This information is posted on Dr. Hertoghe's website:

There is some hesitancy among physicians to give estrone, because a few reports have suggested that estrone could be carcinogenic. Estriol, on the contrary, has better press .Many voices say estrogen should be added to every female hormone treatment because several, but not all, studies have reported it to produce protective effects against breast cancer. If a physician decides with his female patient for estriol supplementation, the best way seems not to take estriol transdermally as it is hardly or not absorbed through the skin, but orally or vaginally. My experience is with the oral form. It is in this form hardly, if ever metabolized in the liver. The average dose is 2 mg/day. Estriol should be given the same days of the menstrual cycle or month as the estradiol gel. Never give estriol alone as one study showed that it may highly increase the risk of endometrial cancer if no progesterone is supplied.

However, in his book, The Hormone Solution, he says oral estrogen should be avoided as that puts too much stress on the liver, and that estrogen should be taken either as a cream, patches, or vaginally. Of course, that book was written more than a decade ago, and things change...I have been on E cream (Oestrogel) for several years, take the maximum prescribe dosage (two pumps a day applied on thighs or abdomen), but cannot say it's done much for me...I wonder if oral estrogen would be preferable...? Has anyone here successfully taken estrogen? If so, how (cream, patches, pills...)?

33 Replies

I have oral estriol and estradiol (among others) adding up to a total of 2mg- creams didn't work at all, although intravaginal estriol was great for stopping symptoms of vaginal atrophy very fast.

What type of oestrogen is in your cream. He says use estradiol as a cream/gel and estriol orally.

The cream is called Oestrogel and contains estradiol 0.06% gel. I have not found it effective, and was wondering if I should discuss estriol with my doctor.


I take Oestrogen (2.5g estradiol) -2 pumps daily applied to inner thighs, shoulders, abdomen, etc & Utrogestan 100mg 25 days out of a 28 day cycle. I am menopausal and started HRT about 8 weeks ago to improve low mood and volatile emotions.

My oestrogen & progesterone were none existent and testosterone very high. Due to MTHFR issues & iron overload my endo said transdermal was the only way as deemed my liver has enough to put up with ! ! .. It has worked extremely well.

You say you are on the maximum dose but on my canister it says 2-4 measures so 2.5-5.0g daily. Maybe you need a dose increase ? ? ....

I read progesterone should be supplemented with Oestrogel to encourage a shedding of the womb lining so prevent a thickening which may contain cancer cells. I have not bled since being on HRT but I guess it is early days.

Everything I read says transdermal (or patches) is better when there are so many other health issues to consider as (unbalanced) hypothyroidism puts a strain on the liver as it is (hence many on the forum having elevated liver enzymes.)

Do you supplement progesterone ? ? ...

Yes, I am on Utrogestan 200 mg from day 15-25 of cycle, and Oestrogel (two pumps) from day 5-25. When prescribed these, three years ago, I was still having regular periods. They have been acting up lately, coming more irregularly, but they still come...I remember my doctor saying that once menopausal, you take both 25 days a month.

I will look for more info on the manufacturer's website.


I take the gel every day as directed by endo but the instructions leaflet says differently. I have googled & there appears to be different protocols, probably depending on menopausal state.

Maybe you need a different protocol.

Yes, I am seeing my hormone doctor in early August...and plan to raise it then. Thanks for your input, very valuable!

Hi, sorry to crash this, but o had the tabs and gel.. I can finally sleep, but I can't recall her telling me that I had to stop.. I have had no periods for 2 yrs ... I have tried to google this but it seems to give different regimes on how to take.. I've only had it for a month and don't see her til Sept at Barts.. Have you ever heard of having the tabs all the time no break? Again so sorry to crash a thread with a? X😊


If you refer to Utrogestan, no I haven't heard of anyone taking them continuously.

I thought a break was imperative to give the body a chance to bleed, offering opportunity to shed the womb lining and discouraging cancer cells, etc.

My progesterone level was so low my endo has told me to take pills on days 1-25 of each 28 day cycle. I only started HRT at the end of Feb and like you, am now enjoying better sleep ( except tonight ! ! ) ... .. I haven't had a proper period yet, only a very light show.

You could repost your question for a more informed response from others ..... as I say I haven't been taking HRT very long and really knew nothing about it previous as was always so ( ignorantly) anti ! ! . .... until completely desperate ! ! ... ;o))))) .......


Thanks for this... I'd stopped having periods, so the last thing I want is periods... I'm going to have to check this out... Thanks hun x

I was told to take Utrogestan day 15-25 of cycle, and Estrogel day 5-25 of cycle, to imitate normal body function. When you don't take those hormones, you are supposed to have your period-

Thanks I'm going to have a look into this.. I go back in September so I will possibly do as you do untill then...


