Dr. Kyrin Dunston | HRT 101: Is Your Hormone Dosing Method Helping You or Harming You?

Welcome to another energizing and empowering episode of The Hormone Prosperity Podcast with Dr. Kyrin! This week, we’re tackling a pressing question from our listener, Mavic, who’s confused about the various ways to dose Hormone Replacement Therapy (HRT).

Are you wondering if that HRT pill, patch, or cream is the best choice for your body? Curious about the hidden risks of oral estradiol or why your patch might be causing skin irritation? Dr. Kyrin breaks it all down with heartfelt clarity and solid science, as she explains why the method you use to dose hormones can spell the difference between prosperity or problems for your body.

What You’ll Learn in This Episode:

• The First Pass Effect: Find out why oral estradiol and testosterone are problematic—hint, it’s harming more than helping by overloading your liver.
• Better Dosing Methods: Discover why transdermal creams are the healthier alternative to patches, and how compounded bioidentical hormones can open up new possibilities for vitality.
• Progesterone Done Right: Why oral progesterone is Dr. Kyrin’s go-to method for stress relief and sleep enhancement—but only when it’s crafted properly!
• Myth-Busting Mainstream HRT: Are you still trusting the advice of a general physician or weekend-trained bioidentical hormone practitioner? Learn what to look for in a credentialed HRT expert.
• The all-important balance of estradiol and estriol to protect your health and happiness.

Why This Episode Matters

Hormones hold the key to midlife joy, vitality, and a stronger, healthier you—yet too many women are left confused by mainstream advice or trapped in hormonal poverty. Dr. Kyrin’s insights will help you leave behind one-size-fits-all solutions and make confident, informed decisions about your HRT treatment.

Empower Your Journey

Dr. Kyrin invites every intelligent woman to stop settling for "good enough." This episode gives you the knowledge to question your current treatments, explore more effective options, and step into the hormonal prosperity you deserve!

 

Your Call to Action

Take the Free Hormonal Poverty Quiz

Could you be in hormonal poverty? Find out in just 90 seconds!

👉 CLICK HERE to take the quiz and assess where you stand.

 

Help Other Women Get Their Bliss Back

Enjoyed this episode? Please share it with a friend who’s also struggling with hormonal imbalance or midlife metabolic mayhem. Together, we can help more women reclaim their vitality and health. Don’t forget to leave us a review or rating—your support helps build this empowering community!

 

Podcast Episode Transcript:

Dr. Kyrin Dunston (00:00):

Coming up next, could your hormone dosing route be putting you at risk for greater problems? Find out next.

Dr. Kyrin Dunston (00:11):

Greetings friend. Welcome to the Hormone Prosperity Podcast with me, the hormone prosperity coach, Dr. Kyrin. Here's where intelligent women over 40 go to get credible guidance and inspiration on getting out of hormonal poverty and into hormonal prosperity and the joy and vitality that brings. Go from asking disempowering questions like, what's wrong with me? To asking empowering questions like, what would hormonal prosperity do? Hashtag WW HPD. Join me as we dive into today's episode and get started on your journey off the couch, into your genes and back into life because bliss is your birthright and a healthy body filled with hormonal prosperity is the vehicle that gets you there. Welcome. Let's get started.

Dr. Kyrin Dunston (01:01):

Welcome back to another episode of the Hormone Prosperity Coach. As we dive into talking about a question from Mavic, who wants to know about different dosing routes for HRT, which is a question that I see often, a lot of you are confused about. Should using a patch, should I be using a cream, a pill, a shot? Oh, like a pellet? What should I be doing? So let's dive into this question that Mavic proposed. She says, what's the latest on oral versus patches versus gels? For HRTI was initially prescribed patches, but that horribly irritated my skin. The adhesive question mark. So I'm on oral estradiol and progesterone, but are these oral pills less effective? I'm wondering about trying gels or spray that I've read a bit about in case the oral isn't as helpful pro slash protective. So thank you for this question, Mavic, I love it.

