HRT Clinics, what are they giving women?

[UsmcOldSchoolMuscle]

My lady is considering bio identical therapy for women. I’m wondering what these clinics typically giving women. A yelp search of local clinics near me isn’t giving me much confidence as each seem to have at least some bad reviews of the reviewer stating shady business practices etc. Is it like the Wild West with these TRT clinics? Nevertheless I digress,
What are women typically being prescribed at these HRT clinics?

 

[Scorpyd]

My wife and both see a Wellness , Anti Aging, Geriatrics, HRT Doc with an excellent record locally.
We are 55+.

My wife is currently prescribed 20 mg Cyp/wk with progesterone.

She was started at 10 mg wk for 1.5 yrs.
Went to 15mg for 1.2 yrs and 20 mg wk since 2020.

Below is what works best for her. We are doing the following protocol because of occasional Pharmacy Cypionate inventory shortages to build up a reserve in case of shortage.

10 mg Cyp week 1
15 mg Cpy week 2
20 mg Cyp week 3
10 mg Cyp week 4
etc..

So far no complaints. Quality of life is good!

 

[m302_imola]

My wife and both see a Wellness , Anti Aging, Geriatrics, HRT Doc with an excellent record locally.
We are 55+.

My wife is currently prescribed 20 mg Cyp/wk with progesterone.

She was started at 10 mg wk for 1.5 yrs.
Went to 15mg for 1.2 yrs and 20 mg wk since 2020.

Below is what works best for her. We are doing the following protocol because of occasional Pharmacy Cypionate inventory shortages to build up a reserve in case of shortage.

10 mg Cyp week 1
15 mg Cpy week 2
20 mg Cyp week 3
10 mg Cyp week 4
etc..

So far no complaints. Quality of life is good!

I like this protocol but I have to assume your wife is post menopausal which does feed into the equation. A younger woman premenopausal “should” need less cyp.

My GF is 35 (premenopausal) and she was put on hrt last year. Dr said she has the lowest levels he had ever seen in a 35 year old. She pins 8mg cyp twice a week and it puts her on the upper end of the range (which is where I like her) as she’s incredibly active between her job being a fitness coach (she conducts group classes), body building (she trains with me 1.5 hrs 6 days a week, and she’s also a hybrid athlete. She runs as well as some trail running.

I do like your layout with titrating up then back down. I might give this a shot with her. Women are way more complex than us guys.

 

[mexbeast]

My lady is considering bio identical therapy for women. I’m wondering what these clinics typically giving women. A yelp search of local clinics near me isn’t giving me much confidence as each seem to have at least some bad reviews of the reviewer stating shady business practices etc. Is it like the Wild West with these TRT clinics? Nevertheless I digress,
What are women typically being prescribed at these HRT clinics?

Why don't you consider a endocrinology Dr?

 

[mexbeast]

My wife and both see a Wellness , Anti Aging, Geriatrics, HRT Doc with an excellent record locally.
We are 55+.

My wife is currently prescribed 20 mg Cyp/wk with progesterone.

She was started at 10 mg wk for 1.5 yrs.
Went to 15mg for 1.2 yrs and 20 mg wk since 2020.

Below is what works best for her. We are doing the following protocol because of occasional Pharmacy Cypionate inventory shortages to build up a reserve in case of shortage.

10 mg Cyp week 1
15 mg Cpy week 2
20 mg Cyp week 3
10 mg Cyp week 4
etc..

So far no complaints. Quality of life is good!

No estradiol? Are they supposed to derive it fro the test?

 

[UsmcOldSchoolMuscle]

My wife and both see a Wellness , Anti Aging, Geriatrics, HRT Doc with an excellent record locally.
We are 55+.

My wife is currently prescribed 20 mg Cyp/wk with progesterone.

She was started at 10 mg wk for 1.5 yrs.
Went to 15mg for 1.2 yrs and 20 mg wk since 2020.

Below is what works best for her. We are doing the following protocol because of occasional Pharmacy Cypionate inventory shortages to build up a reserve in case of shortage.

10 mg Cyp week 1
15 mg Cpy week 2
20 mg Cyp week 3
10 mg Cyp week 4
etc..

So far no complaints. Quality of life is good!

Thanks Scorpyd, your post is much appreciated.

 

[UsmcOldSchoolMuscle]

Why don't you consider a endocrinology Dr?

She’s worked with more than one. These particular physicians were opposed to HRT, acting as if it’s snake oil.

 

[Fattyone]

My wife is 32 and defy has her on test cyp and some thyroid meds.