Today I read on a forum that women who are post menopausal can take Utrogestan every day without a break but I can not find any official literature to support this.

hmmm see what b12 def does to you! I can't recall her telling me stop... I had my last period 2 years ago... I may email and find out... X. Let me know where you see posts re everyday users 😃

My doctor told me the same and that, once menopausal, I will take it daily.

It worked for my self diagnosed VA too, AotN.

This is the gel I use, and have for the past three years...although it says in the package leaflet that it should only be used by postmenopausal women:

Before supplementing hormones, I had asthma, migraine and DCIS - now, as far as I can tell, I don't - so the contraindications on the PIL don't always apply. However, I have also improved my B12 and D status.

I have estriol, estradiol, progesterone and DHEA and take it every day (post-menopause). Sadly, my pituitary seems not to want to spend its time making any hormones - low TSH, low sex hormones, low cortisol ... I tried various Chinese remedies and every Western herbal first, but nothing worked apart from replacing/supplementing hormones. I would have killed myself if I'd had to stay in the state I was in.

I use Wellsprings Twenty to One (Bioidentical Progesterone with added estrogen,) applied vaginally, it healed and turned round my my VA problems straight away, I was amazed.

Sorry to crash what does va mean.


Thankyou. Feel silly. I am 16 months since last period gone through he'll. GPS up and then lower thyroid meds this is making me more insane than menopause. Taking estrogen tablet in vagina as I'm terribly incontinent sorry very embarrassed at 48. Feel ver old. And upset.


Is the oestrogen helping ?

Did GP test sex hormones in order to prescribe oestrogen ? Many members are oestrogen dominent meaning they would need progesterone to be prescribed.

Replacing these missing hormones seems to help members with VA. I take HRT for low mood & hot flushes and the difference is truely amazing.

Thanks for your reply at 3.49 am shouldn't you be asleep. Not sleeping terrible tinnitus. Have a horrible meeting with child's school tomorrow that's playing on my mind. Can I talk to you tomorrow about hormone stuff as I'm so confused as to what is wrong with me is it thyroid or is it hormones. Going round the bend.

Just a thought kjc1tisdell, you mentioned tinnitus, there is a connection of B12 Deficicency with tinnitus. Have you been checked for B12 Deficiency. If you have Low thyroid it can often run alongside, almost identical symptoms to Low thyroid (Hypothyroidism.)

As Radd replied :) VA is worse than dry vagina, I have had both, but not anymore. :)

It's been a while but I hope you are reading this.

I have looked into this product, but I don't understand how to use it as it combines E and P but you don't take both for as many days a month, at least not before menopause. What I mean is that I have been told by doctor to take E from day 5-25 of cycle, and P from day 15-25. I am most likely peri-menopausal at this point (I was put on E and P five years ago). My cycles have always been regular (28 days), but I've noticed lately they are now shorter (24-25 days) which I understand is a telling sign.

It does seem like a very good product with great reviews, so I'd love to try it, I just don't understand how to use it.

I hope someone can explain it to me!

I have read that nobody should ever take hormones as pills, only as cream, which is why I am trying to find an alternative to my prescription P pills (Utrogestan).

Hi there Anna 69.

I have to use this everyday to keep my VA at bay, though there is a recommendation that you leave so many days gap a month, 5 days I think, but if you have VA I am sure it says you can use it more, though check this yourself on the Wellsprings website where it tells you a lot about the cream and how to use it and have a set of questions usually asked by customers.

On my Twenty to One it says you can use it internally, many miss this, I did till my Daughter pointed it out, not sure about the Progesterone only one though. By applying it internally you can feel it being better absorbed, a bit of tingling, but no problem. I don't think there is such a negative with estrogen and breast cancer with the bio identicals as there is with prescribed HRT.

Hope this helps a little Anna :)

Ask more if you need to :) :)


Thank you, yes, that is very helpful indeed:-)

I have been giving this a lot of thought lately. Five years ago, when I first went to see this hormone doctor (a so called Hertoghe doctor), I was told anyone over 40 needs HRT, which of course includes both estrogen and progesterone for women. However, since, I have started to read more, be more critical and, above all, discuss these things with others in the same situation. Sometimes, I believe people here are more knowledgeable than even those so called top doctors...!

I have read, over and over again, that most women can make enough estrogen on their own, as estrogen levels only drop 40-60% in menopausal women compared to what they were in their mid-20s when they are said to be optimal. But progesterone levels can drop by as much as 90% during that same time, which means estrogen dominance is more likely than estrogen deficiency in many women approaching menopause.

The main reason for this is said to be that most women can make enough estrogen from fat, but progesterone only comes from the body itself. Also, unfortunately, it seems a lot of things we are surrounded by contain bad estrogens or estrogen-mimicking substances contributing to this problem...including plastic water bottles. Apparently, we are supposed to limit our exposure to plastic materials as much as possible, but how do you do that in modern society...?!

