Bad pharma:  The Pharmaceutical industry’s (pharma) prime goal is the maximization of profits; thus, public’s health is their hype.  I call this tobacco ethics and science. To know how broken the system is read Marketing Science, on the FDA , how doctors are their pawns, and watch Prof. Angell.  The attack on HRT follows the pattern of eliminating an off-patent drug that reduces profits especially when they prevent chronic conditions (see above). 

Natural HRT Benefits vs. Mare’s Urine Estrogen with MPA--the tragic differences

Setting the record straight Prempro vs. natural HRT --  for  more

Section II:  Tobaccos Science and Bad Press:  Prempro, one of the first HRTs[1], has been marketed since 1942 by Wyeth Laboratory (bought out by Pfizer in 2009).  It has been and still is the best-selling HRT.  A supposedly definitive study of HRT was done by the FDA’s drug research branch, National Institute of Health (NIH) (with undoubtedly a nod from pharma).  The Women’s Health Initiative (WHI) knowingly selected the worst formulation of HRT, Prempro.  NIH had the results of the Hormone Estrogen Replacement Study (HERS) UK completed in 1998 which used Prempro; moreover, earlier studies singled out (medroxyprogesterone) MPA as the cause for the  increased risk of breast cancer (Goodman & Gilman 2006, 1552).   Prempro consists of an estrogen cocktail derived from pregnant mare’s urine—7 unique mare estrogens-to which is added the synthetic progestin MPA.  (The cruel treatment of mares and subsequent slaughter was broadcast by Frontline.)  “Pregnant mare’s estrogens are the weak estrone (>50%), and the two mare estrogens, equilin (15-25%) and equilenin….  Mare (equine) estrogens such as equilin, that are foreign to the human body, have been shown, when compared to other studies, to have effects that are significantly worse than the natural estradiol[2].” MPA, the synthetic progestin used in Prempro, blocks most of the beneficial effects of estrogen--the natural progesterone doesn’t.  Using Prempro, the WHI found that compared to a placebo there was increased incidents:  heart attacks 29%, breast cancer 26%, pulmonary embolism 113%, strokes 41%, total deaths 15%, all cancers 3%; reduced incidents: hip fractures 34%  and colon cancer 37%.”   “MPA antagonizes this athero-protective effect [arteries, including coronary]” at 1997.  Though “all causes of mortality were not effected”, the press highlighted risks for HRT (undoubtedly with a nod from their biggest advertiser[3]), & HRT sales plummeted.  The equine estrogen only arm of WHI had better results; more proof that adding MPA causes the harm.   Pfizer in 2010 settled a suit over breast cancer for $330 million or $150,000 per person.  Yet Prempro is still on the market (thank you FDA & pharma) and still first in sales.  Based on the WHI, NIH issued this warning on all HRTs: “…increased risk of myocardial infraction, stroke, invasive breast cancer, pulmonary emboli, and deep vein thrombosis in postmenopausal women… Estrogens with or without progestins should be prescribed at the lowest effective doses and for the shortest duration consistent with treatment goals…”  The warning is placed on all packages of HRT, and it is accepted as correct by most doctors and patients.   My doubts were confirmed when attending a lecture on the WHI given in 2002 at UCSD by Professor Dr. Robert Langer.  He explained to a large medical audience that the WHI Prempro results cannot be validly applied to other HRT formulas.  Over 50 years of research was not overturned; rather physicians and the public were tragically misled by the press, pharma, guidelines, and the NIH.  This is another example of regulatory capture.  Tobacco ethics guides pharma. 

CONFIRMATION: Set Up to Fail was published in the highly acclaimed science journal, Nature, 09/09/2010:  “Is Nature ignorant of the vital fact that Prempro contains no progesterone, but instead the artificial progestogen Provera [MPA].  The other component is Premarin (conjugated estrogen), which is a very uncertain, patent mixture of substances from the urine of pregnant mares…. [equine (horse urine) estrogens] have crucially different effects.  Prempro is totally unrepresentative of any other product used for HRT purposes…. . Much of it was known before the NIH chose to use Prempro in its intended landmark study.  Using a study of the effects of Prempro to attack the entire use of HRT has, through needless fear, caused millions of women to forgo considerable benefits of HRT using better products.  This point has been repeatedly made by endocrinologists.   Why does Nature not know it?--END OF ARTICLE.

