used as an effective therapy for obesity. PYHP 095 Full Transcript: Download PYHP 095 Transcript Dr. Maki: Hello everyone. Thank you for joining us for another episode of the Progress Your Health Podcast. I am Dr. Maki. Dr. Davidson: And I am Dr. Davidson. Dr. Maki: So on this episode, again, we are going to introduce something that we have used quite a bit with our patients. We are going to talk about a hormone, actually, a hormone prescription called oxytocin. I know a lot of people have heard of that before, right? It is considered to be kind of the love hormone. But it can be used, it can be turned into a prescription and we use it quite often. Dr. Davidson: Yeah. I have actually used it a lot with patients. When it works, it works really well and the great part to it is there is not any necessarily, negative side effects to it. So if it works, awesome. If it does not, then okay, we are back to the drawing board. Those of you that have heard of oxytocin, they think of it as like the love hormone. But it is. You know what, it can help with female libido and that is probably a cup. Probably the two reasons that we use it or I use it is for working on female libido because we know that that can be a tough one. Because school rules are complicated. The other part that I use it for is just a sense of well-being. It does kind of help bring up that mood. We live in a stressful world. We live in a sympathetic, adrenal fight-or-flight world, whether it is watching the news, or driving your car, or getting to work on time, or working with family, things are stressful that I find that oxytocin can really push you over to the other side to help bring that joy back so you do not always feel so rushed and overwhelmed. Dr. Maki: Yeah, right. I would agree that those are the two main things that you and I use it for. We are not really big fans of antidepressant medication in general. We never use them. That is fine if people want to take them, but we are not necessarily going to prescribe those things. That is just not what we choose to focus on. Oxytocin is kind of our version of something like that. It has very good, as we are talking about one of our previous episodes, the cost-benefit ratio oxytocin, also has a very good cost-benefit ratio. It works great. You get some benefit from it. There have been a few where they just do not notice anything or the effect of it is not substantial enough for them to notice any subjective improvement. Again, it is very subjective. Libido, maybe not as subjective either, your libido increases or it does not. The mood can also be kind of an up-and-down roller-coaster. There are good days and bad days that it can also be a hard thing to gauge or quantify over time if it is actually helpful or not. But the ones that it does, I had a patient to talk to earlier this week.

What Is LDN Used For? | PYHP 094 Jun 18, 2020

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Question: What is LDN Used For? Short Answer: There are many possible uses for Low Dose Naltrexone (LDN). The common use for LDN is autoimmune diseases but has also been used in many immune system-related conditions, including cancer. PYHP 094 Full Transcript: Download 094 Transcript Dr. Maki: Hello, everyone. Thank you for joining us for another episode of the Progress Your Health Podcast. I am Dr. Maki Dr. Davidson: And I am Dr. Davidson. Dr. Maki: So today, we are going to do not really an actual question like we have been doing on some of the past episodes. But today, we are going to actually something that does come up quite often. So it is kind of a question. It is not coming from one person. But today we are going to talk about low dose Naltrexone or LDN. Dr. Davidson: Exactly. So LDN, low dose Naltrexone. We have actually used with our patients for a number of years, but we do get a lot of listeners, just people that run across our website, people from thyroid groups looking for low dose Naltrexone, because while it has been around for… Gosh. Naltrexone has been around like… Dr. Maki: Thirty years. Yeah, late 70s or early 80s. Dr. Davidson: Yeah, the 80s, you know, doing low dose Naltrexone has not been as, you know, as common wise. Maybe for about the last ten like we have been using it probably for about the last eight to ten years, but it is not very much wide-known. I guess you could say, conventionally, so people will go to their conventional doctor looking into it and then, you know, they then their doctor looks at him like you want to go on Naltrexone. Dr. Maki: Yeah, right. Yeah. It was originally developed for as the HIV and AIDS epidemic was starting to kind of show up in the early 80s. It was used as a medication to curb alcohol and drug addiction because it has certain effects on the brain. It is supposed to limit your cravings for those types of things, those kind of dangerous behaviors that becomes a little bit too habitual and you have an addiction. But actually, along that path over the early 80s, a doctor in New York – I think his name is Dr. Bukhari – noticed that his, and I am not even really sure how he discovered or how we figured out the low dose part, but notice that some of his patients were actually improved. Their immune system status was improving with HIV. Now, we do not necessarily hear as much about HIV or Aids anymore. It is still around but not nearly as stigmatizing as it was in the early 80s. In some ways, if you think back, even up until the 2000s, you know through the 80s and 90s, you know, HIV and AIDS was kind of, you know, everyone was very fearful of that kind of like they are now at the Coronavirus. A little bit similarities there as how fearful everybody was because we just did not know anything about it. But low dose Naltrexone, so using it for what it was intended for, FDA approval, that was in doses of let us say 50 to 300 milligrams. What we are talking about low dose Naltrexone if you look it up online and there is some couple of re

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