• A few more questions, if that is o.k. Can a person take Bio-identical hormones indefinately? Is there an increase risk and side effects taking Bio. HRT for long periods? In general, when do you feel that a woman will no longer benefit from Bio-identical hormone therapy? Thanks again.

  Answer:  The jury is still out. I feel that low doses, to control the side effects of low levels of hormones is beneficial. The time issue is up for debate. There have been no problems that I am aware of with BHRT in the long term. JJP 7/29/08

• Dr. Pierce, I have just commenced using bioidentical hormone replacement therapy.  My Doctor has prescribed Triest 2.5; Testosterone 1.0; and Progesterone 100. This is made in a cream base to be applied on my skin 1/2 gram daily.  Would this prescription of Bio. HRT be typical of a low dose, particularly the progesterone?  I have been assured it is, however as this is my first time in using Bio. HRT to address mild symptoms, another opinion would be appreciated.   Thank you.

  Answer:  This sounds to be low to moderate dosing. JJP 07/29/08

• Dr. Garcia, My question is regarding pigmented demarcation lines in the legs/thigs. Is there anything you can do for me to make it less noticeable/eliminate them? I have read a lot of literature about the problem but cannot find a treatment for it . Can you help me? Respectfully, MCDJ

  Answer:  maybe a YAG laser as a series of treatments. JG 5.31.08

• Hello Dr. Garcia, what do you think about Bio Identical hormone pellets? I am 44, in great shape, but was heading towards menopause. Have been using pellets for 4 months. All of my symptoms have disappeared! I sleep like a baby, have energy and have fallen in love with my husband all over again. ;) thx

  Answer:  they work great but you need to know what steady dose you need, they can be used at a low dose and then supplement with creams until you figure it out, and progesterone cannot be done in pellets but oral progesterone or cream works great, glad all is well. JG 5.29.08

• Dr. Garcia, I had a baby six months ago and just do not feel like myself. I am tired all the time, I am having difficulty dropping the last ten pounds even though I diet and exercise, and I am moody...very moody. Do you think I might need hormone replacement? I do not have a history of depression and I typically handle stress very well. Thank you for your time.

  Answer:  I think seeing your doctor and getting the blood tests done first is the first step. JG 5.8.08

• One more question if that is o.k Does alternatives such as evening primrose oil and fermented soy help with menopausal issues such as hot flashes

  Answer:  In some people it does. JJP 5/04/08

• Hello Dr. Pierce, does a lack of estrogen or low levels prematurely age you? Can women take hormone replacement forever?

  Answer:  Low levels of hormones help to make people feel the effects of aging more profoundly. If a woman is on the proper balance of hormones she can take them indefinitely, unless there developes a problem. JJP 5/04/08

• Is there a risk of copper excess using Estraderm Estradiol Patch

  Answer:  I have not heard of that. JJP 5/02/08

• could the estrogen patch cause copper level to rise

  Answer:  Not sure. Never heard anything like that. JJP 5/01/08

• Dr Pierce if a woman`s lab results reveal she is menoapusal but displays little of the symptoms such as hot flushes or mood swings. Would you still advise her to take hormone replacment and if so why? thank you

  Answer:  Yes. Using minimal amounts to balance the hormones can be beneficial. If hormones such as esterone are out of balance the risk of cancers increases, according to the studies and my teachings. Also, bio-identical HRT will help to prevent osteoporosis. JJP 4/24/08

• Dr pierce in your opinon would you agree that bioidentical hormone replacment helps the anti aging process? Is a lack of estrogen in menopausal women one of the main causes for aceleration in the aging process?

  Answer:  I feel that if a person has symptoms and they are severe enough to cause the person not to live the life they desire, they should be treated. I also think anti-aging is a bit of a misnomer. We can not stop time. We can however, deminish the effects time has on our lifes. If bio-identical hormone replacement helps one feel younger and live life to the fullest, than, in my opinion that is defeating the process of aging. JJP 4/24/08

• Dr Pierce, I am menopausal and I am contemplating bioidentical hormone replacement. There seems to be alot of controversy surrounding these types of hormones, why is this and are they safe?

  Answer:  They have been safe to date. They have been used for a long time as well. The big drug companies like to cast doubt on bio-identicals, because they are competition. They can not patent Bio-identicals, therefore they can not make any money off of them. I ask you, when you`re ovaries are producing the proper balance of estrogen, how many problems do you have? There are always people that will have an issue, but they are individual cases and not the norm. BHRT is a personal decision, see a qualified practitioner and find out more and then make an educated decision. JJP 4/24/08

• Just wondering about the hormone pellets I have been reading about. If you had an allergic reaction to the gels and creams would the pellets cause the same problem? Do you use Soto pellets? Is this something you have done a lot of? If your symptoms are vaginal dryness and pain during sex would this be the route you would suggest using or is it too drastic for these symptoms. Thank you

  Answer:  Most of the allergic reactions are caused by some thing in the cream or gel. No we do not use soto pellets. We use a compounded pellet. It will work the same as any other hormone and if your symptoms are caused by a hormone deficiency will treat them. JJP 4/3/08

• Hi Dr. Pierce, I am interested in finding a doctor who really knows about BHRT. I am seeing one now that I am not that confident in. What background do you have with BHRT and how many years have you been practicing it. My issue is that I was on BHRT and was feeling great. All my symptoms disappeared after being on it for 2 months, no more anxiety, depression, painful sex, lack of sexual feelings or sleeping problems. Then I ended up with a allergic reaction to the gel in the hormones and ended up with severe itching and redness in the vaginal area. The itching became so intense I thought I was going to lose my mind. After being off the gel BHRT (we figured that the gel was the cause) I went on a cream and still ended up itchy but not to the same intensity. Now I am on nothing and want to get back. I am afraid to start up the itching, however, even being off everything I am still having itching once and a while. The itching is always on the outside never inside. I`m taking Atarax for the itching but don`t want to keep taking that either. Could the itching still be because of the reaction a month ago and can itching be caused by not having enough hormones. Sorry for the extremely long email but I really am bothered by this and no one has answers. By the way I have had every STD and vaginal test possible and they are all negative.

  Answer:  I`m not sure as to the exact cause of the itching. It may be you had a reaction to the gel and scratched the area causing more inflammation. When the gel was stopped and cream was started the area was not completely healed, thus the itch was still there and after everything has been stopped it sounds as if it slowly improving. Just speculation as I do not see you in front of me. Any way, as to my credentials, I am board certified by the American Academy of Anti-Aging medicine. I have been in private practice for almost 2 years doing only this type of medicine. My mentor Dr Julio Garcia has been doing this type of medicine for over 10 years. So, between the two of us we generally can find the answer to the problem. We offer BHRT in implantable pellets. This may be the answer to your problem. JJP 2/24/08

• Hi Dr. Pierce, I`m a 52 y o female and may have been in perimenopause for a while, but, while I`ve had some symptoms, bloating, constipation, heavy periods, it seemed manageable without any medication until recently. I started experiencing severe tingling, even itching at times, in my hands. I have an annual gyn checkup coming up soon, but in the meantime, he recommended progesterone cream. I started with one from GNC 5mg/ounce, but after some research it seems that it should have a strength of 480mg per ounce to be effective. Directions on both recommend 1/4 to 1/2 teaspoon twice a day. Any thoughts or suggestions? Should I just discard the GNC 5mg/ounce cream or can I use liberally at as a face/hand cream in addition to the stronger cream as it`s pretty weak? Thanks.

  Answer:  That would be a lot of cream. I like progesterone orally. It has all the benefits of the topicals plus it helps sleep and has anti-anxiety effects. JJP 2/11/08

• Thanks for replying. Apparently I havent got diabetes they are doin tests but I have some problem with food Ive changed docs and the new one is doing more tests.Ihave got pcos which can be to do with hormones I think and IR. But I dont understand the skin change ..I am going to try te cream and see even if my skin improves it will make me feel a a bit better. Iam going to have a filler under my eyes as if I look better it will help me to try and hold it together. Thanks for your help xx

  Answer:  Since you have PCOS, your symptoms are probably coming from an excess of androgens. This is difficult to treat. JJP 11/28/07

• Thanks so much to the lady that tried to help me (my names Mandy by the way). It did help you thats great news i need something positive right now. Did it help your skin at all?? Th elasticity ?? My mum keeps saying she thinks menapause as my skin has that crepe kind of look not as bad as my mums but it feels horriblenot plump anymore and it happened so quickly..I did loose about a stone very quick with the stroke which I think has also caused fat loss under my eyes hich makes me look 10 years older.. I want to get salvia test but signed off work coz of stroke..its ridiculous coz I work for the hospital but they just dont know whats up with me..xx My doc said no menapause but he said the readings from test would suggest it but coz i am on th pill it could be that..but i am too scared to come off the pill because my skin changed somuch when i did before but it could be due to insulin ?? i dont know ..but thanks so much anyway Ill try this cream xx

  Answer: 

• Hi sorry its me again...by the way I havent got celiac..but I am being tested for Inlin resistance thyroid etc..but I am not confident with nhs as they have already done some tests but I keep going on blood sugar diet which could mask results..but this doesnt explain my skin.. I am hoping the progesterone will rehydrate my skin..Ive been on pill for 15 years apart from one occasion i stopped for 12 months didnt have period so went back on it..I ve read that estrogen ddominance can dehydrayte the skin???? thanks really appreciate your help

  Answer:  The progesterone will help if you do have estrogen dominance. JJP 11/27/07

• Hi, I havent been well for two years I am 32 all started with a big cyst and loads of stress. The think may be to do with insulin ive recently had a mild stroke to. I came off the pill for 3 months whilst i was eating foods for a gluten challenge 6 months ago and my skin changed.. It feels thin, crepe paper looking I feel like I am in an old body. When I came off the pill for months I had bad night sweats doctors keep sayin i am too young for menapause but I ve been reading about estrogen dominance and have brought some progesterone cream as it is really depressing me. My symptoms are: thrush all the time, cant eat sugar carbs, freqent in the loo in th enight, constipation brittle hair, no libido I wont go on as will take to long ..I just want to try and help myself as its bad enough with facial drop etc.. Thanks so much for listening Mandy

  Answer:  I feel terrible for you, and for what you have been going through. It seems as if you need a total hormone profile to determine if any of your symptoms are hormone related. It sounds as if some may be. You also appear to have complications with your diabetes. That should be sorted out first. JJP 11/27/07

• IT IS MY UNDERSTANDING THAT ESTROGEN ALONG DOES NOT INCREASE THE RISK OF BREAST CANCER BUT IT IS THE COMBINATION OF ESTROGEN-PROGESTERIN THAT INCREASES THIS RISK. I HAD A PARTIAL HYSTERECTOMY AT 40 (STILL HAVE OVARIES) AND HAVE BEEN ON THE ESTROGEN PATCH FOR 15 YEARS. THERE IS NO BREAST CANCER IN MY FAMILY AND I HAVE REGULAR MAMMOGRAMS. WHAT IS THE LATEST STUDY ON THIS? THANK YOU.