"I think that it borders on a tragedy that Premarin and Provera [the 2 compounds in Prempro] were chosen as the only HRT treatments [for the WHI Study]”.  Another researcher finds that Provera [MPA]--and no other progestin--blocks the mechanisms that allow estrogen to fight the brain's immune response to Alzheimer's….  Bruce S. McEwen Neuroendocrinologist of the Rockefeller University is unequivocally critical of the study: "I think that it borders on a tragedy that Premarin and Provera were chosen as the only HRT treatments."  “With Medroxyprogesterone [MPA] in Provera you are activating two receptors involved with cell division in the breast," she says, "and that's the culprit, not estrogen [for breast cancer].”  Recent research shows that Provera interferes with estrogen's ability to prevent memory loss and dementia. “Estrogen is able to protect neurons against toxic assaults that are associated with Alzheimer's disease," notes Roberta Diaz Brinton, a neuroscientist at the University of Southern California…. she found “that Provera--and no other progestin--blocks the mechanisms that allow estrogen to fight the brain's immune response to Alzheimer's”. This immune response wears away at brain cells and causes them to leak neurotransmitters such as glutamate, which overloads and kills neurons.”  Hormone Hysteria, Scientific American Sept. 2003.  “Premarin, conjugated estrogen or conjugated equine estrogens[4].  Since it is from a pregnant mare, like with mothers they make enough of an estrone to block the non-pregnant most beneficial estradiol, namely estrone.  Thus there is a double whammy that of the progestin which is inferior to the natural progesterone and the estrone” Wiki Nov 2012. 

The 2008 study “Could transdermal estradiol + progesterone by a sager postmenopausal HRT?  A review confirms the criticism of the WHI studies through an extensive review of existing research, while at the same time strongly supporting the continued use of HRT in menopausal women because of lowering the risk of degenerative diseases such as osteoarthritis, rheumatoid arthritis, cardiovascular disease and their consequences, other benefits include reduced risk of sarcopenia, osteoporotic fractures, diabetes, hypertension, cognitive decline, sexual decline, and without the risks caused by the synthetic HRT such as deep vein thrombosis, pulmonary thromboembolism, and breast cancer.  This study has been lost in pharma dominated education and guidelines which has turned doctors into dupes of pharma.  Sadly and reluctantly, I have concluded that medical science has been replaced with marketing pants that is wearing the language of medical science.  Following the business imperative for quarterly profits pharma applies tobacco science and tobacco ethics thereby putting profits come before people.  We have the greatest black man-made health disaster dressed as the miracle of modern science.  The number of drugs not worth their side effects is the norm.  Until the national data banks for the real-world population are opened, the harm done and benefits caused by the weird chemicals called drugs won’t be known.  Our high sugar diet has damaged every cell, and thereby greatly increased our vulnerability

Section III: BENEFITS OF HRT  Why are the sex steroids (sex hormones) so beneficial for those with hypogonadism?  I lean heavily upon our ancestors living in villages, for most there is incessant warfare with neighboring villages and/or clans.  The elderly being a burden because of their decline in functions to labor, produce children, and fight (males), this entails that biological systems that removes the elderly would be selected for.  The andropause and menopause occur in the 6^th promotes their elimination.  Hormonal supplementation counters the steroids role in the aging process, thereby improving quality of life. 

