10 Immutable Laws of Estrogen

from person.com. [sighs] Today we're going to talk about the 10 immutable laws of prescribing estrogen for women by for anyone because I only prescribe it for women. So, uh these are critical. This is the the whole thing about estrogen. You need to know these

10 laws. Your doctor needs to know them. Oh, wait. Hold on. What? We didn't go live. Sorry, Jackson. It just says on air. I don't know what happened. Are we live? There we are.

Okay. Sorry. Hey. Today we're going to talk about giving to women. This is Dr. Dan Perer. Danpermd.com. I'm excited to do this. It's been a while. I'm going old school. Going to be talking about more HRT stuff in this

stream of Facebook lives that we've been doing. Today we're going to be talking about estrogen. And really, we're going to talk about the 10 immutable immutable laws of prescribing estrogen to women. Well, prescribing estrogen because you

only prescribe it to women. You don't prescribe it to men. So, um, that wouldn't be good. But, um, so real quick before we start helping me. Oh, wait. Jackson, what? Oh, he can't hear me.

Yeah, he can hear you. I'm too quiet. It's okay. Let's just let's just have Dan have Dan Let's have Dan talk. I'm I'm echoing over here. So Chicky will ask the question. Ask the questions. Perfect. There are no questions. There are no questions. Then go just go ahead. You're good.

Are we live? Yeah, you're good. Okay. Okay. We're going to go through the 10 mutable laws. Are we ready? Yep. I've even typed them up. So I hope don't screw this up. On your little typewriter. On my little typewriter. My little oldfashioned typewriter. here at

number one. Number one, are you ready? We're going to go through these 10 laws because you guys are watching during your lunch hour or whatever. We need to get this job done. So, I've got an eye appointment. Going to get my eye lasered and I'm going to hate that because it hurts. Um, okay. So, let's This is not

painful. So, [clears throat] number one, estradile 17 beta estradile only. I don't prescribe estriol. I don't do the E3 E4 thing. I do the estriol is not very breast friendly. That's why I don't

do it. I I've never done it. Um it it's uh you can convert um everything you need from the estradile. So I'm good with that. I like estradiol and we're just going to stay with that. That's what I've been doing for years. Not had any problems. Number two, do not use

estriol or synthetics. Why? Well, the synthetics especially um they cause breast cancer. 250% increased risk of breast cancer if you use the synthetics like conjugated ecinestones or um or the uh the estrins that are out

there uh or ethanol estradiol. They are not healthy. They are not good for you. Do not use them because they give you breast cancer. 250% increased risk of breast cancer and a massive clot stroke risk too. So, we don't use them. Number

three, birth control pills do not equal HRT. I see doctors do that all the time. Let me tell you a story. When I was really young and dumb, I did that. And I'm most regretful that I ever did that. I paid a lot of stress for that. Doing

the wonder who I gave breast cancer to back then or who I caused to have a clot or stroke. Birth control pills do not equal HRT. I know there's a big push a few years ago um with you know a lot of ads saying they take the u that women

were taking birth control pills for the HRT. It's just no. It's not the same thing at all. It's a bad option because of all the side effects and and breast cancer risk and everything else. Number four, oral estradol 1 milligram is the usual

dose or should should or could be up to two milligrams. Um um it's the highly preferred one. Uh why? Because oral estradiol prevents the top three killers in women.

Topical will not do this. So oral does this. This is why you want to try the oral if you can take it. We're going to go through all the reasons why you can't take it or why you should take it. So um top three killers in women are heart attacks, strokes, and type two diabetes.

and oral estradile prevents those. It it's not absolute, but it dramatically reduces your risk for those things. We know these from a lot of really big studies. So, uh you got to try the uh the oral estradile. Don't just go try it yet. Let's go through all 10 laws first.

