We also had the patient fill out a detailed history for Dr. Streeter's use and faxed it to his office so he could determine whether natural hormonal therapy was indicated. To say that these requests proved challenging would be an understatement. The weight gain, headaches, high blood pressure, elevated cholesterol, hypothyroidism and low energy could all be attributed to horse's estrogen and the lack of progesterone. No woman should be placed on any type of estrogen therapy without natural progesterone, whether or not they have had a hysterectomy. After a hysterectomy, a woman's breasts are very sensitive to estrogen, especially estrone-dominant horse's estrogen, which is a cancer risk.
Fluid retention accompanies estrogen replacement without progesterone.
After reviewing the patient's form, I called Dr. Epitropoulos to deliver my opinion. It was provided for her in separate syringes to control the amount of cream she was using on a twice-daily basis. I weaned her off the estrone-dominant hormones gradually, using an every other day dosage while alternating days with triest for the first month. This allowed her body to adjust without withdrawal symptoms or aggravating problems. I prescribed progesterone and testosterone in the same syringe daily while alternating triest, which seems to work best for most women.