Mitochondrial dysfunction:  This explains all the benefits below!  Mitochondria have sex hormone (including DHEA) receptors, that turn up the various processes that “is mitochondrial protection.” At 2013,  Optimal cellular functions entail an adequate supply of the energy molecule ATP, which is what fats and carbohydrates are used to make through their conversion acetyl-CoA and pyruvate produced in the cytosol and then transported into the mitochondria to make the essential ATP. EVERY PROCESS IN THE BODY RUNS ON ATP. Early, in 2018, I came to the realization that the long list of conditions associated with the western diet had as a starting point the reactive sugar fructose damaging mitochondrial DNA.  Subsequent investigation found that the sex hormones TTT and estradiol are mitochondrial protective re reactive chemicals, and this is the mechanism behind their long list of benefits.  “Both steroids trigger a complex molecular mechanism that involves crosstalk between the mitochondria, nucleus, and plasma membrane, and the cytoskeleton plays a key role in these interactions. The result of this signaling is mitochondrial protection”, at Sept 2013. “Our results indicate that testosterone improves cell survival and mitochondrial membrane potential and reduces nuclear fragmentation and reactive oxygen species (ROS) generation.  These effects were accompanied by a positive regulation of neuroglobin, an oxygen-binding and sensor protein, which may serve as a regulator of ROS and nitrogen reactive species (NOS), . . .  these findings suggest that astroglia may mediate some of the protective actions of testosterone in the brain upon pathological conditions” at June 2016 and similar for cytoprotection and cardiac recovery after MI, at 2004.  Overall benefits through signaling and turning on DNA is covered in an 2011 seminal article.   All three very similar in structure hormones, testosterone, DHEA, and estradiol have similar protective functions.  Unfortunately, the industry that profits from illness has opposed their usage and does tobacco science to “educate” physicians and the public that hormonal interventions has major “risks” and minimal benefits, while at the same time ignoring studies that contradict their findings.  We have gone from the golden age of medicine back to the snake-oil era now dressed in the language of science and clinical trials.  The devil is buried in pharma’s details. Sadly I have come to realize the corruption worked by an industry that profits from illness and has created pill pushers and pill poppers—for some examples, and.         

Alzheimer’s disease with past long-term HRT, 7 vs 30 control.  Estrogen is neuro-protective by inhibiting oxidative damage.  Progesterone is also neuro-protective:  used in large doses following trauma “to limit central nervous system damage.”  Again MPA in WHI study increased risk of dementia, 40 cases of dementia versus 21 in the placebo group, at. .  A study of hypoxia and DHEA, TTT, and estradiol and their metabolite epiandrosterone (EPIA) found only EPIA neuro-protective. This helps to explain why the method why some have failed to find estradiol neuroprotective.      

Breast density maintained for women on HRT.  The difference has been repeatedly noted on mammograms. 

Cognitive Function: “There are plausible biological mechanisms by which estrogen might lead to improved cognition.”  Estradiol surpasses oxidative stress in the brain’s mitochondria, thus increasing ATP needed for optimal function, at 2007. 

Sexual Satisfaction: prevents vaginal atrophy, “HRT improves sexual function” better, estradiol & testosterone, &.

Cancer breast et al risk decreased:  73% less for estradiol:   “in breast cancer 10 in treated group v 17 in control group.”   HRT after & also during breast cancer greatly increases survival, also ratio 0.28, and 53% increase-results would be better estradiol  with progesterone. “MPA (in Prempro) increases the risk of breast cancer” some progestins increase risk.  Contrary to pharma, estradiol  progesterone doesn’t  increase risk,  and when given following breast cancer over  2/3rd fewer deaths at 15 years HRT, and  also, also, same for uterine cancer.   HRT also prevent skin cancer.

Colon cancer: “the reduction among current users RR = 0.55… users of 11 years or more RR of 0.54 [46% lower, also].” Estrogen and progesterone have beneficial effects for “esophagus, stomach, gallbladder, and intestines.”

Breast cancer survival:  “Cancers in women who use HRT are often less advanced, and lower mortality has been reported in those who use HRT than in nonusers… The association of HRT with lower proliferation rate and smaller tumor size was exclusively caused by ER-positive tumors” at.  After diagnosis 72% higher survival: “The risk of death was lower among the HRT survivors; odds ratio 0.28…” at,  Also, breast cancer mortality rate of 5 per 1000 person years in HRT users compared to 15 in nonusers, at.  This was explained, along with the fact that women post-menopausal women on estradiol and those  were pregnant have a lower risk of breast cancer in that their estradiol and estriol blocker estrone (E1) stimulates cancer growth—at 1974.   For negative results, pharma used the progestin MPA (WHI study) which blocks the cancer protecting and CVD protecting effects of estradiol; other progestins could be similar; however, “progesterone combined with estradiol induces apoptosis [cancer cell death]” at.  So rather than go after the block buster culprit estrone with E1-3-MTP (at 1993), pharma blocks both estradiol its health benefits and estrone. 

