For women, balancing our hormones can be a lifelong challenge that affects our moods, energy, sleep, pain tolerance, and fertility.
No matter what stage of life you find yourself, understanding your cycles and or depleted hormones matters. After puberty a woman’s hormones can fluctuate each month with phases moving from follicular to ovulation to luteal to menstruation. These changes are particular to each woman and are altered by our unique body chemistry, the hormones we take, the drugs we use, and how we take care of ourselves.
Estrogen is understood to be the happy, energetic, “female hormone” and is key to sexual maturation and reproduction. It is a steroid, a growth hormone that signals communication between the brain and the body. Its fluctuating presence is very different between men and women. It is instrumental in brain functions such as cognition, memory, neurodevelopment, and anti-inflammatory effects.
Estrogen does not work in a silo but in conjunction with other hormones including progesterone and testosterone. Left unchecked and unbalanced it can lead to a plethora of health issues ranging from PCOS, to endometriosis, to unexplained pain, and early or disruptive menopause.
Estrogen’s Misinformed History
In the 1950’s estrogen was the key ingredient in most face creams and for good reason, it helped plump the skin and reduce wrinkles. So what happened? Why did it go away?
A little history on the FDA is warranted here. In 1906, Teddy Roosevelt formed the FDA, a shell of what it is today, it oversaw labeling only. By 1938, still no drug efficacy but directions and prescriptions were now required. By 1962 the gig was up. New FDA regulations required “Approved” drugs to prove they treated a specific medical condition and did not cause harm. The onus of responsibility was entirely on the drug manufacturer at a cost of 10 to 20 years and over $100M for the hope of approval. All a challenge that would prove cost prohibitive for most innovative drugs, especially ones to treat women.
So what happened to our estrogen? Despite the fact that by 1997, Premarin (conjugated estrogen derived from pregnant horse urine) was the #1 prescribed drug in the US with sales exceeding $1B, in 1993 the FDA weighed in that they were “skeptical” of estrogen face creams. They did so while admitting results of plumpness and reduced wrinkles while not concluding any harm. The FDA’s job was to weigh in, not to study. Needless to say, this skepticism coupled with newly mandated, very low doses of estrogen and cost prohibitive testing caused estrogen face creams to immediately disappear from the market. Yet another blow to women’s health.
In 1991 a large, long-term study on the risks and benefits of hormone therapy was initiated by the Women’s Health Initiative (WHI). In July, 2002 the WHI terminated the study after it reported a small but increased risk of breast cancer diagnosis. Unfortunately for women, the WHI inaccurately identified estrogen therapy side effects and it spread like wild fire through physicians who never bothered to look closely at the study.
The result, once again, women got the short end of the stick and were unilaterally taken off hormone therapy.
Getting it wrong once again, The Lancet - Menopause 2024 suggested women rely on themselves, raw dog it, without supplementing hormones. This time, however, millions of women had the outspoken and enraged support of menopause experts such as @Dr.LaurenStreicher, @Dr.MaryClarieHaver, @Dr.JenniferGarrison, et al, who have taken charge and changed the way we think about menopause and the benefits of hormone therapy.
Today, with more doctors stepping up on behalf of women, estradiol, progesterone, and testosterone are prescribed “off label”. Understanding that transdermal estradiol cream is only FDA-Approved for vaginal atrophy and dryness and 30% of hormonal birth control is also prescribed “off label”, it is incumbent on us, as consumers, to lean into this loophole and choose our doctors wisely.
Keep in mind, women’s health is only beginning to be studied. In 1977, FDA policy excluded women of child bearing potential from trials. It was not until 1993 that Congress passed a law requiring the inclusion of women in clinical research. Yet, a 2022 Harvard Study found that as of 2019 women are still “substantially underrepresented in trials for all leading diseases”. https://hms.harvard.edu/news/more-data-needed)
Needless to say, men do not suffer from the same rigor, challenges, and lack of access and have no problem getting prescribed FDA-Approved Testosterone, Viagra or Cialis.
Tanya’s Tip: If you have access to healthcare, vet your medical team. If dancing with menopause, be sure your doctor is dialed into the latest menopause research and studies.
My Hormone Therapy Story - Dialing in oOrgasms
My passion and pursuit to dial in oOrgasmic pleasure is what first led me to Estrogen.
I am a Scorpio born in 1968, I chose not to use hormonal birth control during my reproductive years. I gave birth to my kids naturally and was reluctant and afraid to use any drugs for most of my life. By age 53 the early signs of peri-menopause were at my door and manifested in irregular periods disrupting my very active sex life.
