Common Formulas
An approximate replacement dose for .3mg conjugated estrogen and 3mg to 5mg medroxyprogesterone acetate (or any other low dose estrogen/progestin):

Approximate dose to replace .625mg conjugated estrogen and progestin:

Approximate dose to replace 1.25mg conjugated estrogen and progestin:

Remember, estriol is about 80 times weaker than estradiol. And, because of metabolism and excretion, these are dosed about every 12 hours. We can add natural testosterone to each troche in oophorectomized women, or those whose libido has not returned while on HRT (commonly .25mg to .5mg twice daily). Testosterone is also bone-trophic.

Natural testosterone troches are also available for men, again dosed twice daily, as a possible replacement for injections of synthetic testosterone. This may reduce the blood level fluctuation seen with injections given at two to four week intervals.

Dehydroepiandrosterone (DHEA), is the precursor to most hormones, and also has its own specific receptors. It is well known that DHEA blood levels decline with aging and certain disease states. Many clinicians find it extremely beneficial to add DHEA to patients with auto-immune diseases like systemic lupus erythmatosis, inflammatory bowel disease and rheumatoid arthritis. It is typically dosed 2.5mg to 5mg twice daily for women and 10mg to 20mg twice daily for men. This can also be added to any troche formula.

Of course, since we begin with pure ingredients, troches are also available in virtually any combination or strength. Estrogen-only troches are available for cyclic applications, and progesterone-only for PMS, luteal-phase deficiency and other reasons.

Some clinicians have also found estriol .5mg to 2mg / progesterone 200mg troches dosed three times per day are preferable over SSRIs and other prescriptions for post-partum depression. Since estriol is a placental estrogen, breast feeding may continue. The hormones are gradually reduced to avoid a relapse.

Topical creams and ointments are also available. These can be used for natural hormone replacement, or for local application to the pelvic floor to help normalize tissue, arousal and climax.

Also, it is good to remember blood work is a monitoring tool, but does not always coincide neatly with resolution of symptoms.