  Answer:  You are partially right. MPA (medroxyprogesterone Acetate) is the synthetic form of progesterone used in standard HRT prescriptions. It has been associated with the increase of heart disease, stroke and cancer. It is a progestin, not progesterone. Progesterone has been shown to do the opposite of progestin. It decreases risk of stroke by increasing vaso dilitation and decreasing platelette activity. It has not been shown to increase cancer. It is used to balance the effects of estrogen. JJP 11/20/07

• In 1994 I had a total hysterectomy, uterius, cervics , ovories, etc. The dr put me on a patch imediatley, lately I have been doing a lot of testing , with the doctor for diverticulosis, and my patch perscription expired, and frankly I just don`t want to go to the another dr to be looked at another time. I am thinking of stopping the vevelle patch and ride it out , is this possible. will I be miserable? what should I expect besidces these hot spells that has already started and it`s only been two weeks without the patch. Please help. Roxann

  Answer:  Yes you can stop the patch. Your hot flashes may get worse. You may experience more anxiety, irritability, decreased sex drive, loss of vaginal fullness, painful intercourse, and increased weight gain, just to name a few. JJP 11/14/07

• Hi Dr. Pierce, I started taking progesterone and esradiol 9 months ago. I have noticed in the past few weeks that I have lost the outer portion of both eyebrows. Do you think this could be due to the HRT? Also, my phyisician prescribed the HRT to me based solely on my request (recurrent UTI`S, hot flashes, mood swings.), but there have never been any blood tests done. Shouldn`t lab work be done so I know if I have the correct dosage, or is that not necessary? Thank you for your time.

  Answer:  Most definitely, lab work should be done. We do use symptoms to guide our approach, but none the less lab values provide valuable information. Your eyebrow issue may be due to and issue with your thyroid or cortisol. Those levels need to be investigated as well. JJP 10/12/07

• Hello Dr. Pierce, I`d like to know if a 55 year old woman, who has gone through menopause and is using progesterone cream, should be concerned about becoming pregnant? I have read of some cases of this happening. Thank you.

  Answer:  Although it is unlikely, anything is possible. If you are not menstruating this is more unlikely. You should be on progesterone if you are on estrogen therapy. JJP 10/3/07

• Hi Dr. Garcia, I started taking HRT 8 months ago. I was initially prescribed progesterine 2.5 mg, and estradiol 1.0 mg. While my hot flashes and mood swings improved tremendously, I did have the negative effect of gaining 10 pounds in 7 days. 2 months ago my estradiol dosage was reduced to .5 mg; and I was hoping I would lose the added pounds; however they are still there (regardless of my 8 motnhs of dieting!) Is there any other HRT that might help me lose this weight, or do you think perhaps my dosage is incorrect? Any advice you might have is greatly appreciated...I don`t want to get in the position of having weight related health issues if I can avoid it.

  Answer:  well I think oral estradiol tends to lower thyroid function so I prefer to use the estradiol and progesterone as a cream, might need to get your thyroid checked to see. JG 10.2.07

• Thank you for your anwer regarding my question about the lower dosage of HRT and the eeffect on breast fullness and firmness, You suggest supplements to slow this down. What supplements shoudl I start taking? Thank you

  Answer:  I suggest proper hormone balancing after a complete evaluation, as well as supplementation. Omega 3`s, antioxidants, vitamins and minerals are all important for a healthy body. Once all are in balance the effects of time are reduces and/or improved. Therefore I am not able to say one or two supplements that will help with your issue. JJP 9/10/07

• Will reducing my estrogen dose cause my breasts to lose their fullness and firmness?

  Answer:  It should not do that. Breast tissue will loose fullness and firmness over time, and with pregnancy, due to breakdown of the connective tissue inside. Proper support and supplementation should help to slow this process. Smoking also accelerates this process of breakdown. JJP 8/27/07

• Dr. Pierce--Thank you for your response to my earlier questions regarding Pregnenolone, Progesterone, and Dhea use while on the oral contraceptive, Loestrin 1/20. As I stated earlier, I am 43 and in menopause transition. Prior to the start of OC`s, my blood levels on the 5th day of my cycle registered estrogen at less than menopausal levels of 35, but FSH levels only at 12. Given these results, what are appropriate dosages of Pregnenolone, Progesterone, and Dhea to be used in conjunction with Loestrin 1/20? And, should these dosages be taken daily? I also currently use bio-id. Testosterone cream 3X/week--without it I have 0 free Testosterone and with its use, I have 1.4 free Testosterone. I appreciate your time, as I am truly confused regarding these matters.

  Answer:  Your question is more involved than what this site is ment for. I would be happy to evaluate you and your lab work at my office. Appropriate dosing of medications can not be done effectively in this manner. Please contact my office for an appointment, or find a physician in your area that does bio-identical hormones. JJP 8/5/07

• Can pregnenlone, dhea and bio-identical progesterone cream (50mg/1/2teas.)be safely used while on Loestrin 1/20? I am forty-three and blood work shows me to be peri-menopausal. I also have been prescribed bio-identical testosterone 2% for use 3X/week.

  Answer:  I feel they all may be used safely together. If your DHEA is applied as a cream you may not need Testosterone supplementation as well. DHEA is a precursor to Testosterone, and will convert into Testosterone when applied transdermally.

• Hi Dr. Garcia, what are your thoughts about Progesterone pill vs. the cream? I see that some of the places use that for HRT instead of the cream. Is it as good? Also, I take aldactone and B.C. pills and my DHEA levels is below 15. Can that cause hairloss?

  Answer:  pretty close, well absorbed both ways. The BC can affect hairloss if it has synthetic progesterone because the synthetic behaves more like testosterone, also low DHEA implies stress and that can thin your hair too. True proesterone should help. JG 6.15.07

• I am 51 and go through mood swings. I know it is part of menopause. Is there any supplements that I can take that will help me stay I want to refer as normal? I`ve taken primrose and estroven and I don`t feel any better. I have good days and then there are days when I become anti-social. I want to be left alone, and everything bothers me. I`ve taken anti-depressants and they make me feel abnormal. I work with 10-11 year old children and need to feel stable. When I take the anti-depressants I don`t feel like myself. The doctor has given me a low dosage of anti-depressants and none seem to work. I have just given up and prefer not to take any kind of drug. Any suggestions??? The doctor did prescribe hormone replacements for 3 months and would not prescribe it again. I had a hystectomy at the age of 39, I still have my ovaries so again please help me or give me some advice to take to my doctor.

  Answer:  well there are herbal products you could try that release serotonin, but they may behave like the anti-depressants. In many cases balancing your sex hormones might help, your gynecologist could speak with you about that if it does not get any better. JG 6.5.07

• Hi, I am the 34 year old with hair loss problems. I am on Ovcon 35, but my Dr. also agreed to try the Progesterone cream as nothing else is working. A few questions for you: I got the Awakening Woman cream which says 3 pumps is 20 mg. How many TOTAL mg per day should I apply? Also, it says for PMS, start 14 days before menses and stop 1 day before menses. Is that the procedure you recomend? And also, are there any creams that you prefer? Thanks a bunch D.D.

  Answer:  I do recommend the above dosing schedule and as to the dose, normally we determine that with blood tests to see what the progesterone level is, but 20mg is a good place to start, it is on the low side. JG 5.15.07

• Hello, american living in Brazil here. Thanks for your response to question regarding progesterone. I was thinking if you go to this page on my blog you will see photos of me dancing and an older photo before I took the progesterone. Does this appear to be; progesterone or homone induced, or just more food and less exercise? http://rosemarybrasil.blogspot.com/search?updated-max=2007-04-10T10%3A43%3A00-03%3A00&max-results=7ng,

  Answer:  more likely diet and exercise. JG 4.15.07

• I am an American living in Brazil. I travel to the US once or 2 times per year and often check with doctors up there regarding health issues. A brazilian endocrinologist put me on bioidentical estradiol but no progesterone. I have my uterus intact. The gyn in MI and another endocrinologist here said that I needed progesterone. Another Brazilian gyn siad it is optional. So, I started with 10mg of duphaston for 2 weeks every month. It was horrid so I switched to Emerita cream which I liked. After 8 months I went back to the original endocrinologist and he said he could tell by my appearance that I was using progesterone. He said I was full of water and swollen everywhere. He said progesterone replacement is not needed even though my blood level without replacement is low, it is menopausal normal. he feels that progesterone is over prescribed and does women no good at all. he said american doctors need to do more research and pay less attention to the heavy threat of lawsuits in the US. What the heck am I supposed to believe. Where would you suggest I look to do my own research?

  Answer:  you cna look at www.worldhealth.org for info or at www.lef.org to find info on progesterone. Another site to look at is that of Dr John Lee. As to using progesterone, I think if levels are low it should be used, it avoids estrogen dominanace and the development of uterne fibroids and many other issues. It is certaily not used only to avoid lawsuits.Progesterone affects many tissues, not just the uterus and that is why it should be used I think he is the one that needs to read about the problems caused by estrogen dominance that occur when progesterone is not used. Proegesterone has many good effects that you will read about at those sites, I would continue to use it as long as it is bio-identical porgestereone as the synthetic ones are not good. JG 4.14.07

• Can a woman stil have hot flashes after her ovaries have been romoved? thanks Doc

  Answer:  for a while, yes, especially if they have a large amount of visceral fat. JG 4.9.07

• I`m a 42 year old female. I`ve been taking Black Cohash for a couple of years for hot flashes. A couple months ago the hot flashes returned, so I doubled my dose (2 capsules a day - 540 mg ea). A month ago I began taking Estrin D weight loss supplement, which has DHEA, but not estrogen from what I can see on the lable. The past week my nipples have become very sore. Could I be getting estrogen dominance from the combo? Also, will the estalis restore fertility if it restores you to having a period? I just stopped having periods 3 months ago, but still want a child one day if possible.