This was a wake up call.
If you have ever experienced spotting or irregular periods as peri-menopause sneaks up it is like a water spigot on the fritz shutting on and off when you least expect or want it. At the time I was desperate, I had no other signs of menopause but this one was annoying. I considered and even scheduled an endometrial ablation which I was told comes with a tubal ligation. This minimally invasive procedure would remove a thin layer of tissue from the lining of my uterus and presumably had good success rates in stopping sporadic bleeding in women over 50.
My sister, 8 years younger, tried it. It did not fully stop her bleeding. Desperate, fearful and relying on hearsay that my vulva would be a bloody mess before drying up, I scheduled the surgery.
In the eleventh hour I got a second opinion. I was wisely counseled to have the Mirena® IUD inserted in lieu of surgery. The Mirena® would provide localized progesterone and, bonus, it could be left in for 8 years. This made all the more sense when I was informed that an ablation could restrict my body’s ability to uptake hormone therapy. Having abstained my whole life from putting systemic drugs in my body I was ready to indulge and looked forward to the chance to play with a hormonal cocktail.
After several months my period finally stopped and was no longer getting in the way of sex. It would start and stop again twice after surgeries, a circumstance that alluded my doctors, both times.
When I was young and fertile, my Catholic mom and dad taught me to track my cycles using Natural Family Planning. This included a paper chart with red, yellow and green baby stickers that helped track ovulation based on cervical mucus and the option of using a basal thermometer to track temperature. I mostly relied on the rhythm method. I immediately understood that when one is most horny, when estrogen is at its peak, is also when the risk of pregnancy is the greatest. I gave birth to four kids.
Tanya’s Tip: You can use topical estradiol on the urethra, clitoris and vestibule of the vulva during your morning routine. Use your fingers to apply in lieu of the applicator. Remember, estradiol cream can plump skin and reduce wrinkles, apply under eyes and neck.
Estrogen, Movement and Drug Use
One of the beauties of aging is you no longer have to worry about getting pregnant.
Late in my 55th year I was ready for topical Estrodiol. Before my 56th birthday I added 1mg of systemic Estradiol to the mix. I was wetter than ever, my memory was spot on, my sleep sound, and my energy off the charts.
Before I started hormone therapy, despite exercise and a healthy diet, I started seeing rolls of fat around my thighs that I could not explain? I thought I was working out? At that point I had a personal trainer twice a week, hot yoga 5 times a week, 10 hours of active orgasmic sex each week, and long walks around the park. Still unexplainable jelly rolls on my thighs.
Due partly to estrogen but largely to tracking and knowing my body, practice, and good routines, I am now in the best shape of my life. I am 5’6” and weigh 135 lbs give or take a few. I eat as much protein and as little sugar as possible. Little to no alcohol and no meat or supplements. My drugs of choice are caffeine (coffee), cannabis and micro-dosing psychedelics and occasional MDMA trips for the purposes of next level intimacy. Note: I choose to live between Colorado and Oregon where my drugs are legal or decriminalized.
Tanya’s Tip: Estrogen is that happy hormone that mixes exceptionally well with cannabis, psychedelics, and oOrgasms. My routine includes dosing 1mg every evening to coincide with sexy time. More in this can be found @YestoSex. Article, Dancing with Estrogen, Cannabis and oOrgasms.
Share Your Story - It Takes a Village
As the oldest of her 10 kids I want to share my mom's story. I do it partly because I understand that getting through the challenges of menopause does take a village and sharing our stories is important.
Now in her mid-80’s, since menopause, she is prone to horrible UTI’s. This keeping in mind, until very recently, caught up in decades of misinformation, she was too fearful to supplement with any hormone therapy. She took her doctors at their word and believed that estrogen would cause breast cancer despite no family history and breastfeeding almost continuously for 20* years. She was treated unsuccessfully with antibiotics among other “shots in the dark”. Without topical estrogen, her urethra naturally shriveled up causing painful urination and recurring UTI’s. She is finally using transdermal estradiol.
I share my mom’s story because women need to discuss what is working and what is not. While we may finally get the research and studies we need with the new FEMtech boom, history shows that shaming women and not looking under the hood is par for the course.
While we wait, tuning in, tracking behavior and tapping into biometrics including activity, heart rate, temperature, and sleep can be very empowering and help you better understand your needs and dial in experiences with family, friends, and your healthcare team.
Love to hear what is working for you! Follow @YestoSex or DM here to join the conversation.
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