A Practical Guide to HRT for Women and Men

Dr. John is joined by nurse practitioner Marilyn to unpack the complexities of hormone use in both women and men, starting with the history of hormone therapy, the legacy of the Women’s Health Initiative, and the persistence of outdated black box warnings. They stress the importance of shared decision-making, noting that while risks like clotting, liver issues, and breast cancer must be considered, the potential benefits for mood, sleep, bone density, and quality of life can be significant when therapy is managed thoughtfully.

In the discussion of female hormone therapy, they review perimenopause, menopause, and post-menopause, explaining when estrogen, progesterone, and testosterone may be appropriate. Marilyn shares practical guidance on lab testing, timing in the menstrual cycle, and tailoring treatment to symptoms. They also highlight the problem of inappropriate hormone use in younger women and caution against hormone “mills” that prescribe pellets or high doses without proper monitoring. Compounded formulations, oral progesterone, and topical or vaginal applications are all discussed as flexible tools when individualized to the patient’s needs.

The conversation then shifts to male hormone therapy. Dr. John highlights the American Urological Association’s clear guidance on hypogonadism, stressing the need for accurate diagnosis and lifestyle interventions before prescribing testosterone. They discuss causes of low testosterone, including obesity, poor sleep, stress, and environmental exposures like plastics and pesticides. Alternatives such as Clomiphene and HCG can support fertility while boosting testosterone in younger men. Both hosts agree that while inappropriate use is common, properly monitored therapy can improve energy, mood, libido, and overall well-being. The episode closes with a reminder that HRT is not about making people 20 again—it’s about improving quality of life and aging with vitality.

Disclaimer: The content provided in this podcast is for informational purposes only and is not intended as medical advice nor as a substitute for professional medical consultation, diagnosis, or treatment. Always seek the a​​dvice of your physician or other qualified health provider with any questions you may have regarding a medical condition.