  Answer:  as to the fertility, I guess it is possible to regain uterine lining but you may not be able to have viable eggs still if you have gone through the change. As to the onset of nipple tenderness, it could be the new product, I suggest stopping it and see what happens. JG 3.16.07

• Dr.G, is saliva or blood test best when testing for hormone levels?

  Answer:  we typically use blood, but saliva can be used and is more convenient for patients to do at home and might be more accurate for progesterone levels. JG 3.3.07

• Dr. Garcia: I had a total hysterectomy at age 16 and have been on Premarin since, I am now 45. I take 1.25mg a day. Can I be on this for life? Is is dangerous? My doctor wants to put me through menopause, but I don`t want to, if I don`t HAVE to. I am also on thyroid replacement and Lisinopril for HTN. Thank you in advance. LL 2/07

  Answer:  I think going on a lower dose of bio-identical hormones is a good idea, I think you can stay on low dose bio-identical hormones for a longer period of time, should not interfere with the other medicines, you can look for a doctor to do that for you at www.worldhealth.org. JG 2.20.07

• DEAR DR. GARCIA,IS VAGIFEM VAG TAB 25MCG, TAKEN AT NIGHT AND FOR HOW LONG BEFORE IT USUALLY STARTS WORKING? B.M. 02.16.07

  Answer:  should see it help in 1-3 weeks, the worse the problem the faster it feels better. Might take 6 months or more to reach maximum improvement. JG 2.16.07

• I am tasking estalis, I got my period last month why is this.

  Answer:  due to the hormones in the prescription affecting that. JG 1.22.07

• I have just started taking the patch estalis , and last months on my eight patch I started my periods. why is this. then today this morning I started spotting , agin . what should I do. also can I become pregnat taking this patch, because I am 45 yrs old and it would be a bit scary to become pregnant. my sex drive has gone, is it due to the patch if so what can I do.

  Answer:  all that is related to the patch. I suggest seeing the doctor that prescribed it for you and considering switching to another method. In the meantime I think you need to use an alternative method of contraception. JG 1.22.07

• Can DIM be taken with femara? I am about to start femara (aromatasse inhibiter) after breast cancer and am worried about the side effects. Thanks, BN (Jan. 20, 2007)

  Answer:  should be no cross effects, it should actually help. JG 1.20.07

• Dr Garcia, i want to do a hair analysis, i found a few sites that i can send for the kit, I`m not sure if they are trustworthy? can you recomend one? and if not, maybe point me to a site where they list legit and reliable ones. thanks

  Answer:  sorry but I am not sure which ones are reputable. May want to look at www.worldhealth.org JG 1.18.07

• To the lady with the hair loss who was previously on Ovcon35, we have the same symptoms, please contact me at. Majimajix@msn.com Thanks Raquel

  Answer:  thanks for helping each other out. JG 1.16.07

• Dr Garcia, would i be able to get in tough with the lady who posted about her hair loss on Ovco35, she has the same symptoms problems I`m having, the exact same thing, the only time my hair stops falling is the week of my period, the only difference is I`m on Yasmim instead of Ovco35. thanks Raquel

  Answer:  you can post your email here for her to find you and communicate with you. JG 1.16.07

• Dr. I went to see a dermatologist in Ny, Ted Daily, he said my hair loss is called Diffuse Global Alopecia/female pattern baldness, i guess both are the same. I`m not so sure about that, but it is possible. I think i have lost most of my hair on top and back since this past summer, and i have done all the necessary test to rule out everything else, except lupus, which I`m doing this wee. My question is Will ScalpMed help? The comercial says to spray it 9 times, what does that mean and do you really have to? thanks Raquel

  Answer:  well, it is worth a try and if by two months you see no improvement it might not work in your particular case. Best of luck. JG 1.16.07

• Dr, i saw you on tv for the scalpmed comercial, i have a few question, my hair is difussing, thinning or what ever is call all over my head, but more so on the top, you can see the scalp already. I`m on BCP, been on since april of last year, my hair has been thinning way before i even started the pill. I have had complete work done, including thyroid, everything comes back normal. Here are my questions? 1-Which women benefit from Scalp med? 2-Which kind of hair loss scalpmed is supossed to treat? 3-What is the difference between Scalpmed and Regular minoxidil you buy over the counter, reading the ingredients, scalpMed is basically minoxidil? 4-Does Scalpmed promotes hair loss of the hair you currently have? 5-What happens after you stop using scalpmed? Sorry for the many question, i have been coming here and reading your site for quite some time now, and I`m basically pulling the rest of my hair out trying to figure out why still thinning. Started to thing back when i was in my 30`s, Now I`m 43 and still going, but faster. Thanks

  Answer:  ScalpMed is mostly for hormone induced hair loss and women do benefit from its use. The difference between ScalpMed and regular minoxidil is the carrier it is dissolved in for better penetration and less irritation. ScalpMed does not promote loss of hair in place but if that hair was destined to fall out it might stil fall out with the ScalpMed, it is not a 100% stoppage. When you stop using it the hair you have regained will fall out if the hormone imbalance remains. JG 1.10.07

• Have seen two doctors one says I need estrogen the other says progestron. Are you able to tell me what can happen if I refuse both estrogen/progestron pills should my levels get lower?

  Answer:  what you need should alwyas be determined by blood tests, there should not be guessing involved. Happy New Year. JG 12.31.06

• It`s been one year since my hysterectomy and my blood test show my estrogen and progesteron levels are low. Should I take estrogen/progestron pills to replace? Do I really need them?

  Answer:  that is a difficult question to answer. Certainly there are benefits to hormone replaceent such as maintaining bone masss and avoiding vaginal and urinary symtoms, emotional roller coater effects, hot fashes and poor sleep and improved sex drive, but if not done carefully can also potentially increase problems with blood clots and in rare cases cancer so it is a personal decision you need to make after consultation with your gynecologist. Happy New Year. JG 12.31.06

• Dr. Garcia you said same thing. I think they could do a challenge test to look for toxic metal build up, things like lead and mercury and others Too late for that, i did all the test on Saturday morning, and i had to really push my Primary doctor for the prescription for all the thyroid tests, he did not want to help, and did not even know what thyroid antibodies were. Really something,he said that What is happening to me is in my head, he told me to take vitamin B for my hair loss, I take an excellent multivitamins and mineral already. Can i do the metal test with you? I`m calling your office monday for the saliva test for the hormones.

  Answer:  the tocxic metals need to be done there as you need to be given medicne and then have urine samples taken. JG 12.17.06

• Dr Garcia, you said in a previous post to get a test called Thyroid binding globulin, well, i had the blood work done saturday, they could not find anything called thryroid binding globulin, they found something called Thyroxin binding globulin or something like that, is that the same? i hope so, besides what we talked about in a previous post, i did also a thyroid antibodies test just in case. You said i also need a metal test? is that the name? can i do that with you when i call your office monday for the saliva test? Thanks Raquel

  Answer:  same thing. I think they could do a challenge test to look for toxic metal build up, things like lead and mercury and others. JG 12.17.06

• Dr, what is your opinion on http://www.macafem.com getting off the BCP is going to be tough, do you think that would help? thank you.

  Answer:  I am sorry but I have no experience with that supplement. JG 12.16.06

• A woman at the age of 39 with a total estrogens serum of 563, now age 43 taken Ortho Cyclen with 35 estradiol, how is that compare to 563? less, more, the same, not enough? thank you.

  Answer:  I think that is plenty of total estrogens. JG 12.16.06

• Dr, i have decided to call your office on monday, i have a few post just now and i think my doctors endo, obgyn and primary care are missing something and they are not listening to me. I`m the lady with all the problems with the eyelashes, hair loss, and on BCP. I want to do a Saliva test for all the hormones? is it possible even on the BCP? can you guys send me a kit, i will do the test here in NJ, and send it back to you for the results. how does it work?thanks Raquel

  Answer:  call Theresa in the office and we can send you a kit. JG 12.16.06

• You said I am sorry but I think most likley your hair loss is not hormonal in nature. What do you mean by that? I`m pretty healthy, eat well, eat veggies every day, and excirse 4 times a week, my hair keeps on falling, but i don`t know what else to do. Any chances of you opening an office in NJ? I will be the first one there for an appointment, that`s for sure.

  Answer:  what I mean is that hormones, specificlaly DHT, in susceptible patients is the most common cause of hair loss but there are many others, if your thyoid function is normal and there is no toxic metal problem, then the next cause is auto-immune and that can be difficult to correct. The hormone related hair loss is the asiest and most common. JG 12.16.06

• more questions? i went back when i had my previous hormonal check up, this was two years ago and i was not on the BCP at all. My Estrogens total serum was 562 i was 42 years old, this was 2 years ago, my hair on my scalp was falling as well, but not my eyebrows or eyelashes. I`ve read most women are estrogen dominant, for women like this do you prescribe the loestrin pill? This is so confusing. I just came back from the doctor so i will be doing another thyroid test. Thyroid panel with TSH, thyroid cascade profile, t3 uptake, t4,& thyorid binding globulin. anything else i should add to the mix? I`m going to do the test tomorrow. Raquel

  Answer:  for estrogen dominance I use oral or topical progesterone. JG 12.15.06

• me again, I just wanted to say that prior to taking yasmin and progesterone, i had no eyelashes or eyebrows issues as far as falling out, they were fine, however, i did have problems my hair thinning on top and falling out. I had then a hormonal check and it was fine according to my regular doctor. BCP helped a little with my hair falling on the scalp, but did not do much as far as regrowth, still falls maybe not as much. I have noticed the only time my hair looks healthy and does not fall is the week of my period, that week my hair is healthy, shiny and does not fall at all. Weird. Any advise?