Um number five, there's no solid cause and effect or evidence. I know it's going to anger people, blow people away, going to piss off a bunch other doctors, but I don't care. This is what we know that estradile actually causes breast cancer. Her two estrogen so women with

her two breast cancer get a estradile receptor positive breast cancer. Um a lot of women get that. That's not just having a a estradile receptor on your breast cancer does not equal cause and effect. It's not is not the same. It's

not a it's not the causation. So it just happens to have occurred. Uh that's at least what we concluded after 10 years of pituitary endocrinology research looking at the data n Patel and chinron and I discuss this all the time and no gem anyway we all talked about this all

the time trying to figure this out and looking at the big studies like the women's health initiative the and all those um so number six but we don't believe let me back up we don't believe that um that there's a real cause and effect there

but I'm going to get a lot of blowback effect. So the standard of care is that there is a cause and effect. So I kind of got to play that role, but just know what I really think inside. Number six, dosing 1 milligram to 2 milligram orally each day and it's super cheap. You can get it anywhere and but I you got to be

careful because the pharmacies now are switching it for even cheaper generic synthetics. So you got to be super careful now. I used to not do that. they that was illegal but somehow it's been allowed in the last few years or it's it's a thing.

It shouldn't be a thing. You should not get ethanol estradile or conjugated ecquin estrogens estrone sorry um with uh with your prescription when really you want natural 17 beta estradile estradile like mama makes is 17 beta

estradile. So you want to get at least bio identical estradile. Um, do not number seven, do not take orally if you have a strong family history of blood clots or pulmonary embolism. Got it? Don't if you already have the

history, don't do it. Um, and um because it's too high a risk that you might have the same thing. You could have a factor five lighten and not know about it. And uh and because no one's tested your genetics. If need be, we can do that. Um,

number eight, do not take if you have factor 5 liden. Right there it is. And uh because it ord clotting if you have factor 5 lighten they say don't take any hormones. That's wrong. Testosterone

progesterone are both fine. Uh ordile is not. Um I don't even use topol those women. Uh, I'm having a few and having any problems, but because they really wanted it, but just know um I just

trying to avoid that. Factor by blind is a big no no. Uh, number number nine, do not take orally if you're outside the 10-ear window. Here's the biggie. The 10-year window. What is the 10ear window? First of all, it's screwed up.

Most doctors don't understand it or even know about it. The ones that have heard about it, they misconrue or conflate it to mean something it doesn't mean. They think it means after 10 years after menopause, you can't take any oral estradile or any HRT.

Uh that's wrong. What it really means being strictly defined uh by the laws of uh of the major top world's best endocrinologist blah blah blah HRT people.

It means that if you are 10 years past when you went through natural menopause or surgical menopause or traumatic menopause or whatever menopause and you haven't had a period that it's unsafe

for you to take because it would cause a much higher risk for a clot or stroke. If it's before the 10ear window I usually go it has to be nine years or less to play it safe. Uh but if it if it before the tenure window has occurred,

it's safe for you to take the ostraal if you haven't met any of the other criteria. So um this is the steps I go through with every patient and uh and trying to figure out where they are with all this. Um

I see one thing that's been left off of here when we have this typed up. Uh, you can't take oral estradial if you have hypertension either. So, that's another let's I don't know. We'll put that under um um

maybe that should be number six. And the dosing is just a side bonus. So, let's call that number six. Okay. Do you want to answer three really good questions quick? Not yet. I'm almost not done. So, um I'm really trying to go through this quickly because I figure people watching this trying to make notes. Anyway, we will have a a

uh PDF you can download with all these points on it. We'll do a little better job. We're just trying to get this ready uh to get today very quickly for this event. So, I apologize we don't have that ready yet, but email our office um at dan danpirstmd.com

and we can um and ask for the handout if you want to get it the PDF. You have 50 people watching right now. Hey. Hey 50 people. Thank you for watching while you're eating lunch. If you say hi if you're eating a chili dog because I really like Anyway, we won't talk about that. Um so um also the 10ear

window if you have so I already said if you have hypertension or if you have family history clots or um or you've had breast cancer in the last five years, you shouldn't take estradile or oral estradile. Um but uh if you're within

the 10ear 10ear window you can take it um and you should do it because it's much more beneficial to take oral estradile and you could take it forever once you get on it. The reason you can't take it past the 10ear window is because

um the lack of the estradile you form metal patella protein aces in your along your art arterial walls and um and those flake off when you go back on the oral when you start taking oral estradile they'll flake off and cause a heart attack or stroke. So you can't do it if

it's 10 years. Uh, [clears throat] number 10, do not take if if within 10 five years of breast cancer or gallologist says not to. I kind of mentioned this earlier. Uh, why? I don't want my license questioned.