 

[Scorpyd]

No estradiol? Are they supposed to derive it fro the test?

My wife has not had a prior hysterectomy . Her estradiol falls within low/normal.

I like this protocol but I have to assume your wife is post menopausal which does feed into the equation. A younger woman premenopausal “should” need less cyp.

My GF is 35 (premenopausal) and she was put on hrt last year. Dr said she has the lowest levels he had ever seen in a 35 year old. She pins 8mg cyp twice a week and it puts her on the upper end of the range (which is where I like her) as she’s incredibly active between her job being a fitness coach (she conducts group classes), body building (she trains with me 1.5 hrs 6 days a week, and she’s also a hybrid athlete. She runs as well as some trail running.

I do like your layout with titrating up then back down. I might give this a shot with her. Women are way more complex than us guys.

Yes, post menopausal for 10 years. We chose the ramp up dosage schedule to trial with a positive outcome . It seems work well with little sides using long acting Cyp varied schedule with a little left over incase of a pharmacy shortage. Shortage has occurred numerous times I might add.

 

[m302_imola]

She’s worked with more than one. These particular physicians were opposed to HRT, acting as if it’s snake oil.

That’s the sad reality of some physicians. Women need adequate test levels just like a male does. All be it, they happen to make about 1/8 of what we make naturally but it’s hormone they are born with so if the body isn’t making enough naturally then they need replacement.

 

[hogan87]

Most women in our office will get testosterone pellets, 87.5-100mg every 3 months. They normally get enough conversion to bump their E2 but that really does not need to be supplemented UNLESS they are feeling symptoms. If we do Rx estrogen it will be Bi-est, E2/E3, 1:4... Ie; .5mg E2/2mg E3 in a troche. Straight E2 leads to higher rates of cancer, this was discovered many years ago. Some women will also get progesterone 50-200mg caps or in the troche also. Thyroid is a common med for women but we always do NP thyroid.

 

[m302_imola]

I don’t like the pellets. To much variability there. Way too tough to keep stable blood levels.

 

[UsmcOldSchoolMuscle]

Most women in our office will get testosterone pellets, 87.5-100mg every 3 months. They normally get enough conversion to bump their E2 but that really does not need to be supplemented UNLESS they are feeling symptoms. If we do Rx estrogen it will be Bi-est, E2/E3, 1:4... Ie; .5mg E2/2mg E3 in a troche. Straight E2 leads to higher rates of cancer, this was discovered many years ago. Some women will also get progesterone 50-200mg caps or in the troche also. Thyroid is a common med for women but we always do NP thyroid.

So you work in a clinic?
That’s really cool insight.

 

[hogan87]

So you work in a clinic?
That’s really cool insight.

Yes. Wife and I own and run it, she is the doctor. We do more medical aesthetics (botox, laser, etc) but also a little bit of HRT for women because that is our main demographic of customer.

 

[m302_imola]

Most women in our office will get testosterone pellets, 87.5-100mg every 3 months. They normally get enough conversion to bump their E2 but that really does not need to be supplemented UNLESS they are feeling symptoms. If we do Rx estrogen it will be Bi-est, E2/E3, 1:4... Ie; .5mg E2/2mg E3 in a troche. Straight E2 leads to higher rates of cancer, this was discovered many years ago. Some women will also get progesterone 50-200mg caps or in the troche also. Thyroid is a common med for women but we always do NP thyroid.

But in most cases don’t you find once you put a woman on hrt and blood levels stabilize that thyroid levels normalize as well? Seems to be a direct correlation in MOST women.

 

[hogan87]

But in most cases don’t you find once you put a woman on hrt and blood levels stabilize that thyroid levels normalize as well? Seems to be a direct correlation in MOST women.

No. If thyroid is off, putting a woman on test and/or estrogen is not going to fix her thyroid levels. She might feel better, some relief of symptoms with HRT but thyroid needs its own meds. Especially if there is an autoimmune condition related to the thyroid which is very common among women.

 

[m302_imola]

No. If thyroid is off, putting a woman on test and/or estrogen is not going to fix her thyroid levels. She might feel better, some relief of symptoms with HRT but thyroid needs its own meds. Especially if there is an autoimmune condition related to the thyroid which is very common among women.

But if thyroid is off because of low test it will and I’ve seen that in both women and men. I’m not talking about those with autoimmune disorders.

 

[ironmaster73]

I coach a few women. Pre menopause we use anabolics only. Post menopause or anyone over 50 I advise micro doses of Test e.