  Answer:  I am sorry but I think most likley your hair loss is not hormonal in nature. JG 12.15.06

• Dr Garcia..I have two questions? i`ve read someplace that you prefer Loestrin birth control pill, may i ask why? this pill is very androgenic from my research and most likely not suitable for all women. I`m asking this because, I`m currently take yasmin and i love it, my problem was i added progesterone and my eye brows started to fall out, my eye lashes too. Yes, i went all did all the blood work, thyroid included everything came back fine. I asked my doctor OBGYN to switch pills because of my eyebrows, and i was not sure if it was the pill or the xtra progesterone cream i was taking. Well, I`m on the 4 day of taking Ortho Cyclen and i feel so sick, i have not been able to go to work. My breast are so sore, i have a metalic taste in my mouth, my stomach hurts, and i feel like i have to throw up every second but nothing comes out, plus i feel like i have a fever. I`m going to go back to yasmin. So here are my questions? Loestrin pill? why? Is the xtra progesterone cream i was taking the culprid for my eyebrows and eyelasher falling out? Can i switch to yasmin tomorrow? i took 4 pills from the ortho cyclen package, i just cannot do it, or do you think i should stop alltogether? I was on yasmin for 8 months with no problems. Please advise? thanks Raquel

  Answer:  well, there is not one pill that is best for all, I believe the question where I expressed a preference was due to what that circumstance was. As to being happy with Yasmin, many peoople are but when progesterone is added, for whatever reason you did so should not normally cause hormonal hair loss as it competes with the 5-alpha reductase that is needed for testosterone conversion to DHT which is the most common cause for hair loss. Hair thinng associated with eye lash issues is more likely a thyroid problem and birth control pills cause a relative low thyroid very commonly which is not appreciated. I think switching back to what you liked is fine but you will need to use a back up contraception method just in case. I think you need to get your free T3 level and thyroid binding globulin to decide if there is an effect with the contraceptive. If not the next cause is possibly a toxic metal issue, auto-immune disease, or other very rare causes. Best of luck. JG 12.14.06

• DEAR DR...I am the one who had hormon imbalancing and my dr always out of country.I stoped all the med i was taking and its almost a week now.My bleeding stoped but headecheches still severe some time...plz tell me what todo?I am really sick and tired to having hormones from past 4/5months.If i do not want take HRT any more option ihave to ix my Estrogen hi level?How can i make my hormones normal...if i do not go for HRT it can harm me OR what can be happpen?? Can u recommened me a really expert dr HOUSTONTX i can go ??PLEASE DR HELP ME..THANX.

  Answer:  I think you need to see your normal primary care doctor because the headaches do not appear to be from the hormones as you have stopped them. JG 12.11.06

• DR GARCIA, Today i faxed u my blood report and in ur kind response I sent u details email on ur agesless board coz it was related to HRT but i have no idea why it was gone to ur cosmetic surgery board??plz findoud coz i posted on right borad and hope u will response me URGENTLY in ur expert and experiences....I trust u alot..HELP PLZ.

  Answer:  I think you should stop the DHEA, progesterone and testosterone, wait at least a week and then if and only if the symptoms get better should you try to re-start them at one half the dose, but you really need ot see your doctor, I cannot imagine how he can leave town without someone to be there for emergencies, not a good idea. JG 12.5.06

• Dr Garica, I desperatly waiting for ur email and wanna know why my HRT is not fixing my probs??I am getting married in 3/4months and worried.Dr said one time the ovaries are not functionaing properly...its very upsetting and i m am wondering if i stop HRT or continue taking what ever i emailed u.If any OVARIES prob is it serious or can be fixed?? plz email me in details..I am thinking to change my DR who is available when i need.I CAN COME TO U OR U JUST TELL ME WHERE IS THE PROB...AND HOW IT CAN BE FIXED..I need ur HELP.

  Answer:  well I need to know some things, like what time of your cycles were the blood tests you sent me taken, why were you started on these hormones 4 months ago as the blood tests seem recent,are you on oral contraceptives or any other medicines, what is your menstrual history in general, I think you probably do not need much of what you are taking. I think stopping the progesterone, DHEA and cutting the testosterone in half for now is a good place to start. Your estradiol level is very high and that can cause the headaches and as to the bleeding, one can experience that when they are taking hormones from the outside and then their own production shuts down. I think you should probably be able to conceive in the future but without an exam and more information I cannot say for sure. JG 12.5.06

• Dr Garcia....i just faxed on(702-8700068) u my blood report with usages of medicine i m using.PLz give me advice whats wrong and i have heavy periods frm past 10days.My dr is away for 4weeks.I m on HRT from past 3/4 months and my prob are not ben fixed?Can u tell how long it will take to fix all these hormonal imbalancing...KINDLY read the report and emil or advice me on board....PLEASE DR HELP ME.. maya_008@hotmail.com

  Answer:  I will email you later today. JG 12.5.06

• Dear Dr....THANK u so much for responsing me and agree to ee my blood report./My dr is still out of country as he teach all our the world.I am faxing u my blood report tomorrow and i just need to know after 4/5months on HRT i still have the prob.My dr has an office but no one sees the patients inhis absense...I will be writing my dosege and email adress and will greatly appreciate if u look and give me some advice coz i m bleeding from 12days as fresh red blood.I will send u a piece ce of paper to tell my condition and hope u can help me....U are a blessing for all of us.GOD bless u.thanx.

  Answer:  chat soon. JG 12.4.06

• Hi Dr.Garcia,I had a consult with you last year during which a few things I wanted to cover did not get addressed.( you and I discussed this via email later,if you dont remember the details please contact me privately keri@gci.net) anyway I was wondering if I need to have another consult or can I make an appt. to have my hormone levels tested?Also will your office help me with filing my insurance?

  Answer:  I will answer to your email address. JG 12.14.06

• DR...What is the best effective way to detoxify the body?? What ur opinion on enema tx???

  Answer:  There ar m any body detoxs out there and I do not believe in most of them, I think if there is a specific toxic build up it is best to determine what that substance is and then remove that, I am not a fan of overall detoxs. JG 11.28.06

• Hi. Dr. Garcia, Would it accelerate the aging process if I went off the pill? I am 47 and currently on Ovcon 35. Thanks.

  Answer:  well, maybe, slightly, if you are post menopausal. JG 11.28.06

• hormones therapy?

  Answer:  need to see an experienced physician for that. JG 11.26.06

• DR GARCIA.....What are the side effect of hyper ESTROGEN??I am on HRT and my ESTROGEN level is high.My breast hurts like hell and very tender?I do not feel hunger?PLEASE dr tell me how long it will take to normal my hormones and what type of problem i will face .Any suggestion u can give my ....THANX FOR ANY HELP.

  Answer:  tender larger breasts, endometriosis, migraine headaches are the most common. As to normalizing your levels, it all depends on how you do it but it should be feasible in a month or two. JG 11.26.06

• I`m 51 years old, post-menopausal (@5 years). A few weekds ago, when seeking help for loss of libido, I tested low for thyroid, DHEA, and estrogen. I was prescribed HRT. I understand some of these drugs are to be taken during menopause and should not be taken for more than four years. What happens then? Is there anything more permanent that can be done to elevate the libido of the post menopausal woman?

  Answer:  as long as the levels are checked and they are not too high it is probably safe to continue them. JG 11.20.06

• Hello Dr.Garcia. I`m trying to buy a natural progesterone cream. I found a site womantowoman. They sell this stuff it reads usp cream syntesized from Wild Yam (dioscosia villosa)or something similar, also reads Certified 800mg 2oz cream. Now I`m not sure if you told me before to get the one from soy or yam? this is so confusing especially when there are so many and it is very difficult to pick the legit ones. What do you think?

  Answer:  either Soy or Yam is OK, that is the correct form, the USP. Best of luck. JG 11.6.06

• Well, Dr. Garcia the cortisol level of 43.9 test was done in the morning, i was getting ready for surgery the next day and i was so extressed out, i don`t respond well to problems. They are doing the 24 urine test, but i think the saliva test is more accurate? what is your opinion? and why are doctors not doing the saliva test more often to check for cortisol. People get stressed out just by looking at the needle you know. If i request the saliva test instead can they do it? thanks

  Answer:  a full 24 hour test is very accurate. I personally like the saliva tests as they can be done by the patient at home with less stress, and done a few times through the day. JG 11.3.06

• Can taking beta glucan pills to boost immune system causes cortizol levels to rise?

  Answer:  I have not seen that happen. JG 11.2.06

• I am supposed 2 get my buttocks done and this lady from coloumbia has something call bio gel, and u insert into ur buttocks she told me that it is safe and has know side affect...what do u think?

  Answer:  stay far far away, not safe at all. JG 11.2.06

• Dr. what are copper peptides? and what is your opinion on hair growth on the scalp using such products? thanks

  Answer:  I think they help during acute injuries or in cases of copper deficiency but offer little in normal skin or scalp. No harm though. JG 11.2.06

• Dr Garcia. This is a strange question, but would you happen to know what is the Range for cortisol Levels? From which number to which number are normal for a female? I have been looking over the net and i cannot find that info anywhere. I just had that test done and according to my Dr. They are through the roof, 43.9 Thanks Debbie

  Answer:  well hard to tell because cortisol levels vary throughout the day, they start low and go up as the day progresses so it depends on the time of day and how nervous you get with the blood draw. In general 43.9 is high no matter what time of day. JG 11.2.06

• Dear Dr. Thanks for this excellent service. I have been taking 25mcg (one half morning one half at night) of cytomel daily for chronic fatigue like symptoms I had a few years ago, although my bloodtests were always normal. The cytomel has helped a lot, but now I feel my body has adjusted to it and I am starting to sweat a lot and get hot in the summer more than I used to. I feel I may need to go down on the cytomel but I am worried I will gain weight because my body has stopped producing it`s own thyroid. Is this a realy worry? Do you think I should half the dosage?