Dr. Kyrin Dunston (01:55):

There is so much to dive into here for all of you, hormone seekers, hormone finders, hormone users because oh, so much to dive into. So the first thing I'm gonna like circle with my red pen, the things that really catch my attention that are crucial alerts that need to be addressed. So number one is you say, I'm on oral estradiol and progesterone, oral progesterone, no problem. Cool. That's my favorite way, way to dose it for women, because it help can help with anxiety. When it goes through the gastrointestinal tract, it stimulates the nerves and neurotransmitters that go directly to your brain. Your gut is your second brain and it helps your GABA nerve neurotransmitter, which is your calm anti-anxiety, and it helps with sleep, love, progesterone, orally. Now estradiol or any estrogen orally or testosterone, no step away from the oral estradiol, the oral testosterone.

Dr. Kyrin Dunston (03:02):

Why? Because when you take estradiol or testosterone orally and it goes into your gastrointestinal tract, there's something that happens called the first pass effect. First pass effect, where these hormones go into the bloodstream that go right to your liver through the portal vein. They go from the gastrointestinal tract, collects the blood in the veins, and then it goes right up to your liver, the portal vein into your liver. Now your liver is the main sanitation department or detox central for almost everything in your body, most things, and especially your sex hormones. So you have a flood of sex hormones, estradiol and testosterone coming to the liver. And what that does is it overloads your detox profile and it causes biochemical changes that can actually increase your risk for well heart disease for one, but other health problems as well. And we call that the first pass effect you do.

Dr. Kyrin Dunston (04:10):

It doesn't happen with progesterone. So you do not want to take estrogen or testosterone in an oral capsule. Why? It's still on the market. I don't know. Now I say I don't know, but why? If you wanna ask anything about the pharmaceutical industry and why it's allowed, it's always a for-profit motive <laugh>, because a lot of women are not comfortable with the idea of using a patch. And that's really the only other route that we have right now for estrogen, for women that's commercially prepared by one of the big pharma companies. So that's an aside. You wanna step away from the oral estrogen and testosterone. It can contribute to all kinds of hepatic and systemic problems. So one thing you said is you were horribly irritated with the patches by your skin. The adhesive. Yes. The adhesive is made up of chemicals, primarily petrochemicals that come from fuel.

Dr. Kyrin Dunston (05:09):

Most of the medical industry's products, even the medications that we take are made and synthesized from petrochemical byproducts. You probably didn't know that. And that actually was part of the inception of the big pharma industry many decades ago was Rockefeller and a bunch of these other wealthy magnets had all this petroleum leftover byproducts and they were wondering what to do with it. And some genius scientists came up with, oh, we can use it to manufacture pharmaceuticals, <laugh>. And so that was one of the reasons why the pharmaceutical industry at its inception grew so rapidly because they had to use up these very cheap products. So anyway, I'm off on a tangent back to the estradiol. So adhesive, using the patches, the adhesive can be irritating to people and probably to more people than admit or realize it. They tell you to rotate the location of your patch every time you place it.

Dr. Kyrin Dunston (06:14):

So that probably is to minimize the chemical sensitivity reaction of your skin. A healthy normal reaction to a toxic substance, albeit a mildly toxic substance for most people, most people will react to some type of bandage that has a petrochemical byproduct in it. It's not a naturally occurring substance. So I'm not surprised that you had that. I've had that with a lot of patients too. I love the transdermal creams. That's my first choice for estradiol for women. Because usually there is no sensitivity. They put it in an organic hypoallergenic base without perfumes, dyes, or petrochemical additives. So I, it's a rare, rare patient whoever has a reaction to the transdermal cream. Now it sounds like you're working with a mainstream doctor because they've put you on an estradiol pill and a progesterone pill that you're taking two of in the morning, that's for sure a mainstream medical prescription because that's what I used to prescribe when I didn't know what I know now.

