Hormone Replacement Therapy in Menopause with Dr. Mache Seibel

March 17, 2018by Reena1


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This interview is just for the ladies 35 years and older especially for Women going through Menopause and Peri-Menopause, and are currently experiencing its known effects on the body and mind such as Anxiety, Hot Flashes, Depression, Hair Loss  and more! We are also going to talk about its hidden issues like Alzheimer’s, Heart Disease, Breast cancer which have a big impact on one’s life.

Listen to the podcast as we have world renowned Dr. Mache Seibel, an expert and one of the most entertaining, informative and influential speakers on women’s wellness and menopause. He is a 20 year veteran of Harvard Medical School, winner of multiple patient education awards, appearances on NPR, PBS, People magazine and a doctor who has taken care of over 10,000 women as they journey into and through menopause.

Dr. Mache is an author of the best selling book, The Estrogen Fix: The breakthrough guide to being Healthy, Energized, and Hormonally Balanced – Through Perimenopause, Menopause, and Beyond, creator of MenopauseQuiz.com and Editor of The Hot Years Magazine.



Here are the Key Questions answered and highlights:


1. What is Peri-Menopause? What’s Menopause? What age do these begin? (02:53)

– Menopause is one year after the last menstrual period of a woman.

– Surgical Menopause is women still menstruating but have ovaries taken out of their uterus.

– Peri-menopause is the window of years around menopause, usually 3-6 years for most women up and can go up to 10 years.

– It’s when the hormones start to become unbalanced.

– Menopause is not an age; it’s a transition.

2. Why do we have these amount of symptoms? 75% will have hot flashes, will kill sleep, libido, and mood. What is going on in the body? (04:30)

– The mean age of menopause is 51. Women are going to live a 3rd of their life beyond menopause.

– When you were going through puberty, your hormones were raging, your mood was up and down, your body was changing, etc.

– Your hormones, estrogen, and progesterone, were transitioning from unmeasurable levels to imbalanced levels until through puberty where you become reproductive and hormonally balanced.

– Every month you have a menstrual period with very paired and cycling hormonal balance.

– In peri-menopause, the same things are happening but backward. The hormones come from paired to unpaired.

– It can lead to symptoms that can affect your mood, skin, intestines, libido, sleep.

– All are unraveling because of hormonal imbalance.

– The hormones will drift once again to those low levels that you’ve had pre-puberty. It’s all related to hormonal imbalance.

3. What are the 3 types of menopause? (07:23)

– Natural Menopause

– Surgical Menopause

– Iatrogenic Resulting from treatment such as chemotherapy

4. Can you help us understand Peri-menopause with respect to how does a woman figure that out? Is there a test or is there a number I’m looking for? (11:10)

– In peri-menopause, the common symptom is “I don’t feel right” or “What’s happening to my body, my mind?”

– If you feel that you aren’t the way you think is normal for you, seek medical help and find out why that is.

– The time of Peri-menopause is the time women will experience gut issue, low thyroid, diabetes, symptoms overlapping.

– May cause frequent urination, foggy thinking, anxiety, sleep problems, acne, sadness, depression, hot flashes, changes in hair quality.
– Frequent urination is a sign of diabetes or can be sensitive bladder due to changes in estrogen
– Check your Blood. Follicle Stimulating Hormone (FSH) is a pituitary protein hormone that stimulates the ovaries to produce an egg each month.
– High levels of FSH is a good indicator of Peri-menopause where ovaries are transitioning to a new role.

5. What are the long-term effects of bloom/menopause? What is the deep long-lasting impact of menopause if we don’t handle it correctly? (19:16)

– “Noisy” Symptoms: Hot Flashes, Sensitive bladder, Mood Swings, Vaginal Dryness
– “Silent” Symptoms: Changes in blood vessels that can lead to heart disease and dementia, Changes in bones that can lead to osteoporosis or thinning of the bone
– Hot flashes can be an indicator that something bad is happening the body. Blood vessels in your body are narrowing and causing a shift in the blood flow.
– If you have frequent, severe hot flashes, it can be an indicator of hearing problems because of the narrowing
of the blood vessels which can lead to chest pain, mood swings.
– As a result of lower estrogen after you go through Peri-menopause, the endothelial cells, the lining of the blood vessels throughout the body, as the estrogen gets lower, the damage to the endothelial cells go up which increases the risk of plaque forming and narrowing of blood vessels.
– In the brain, a lot of thinking and motor activity is based on the estrogen working as a lubricant for the
brain. Estrogen allows synapses of the brain to work faster as the brain needs 15% of the blood flow from the
– Estrogen makes serotonin higher which improves mood and the impact on the blood flow to the brain is giving more oxygen, making it more efficient.
– In bones, the estrogen is responsible for keeping cells in putting calcium into the bones in balance with what is taken out, keeping balance in the cells.
– It is important to realize silent conditions before they reach a tipping point.
– Get your bone density, cardiac evaluation, keep brain moving, do exercise and exercise your brain.