  Answer:  I would stop the night time dose, that is a fairly small dose, especially when divided into two so I think your body should react pretty well and start making its own again as long as you go down little bit at a time. JG 10.31.06

• Hi Dr. Garcia, I am having problems with a dry vagina, labia that burns and is sore to touch. My Dr. says the labia looks normal. I have also had a biospy. She found nothing. I am using vagifem 25mcg and estrace vag o.1mg/gm cre on the labia only and I take 0.025 premarim. Als0 I am taking Elavil for the pain. This has been going on for months and nothing has helped. Do you have any suggestions for me. Thanks CB 10/23/06

  Answer:  well, the first thing I would do is to increase the topical estrogen creams you are applying, also no douches. JG 10.23.06

• Hi Dr. Garcia, I am 44 years old and am loosing a great amount of hair. Can`t even touch it without a handful of hair coming out. I also just started taking Yasmin birth control. Will the progesterone help and should I take it at the same time I`m taking the birth control? Help!!! 10/19/06

  Answer:  the progesterone might help, yes, but it appears to be a side effect from the birth control pill. JG 10.20.06

• where can i get estro balance tab and which company

  Answer:  http://www.wholesalesupplementstore.com/estrobalance.html

• My daughter is 51 and receives the hormone pellets you speak. She has very low levels of proges and tes. This procedure seems to have had dramatic results for her. I asked about this for myself since I am quite sure my hormone balance is totally incorrect. I cannot sleep, have so sexual desire or response. little or no appetite. I am wondering if the pellets or hormone cream would assist me at this point since I am 71 years of age. I had a complete hysterecomy at 36 years of age. thank you for your response.

  Answer:  in most cases the work very well, but the porgesterone is not in the pellets, it is tesoterone and estradiol, just have your levels checked and then they can decide on the dose needed. JG 10.17.06

• Hi Dr Garcia, I have emailed you before about my thinning labia. I have used estrogen and testosterone cream with no results.The only thing I have not yet tried is progesterone cream-perhaps the combination of all three hormones would be effective? What do you think? Thank you.

  Answer:  I think estrogen and progesterone help, testosterone will not ,and if it is too advanced, nothing will help. JG 10.15.06

• So SORRY to bother u again..I sent u the question already.I am using progestrone and DHEA and thyroid.Doc told me i need a little strong progestrone dose coz my breast still tender .I am just afraid the using hi dose progestrone or constantly usage will not end up on manopause??I am getting married in 3months and want to have a baby..plz dr guide me..thanx.

  Answer:  I do not think you will go through menopause with progesterone cream. Menopasue is from low hormones, not high. JG 10.9.06

• Dr....I am 30yrs old taking progestrone and thyriod for my endometroysis and hormones imbalance.Dr told me i do not need leporescopy and progestrone will thickened the utres linning and gradually periods bleeding will be less and in resut my inflamation and pain will improve.My periods will gradually less and less.I do not want my periods stop or in age of 30 on maupause.(2).I am taking DHEA TR-10mg cap 1,daily to improve my imune system`1.Another DOC told me not to take DHAE coz it will make my inflamtion and endo pain worse....I am confused who to listen and what will help my endo pain and correct my hormone imbalancing and i do not want my periods to stop...please HELP.

  Answer:  I do not think the DHEA will make any effect on your inflammation and progesterone will only stop your periods if you take a large dose and take it constantly. I think hormone levels need to be checked before using those hormones so doses can be used and adjusted as needed. Endometriosis is due to estrogen dominance and progesterone does help balance that out. JG 10.8.06

• Dr...Is taking Progestron and thyriod hormenes treatment will help my skin and hair?and will help my endometroysis?how long it will take to work for me this treatment??bye

  Answer:  it might help the endometriosis. The effect on your skin will be slight but possibly if it is dry. If it is going to help you should see it in 2-3 months. JG 10.6.06

• iam56 year old and taking half premrin every altrernative day.i am using evlon tube for lubrication.i read in your coloumn about estro balance tabs,can i use them.thanks.

  Answer:  yes, it will help you eliminate the bad estrogens in your body. JG 10.4.06

• DR..i asked u about my daughters endometroysis problem and hormones therapy.U suggested me to visit the website...worldhealth.org I visited this but what type of info i will get from there.There is no related info what i need..please correct me...THANK U.

  Answer:  I was thinking you could find a doctor listed there near you to help her out. JG 10.3.06

• Dr..my 30yrsold daughter had endometroysis surgery 4yrs ago and has having hormones therapy for LOW thyriod and progestrone.She is having streching and pain gain before she had remove endo.Do u know any of option to avoid the surgery again.Hving hormones tab and topicals creams she has aches pains,weekness,hair falling and sleepness less.PLEASE help her she does not have health insurance and energy to have an surgery..do u have anything to suggest for her?She is sick all time and getting married in few monnths.Please recommened any good supplements and brands and tell where to get them??I m new in this country.Is she can be cure compleltly ever and how???please help a MOM??THANX.

  Answer:  I think balancing her hormones would help, I would suggest looking for an age management physician on www.worldhealth.org. Best of luck. JG 10.2.06

• Hello Dearest Doc, I have a question , there is some pills on whole food market which is called estro Balance (and mentions supports youtful blance of hormones)and also mention a brilliant way yo get DIM , I am about 30 years old I just want to know can I use it and is there any side effent , what exactlly it does?? thanks a lot , you are indeed a wonderful Doctor.

  Answer:  it is safe, what it does is make the bad estrogens easier for your body to eliminate, DIM is one of those ingredients that comes from cruciferous vegetables. JG 10.1.06

• Sorry Dr i m the one from Dubai.I asked u using a long time about 13yrs ,hormones TAb(PRAMPAK) are they bad for me using constantly and i m having all health problems??and also the headeches,backechs and health problem due to my premature manopause?In age of 47 when a woman has natuarl manopuase why should i still keep using the medicine??plz help me.

  Answer:  they can be used to diminish the menopause symptoms. JG 9.29.06

• DR...I am 47yrs old live in Dubai.I had prematue manopause in my 30`s and using the hormones tab daily called(PRAMPAK)from past 13yrs.I have 7days normal periods if i take that 21 days constantly.My physical problem do not leave me alone.Headechs,backechs,sometimes hi BP.I have hot fleshes when i skip my TAB and feel very hot and thirsty during night time.My doctor tell me to start taking TAB again when i feel bad so my question is the 13yrs is a long period to use the med constantly??or should i stop it now?I am 47 now and naturally should have manopause but still using the medicine..PLEASE dr help me what i need to do and avoid all my physial problems....thanx for any HELP.

  Answer:  well, maybe try taking the pill again but see if they have a lower dose or try taking half the pill and see what happens. JG 9.29.06

• Dr. Garcia I am a 58y/o female who had a vag hyst and lt oophorectomy 13 yrs ago. I have been diagnosed with osteoporitis and have been on Fasomax 70 mg every other week (my choosing since I have some concerns about this drug) for the past 9 mos. I am small boned, 5`3 , 127#. I have not been on HRT and am seriously considering a bioidential estrogen patch. What dosage would be considered safe? Would I also benefit from progesterone cream.

  Answer:  I woul start with a 1mg patch and start with 100mg of oral progesterone or a 5% progesterone cream. JG 9.29.06

• Dr Garcia...I asked the complete suppliment for me(50yrs) and my daughter(30yrs).You have mentioned so many things,B.complex,sulphour,calcium,fish oil and many more.Is there any suppliment can be used which has all these?Can u please tell any of the BEST all in one??thanks.

  Answer:  they can all be used, there is not one thing that is the best, they all compliment one another. JG 9.25.06

• You mentioned that you like to keep progesterone and estradiol in balance. What do you mean by that? If for example I use a bioidentical gel and feel better when my blood level registers 100, twice what a patch delivers, what level should my progesterone be to keep it in balance?

  Answer:  I am sorry but it varies form lab to lab, but you are looking at between 5-10. JG 9.25.06

• Few questions but first a note of appreciation for your help. I`m not sure you realize how valuable your forum is to many of us. Thank You. I am a 43 year old who had a hysto - ovaries removed almost 15 years ago for endo and fib. After going through significant hormonal changes I finally came upon the Vivelle - Dot patch.075mg. It seems my body doesn`t metabolize HRT well, because pills don`t work well and only transdermal or injections seem to have a positive effect. Nonetheless, I use 2 of these .075mg patches 2x a week. This is double what the normal dosage is. My Dr; general practitioner has prescribed this and does not have me any prog or testosterone. Do I need these 2 hormones or should I be concerned? Lastly, have you ever come across anyone who has taken normal dosages of estrogen and they feel terrible on it. When I take normal estrogen dosages my extremities are always cold and I am always very tired. I suspect it screws with my thyroid. Any thoughts to this?

  Answer:  I think it is hard to tell without checking your blood hormone levels, so checking your testosterone, progesterone and estradiol are a good idea. Progesterone orally is much better than estradiol orally, it is absorbed much better. I like to keep the progesterone estradiol levels in blanace if possibe, even in cases of a hysterectomy as there are porgesterone receptors all over the body,especially in the brain and in bone. Taking twice the dose is sometimes needed, that is what you can monitor with blood tests to make sure you are getting enough and not too much. As to cold insensitivity, I have seen that many times with oral intake of estradiol as it lowers effective thyroid levels, may need that checked too. Best of luck and thanks for visiting. JG 9.24.06

• Dr.When a woman on maopause,what type of vit and supliments she need to use??Can u suggest somthing really effective gives energy and healthy glow to the skin and hair??thanx.

  Answer:  I am farid that it will vary from woman to woman, there is no simple answer that fits them all. JG 9.15.06

• Can H. Pylori cause horomone inbalances and hair issues if you have it for a long time? And how come the blood test for it isn't that accurate? I had to have a scope to prove it was there and I had several uclers, and polyps. Scary! But I'm happy now that I'm being treated.

  Answer:  the blood test is not as accurate because it lives in your stomach so the concentration is not always able to be picked up in your blood tests. Ulcer disease can affect the absorption of certian nutrients so it potentially can affect hormones in a round about way. JG 7.28.06

• DR. Garcia: My hair has become thinner over the years (I'm 55, female)but now it is very thin on top of the head as well as on the sides. I saw one dermatologist and my endocrinologist who told me it

  Answer:  I think it is most likley due to low progesterone and its loss of competition for the 5-alpha reductase enzyme that makes DHT and makes your hair thin. Progesterone supplementation should help. JG 8.3.06

• if i stop taking estrogen will the pigmentation go away with the use of hydroqunon.