It makes a lot of sense to me. That your body's progesterone production decreases much more rapidly and drastically than estrogen production, that is, creating a hormonal imbalance which many doctors, unfortunately, diagnose as estrogen deficiency.

I have thought for a long time that since I have been diagnosed with adrenal fatigue, after being hypothyroid for years, I probably need to replace all hormones normally produced by the adrenal glands. However, last month, I decided to experiment and not use Estrogel. I did this because my cycle was only 21 days long, and that is shorter than it has ever been. I said to myself "I am either approaching menopause (after all, I'm 47), or this is related to estrogel". So I did not start Estrogel again on day 5 of cycle. This time, my cycle was 25 days. Granted, only four days longer so maybe not significant in any way, but I feel quite good (I did take Utrogestan from day 15-25), and have had no ill effects from not using Estrogel this last cycle. I have no idea if it's related in any way, but I have been peeing like crazy. Things have finally calmed down but, for a week or so, I had to locate the ladies' room first thing I did wherever I went.

All this makes me wonder if I have been estrogen dominant all along, rather than estrogen deficient...?

I have mainly found this information on US sites, in articles written by MDs, NDs, RNs etc. I am not saying everything in the US is better than here, but the fact remains that there are so many practitioners there who really focus on hormone replacement treatment and get really good at it, and that includes thinking outside the box and using unconventional methods instead of "one size fits all" approaches. I don't know about the UK but, in the Benelux countries, which I know best, it's a disaster...hormone specialists are few and far between, and not all of them are knowledgeable either. My personal experience is also that they are too focused on "one size fits all" solutions. First, they all prescribed Armour until it was reformulated. Then, they switched to Erfa. If you are diagnosed with adrenal fatigue, you are prescribed either hydrocortisone or Medrol, depending on whether or not you tend to retain fluid (in which case you are put on Medrol). Every woman over 40 is supposed to use Estrogel and Utrogestan, etc. I have all of Doctor Hertoghe's books, but I find no mention of estrogen dominance in any of them.

Grey Goose, you know as much or possibly more about those docs than me, so I'd really love your input on this! Am I being unfair...?

Hi anna69, firstly I think you know more about Progesterone and Estrogen than I do, secondly I think you have forgotten to take your B12 supplement today for your memory because I am Coastwalker, not Grey Goose ;) :) but no worries there :) :)

Some of those Doctors in the US seem very good, years ahead in knowledge than our NHS Doctors are allowed to be.

No, just throwing in a question for Grey Goose anyway as she usually answers very quickly:-) I also know that she, like me, has some experience with the so called Hertoghe hormone doctors.

I have been wondering about Wellsprings Twento-to-one cream. You are supposed to use it from mid-cycle to end of cycle, and apply 1/8 teaspoon in the morning and again at bedtime. So: 1/4 teaspoon daily for about 14 days. I wonder how you can know exactly how much estrogen and progesterone you get with each 1/8 teaspoon...? It seems like a very good product, and I am currently considering trying either it or the other Wellsprings product (pure progesterone cream). I am going to carry out a little experiment. I found an interesting article on how to determine whether you are estrogen deficient or estrogen dominant. Once I've found out, I will decide which product to order.

Sometimes, when reading posts here, I get the impression that the situation in the UK is even worse than in many other European countries. I admit being curious about the situation in the Nordic countries; does anyone know...? From what I've heard, doctors only go by TSH, will only prescribe sex hormones if you are clearly deficient (only lab results count, not symptoms), and do not care about symptom relief. It would be interesting to know if I'm right.

Grey Goose definitely knows her stuff :) yes she does have connections with the Hertoghe Doctors.

Sorry I don't know much about adrenals or adrenal medications either, only that once I was optimally medicated with Levo at the time, (now on NDT,) did my adrenal issues of not being able to exercise and feeling worn out all the time disappeared almost over night, but I never used any other type of medication to help my adrenals.

Interesting about your experiment, I like it when people figure it out for themselves, do let us know if it works and you find out which one you need.

The 20 to 1 cream (estrogen) worked straight away and helped my dry eyes, if I forget to take my 20 to 1 both problems come back within a few days, but also I wondered if the progesterone cream would still do the same. I did use bio identical progesterone before, but only used it topically on my skin and felt it wasn't doing much, maybe the trick is to use bio p internally too ? (does it say you can do this on the bio p label ?)

Yes I agree all Doctors should go by symptoms, not rely completely on the unreliable bloods, how many times do we read on here, TUK daily that members go into their Doctors with terrible presenting symptoms only to be told, your bloods are OK, nothing is wrong with you ? Same is happening on other the communities here on Health Unlocked too, many are complaining they are not being helped by their Doctors despite being very ill.

anna69 - I believe 20 to 1 has 3% estrogen in it.

You may also like...