Cardiovascular disease (CVD) & MI: “estrogen lowered … 37% LDL …, extends life 2.1 years,” Braunwald, Heart Disease 5^th Ed, 97, p 1708.  “HRT decreases CAD morbidity and CAD mortality … was 0.56 compared to subjects not taking estrogen” Braunwald 1142; another 50%, 16 vs 33, reduction in CHD.  Estradiol blocks oxidation of LDL to prevent atherosclerosis.  “Estradiol completely reverses the effects induced by OX-LDL on the DDAH/ADMA/NO pathway,” Avoid MPA and LNG (levonorgestrel).   Another study found 26 MI deaths for estradiol vs. 56 for placebo (115%).  A meta-study found and a 50% reduction of Coronary Heart Disease.  Lowers hypertension risk.  Two AHA studies explain mechanisms of cardio arteries protection and Wiki,  also,   Angina pain is associated with low estrogen, treated.   Calcification of arteries is strongly associated with MI.  HRT lower calcification of coronary arteries—at, using Prempro.

Cholesterol effects, percentage of reduction in LDL with E 37%, with E + PA 46% (E is equine estrogen and PA is medroxyprogesterone Braunwald, Ed 6, Table 51-2).  Estrogen significantly protect LDL from oxidation at . “E2 at a concentration of 1 μmol/L inhibited LDL oxidation by 37% to 62% at the various concentrations of copper” at.  Oxidized LDL in the tunica media of the artery is held to by pharma to be the major cause for atherosclerosis and CVD.   I DO NOT SUBSCRIBE TO THE LIPID HYPOTHESIS, statins are poison, wrong cause, and more, expert’s review on statins as poison.

Diabesity, which is both Obesity & Diabetes:  the drop of estradiol increases LPL which regulates weight, distribution of fat, and activity.  Gary Taubes, Good Calories, Bad Calories, 398, Taubes Why we Get Fat, 90-91, and Wade at,  In the obese estrone is +40% at.   Weight related issues (metabolic syndrome, insulin resistance, & diabetes) are associated with drop in estradiol, at.  Likely mechanism is a reduction in the related hormone DHEA whose metabolite (7-oxo-DHEA) promotes significant weight loss (at) and is neuroprotective (at).  Note, JK takes DHEA 40 mg sublingually; it diminished appetite for one hour, mild stimulant and avoid first–pass over 95% metabolism by the liver which occurs with oral dose, no additional weight gain.     

Endothelial cell dysfunction prevented, the compromised performance of the single layer of squamous cells lining all the blood that form an interface between circulating blood content and interior tissue.  Their under-performance is responsible for over 95% of all cardiovascular disease.  Estradiol significant improves the performance of these cells at 1996, 1996.   “Hormone replacement with estrogen has been shown to improve endothelium-dependent vaso-relaxation acutely in a number of animal models, including primate coronary arteries (97)” at 1999—relaxation a measure of health. “Endothelial function is abnormal in many postmenopausal women compared with premenopausal women, and in some postmenopausal women it can be enhanced by estrogen replacement therapy. This effect may increase with prolonged use” June 1998.   

Longevity:  Telomere numbers of units on the end of DNA are essential for cell longevity and functionality—see Wiki.  It has been shown both in animal and human studies that treatment with estradiol lengthens through action on telomerase the number of telomere units, see careful matched study of HT therapy, and, and, and, for animals.  This action on telomerase in part explains the many benefits from estradiol as to the protective effect in mitochondria. 

Macular degeneration, and hearing:  HRT resulted in a 36% reduction and other eye pathologies.  Hearing better.

Mental Health:  Estradiol like several hormones (DHEA and testosterone and probably others) have receptors in  some of the cells in the brain. For example, DHEA is produced in the brain.  “Estradiol has been found to be effective in the adjunctive treatment of schizophrenia in women. It has been found to significantly reduce positive, negative, and cognitive symptoms, with particular benefits on positive symptoms.” Wiki 4/19.

Mitochondrial protection as antioxidant: “Estrogens have antioxidant properties which are due to their ability to bind to estrogen receptors and to up-regulate the expression of antioxidant enzymes via intracellular signaling pathways. . . . Recently, estrogen receptors were identified in mitochondria at 2010. This function is at the heart of E2 benefits.

Mood elevation and depression: “Numerous molecular and clinical studies have implicated estrogen in modulating brain function including that related to mood,” treatment of mood disorders and depression no additional weight gain.

NAFLD:  “Non-alcoholic fatty liver disease) is also more common among men than women in all age groups until age 60, where the prevalence between sexes equalize.  This is due to the protective nature of estrogen,” Wiki.— diet's role.