Never never been sued for mal well I've never been I've been named a couple times because it's in the hospital when someone someone else did something or whatever. But so only named indirectly but never been sued for malpractice. So I don't want my license being questioned. And number two, I don't want

to get sued if by some rare chance you do get breast cancer, but it's still I'm going to tell you there's not a cause and effect. So that's the 10 immutable laws of of um of prescribing estrogen to women. Let me go through them again. Uh

17 beta estradiles, the preferable form. That's number one. Do not use estro or synthetics because they're not breast friendly. They give and the synthetics give you 250% increased risk of breast cancer and a massive increase of risk of

strokes or clots. Number three, birth control pills do not equal HRT. Don't let your doctor go take this birth control pill. That'll be great. You'll love it. You won't love it. Uh I won't love it at least. Number [clears throat] four, the oral estrad doll is the the much

preferred one because um it u it prevents the top three killers in women. Heart attack, strokes, type two diabetes. Number five, um there's no solid cause and effect. This is my opinion. I'm just going to stick with it. Um that estradile actually causes

breast cancer. Even if you have a heru estrogen receptor positive breast cancer, that's not equal cause and effect. just happens to be there. It's just chance. Um and uh and doctors are going to argue with me fine. That's great. I appreciate the points of view.

Mine's just different. Um number six, dosing. I use one to two milligrams each day. I like your level above 45 to 50. If if we get above 50, great. With oral estol, that's the idea. Um number seven, do not take if there's a strong family

history of blood clots or strokes. Um and number eight, do not take orally. If you have factor 5 liden, um number six actually was if you have hypertension, don't um don't take oral estradile

because again the metallic protein thing it's going to cause clots or strokes. Number nine, uh do not take if you're outside the 10ear window and number 10, do not take within your 5 years of breast cancer or your doctor or oncologist saying you should not take it. I'm not going to prescribe it. I

don't want to get between you and them. Okay, questions. I'll slow down. This one is from Hope Renewed and she asks, "For those of us that estrogen throws into a histamine flare, is there a better alternative or should the focus

be getting the histamine under control so I can take the estrogen? I have PMT, PEMT, MTHFR, and a lot of other genetic issues." Kelly Samson. I know. Who does? Um and um yeah, it's not the estradile causing

your flare. It's something it's one of the additives or one of the incipients that mix with the estradile would be my guess. Okay. Um so you're not if you're allergic to you're dead. So you'd be dead. So, um,

and so it's not that, but it's something else in the, um, the tablet or capsule, uh, or some incipient. They also put them in there often to make the, uh, make them able to be poured into capsules, stuff like that. You might want to try a really pure

17 bit estradile without any incipients, made by a local pharmacy. Get it compounded. Um um talk to your doctor or to me if you need help with that. Perfect. I'd try that. Okay. And here's let's let's do two more. And then this is a question from

Instagram. If in pmenopause, should you check estrogen levels prior to taking natural oral estradile? Yes. Yeah. Because usually permenopause what the only thing that's usually decreased in per menopause is progesterone. hot

flashes, night sweats, migraines, stuff like that. Cert um and that's from um that's usually what fails first, but usually years before anything else does. Testosterone will go next and usually and it can linger on for years.

They're saying that they love you and you're a straight shooter. Boom. I don't know what that means. Okay, thank you. There's one more I think you should answer. This one's interesting. What's factor five? MTFR question. No, factor 5 is a genetic condition called factor 5 lighten. L E I DN.