6. What is the window of time to act? What do you recommend? (27:01)

– The study presented in 2001 was incorrect and inaccurate that women who take hormone therapy increased risk of breast cancer, heart disease, and dementia. It was an unfair study and it had issues with time and medication. It compared women who were mostly 50 to 59 and who took a placebo with women who were mostly 60 to 79 and who took a combination of estrogen plus a synthetic progesterone called provera.
– A redo of the study testing hormones vs. placebo was done on 2013, where the results showed hormones helped women. Symptoms went away except for a small risk of breast cancer at level of 1/1000 cases. For those who took only estrogen, there was a 23% reduction of breast cancer and 32% reduction in heart disease. A follow up of the same patients published in JAMA in 2017 found that taking estrogen or estrogen plus provera did not increase overall lifespan or risk of dying from heart disease or breast cancer. –  The best time to begin taking hormone is take it closest to the time of menopause beginning to start the estrogen. Evaluate yourself for 5-10 years.

7. What are the different kind of hormone replacement therapy? Which is the one that is least risky? What do you typically recommend? (33:30)

– Bioidentical are biologically identical in structure to what the body makes, but are synthetic because they are made in chemical plant. The only plant that can make a hormone is the Chemical plan

– The bioidenticals can be put on your skin as patch, spray, gel, in the vagina as a ring, cream. There are lots of ways to take bioidenticals like pills and creams.

– Compounding pharmacies vs drugstore:
In a Regular drugstore, all of those have FDA approved hormones where every batch is same, wherein Compounding pharmacies, what you get in prescription may not be the same as what your doctor ordered. Typically estrogen doses are higher and progesterone dosages are lower.
– If you are a person who insist that you want to have hormones form a compounding pharmacies, be sure that you’re having your health care provider check your uterine lining so any changes can be caught early and can be reversed before becoming uterine cancer.

8. How do you check your Uterine Lining? (40:55)

– Vaginal Ultrasound

– Endometrial Biopsy

– Hysteroscopy – looking inside with a very small telescope

– Get checked every year or two.

9. What kind of hormones do you like? Ingesting hormone impacts gut – What is truth around that? Best form to take hormone? (42:20)

–  People who have bad GI track bacteria or people whose intestinal track has been fed too much sugar, fast food, processed food, or other food that are unhealthy have changed the bacteria in their intestine. Those bacteria cant digest estrogen.

– The worse the gut the higher the blood levels of estrogen.

– The healthier your diet , the more you’re going to digest estrogen and keep estrogen lower in bloodstream.

– Its been shown that the best way to take hormones on skin, transdermal – through skin, vaginal, less risk of blood clot or stroke. Lower dosages of oral may be as safe.

– If you’re going to use oral, go with a lower dose oral to prevent downside of taking it.

10.  What are your Natural Remedies for menopause and Peri-Menopause? (45:28)

– Hormones are only one keystone for healthy menopausal transition and life beyond 35 or 40. If you’re going to take estrogen or not, the healthy lifestyle is essential.

– 4 tiers of a healthy lifestyle:

  • Sleep
  • Exercise
  • Nutrition
  • Stress Levels

– You have to work in all of these things. Improve all areas.

– Drink a lot of water – at least 8 glasses daily

– Alternative medication: A lot of Cognitive Behavioral Therapy (CBT) or like hypnosis, which is a mind-body approach

– For Hot flashes, sleep!

– Over the counter treatments are available – black cohosh, chaste berry, dong quai, estrogen, evening primrose, flaxseeds, soy

–  Try taking supplements one at a time for at least 3 months to see if it works for you.

– Soy has been used for long time, can be effective. Most effective ingredient is Genestein.

11. There is a negative notion on soy – if you have breast cancer, take soy products out? What’s the truth about that? (50:47)

– It is a MYTH!

– If you have cancer already, soy or estrogen or any kinds of these hormones may stimulate growth but they don’t increase death. Even women with breast cancer can eat soy, studies have proven.

– The overall benefit of hormones, if there’s a minimal increased risk of breast cancer, people don’t die with hormones any sooner. Duration of life is not affected, it’s the same with soy.

– Stick with Genestein.

12. How do you take charge of yourself off of hormones and thrive through this time period? (53:13)

– Be proactive. Have a list of questions.

– Talk to someone knowledgeable and someone comfortable to speak with.

– Decide what are your priorities. Are you considering hormones or alternatives?

13. What are those alternative Medicine? (54:49)

There are several FDA approved non-estrogen prescriptions

– Osphena for Vaginal Dryness.

– You can use estrogen locally even if you have breast cancer or going to treatment.

– A new medicine, a form of DHEA, Prasterone, is a medicine for vaginal dryness which doesn’t get into your bloodstream and no black box warning.

14. There are 4 approaches that can minimize risk of hormones. What are some of the things women can do to minimize those risks? (57:10)

– Skin approach or transdermal

– Start with lowest dose

– Regular checkups while on hormones

– Check every 5 years as data may change or your condition may change

Bonus: Hear Dr. Mache’s song about Menopause! >> 

15. What is the one thing to get out there to do to feel better? (1:01:13)

– It’s never too late to start. Invest the time to know what to do next. The time spent on you isn’t lost, it’s invested. The return on your investment is better health, happiness, and hormonal balance.

Learn more about Dr. Mache’s Books here!

The Estrogen Fix: The breakthrough guide to being Healthy, Energized, and Hormonally Balanced – Through Perimenopause, Menopause, and Beyond – Available at www.EstrogenFixBook.com

The Soy Solution for Menopause




WEBSITE: https://drmache.com/







Dr. Mache’s Courses:



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