I think it has a lot more to do with how you are feeling than with what one estradiol level measured. The fact is, the level fluctuates notoriously, sometimes on an hourly basis, so most hormones are not prescribed based just on a blood level.

I would suggest that this is a good time to begin researching the effects of ovarian hormones (estrogen, progesterone, testosterone) on the body, and the implications of their lowering circulating levels. Then, working with your own known health practices and risk factors, begin developing a set of health maintenance goals for your peri-menopausal and post-menopausal years. How hormone replacement, whether prescription or otc or food-based, will fit in with this plan is something you and your doctor should explore together. Bear in mind, too, that this is a fluid situation, and what you work out today will surely need to be revised in the future. But identifying your own needs, preferences and goals will help keep your trials on track, rather than blindly setting out trying things just because you are "supposed to."

I suggest starting your research with a well-written well-researched (with citations to the current medical literature) book like Dr. Susan Love's Hormone Book. A new edition is due to be released this year. I would also look on Medline for current articles. Any research that is supported by the companies that sell these drugs should be viewed with suspicion.

The supposed long term benefits of hormone "replacement" have been pretty much negated by recent placebo controlled studies. These drugs increase the risk of heart attack, stroke, and pulmonary embolism, as well as endometrial, breast, and ovarian cancer. Lower levels are natural and normal after menopause. They are also protective since most reproductive cancers are fed by ovarian hormones.

Using hormones for symptom control is a double-edged sword. Most women find that when they try to stop them the symptoms come back full force. Some women become addicted to these drugs.

Framboise, your insistence that hormones are necessary for all women in some form is untrue. The majority of women, even in a drug - obsessed state like the US do not use these drugs after menopause.

your insistence that hormones are necessary for all women in some form

I would never presume to tell other women what would or would not be suitable for them. If, however, they indicate interest in pursuing the question of taking hormones, I am willing to share what information I have gleaned from study and discussions of the matter with other women. It has long been my habit to advocate identifying the goals of any health regimen, and using the absolute minimum amount of such things as hormones (in conjunction with other health maintenance practices) that provides you with the effect you seek. As I suggested above, I feel that the path to identifying those goals begins with education about the physical processes involved. Only thus are informed decisions made.

For those who prefer a less-demanding approach, you are kind to offer your flat assurances that you know better than all of us what is best for us all.

I have enough respect for my fellow women here to feel comfortable that they will pick, of the various answers that are offered, those that are most agreeable to their own personal philosophies for followup.

"...kind to offer your flat assurances that you know better than all of us what is best for all of us."

In the broadest sense that no drugs is always preferable to drugs when one is discussing drugs that are not necessary to life and limb only, yes.

Nowhere in either of your posts in this thread have you even mentioned the grave risks associated with these drugs. You have not mentioned weighing risks vs expected/desired benefits. Instead you suggest that there are (serious and negative) implications that follow from "declining ovarian hormone production." The intact female produces all the estrogen and testosteone required for the non-reproductive body. Progesterone, as the hormone of pregnancy, is not produced because it is no longer required unless one takes exogenous estrogen in which case it is used to counter the extreme carcinogenicity of estrogen.

I have my feet sufficiently grounded in reality to know that most women are being pressured to take hormones of some kind after menopause despite the lack of evidence for benefit. They are not warned of the dangers and those who get their drugs from "compounding pharmacies" may well never even see the federally mandated warning that is supposed to be included in all estrogen drug prescriptions. Many women see the word "natural" and assume therefore safe. Compounding pharmacists/pharmacies encourage this belief because it contributes to their bottom line. In this last post you pay lip service to the notion that "absolute minimum" dose is best, but carefully avoid saying that for most women that minimum is none at all.

The difference between our approaches is that I make my biases clear upfront. You disguise yours in apparently neutral but actually highly biased language - launguage that is eerily similar to that used by drug companies/compounding pharmacies/mlm scammers and the like to sell their product(s). I wonder if you would post in equally (apparently) neutral fashion, if someone came here asking about the use of street drugs or tobacco.

Aunt Bea,

Testing the blood for estrogen is inconsistent/inaccurate. More informed doctors will use saliva testing.

It is highly possible that you are SO ESTROGEN DOMINANT that your body is in self-preservation mode.

Read the book The Estrogen Alternative by Raquel Martin. NATURAL progesterone is more likely what you may need. Not more estrogen, not even natural forms. Read all articles at http://efn.org/~raypeat

In answer to the arguments produced from your question, it is the synthetic hormone replacement therapy causing the problems women are experiencing, not natural hormone replacement. All the hormones, adrenal, thyroid, reproductive are available in natural forms. Just not as profitable to make, so advertising is nil.

Our diet, and chemicals are causing estrogen dominance in female and male/child and adult.

Leigh said: "The intact female produces all the estrogen and testosteone required for the non-reproductive body. Progesterone, as the hormone of pregnancy, is not produced because it is no longer required unless one takes exogenous estrogen in which case it is used to counter the extreme carcinogenicity of estrogen."

WRONG! Are you pulling this stuff out of the air?

If you would read a textbook on hormones you will discover that progesterone is necessary for intact and non-intact women, men and children. From birth to death. How in blazes do you think women become pregnant? What is the hormone they use to assist women in getting pregnant and keeping pregnancies? Progesterone

What do you think prepares the uterine lining for a pregnancy? What do you think is necessary for proper menstruation? What do you think is necessary to counteract estrogen in an intact woman?

Estrogen out of balance with progesterone is carcinogenic. You said this yourself. So we obviously do need it if we don't make enough for whatever reason the cause. Stress, surgery, illness, etc.

Please quit discounting valid poster's information until you have done more studying on simple biology.

How many post menopausal women do you know of who are getting pregnant? How many are trying to get pregnant? How many need to "prepare the uterine lining for pregnancy?" How many have "proper menstruation?"

Progesterone is indeed the hormone of pregnancy. That's why when one's reproductive life is over one no longer needs it. That's why the female body can't make it after menopause - because it doesn't need it.

I have never said that estrogen out of balance with progesterone is carcinogenic. I *have* said that if one takes exogenous estrogen *and* one has a uterus then one must take progestin/progesterone to cancel out the carcinogenic effects of the estrogen on the uterus. Since studies last year indicate that progestins/progesterone increase the risk of breast cancer 8 fold over the increased risk supplied by estrogen alone, protecting the uterus may well come at the expense of the breasts.

You ladies may be interested in reading a quote from a reference that Leigh posted previously I've also moved up the thread so that you can read the complete reference. It is in the thread : Progesterone cream for bone loss. Here's the quote:

"Feldman et al., however, may have been prophetic when he commented; "If this anti-glucocorticoid effect of progesterone also holds true in bone, then postmenopausal osteoporosis may be, in part, a progesterone deficiency disease." Hmmmmmm let's consider that phrase again, "POSTMENOPAUSAL OSTEOPOROSIS MAY BE, IN PART, A PROGESTERONE DEFICIENCY DISEASE". Now mind you this is from a reference that Leigh herself posted. Seems to me that I read this same thing in Dr. Lee's book. So why is it that Dr. Lee is accused of being a quack and a charleton who is only out to sell progesterone cream, sounds to me like he is prophetic. Perhaps we should re-examine the functions of progesterone in regard to bone maintenance.

Ladies, I want to thank each of you for taking the time out of your busy schedules to answer my question. I am fairly new to this forum and have gleaned a lot of good information. One change I would like to see happen and that is for each of us be able to post without fear of being attacked by someone. If we don't agree, we can say so but move on with our view point. Here's wishing everyone a happy and healthy 2002. Bea