The slender, nervous appearing woman told me she was the CEO of a company and thought maybe she was losing her mind. She forgot things, couldn’t sleep, made lists and then forgot about making a list, night sweats and hot flashes. She had been to several doctors who had done complex tests involving genes and vitamin levels, but said nothing had really helped, and could I take a look at these labs?
She inserted a tiny estradiol secreting device into her vagina every 3 months. Despite this vaginal estradiol, her blood level was very low. Estradiol nourishes the brain and helps to improve memory, stops the temperature dysregulation which was wrecking her sleep. The blood level desired is around 50-100, and she was non-detectible.
“Are you taking progesterone and testosterone,” I asked. No, she was told that she didn’t need progesterone as she had no uterus. If you want to sleep, be calm, receptive in sex, and have thick, mucoid secretions, you most definitely do need progesterone. With estradiol only, secretions are thin and watery and don’t do the job of lubrication when you most want it.
Testosterone enhances sexual energy and, I believe based on years of prescribing it and using it myself, mental focus, drive (for lack of a better word), and most importantly worthiness. Testosterone seems to help with self worth and has been found in men in high dose to alleviate depression.
Oh! I exclaimed, “Your B12 is low and homocysteine, a marker for memory loss according to researchers studying Alzheimer’s, is too high”. I wrote down a vitamin with the methyl-group of B Vitamins she could purchase.
She agreed to make a full appointment after I told her that I could certainly help her. We discussed in detail the risks and side effects of hormone replacement therapy, which some doctors and researchers believe might cause blood clots, cancer, or strokes. The WHI study, did not show that a synthetic estradiol caused cancer. I reminded her that one could have all the above mentioned illness whether taking hormones or not.