Dr. Kyrin Dunston (07:28):

So they're probably not comfortable or versed in prescribing transdermal cream. So you'll need to find a doctor who knows and is trained in prescribing dosing transdermal creams and the management and proper testing of it. You cannot follow cream dosing with blood tests. You can't follow any of these sex hormones dosing with blood tests. Let's just put it there. And the only way that mainstream doctors know to test anything if they know to test sex hormones is in blood tests and they will be incorrect. So you're going to need find someone who is trained, and I don't mean someone who went and took a weekend course. You need to actually check, did they do a fellowship in functional medicine, anti-aging medicine? Did they do on a naturopathic medicine? What is their training? You really gone are the days when you can just go to someone who says, oh, I do bioidenticals.

Dr. Kyrin Dunston (08:24):

And you're, you're knowing that you're getting the highest level of care because there are so many of these little mom and pop courses that pop up just for a weekend. And doctors and nurse practitioners and physicians' assistants can go and take these and then they can hang out a shingle and say, I do bioidentical hormones. But you as the consumer don't know what you're getting. And you need to question, what is your training and how long have you been doing this? Make sure they've been doing it like I've been doing this 30 years working with women and their, their hormones as a board certified ob, GYN. They really should have that type of experience. And then they probably should have done an entire fellowship in anti-aging, metabolic and functional medicine like I have. So they don't only know this little sliver about hormones. They know about how the hormones interact with every cell and every system in your body.

Dr. Kyrin Dunston (09:15):

Alright, so back I'm off on a tangent. So the reason why I'm pretty sure you're working with a mainstream doctor is 'cause you're on estradiol, orally nono, you are on two progesterone a day. So pretty much that's the commercially available a hundred milligram ones that are mixed in peanut oil. Note a lot of peanut oil is high, highly inflammatory. And there's a high allergen rate with that allergic reaction rate with people. So it can increase the inflammation in your body. So while you think you're doing something good for your hormones, you are actually causing inflammation in other areas that are hurting you in other areas. So I do not like that commercially available progesterone, but mainstream doctors prescribe it because it's inexpensive, it's covered by insurance and they don't really understand the bigger picture of hormonal poverty and getting to a hormonal prosperity. So, you know, and some is probably better than none, right?

Dr. Kyrin Dunston (10:11):

An oral progesterone, oral estradiol, and oral progesterone. Two of the over the counter is probably better than nothing. I'll say that. Yes, that's for sure. But it's kind of like there's bad and that's nothing. Doing nothing about your hormonal poverty. That's way bad. Don't do that. Big, big problem. You are looking for trouble. Then, you know, better is or good is use these mainstream pharma preparations better is go to a doctor who has training in bioidenticals and maybe they don't do the proper tests, but they're gonna do some type of treatment that's above that, like a transdermal cream and maybe an oral organic progesterone. But the best is do the proper tests, do the right test, breathe in the right way, and then give your body exactly what it needs. So not only estradiol, that's one of the types of estrogen, but there are three, there's estro, estradiol, and s trial.

Dr. Kyrin Dunston (11:16):

We do not replace estro. It more often promotes breast cancer. So we replace estradiol and estriol. And estriol helps to prevent breast cancer. And most women feel their best when they have a certain amount of estriol. There is no estriol available in a commercially available big pharma preparation, whether oral or any other. It's just not available. But if you get a compounded prescription, you can get the estradiol along with the estriol compounded. It's called bi est by estrogen, bi for two estrogen, two types of estrogen, estriol and estradiol. So that's really the best gold standard of what you want, if you can. So we've talked about the estradiol, we've talked about the progesterone. So you would rather have one that's not big pharma company with peanut oil. It's also an immediate release progesterone, the big pharma one. And I find that women do much better myself and the women I work with, with a slow release preparation, which they can create in a compounded formulation at a compounding pharmacy for you so that it's not like you take consume it and then your level goes way up and peaks and then drops within a few hours.