Neurosteroids:  “These brain-mainly glia cells produces sex steroids that are labeled “neurosteroids”, and have been found to exert important regulatory functions” at 2008.  Among the neurosteroids are pregnenolone, estradiol, testosterone, and DHEA and their storage form such as DHEAS and pregnenolone sulfate.  Those just listed I have I have extensively reviewed their literature.  There are over a dozen other neurosteroids.  As a senior I take sublingually or in lotion 3 of those hormones.  They reduce the risk of for age related neurodegenerative conditions and slow the rate of cognitive decline (contrary to pharma’s warnings and the belief of most physicians).      

Osteoporosis and bone remodeling: “Bone loss increases after menopause due to lower levels of estrogen.,. [causes removal of ovaries” Wiki  “Esterified estrogens produced significant increases in bone mineral density (lumbar spine, hip).   54.2% greater spinal mineral.  “1 of 4 white women over the age of 60 had spinal compression fractures associated with osteoporosis. One woman of 5 will fracture a hip by the age of 90,” and even more will have knee replacement operations.   Bone gain from long-term HRT, also; estradiol's role. Numerous journal articles hold that progesterone work with estradiol to increase remodeling of bone, at, and, and.  Estradiol slows the loss of bone calcium and progesterone increase the rate of calcium replacement.  Bisphosphonates drugs increase bone density by adding unnatural phosphate to the bones which result in an increased brittleness, and “they disrupt intracellular enzymatic functions needed for bone resorption” and they have other major side effects. Including atrial fibrillation.    

Osteoarthritis (OA): When both incident and progressive radiographic knee OA cases combined, “current ERT [estrogen only replacement therapy] use had a 60% decreased risk compared with never use”.    Progesterone is most important.

Rheumatoid Arthritis (RA):  “HRT was well tolerated, increased well-being, reduced articular index and increased lumbar spine bone density over a one year period in postmenopausal women with RA” also, & lowers RA CVD deaths.

Parkinson’s disease,” loss of estrogen resulted in decrease neuron density in the substantia nigra (structure of brain damaged by Parkinson’s disease), and restoration of estrogen in increased density” at, and.  Again MPA exacerbates condition & risk, at.  Pharma of course does junk science to show that HRT does not affect the course of the disease. 

Programed death & longevity through menopause is to remove elderly women from the community, thus the precipitous decline in health of women after menopause.  To slow this process requires the taking of natural HRT.

Sarcopenia age related loss of skeletal muscle mass with age is associated with low level of estrogen & testosterone in 22.6% in older postmenopausal women not receiving estrogen or TTT.   TTT prevents and reverses sarcopenia, and; however HRT alone does not protect against muscle loss which is why I would add TTT to the compounded formal.    About 10% of estradiol is converted to testosterone by the body for its androgen (muscle building) effect.     

Skin healthier American Journal of Clinical Dermatology & more hair, hair, hair.    “Studies of postmenopausal women indicate that estrogen deprivation  is associated with dryness, atrophy, fine wrinkling, poor healing, epidermal thinning, declining dermal collagen content, diminished skin moisture.  The decrease was preventable by the use of HRT.” “The mean collagen content in the skin was … found to be 48% greater”, slows skin aging, also, and less skin cancer, 2008.

Urinary Tract Infections Recurrent (UTI), also urinary urgency, urogenital & vaginal atrophy are associated with low estrogen in post-menopausal women.  A meta-analysis of 8 quality studies found the placebo group 2.5 times more likely to have a subsequent UTI. Topical administration most effective; however for vaginal atrophy estradiol tablets.

Venus Thrombosis:  an 8% reduction in risk of with esterified estrogen while those on Prempro had a 65% elevated risk JAMA 04, and; a 23% reduction exogenous estrogen (5.1% of cases versus 6.3% control cohort).

10 Reasons for HRT:  Menopause Int. & Oncology:  Both list the above benefits, and the latter advises HRT for survivors of breast cancer because of “a 70% reduction in the risk of death” during the 15 years, also.

The 4 other major sex hormones (DHEA, progesterone, testosterone, and pregnenolone):  What is said of estradiol as to positive effects applies to testosterone, they follow a similar evolutionary path, but for the degree of androgen effect (only about 10% of estrogen is converted to testosterone, thus its lower androgen effect).   In general, the cell types which have estrogen receptors have receptors for other sex steroids, and often the combination is superior to supplementation with just one of those steroids—see below recommendations. 

