Ask Larry:

Your Question: I went through early menopause at 38 and went on natural HRT right away. I got rid of the night sweats/hot flashes, but now they’re back. I’m taking 200mg of natural progesterone caps at night. I was taking Estradiol, but was scared of it, so I stopped. It Seems that is when my symptoms began. For the past several weeks I’ve been applying Estriol cream, but it doesn’t seem to be helping the symptoms. I got blood work done, and my estrone is at 237!

Isn’t that way too high? My progesterone is at 7.2., what should I do?

Your Response: To start I must emphasize that I do not favor taking progesterone by mouth. We are not designed to digest hormones and absorb them. There are numerous unidentified substances formed in the digestion process and only a small amount of progesterone is absorbed AS progesterone.

Some people use progesterone orally because they find that some of the metabolites help with sleep. That might be true, but it doesn’t seem reason enough to use oral doses for progesterone replacement.I have long favored using topical progesterone that is absorbed through the skin directly into the blood stream – and THEN to the liver where it is metabolized as it should be.

The topical doses of progesterone are about 90% smaller than the oral doses. This detail lends credence to my comments about digestion and minimal absorption.

I do not recommend progesterone be used every day. Instead I recommend applying once or twice daily according to a dosing schedule, such as;

·         Apply 20 mg (one pump) once daily for days 1 through 12.
·         Apply 20 mg twice daily for days 13 through 26.
·         Stop.
·         Start again on day one.
·         If having cycles, day one is the first day of the period. Otherwise, a calendar is a great method for keep track.
·         (For men, we suggest 10 mg daily, 6 days a week.)

Regardless of the menopausal or surgical status, most of us – women too – make estrogen in other parts of the body (skin is one of them).

Except in extreme cases I don’t find that estrogen supplements help at all – oral or topical.

I am not up to speed on blood lab values. Each lab has its own set of standards. It seems though, that you feel your numbers are out of balance. I can understand that if you are using estrogen cream and taking progesterone by mouth.

Balance is critical and there are many health practitioners who order hormone replacements without a full understanding on how they work.

In our work we find that most people do exceptionally well using only progesterone cream according to the cycle listed above. There are numerous reasons that I won’t go into here except to state that hormones balance themselves on a moment-to-moment basis.

Progesterone is one of the base hormones from which all of the others are made. Most people need extra progesterone to balance the estrogen activity they are getting from the environment. Also, in a world where everyone seems manic about cholesterol numbers I see the probability for many hormone imbalances.


Cholesterol is one of the most important substances we make. From it we make pregnenolone that becomes progesterone, then on to the other hormones. Lowering cholesterol levels basically reduces the amount of raw material the body needs to make hormones.

Finally, I have become sour on lab tests, especially for hormones. Using the numbers allows a health practitioner to not do the correct clinical work necessary to help their patients feel their best. Too often lab numbers are used inappropriately and too many people place too much trust in them.

If the goal is to feel better, what value is there in a test number that says all is well? Sadly, most doctors don’t have the time to get to the bottom of the clinical complaints and are forced to rely on numbers.