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Estrogens and Progestins

Dosing in the Menopause to Treat Hot Flashes

Once the decision is made to treat your hot flashes with estrogen, the question is which one? Estrogens may differ in how you take them, but your body does not really know the difference in terms of treating the hot flashes. All women with a uterus should take some form of progesterone with the estrogen to prevent the growth of abnormal cells inside the uterus. Daily progesterone should result in the least amount of bleeding.

Estrogens

  • Oral Micronized Estradiol: This is a pill called Estrace – start at 1mg:  0.5 mg, 1 mg, 1.5 mg, 2 mg…[read more]
  • Transdermal Estradiol: This is a patch –  start at 0.0375 to 0.05:  0.025 mg, 0.0375 mg, 0.050 mg, 0.075 mg, 0.100 mg,.
  • Oral Conjugated Estrogen: This is a pill – start at 0.3 mg:  0.3 mg, 0.45 mg, 0.625 mg, 0.9 mg, 1.25 mg, 2.5 mg.
  • Oral Ethinyl Estradiol: This is a pill – starting at 0.02 or 0.05 mg daily.
  • Oral Esterified Estrogen: This is a pill (estrone) – starting at 0.1 to 0.5 mg 2-3 times per week.  0.3mg, 0.625 mg, 1.25 mg, 2.5 mg.
  • Oral Estropipate: This is a pill – starting dose is 0.75 mg to 6 mg.  0.75 mg, 1.5 mg, 3 mg.
  • Intramuscular Estradiol Valerate: This is an injection – dose at either 10 or 20 mg every 4 weeks.

Progestins

  • Medroxyprogesterone Acetate: This is a pill – 1.25 mg daily (scored 2.5 mg tablets), 2.5 mg, 5 mg.
  • Norethindrone Acetate: This is a pill – 2.5 mg daily (scored 5mg tablets).
  • Norethindrone: This is a pill –  0.35 mg (contraceptive dose), it is ½ strength of norethindrone acetate.
  • Crinone Vaginal Micronized Progesterone: This is a vaginal gel – 4% is 45 mg or 8% is 90 mg…[read more]

Combination Estrogen and Progestin

  • Ortho Prefest: 1 mg estradiol 15 tabs, and 1 mg estradiol with 0.09 mg norethindrone 15 tabs
  • Prempro: Conjugated estrogens with medroxyprogesterone.  0.3/1.5, 0.45/1.5, 0.625/2.5…[read more]
  • Activella: 1 mg estradiol with 0.5 mg norethindrone acetate…[read more]
  • FemHRT 1/5: 0.005 mg ethinyl estradiol with 1 mg norethindrone acetate…[read more]
  • CombiPatch: 0.05 mg estradiol with 0.14 mg norethindrone acetate OR 0.05/2.5 per 24 hours…[read more]

Once you are OFF estrogen, and we are sure the hot flashes are gone, then we can discuss any other modifications of the medical treatment of your menopause.


ADDITIONAL TOPICS

Hormone Replacement Therapy

Menopause is the natural change in ovarian function. One of the most obvious symptoms of the menopause is hot flashes. Hormone replacement therapy (HRT) in menopause can treat hot flashes AND keep bones healthy and strong.…[read more]

Heart Health

What you should know about keeping your heart healthy during this transition in life…[read more]

Bone Health

Tips for keeping your bones strong and healthy during menopause and beyond…[read more]

Libido

When you desire a solution for your libido, there are options…[read more]