  Answer:  not always. JG 7.26.06

• i am asian women 56 year old. i am taking astrogen tablets 3 in a week as suggested by doctor but i have seen pigmentation on jaw line and side of my face .is it due to estrogen or some other reason .i have tried hydroqunon for long time but it gets light for few days .i use lots of sunscreen.i am dipressed .pls help.

  Answer:  estrogen can make it more likely to hyperpigment, and once they are there the skin has memory and they will come back, sorry. JG 7.17.06

• Hi dr Garcia, what is your opinion of DHEA supplements(over the counter). What are the benefits of it? And, what dosage do you recommend? I am a 46 year old woman. thx.

  Answer:  dosages I suggest are based on blood levels, otherwise it is not safe and a guessing game, I think that topical skin application is better because in women it quickly converts to testosterone and in men it converts to estrogen when taken orally. Saliva or blood tests are easly available and will help dosing, it takes very little though, much less than usually found in health food store bottles. JG 7.15.06

• What is the normal range for estrogen levels?

  Answer:  can vary from lab to lab and also on what time during the menstrual cycle. JG 6.6.06

• Is Ortho LO with 25 of estrogen higher than what women produce naturally?

  Answer:  yes. JG 5.30.06

• Why do some birth control pills cause fatigue? Specifically low dose? I'm on Ortho LO and it's 25 of estrogen and .18 of norgestimate.

  Answer:  some people just react to the synthetic hormones that way, no one knows the exact mechanism. JG 5.4.06

• How much estrogen is in Seasonale versus progestin? If there is too much progestin can that make you depressed?

  Answer:  it is a synthetic estrogen, so no real estrogen, and progestin is a synthetic progesterone. Some people do get depressed from those medicines. JG 5.3.06

• Can birth control pills cause estrogen dominance- after discontinuing them and does it usually subside?

  Answer:  yes, and it usually subsides. JG 3.28.06

• Can too much progesterone be a bad thing- and can this cause some of the same symptoms of estrogen dominance?

  Answer:  too much of anything can be bad and too much progesterone will not cause estrogen dominance symptoms though. JG 3.28.06

• Does applying natural progesterone to the breast cause breast growth? If so how substantial and does it going away after you discontinue it?

  Answer:  no it does not.JG 3.28.06

• Why should you not put natural progesterone cream on the breasts?

  Answer:  I suggest putting it on thin skin like inner arm or forearm, no reason why to put it in the breast. JG 3.28.06

• Is it safe to take L-5 Hydroxy Tryptophan if you are taking Bromocryptin to manage Prolactinoma? The monthly cycle is regular and pregnancy is a desireable.

  Answer:  should not have any interactions. JG 3.22.06

• Why are doctors saying that some BC pills can cause libido loss even after the pill is discontinued?

  Answer:  because it has depressed your own hormone production. JG 3.19.06

• Do you practice bioidentical HRT?

  Answer:  yes I do. JG 3.18.06

• In your opinion- which progestin would have a chance to less likely interfere- norethindrone, levonrgestrel, or norgestimate? Thanks for your help.

  Answer:  every person will respond differently to them.JG 3.18.06

• How do you tell if Low dose pills like Ortho Lo have progestins that compete w/the 5 -alpha reductase? What can you go by?

  Answer:  all progestins do. JG 3.19.06

• Does a progestin only pill shut down the body's estrogen levels?

  Answer:  proesterone too. JG 3.17.06

• What do you think of the product GenF20 HGH supplement?

  Answer:  waste of money. JG 3.7.06

• so Progesterone can aid in restoring bone loss?

  Answer:  yes, as can testosterone. JG 3.7.06

• In your opinion does estrogen help prevent bone loss or contribute to it? I read articles saying Progesterone helps with bone loss and others claiming that estrogen does. It's so confusing.

  Answer:  Estrogen prevents but does not fix it once it has happened. Progesterone prevents and treats. JG 3.7.06

• Will progesterone cream help with the few dark hairs I get on my chin?

  Answer:  possibly. JG 3.7.06

• What are some signs of having too little estrogen?

  Answer:  dry skin, loss of sex drive, poor memory, osteoporosis. JG 3.1.06

• I was just wondering cause the pill I was thinking of taking has 35 estrogen and .4 of the norethindrone- could that combination still cause a decrease?

  Answer:  it all depends on how sensitive your breast is, no way to tell until you try it. JG 2.24.06

• Do you believe in phytoestrogens? Which ones would you recomend?

  Answer:  I think in some people they help with menopausal symptoms but do not have any other documented effects. Black Cohosh and Dong Quai or the most common ones. JG 2.23.06

• Are plant estrogens safe to take and can you use them with progesterone cream?

  Answer:  generally they are safe to take and can be taken with progesterone. JG 2.23.06

• Is progesterone a cancer causing agent? On the bottle I read known to cause cancer in the state of California?

  Answer:  some breast cancers are reported to be sensitive to progesterone but there are no studies that show that progesterone itself causes cancer that I am aware of. JG 2.23.06

• by USP progesterone- do you mean United States Product?

  Answer:  United States Pharmacopeia. JG 2.23.06

• As soon as I stopped the birth control pill the hot flashes stopped.

  Answer:  due to the effects on sex hormones on your body. JG 2.23.06

• I tried to take a new pill and it gave me regular hot flashes- is this because the progesterone was having a lowering effect on my estrogen?

  Answer:  hot flashes come from fluctuations in estrogen levels, both down and up. JG 2.23.06

• What are symptoms of estrogen dominance?

  Answer:  water retention, fibrocystic breast diease, irregular periods, endometriosis, breast volume can increase too. JG 2.23.06

• What effect does Progesterone cream have on a women's breasts?

  Answer:  it can settle down some fibrocystic lumps, it promotes the growth of milk ducts too. JG 2.23.06

• Hi Dr. Garcia, The Progesterone cream you had recommended, I found over the counter at Walmart only. Is that good to use and also, how much cream and how often would I use for my hair loss. Thank you.

  Answer:  as long as it is USP, it is OK. Start with a teaspoon size and then go from there, use it at night, rub it on your neck or forearm about 20-30 minutes before retiring. JG 2.2.06

• Hi again Dr. Garcia, you had recommended the Progesterone USP cream for me in earlier conversation for my hair loss. I just got my progesterone and testosterone levels checked and they were 70 and 42. How is Progesterone level of 70 for a 33 year old who is very sensetive to the effects of testosterone and hairloss? Does increasing progesterone levels, decrease testosterone levels? Thank you. From Houston

  Answer:  the progesterone will lower the DHT which is a metabolite of testosterone which is what can cause the hair loss. JG 1.31.06

• Sorry perhaps I wrote too much on that last question about menopause as the last lines were cut off. I was saying the insomnia is a big problem for me, among the other things. I am 47 and exercise regularly and I'm in very good shape for my age but I was wondering if there is anything you can recommend to help me in my situation. Thank you so much.

  Answer:  Insomnia in some people after menopause can be related to progesterone levels being too low as it normally sedates you. JG 1.25.06

• Hello Dr.Garcia, One year ago I was diagnosed with Stage II Ovarian cancer and I had a total hysterectomy followed by six rounds of chemo. I went immediately into surgical menopause. Although I am now clear of all cancer :-), I am continuing to have some menopause related problems -- hot flashes, insomnia, and some mental fuzziness (word finding problems, etc.) I also notice that my skin is more crepey. My oncologist does not want me to take estrogen because my tumor was weakly estrogen receptive. I take effexor for the hot flashes and it does help some but the insomnia is quite difficult for

  Answer:  May want to ask him about progesterone, could be tough to treat though with your history. JG 1.25.06

• Dr. Garcia, the progesterone USP cream that you mention to reduce the DHT, is that a cream that is applied to the scalp? I am currently overseas, is that something that can be bought anywhere? Is there a generic name for it?thank you

  Answer:  no, just applied to the skin, like a forearm. It will get to the enzyme form there. They should have it in a good health food store. JG 1.25.06

• Hi Dr. Garcia, I had problem with my question going through. Here it is again. Would really Appreciate your input. I'm the 33 year old and you mentioned my hair loss is possibly due to testosterone overload and relatively low progesterone. I agree because evrytime my lab work shows really really low testosterone, I have no hairloss. But on the same meds my testosterone changes drastically. How can I bring it to a minimum and maintain it? I already take Ovcon BC pills and 100 mg Aldactone per day.

  Answer:  I think the easiest way is to take some progesterone USP cream topically to reduce the DHT. JG 1.22.06

• Hi. Dr Garcia, I am 46 and in perimenopause.I did have my hormone levels checked recently and they were normal for my age, etc. However, I noticed that my testosterone level was not checked,and I believe I am showing symptoms of low levels, i.e, thinning sparse pubic hair and thinning pubic tissue. Should I suggest to my dr to do another blood test?? And, what do you think of testosterone cream for women? Would be my pubic hair thicken again? Thanks.

  Answer:  I use testosterone on all my female patients that are deficient, it works well. JG 1.14.06

• what does an ideal 34 year old make in estrogen and progestin?

  Answer:  it varies from day to day, no set amount. JG 12.20.05

• What is an example of bioidentical estrogen? And what doctors can prescribe them?

  Answer:  Estradiol, Estriol and Estrone, any doctor can prescribe them. JG 12.17.05

• how do you feel about bioidentical hormones? Do you prescribe them?

  Answer:  I prescrice them and believe they are much safer than synthetics. JG 12.17.05

• How does the progestin only pill effect the estrogen in a women's body?

  Answer:  progestin can act like testoterone and can lower a woman's estrogen level. JG 12.16.05

• I have heard that too much estrogen can cause unwanted aging effects- is this true and likewise so can too little?

  Answer:  too little can have accelerated aging but too much is not a problem with aging, it is a problem with other medical issues. JG 12.16.06

• With the Lo pill would I still be getting more estrogen than my body produces naturally?

  Answer:  it is only low compared to the other pils. JG 12.16.05

• How does an average 34yr. old woman's estrogen and progestin compare to a pill like Ortho Tri-cyclen lo that has 25mcg of estrogen?

