When do you forsee that doctors will be prescribing oestrogen closer to the physiological range? These current low doses up to and including 100mcg are alright for night sweats and hot flushes, which is really helpful, and might slow down bone loss. They're not going to prevent the big diseases of old age though, or build new bone. Optimising our hormones for health, needs to be the way forward, and that's more than just controlling hot flushes. I'm happy to be a test subject for that if anyone's doing research. Meanwhile, back in reality, doctors are still mentioning risks that aren't there, zero benefits, and trying to put women off taking HRT at the first opportunity or excuse. You're miles ahead Louise, and we're following you, but policy and education in the medical community isn't happening the way it should. Women are paying the price for that with their bodies and brains. What can be done? Thank you so much for all your great information and passion for hormone health 💛xx

Thank you for your wonderful work🙏, Dr. Newson (from Germany 🇩🇪 )!!!

Too many women are diagnosed with anxiety, depression, bipolar disorder because they are referred to psychiatrists who have zero training in hormones rather than being asked to track their symptoms against their menstrual cycle or reproductive events ( ie childbirth or stopping breastfeeding both or which result in sudden changes to hormones and can trigger psychosis/ mood changes) - thank you Louise for providing training for the psychiatric community. Unfortunately there are too many (male) senior psychs who will never do your training. One glimmer of hope ( as well as your practice ) for those with serious reproductive mental health issues is Profs Arianna Di Florio and Ian Jones’ CUPS clinic in Cardiff. It is referral only but if you google these clinicians they have several videos about PMDD/bipolar/ BPD/ ADHD on KZfaq .

Fantatic explanation, Thank you x

Important information that all doctors and women should hear and know. I do take estradiol and most recently progesterone and am interested in adding testosterone. Unfortunately, in Canada there is no approved T for women.

Thank you so much! You are wonderful! Warmest thoughts Jennie

V informative as always, much appreciated! Can I request an in depth talk on HRT options for post menopausal women with endometriosis? I have a relative who would benefit, hard to find info on this topic. Lastly, what info is there on how lack of hormones affects ligaments, I think my pain points are parts of joints where muscles attach? After 2 yr still not getting enough estradiol absorption, will likely need an appt with your clinic for more knowledgeable treatment plan.

The other interesting area of hope is nutritional / metabolic psychiatry - Harvard Psychiatrist Dr Chris Palmer ( loads of podcasts/ videos on KZfaq ) has a book called Brain Energy in which he acknowledges vital role of hormones in mental health. He advocates low carb, real food or ketogenic/ paleo diets with v low alcohol, good sleep etc as able to resolve mental health problems and some others claim that dietary changes can massively improve PCOS , PMS , hot flushes etc. As Louise talk about it’s all about improving metabolic health, mitochondria and reducing inflammation. Sugar, refined carbs ( & alcohol ) increase inflammation, exercise, good sleep and hormones reduce inflammation.

I'm on hrt estragel utragestran vaginally until i replace my mireena. I've also got underactive thyroid. The Dr won't put me onto testosterone as I've got normal levels! Do I still need testosterone for my hrt routine? I suffer from sleep anxiety and morning anxiety vi wake up at 4.am and 5.amand can't go back sleep, I've got brain fog low mood, no libido and I'm very snappy. I've been diagnosed with ostapinia the Dr hasn't prescribed anything for that? Why have I got ostapinia if I'm taking hrt and I was on the combined pill b4?

So does that mean that we can be diagnosed if we are perimenopausal by looking at our brain ?