Dr. Kyrin Dunston (12:36):

I think the half-life of the commercially available progesterone is six hours. So it's pretty quickly out of your system. So the slow release, it builds up less rapidly and then it dissipates less rapidly. So it stays in your system longer. And if you're dosing once a day, six hours isn't enough. If that were an antibiotic, they would have you dosing four times a day for a six hour half-life. So you really want the slow release, which more likely has a about a 12 or more hour half-life. So that's the only other thing I would say. But again, you'll need to get that compounded and the prescription will need to be written by someone who has the expertise to know how to dose that. And is it appropriate for you and the drawbacks. All right. What other things did you bring up here? I, I'm wondering about trying gels or spray that I've read a bit about in case the oral isn't as helpful, protective spray.

Dr. Kyrin Dunston (13:34):

I don't believe that there is a pharmacologic spray or gel for progesterone or estrogen or testosterone for women that is commercially readily available unless it's an over the counter preparation. That means it hasn't met FDA regulatory standards for potency and purity and all the regulations that companies have to meet to prove that their drug has in it, what they say it has in it, that it's pure and that it's effective because to my knowledge, there is no commercially available or even compounding farm formulary gel or spray. You will find it compounding pharmacies trophies, which look like little, remember the gum chiclets and it's a little wax chit and you stick it inside between your gum and the side of your mouth and it, it melts and dissolves. So that's one way you can dose them. And there are sublingual drops that you can put under your tongue.

Dr. Kyrin Dunston (14:40):

And there are injectables. I don't ever recommend those. They used to be extremely popular back when I was a resident and came out of my residency and some of the older docs used to give their women this. But so these sex hormones, just briefly on this tangent, 'cause some of you might find this interesting, they are steroid hormones and they do stimulate the endogenous opiate system in your body. The opiates are like opium, right? We have natural receptors for that, and it makes us feel good. It makes us feel euphoric and it can make us addicted to something. So because testosterone and estrogen can stimulate these endogenous opiates, opiates you have in your own body, you can become addicted to them. And because the intramuscular injections are so direct and the peak, the levels go up so quickly, they stimulate your endogenous opiates so quickly that people typically get addicted and they need more and more of the hormone more frequently.

Dr. Kyrin Dunston (15:44):

And they're coming in, they're supposed to get a shot every month and then they're coming in every two weeks and then every two weeks. And I want more. And can you raise my dose? And I once saw a woman early in my career who came in and she had this really low voice because she was on this huge dose of testosterone. Her estrogen was also way high because she had become addicted to them. So I don't like the injections and I forgot to mention the pellets. Those are also very valid ways of dosing these hormones. However, I am not a fan of, there's a certain branded type of pellets that the doctors are trained to follow blood levels and not do the proper urinary metabolite testing like the Dutch test that I recommend. And most all the colleagues that I respect use that test test too.

Dr. Kyrin Dunston (16:29):

And they use blood tests and it's very inaccurate. And they also don't give progesterone because they'll tell women, oh, you don't have a uterus. You've had a hysterectomy. You don't need progesterone. No, yeah, you do. For instance, your breasts, they need not only estrogen, but your progesterone to balance it out. And when you don't have that balance and you only have the estrogen that's causing unbridled growth, which is going to increase your risk for breast cancer. All right. Great question. Maik, thank you so much for this. It's giving us a chance to dive in a little more deeply to these different dosing alternatives. We've talked about methods of testing, we've talked about a whole bunch. So thank you for this very fruitful question. Hopefully you all learn something that can help you on your journey from hormonal poverty to hormonal prosperity. Thanks so much for joining me. I welcome your questions. Until next time, peace, love, and hormones. Y'all,

Dr. Kyrin Dunston (17:40):

Thank you so much for joining me on your journey from hormonal poverty into the promised land of hormonal prosperity. Loved today's episode. Share it with someone you care about, love the show. Consider writing a review and help other women find it too. Remember, we're all in this together right now. There are well over 100 million women suffering in hormonal poverty without answers. Please be of service by sharing, rating and reviewing the show. Help us reach at least 1 million of these women this coming year from one previously suffering woman to another. I thank you. See you next week.