^^^^^^^ Non-technical summation ^^^^^^^^

Natural Estrogen (Estradiol) with progesterone NHRT:  What every woman should be taking because of the numerous, major health benefits, benefits that would slash pharma’s profits.  Of the 4 natural estrogens only estradiol (E2) has major health benefits.  Two--estriol (E3) and estetrol (E4)--are found in pregnant women and block estradiol.  Unfortunately for women, the addition of E3 to E2 (estradiol) in compounded formulas has made the computer of physicians and is commonly included in the prescription.  This inclusion blocks the positive effects and increases side effects—more workings of pharma’s KOLs.  Big pharma being against hormone replacement therapy (HRT) markets ineffective products including those containing estriol and estetrol, and estradiol at too low a dose & with inferior progestins such as in the best-selling Prempro.  Prempro, a combination of estrogen derived from pregnant mare’s urine and the progestin MPA.  The biological effects of mare’s estrogens are different than human estrogen and MPA blocks most of the positive effects of estrogen.  Thus, the results of the major WHI study funded by the FDA apply only for Prempro[1].  Nevertheless, the FDA warns that HRT has only one valid medical use, to manage hot flashes, and should be used at the lowest dose for the shortest time.  Thus pharma has used marketing science & guidelines to overturn 4 decades of positive results for HRT:  Alzheimer’s 83%, Heart attacks 51%, Coronary Heart Disease 50%, Colorectal Cancer 46%, Breast Cancer 73%, Thrombosis 8%, Macular Degeneration 65%, osteoporosis fractures 90%, & prevents arthritic join destruction, firmer breasts, healthier skin (less wrinkles, thicker, 48% more collagen), reduces hair loss, improved cognitive function, less depression and mental illness, and a general feeling of well-being with increased libido.  These results occur because estrogen & progesterone receptors set the body to “premenopausal” maintenance.  Tribal survival benefits from elimination of the elderly, thus we have the reduction in testosterone and estradiol to promote that end.  The lack of estradiol (and possible progesterone) causes the precipitous decline in health of women after menopause.  Life extension with long-term NHRT is over 6 years, and twice that with a low sugar diet.  Progesterone (P4), the major progestogen, is similar to estrogen--they work together.  It has numerous benefits, while some of the artificial progestins are clearly harmful (such as stimulating the growth of breast cancer).  “Synthetic progestins often interact with and transactivate androgen, mineralocorticoid, glucocorticoid or growth hormone receptors”, at 2008, and none have been adequately researched as to side effects.  Like testosterone, estradiol taken at higher dose has more benefits (this is distinguished from oral estrogens which prevent pregnancy by producing effects like in pregnancy, which is why a lower dose is better tolerated.)   A sufficient dose is available only from a compounding pharmacy (15 mg of estradiol plus 100 mg of progesterone) in a lotion obtained per application (there is a 10% absorption rate with topical hormones).  For a month’s supply have prepared 60 gram of  lotion, application of 1/4^th teaspoon which is 2 grams.  Apply widely as possible over the torso, back, shoulders, underarms, and face using water and rubbing it in to promote better absorption.  Ideal free-serum estradiol level is 200-500 pmol/L.  Plant sources for HRT are not natural and are metabolized by the liver on first pass from the digestive system.  These hormone mimics fail to perform well and have adverse consequences (see MPA above).  The mimic can occupy sites that estradiol would go to and block its action.  Doctors who follow the Wiley Protocol are other methods of hormone balancing for post menopause women are milking the insurance and patient, and it lacks convincing scientific evidence.

“Current research shows that the transdermal route of estradiol administration can also be advantageous for women with diabetes, hypertension and other cardiovascular risk factors, as those risks increase with advancing age.^[4] Wiki 2018, and at 2013.  “Oral HRT is associated with an increased risk of venous thromboembolism (VTE), gallbladder disease and possibly stroke. The increased occurrence of all these events can be prevented by the use of the transdermal route of estradiol administration; this route seems also advantageous for women with diabetes, hypertension and other cardiovascular risk factors, and also especially with advancing age” at.  Tell your physician you are aware of risks and are convinced of benefits of NHRT applied topically is safe; then give him a copy 2010 journal article.  Tell him you observed the benefits in a friend & a relative and want the same.  Most doctors will comply with your request.

Lotion from compounding pharmacy of 5 mg estriol and 100 mg of progesterone

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