  Answer:  significantly lower. JG 12.16.05

• Dr. Garcia: I had a breast reduction in 1997. Once I hit menopause at 42 ( 7 years ago)and started on Estrogen ( no progesteron) as i am highly allergic to all forms, my breast tissue increased back t

  Answer:  You may need to decrease the estrogen and or have more breast tissue removed. JG 11.28.05

• Hi.Dr. Garcia, I am the gal that wrote you recently with my hormone levels. I am soon to be 46 and perimenopausal. Suddenly, I have noticed severe shrinking in my labia and it is very depressing. Is this one more sign of declining estrogen? Is there any cream that will help? I will see my gyno in 2 weeks. Thank you.

  Answer:  It can be, yes. Estradiol cream should help if you are deficient. JG 11.10.05

• Thanks for the quick response about the hormone results. Is it worth pursuing HRT even if I feel OK? I was thinking more for the idea of maintaining youthfulness....Thanks.

  Answer:  I think prevention is easier and better then treatment and some of the effects of low hormones on skin and tissue are irreverible, so I think keeping your hormone levels at an optimized level will work better in the long term. You also may feel fine but may not realize you don't feel as well as you used to due to the decline being so slow. Best of luck. JG 10.27.05

• Is it the higher concentration of the progesterone similar ones that could cause hair thinning?

  Answer:  yes. JG 10.16.05

• Could you possibly name the progesterone similar ones so I know what to look for?

  Answer:  I think you need to talk with your gynecologist. JG 10.16.05

• Which drugs in BC pills are chemically similar to testosterone?

  Answer:  the progesterone similar ones that are synthetic. JG 10.15.05

• Which is better Ortho-Novum and Trivora?

  Answer:  everyone responds differently to those birth control pills, you may need to try them both and see. JG 10.15.05

• What BC pill would you reccomend with the least side effects?

  Answer:  I think you need to discuss that with your gynecologist, but I would recommend the weakest one possible. JG 10.15.05

• Hi Doctor,I'm 47 and I have irregular menstrual cycles.I have an period every 3 to 4 months and it's always have blood clote .

  Answer:  Sounds like perimenopause. You may need some blood tests and then some bio-identical hormones if levels are off. JG 10.11.05

• Hi Dr. Garcia, I am a 46 year old woman eperiencing some perimenopausal symptoms. The most troublesome is my aging body skin. I am extremely fit, however my skin continues to sag and wrinkle. I am extremely depressed about this-to the point that it gets in the way of my life. I am on the b/c pill(yasmin) and I constantly moisturize my skin. Is there any way to reverse this process, or greatly improve it? I know it will only continue to get worse with age and that is really depressing to me. Anything you can suggest would be helpful. Thank you for your time.

  Answer:  It can all be related to reducing hormone levels from age. You could get some blood or saliva testing done to optimize them and although it will not reverse all that has happened, it may certainly help slow it down. JG 10.9.05

• Hi Dr. Garcia, Would it be possible to send you a saliva test to measure my hormone levels? I am currently taking the Yasmin b/c pill-does that distort the hormone level reading? I am 45 and perimenopausal and considering hrt to combat aging -I know it's vain, but oh well! Thanks.

  Answer:  if you have the kit already, just send me the results and I can help you interpret them. The BCP can at times affect things. If you do not have a kit, please call my office and we can send you one. JG 9.6.05

• Hi Dr. Garcia, I was unable to finish my email. 45 yr old noticing changes in skin. I am currently on Tri-Cyclen Lo.Wondering if it makes sense to go off and take Bioidentical hormones-would this help skin? Any supplementsor creams yu can recommend? Thx

  Answer:  If your hormones are deficient, then getting on bio-identical hormones wil probably help your skin. JG 8.1.05

• I have been experiencing some problems I think may be hormonal balance related. I am a 43 year old woman. The past 2 months my period has only lasted 2 days - it normally lasts 5-6. I have also had VERY sore nipples the week before my period starts & have noticed a peach fuzz type hair on my face on my cheeks and such. Is this a hormonal issue occuring in me? Also I have struggled with Acne the past few years particularly right before my period and when I get it - it feels more like a rash or poison ivy than true acne. Is this related? I have read that hormonal imbalance can cause itching and rash.

  Answer:  I think all that you describe is most likley due to hormones , specifically sex hormone imbalance. You should get them tested and then see what needs to be done with bio-identical hormone replacement if needed. JG 4.29.05

• Dr. Garcia, I had breast cancer in 2001; now I am taking arimedix until 2007. As you know this is to block my estrogen production. My hair (especially the front)has not grown back the way it used to be; it was full with lots of body. Now it is limp, on the straight side and thin, especially the top which is also a little frizzy. I'm worried that the medication is doing this and that my hormones are not in balance. I feel like I'm in a catch 22 situation; I can not take hormone supplements that might improve my situation. Can you recommend any skin and hair supplements and topical treatments? Thanks

  Answer:  Yes you are in a difficult situation. but I do not think that the Arimidex is the cause, more likely are the teatments you had originally for the cancer. I would suggest trying the products from Scalpmed.com. They will not interfere with your present treatment or cancer. I work with that company as a consultant and have been impressed with their efficacy. JG 4.10.05

• I HAVE BEEN THROUGH MENAPAUSE. DO I NEED BIO IDENTICAL HORMONE THERAPY

  Answer:  Without getting your blood levels that is nearly impossible to say. Not everyone after menopause needs hormones, so I would get tested and then talk with an experienced doctor about whatever symptoms you may be having so you can make an informed decision. JG 3.29.05

• I do hope you can help. I sem to have lost all desire for sex since the menopause. I do use natural oestrogen/progesterone, however, I have been reading that I may need a boost of natural testosteron

  Answer:  I would suggest you get some blood tests to see what is going on. Testosterone may help, but sex drive in women can be afffected by many things and you need to rule out the common stuff first. At times, estrogen levels that are too low can also cause loss of drive, or too much progesterone can also. JG 3.15.05

• im jef montano i have my menopause 2 years ago and i have noticed that my skin is becoming loose and i got many wrinkles now. Im now 50 yrs old but compared to my other friends with the same age, i look much older to them. Can u pls help me on how to keep my skin firm and to remove my wrinkles. Pls advise me on this matter. Thank u doc and God Bless.

  Answer:  Menopause signifies the decrease of hormones that among many effects, have an impact on skin aging. Getting started on appropriate hormone replacement will help slow the progression of the wrinkles down, and I may suggest other skin treatments too, like Retin-A or microdermabrasions that may help. JG 3.2.05

• Doctor, two and a half months ago I began an estradiol/testosterone (4/2) cream. I have switched from premarin which I used for 28 years. Quite a bit of breast soreness has developed particulary about the nipples even though my estrogen level has not responded well (about 8). The testosterone level is adequet (68). There will be another blood test in two weeks. The concern here is the breast soreness; can you comment ? (I had a mastopexy and replaced implants May,2004 and had no discomfort from that.) Thank you, JHB on 2/2/05.

  Answer:  I think you are having an estrogen dominance issue and need some progesterone. Also, it would help to check the individual types of estrogen to see how you are metabolizing it. JG 2.1.05

• I'm having my menaupose, & I'm flying to Las Vegas on the 8th Mar, I'm wondering if I can have Bio Identical Hormone therapy during my short visit (3 days) to USA, Vegas, & if we can have an appointment to go throught the test, & what are the cost for the tests & a stock of one year hormone, as I live in Singapore.

  Answer:  We could raw you blood tests but they take one week to have results and then I can contact you and make recommendations. If you brought your blood work with you we could start you during that time. The cost will depend on what you need every month and we can ship it to you in Singapore, but should be less than $100 if multiple things are needed, assuming no need for HGH. I prefer to give a small amounnt as at times we need to adjust the dose but we can alwyas send you the modified creams. Please feel free to contact us directly via phone, email or the message board and we will make room for your consultation. JG 1.26.05

• I was wondering whether or not you can treat persons needing hormone therapy online. I am 46 years old, approximately 30 pounds overweight, am in fairly good shape otherwise (no blood pressure problem

  Answer:  Nevada law requires that I examine you in person at least once, so you would need to be here for the first vist, thereafter we could do it long distance with blood tests done in your home town and phone communications. JG 2.1.05

• I have a question that none of my doctors have been able to answer: I am 32, and about 1.5 years ago, I began to suffer from severe night sweats almost every night, where I would wake up completely drenched - when they first started, I thought I had wet the bed. After running numerous tests for lymphoma, diabetes, thyroid disorders, and ovarian cancer, I was sent to an edocrinologist who suggested I try going off my birth control pills (Yasmin) for 2 months. (by the way, I had been taking another brand of the pill, Ortho Novum 777, for 11 years with no problems) I did go off Yasmin, and the night sweats decreased slightly in intesnsity, but did not go away, so my gynocologist put me another pill called . After 3 months and no change, I went off those pills, because to me, the sweats seemed to be hormone-induced. Fianlly, after 4 months off birth control pills, my night sweats have almost completely disappeared. I am very releived, but am also concerned about the damage that may have been done - one doctor I spoke with thoght my pills had actually been simulating menapause! Indeed, I do seem to have aged a lot in the last 2 years -and in this time I have delepoed very deep nasolabila folds - which make me look 10 years older - and angry! I also have dark circles that were not there before. (I do take decent care of myself, try to eat well and exercise, and do not smoke.) Do you think this is premature aging pausibly caused by my birth control pills simulating menapause? Is there any way I can reverse this damage? Thank you for help & insight.

  Answer:  I would suggest you getting a sex hormone blood panel to see where you are. It sure seems like you were induced into a premature ovarian failure. Proper hormone stabilization may help regain some but not all of your aging. JG 12.13.04

• Do you know of any doctors in the state of Washington that practice natural bioidentical hormone theraphy? I live in the Kirkland, Bellevue, Seattle area. Thank you 11-29-04

  Answer:  You can try the following website www.worldhealth.net, they have section on clinics. JG 11.29.04

• Do you have a list of doctors in the state of Missouri that practice natural bioidentical hormone theraphy?

