Watching my Mom slowly pass from breast cancer taught me about what I didn’t want as I got older. 

I was 26 when my Mom died and I thought 46, my current age, was “old”.

Funny how the age of “old” increases as you get older.

I knew I had to get out ahead of the cancer and the aging game if I didn’t want to go out like she did.

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My Mom was a nurse but she didn’t talk about peri-menopause or menopause. 

She didn’t even have the period talk with me so when I started bleeding at 13 I freaked out and thought I was dying. 

I don’t even know if she went into menopause because of the chemo or not. 

Dad can’t remember (or he blocked it out – who knows!).

Grandma died 10 years before Mom and never talked about any hormone stuff with me.

My Mom’s sister died 3 months after Mom – both with cancer.

Naturopathic medicine school taught me about menopause but I’m pretty sure we didn’t dive into peri-menopause much. 

Everything I’ve learned to date has been from Dr. Pamela Wartian Smith’s guidance, attending conferences and drilling the owner of my favorite compounding pharmacy in Tacoma. 

Plus all my patient experiences of trial and error. 

Guess that’s why they call it “practicing medicine”.

The good news is I’ve been in the game long enough now to know what works, what doesn’t and that we’ve all been lied to about the “dangers” of hormone replacement therapy. 

Baby boomers should be upset for the mis-communication of data from the Women’s Health Initiative studies.

So many doctors, myself included in the first years of my practice, were terrified to prescribe bio-identical hormones. 

How many women’s relationships with themselves, their bodies, their sexual health and their partners could have been saved or eased with support?

Changes in mood, focus, concentration, and energy – all chalked up to “normal” aging and nothing offered to help. 

It’s disturbing.

I am a huge fan of bio-identical hormone replacement therapy as it has the potential to give women (and men too) back their lives. 

  • Being free from debilitating hot flashes and night sweats.
  • Actually getting a solid night’s sleep. 
  • Memory intact with ability to concentrate and focus. 
  • Not feeling like you’re losing your mind with mood swings.
  • Migraine relief. 
  • Enjoying sex again.

I could go on and on about the benefits. 

Everything I listed is possible when the body is prepped prior to adding in hormones.

Too many women are given super-physiologic doses of hormones at the trendy hormone clinics popping up in every city. 

Then they get side effects and say the hormones didn’t work for them.

Hormone replacement therapy isn’t a one size fits all situation.

Some women and men do not tolerate synthetic bio-identical hormones and need alternative protocols…

…not to be told they are out of options!

I’ve blended herbs and hormones as well as micro dosed hormones to get maximal effect.

Plus I’ve used bio-identical hormones in women before their period stopped. 

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Yes, in peri-menopause, even while cycling you can benefit from hormones. 

To get the most out of hormone support it’s vital to test how you metabolize hormones and prep the body before starting.

I learned this the hard way – with myself and many clients.

Because of my Mom and Aunt both having estrogen positive cancers I was terrified of using hormones in my own aging process. 

Till I started having urinary incontinence and vaginal dryness.

Pelvic floor exercises helped to a point but when estrogen dipped naturally during my cycle my symptoms would flare up. 

I tried seed cycling and adding in herbal support like red clover.

They helped a little more but I realized I needed something right where the issues were located.

Estriol is the estrogen known to help with vaginal dryness while estradiol helps with incontinence and so much more. 

To know where I stood on those two hormones I tested estradiol in the blood, saliva and urine. 

Turns out I metabolized estrogens well through my liver and cells so I could detox extra hormones if I added them in.

Estradiol was low after ovulation to start of the next period, so was progesterone in blood and saliva.

Estriol levels were low normal for me as well.

Armed with the data I needed to give me confidence that I could tolerate hormone replacement therapy I knew I had to do one more thing to prep. 

Work on the gut microbiome, liver and lymphatics to ensure all were dialed in.

I used the Cell Core Lymphactiv (for lymph clearing), KL Support (Kidney + Liver support) and Bioclear protocol from Microbiome labs for a month prior to starting hormones. 

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Then I started…

  • Progesterone from Quicksilver nightly day 14 to start of my period.
  • Estriol suppositories for 14 nights then twice weekly for 2 weeks then monthly as needed.
  • After a month I added in Estradiol from Quicksilver from day 14 to start of my period. 

I’ve been doing this for 3 months now and feeling pretty good. 

I use a variation of this protocol with my clients.

Bio-identical hormone replacement therapy is not a one size fits all situation and you can tweak things quite a bit to get effect with minimal to no side effects.

It’s not uncommon for me to use estradiol patches from a regular pharmacy and progesterone capsules from a compounded pharmacy to support women in peri-menopause and menopause.

The difference – the hormones are used day 14-start of the cycle most commonly in peri-menopause.

In Menopause the hormones are dosed throughout the month. 

How do I know what to do and when?

I base hormone cycling on symptoms.

Women cycle well beyond when their periods stop. 

Taking a month to write down when things show up for you is key as you’ll find at any age there are cycles as well as ebbs and flows to your symptoms. 

If you can identify your symptoms I can help you pair them to what your hormones are up to based on your cycle. 

Women often cycle with the new or full moon. 

Pay attention to those times of the month to see what you’re experiencing from mood swings, to insomnia, and even hot flashes or incontinence.

The more data you have on yourself, even HRV and heart rate data the better to help dial in your hormones. 

For those who are not comfortable moving right into bio-identical hormone replacement therapy I often pair herbs for estrogen boosting like: black cohosh, red clover, sage and mother wort with progesterone boosters like: Maca, evening primrose and chaste berry. 

When you work with me there’s always dietary and lifestyle support along with any bio-identical hormone protocol because you are so much more than your hormones!

Today my podcast on my experience with peri-menopause and how I’m approaching bio-identical hormones comes out – look for episode 480 HERE (after 12p PST).

It’s time I spoke out more about my approaches as I don’t want any woman to suffer through this beautiful metamorphosis of life. 

Especially the women who’ve tried hormones and not found relief. 

Know there are many options to help bring your body into balance. 

Later this summer I’m releasing a new way to work with me on dialing in hormones and optimizing your health. 

1:1 personalized concierge care to get your hormones dialed in paired with the key things to help you to age well at the same time. 

Stay tuned!


Here’s to your health,

Dr. J

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