Can't take oral estradile if you have factor 5in. Um and you're going to you're going to see it gets conflated to you can't take any hormone any HRT if you have factor 5in. I'm going to disagree with that. It's not that's not accurate. But um but you go by what your

doctor tells you to do. um not by what I say clearly because I'm not in control. So um the factor by blightening you should avoid oral estradile. You should definitely avoid oral estradile or you're going to get a clot or stroke, heart attack

or yeah pulmonary embolism. Lots big list big list of stuff. Yeah. Avoid factor pipeline or avoid estrol if you have factor pipeline. If you don't know if you have it our max DRP checks it a lot of other

things too. So do you want to do one more? Sure. Do you recommend it to women with polycystic liver cysts? Sure. There's no connection.

What was this called? How did you find out why you had the polycystic liver cyst? Good question. Do you have PEMT? Look it up. How do you How do you Sorry, this question is a little confusing. [clears throat] How do you test for it? Factor 5 light. Genetic tests. Ask your doctor to test for it. They can, you know, usually

insurance will cover it. Say, I have a strong family history of clots and strokes and blah blah pulmonary ambolism. Can I get checked for a vector bipolid? Okay. Do you do you want to do one more? Yeah, do one more.

Uh, what do you think? I'm trying to avoid getting my eye lasered. Hopefully, I missed the point. Mom will be very upset. Yeah, sure. Uh, this is a good one. What do you think about vaginal estradile? Is this safe for everybody?

Loaded question. That's touchy. Um, not if you have factor 5 lighten. Not if you have factor five lighten. Um, probably not if you're outside the tenure window. I'd go topical. Just on skin. Why topical? Vaginal tends to might have to go through your liver too like like um like

oral. I mean oral certainly go through your liver but um I don't know it just makes me nervous. So I think it's good and vaginal estradiol will not get rid of the dryness. It may be in a rare few people but that that or

top vaginal estradile is not the answer for vaginal dryness. It's it's vaginal testosterone that takes care of that. Uh, if you've have dryness and your doctor's got you on vaginal estradile and telling you to use olive oil and everything else, no, no, no, no, no.

It's it's um it's compounded testosterone um um in a vanishing cream 20 milligrams per gram, one quarter gram a day. Uh and you wouldn't even do it every day. Two or three times a week would get rid of that dryness.

Big bonus answer right there. It's funny when I'd gotten to those damn person hormone health events, there's always be a big crowd waiting for me. I answer questions in the room and then I moved it outside because they're trying to clean up the room after three hours of me uh answering questions. Outside would be another big herd of people,

mostly women, and they'd be asking me questions. I call it the rainbow. I start on the left, work my way around to the right every time. And always on the right were about this 10, eight, 10, 12 little gaggle of women who were just

kind of nervous sitting there and I'm knew exactly who they were every time and they all had vaginal dryness and they kind of sily admitted that and then they're all like patting each other in the back and going, "Yeah, we're the vaginal dryness team." Anyway, [clears throat] and um and and I had to

explain to him it's it's cream, testosterone cream. You get at a compounding pharmacy. If you have a compounding pharmacy in your community or nearby and you need that, go talk to them and say, "How does my doctor prescribe it? Can and can you make a

compounded testosterone cream for women?" And you do, great. Um can you give me sample script so I can take it to my doctor and go and say, "I have vaginal dryness, doctor. You're my doctor. Can you prescribe this? I use it two or three times a week. They may raise an eyebrow, but it might save you

a lot of agony and a lot of lube because you'll get really dry and it gets horrible, like cracked, bleeding, horrible. So, um, and really painful. So, anyway, that's leaving that's we'll leave that on a note like that. So, um,

just use the testosterone cream down there. And that's not even radial. So, I hope this helps. There's 10 immutable laws. Don't forget it. And um and you can make notes on this or download our PDF we're going to have up on the website. Thank you much. It's Dr. Dan

Purser and Chantel or Cheeky Perser as we call her. It's an old nickname. Um long story. Uh and um thank you very much for watching and listen. Thank you guys.