  Answer:  I am sorry but I do not, you could try the website www.worldhealth.net and they have a listing of doctors that do antiaging medicine by state. JG 10.13.04

• Do you know of any doctors in Memphis who specialize in Bioidentical Natural Hormones? I would probably be willing to go as far as Nasville, if necessary...TH - 9/20/04

  Answer:  You could try the following website www.worldhealth.net and look on their physician finder list. JG 9.20.04

• Is there anyone in Michigan who will use the biodential hormones? I live near Ann Arbor Michigan. Is there anyone you would recommend for the thermage therapy? The one I know charges a lot more. Sincerely, Noreen

  Answer:  The only person I know in Michigan is Dr Ed Lichten, (248)353-3433 in Southfield, Michigan. As to Thermage, I would suggest contacting the company at their website at www.Thermage.com for a referral. JG 9.19.04

• Dr. Garcia, Do you specialize in natural Bio-identical hormones? If not could you recommend a doctor in Las Vegas, NV? Thank You 8/26/04

  Answer:  Yes, we have been using bio-identical hormones for men and women since my clinic opened 5 years ago. Please feel free to call us and we can get some testing done to see where you stand and what you may need. JG 8.24.04

• Do you know any doctors in Nashville, TN that specialize in natural bioidentical hormones?

  Answer:  I am not personally familiar with any doctors there, you can try www.worldhealth.net for some info but I do not know them personally. JG 8.20.04

• I would like to look into more information about bioidentical hormones in the Lexington, KY area. Do you know of anyone that uses them as treatment?

  Answer:  Sorry, but I do not know anyone in the Lexington,Ky area, JG 8.19.04

• does it cost alot of money to do the bio identical treatment and how do you know you need it?

  Answer:  Bio-identical hormones are cheaper than the synthetic ones and whether you need them or not is determined by doing blood tests to see where your levels are. JG 8.17.04

• i am 30 years old and i have a major problem with my periods first of all they have never really been regular but in 94 i got pregnant and i had a miscarriage then i got put on the depo shot for about a year then i went off of them and never got took birth control ever again..i gained a whole bunch of weight and my periods stopped for like two years i didnt have any this was after i quit taking the shot and then they got regular again and now for the last two years i have been bleeding for 8 and nine months straight and then go about a week and not bleed and then back to the 8 or 9 month cycle or heaving bleeding and major blood clots..so my question is this ....why am i doing that what could it be caused by? and the second question is will i ever be able to have children since i had that miscarriage in 94? please tell me something i am getting older and want a child really badly ..thank you

  Answer:  The cause is severe hormone imbalance. It can be analyzed and corrected with appropriate tests. In severe cases, you may need a D and C to clean the overgrowth of the uterine lining out. There should be no reason I can see why you couldn't get pregnant once your hormones get balanced. A miscarriage once does not mean you cannot have children in the future. A fertility specialist can help with the pregnancy issues. We can do the testing of the hormones for you if you would like. JG 8.8.04

• Do you know of any doctors in the Memphis Tenn area that specialize in bio identical hormones. 7-30-04 DL

  Answer:  You can look for a doctor in your area on the following website. www.worldhealth.net JG 7.30.04

• I am the 54 year old female from Prince Frederick, MD that wrote to you regarding bio-identical hormone replacement therapy. I need to find a doctor that deals with bio-identical hormone replacement.

  Answer:  try the following website for a doctor in your area. www.worldhealth.net JG 7.30.04

• I am the 54 year old female from Camp Springs, Maryland who wanted to find someone who does bio-identical hormone replacement and you said you were not familiar with that area. Some other areas aroun

  Answer:  try the following website to find a doctor www.worldhealth.net JG 7.30.04

• I am 32 years, male, and using (Micronor) 350 micrograms norethisterone ph. eur. which I found giving me a better looking no wrinkles, do you think it will have any side-effect or dangerous. Thanks.

  Answer:  It is a synthetic progesterone and I would always prefer to use natural bio-identical homones. As to long term bad effects, I think there may be some very small ones, but you have to understand that there are no long term studies on using that drug in males. I could see how it would control acne break outs but I am unaware of any studies showing decrease in wrinkles with the drug you refer to. JG 7.29.04

• Is there a method to stop menstral cycles in severly profound giels?

  Answer:  By manipulating your hormone levels it is possible to stop your menstrual cycles. In younger females it is advisable at least a couple of times a year to allow a menstrual flow to avoid buildup up of the lining of the uterus, but using progesterone is the way to do it, but it has to be used daily. JG 7.28.04

• I am a 54 year old female who lives in Prince Frederick, MD (near Andrews Air Force Base in Camp Springs, MD) I am desperately looking for a doctors that deals in bio-identical hormone replacement therapy. Is there anyone out there to help me? Thanks...........Doris H.

  Answer:  I am unfamiliar with that aea, what other largeer towns are near you?

• I am looking for a good endocrinologist in the Nashville, TN area who can test and prescribe bioidentical hormones for myself, a postmenopausal woman age 52. Can you give me some contacts? My gyn and family dr seem reluctant to give me names, but I am desperate as I cannot take the synthetic ones.

  Answer:  Try Hugo Pribor MD

• I've recently been treated for breast cancer and now face a hysterectomy. Is there any danger to my using bio-idential hormone replacement? Do you know a physician in the North Alabama area that prescribes them? RC 07/04/04

  Answer:  Bio-identical hormones will be frowned upon by the oncologist on the chance that your tumor was sensitive to hormones and giving you hormones may cause the small tumor which may be left to grow. Your best bet would be to treat the symptoms, and possibly some natural alternaives such as Black Cohosh or Soy. I do not know any doctors in that area, sorry. JG 7.23.04

• WHAT IS BIOIDENTIAL HORMONES AND HOW ARE THEY USED TO CONTROL MENOPAUSE

  Answer:  Bio-identical homrones are exact replicas of the hormones we make, instead of the chemically altered hormones that are patented and sold by drug companies. The advantage to using bio-identical hormones for menopause is that your body knows how to metabolize them and there are potentially less side effects from them. They can be measured in the blood and then the doses altered as needed. JG 6.24.04

• Thank you for your answer to my HRT and dark circles question. I'm using Estalis Sequi 50/250. (Proprietory name in Australia). Two weeks oestradiol 50 mcg two weeks oestradiol 50 mcg norethisterone acetate (progesterone) 250 mcg. Is that bio-identical? I only had the symptoms of night sweats which of course was keeping me awake. That resolved immediately on starting the patches. I've been reviewing the literature and most of the studies were of 6 months duration with improvement in ageing skin with the eostrogen/progesterone combination.

  Answer:  The oestradiol is bio-identical, the norethisterone is not. The oestradiol is the more important one for the skin. It can also be applied to the skin with good effects. I would certainly give it a try and see how your skin reacts. JG 6.10.04

• what are the most common side effects experienced by your female patients while being treated with growth hormone replacement? Is the thyroid often a problem? thankyou...

  Answer:  the most common side effect is transient fluid retention which corrects itself with a short decrease in dose, along with a slight elevation of blood sugar for a couple of weeks in pre-diabetic patients, but that also goes away. It is very common for thyroid and growth hormone to both be depressed and I would not use growth homone until the thyroid is optimized as it is needed for the conversion of the growth hormone in the liver to its active forms. JG 6.29.04

• dr garcia, I am very interested in getting bioidentical hormones, in 2000 I had a hysterectomy and things just are not what they used to be. I read that bioidentical hormones can put back what you once had, could they help me, also my husband had prostate cancer. But is doing fine. Can his levels be down also, he is always tired and run down. Could this help us both. The doctor said he was very young for prostate cancer only 50. Is their a doctor in idaho you could refer us to. If not can we see you.I would appreciate your reply.Thank you ksc5/16/04

  Answer:  I would call this doctor.Thomas F. Crais, MD 315 S River Street Hailey, ID 83333 P: 2087887700 JG 5.16.04

• Hi Dr.Garcia-I work at the Suncoast and am a friend of Laurens.I am 29 years old and was diagnosed with Premature Ovarian Failure 2.5 years ago.I have been suffering with the fact that I became menopausal and infertal at such a young age.I have not had a menstral cycle for almost 2 years now.I tried HRT and became emotionally crazy so I have been taking calcium only since.Is this OK or do I need more for hormonal balance? Fertility possibilities? Jessica 5/13/04

  Answer:  I think bio-identical hormones would help you immensely. As to fertility, it is a possiblity and I can refer you to some specialists, once we have you feeling better. Also, a lack of hormones at your age will accelerate your aging process so that is another reason to have put back what nature would normally have given you. Pleasse call the office to make an appointment and we can discuss your options. JG 5.13.04

• IS THERE ANYONE IN THE RENO, NV AREA THAT SPECIALIZES IN BIOIDENTIAL HORMONES? B.D. 5/1/04

  Answer:  I believe there is a doctor by the name of Schellenberger, you may want to check. JG 5.11.04

• How expensive is the natural bioidential hormone replacement?

  Answer:  it can depend on what hormones are used, but it runs approximatley $2/day. JG 5.07.04

• Dr. Garcia - Is hair loss (thinning) due to lack of estrogen? thank you, MNQ

  Answer:  It is due to a lack of progesterone, and therefore testosterone dominance with a preferential metabolization to DHT. Estrogen will influence the quality of the hair, but not the quantity. A saliva or blood test can help direct the appropriate bioidentical hormone replacement to correct and reverse the problem. JG 5.2.04

• I have been taking bio-identical hormones for 1 month- 28 days on, 4 days off cycle - but no period yet. How long before my hormones level off and I start getting my period again.

  Answer:  That depends on many variables, including your baseline hormone levels, your hormone doses you are receiving, and the state of your uterus. I typically see it resume in 1-4 months, although not all women want a period so if you took the bio-identical hormones everyday you would avoid that. You may need to either decrease the dose or take more days off if you don't start in a couple of months. JG 5.1.04

• Dr.garcia.can i get online consultations with you and recieve treatment.and should i get tested for hormone treatment if i feel tierd and fatiged all the time?

  Answer:  We can refer you for testing via the internet and make dietary recomendations and possibly nutritional recommendations, but for us to formally treat you as a doctor, for hormone replacements, you need to be seen here in our office's at least to start. I have many out of town patients that we care for but they need an initial visit here in Las Vegas. Sorry

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