# STEROIDS FORUM > HORMONE REPLACEMENT THERAPY- Low T, Anti-Aging > HORMONE REPLACEMENT FOR *WOMEN* >  Female HRT Best Practices

## mark2014

This post is for my wife, Alice. I'm a 45 year old male who's been on TRT using T + HCG + AI with really great results. Now that my libido and energy have been restored, it's become clear that Alice's libido and energy levels are low. She is 46 years old, pre-menopausal and uses a Mirena IUD (no birth control pills). I think the IUD makes it so she only gets a period every few months and it's pretty light. She takes synthroid and has the dosage under control. She has a very busy life with a demanding job and two young children. She feels tired a lot and has low libido.

She recently went to a GYN who gave her Estrace cream and also a compounded Testosterone cream. But this GYN did not do any labs, which didn't sound right to me. So, before starting the creams, Alice did a self-ordered set of labs through lef.org and here are her results from LabCorp with the reference ranges:

Total T 19 [8 - 48]
Free T 0.4 [0.0 - 2.2]
DHEA-S 146 [41 - 244]
E2 82 [various ranges provided based on phase]
Progesterone 0.4 [various ranges provided based on phase]


Are her labs consistent with having low sex drive?

I'm seeking advice and I'm particularly interested in knowing the current best practices or typical protocol for females doing HRT. What are the optimal/target ranges? What are the typical/average doses? For each hormone, what are the symptoms of it being too high or too low? Is there a recommended order for introducing hormones?, like maybe "start with only exogenous estrogen until serum E2 levels are roughly between ... and ... and symptoms of X, Y and Z are improved, then add testosterone usually starting at ... mg per week with an optimal Total T between ... and ..., then consider supplementing with DHEA, etc. etc."

Any advice would be much appreciated. I got one of Suzanne Somers books and it has some good information including an overview of the Static vs. Rhythmic cycling. I'd like some more specifics. Seems like there's tons of information available for males, but not much for females.

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## BengalWoman

Her free T is close to 2% of the serum. That is about the right range, which is factored with SHBG. A lot of A4M physicians with female BHRT experience will aim to get serum levels in healthy females in the 40ng/dl to 65ng/dl range. Her 2% free test would be very good once the serum is in the optimal zone. 4mg to 6mg per week of testosterone cypionate keeps me in that 50ng/dl range. I prefer the Keto7 DHEA, not wanting additional androgen conversion downstream, which is unwanted in maintaining effective balance with my BHRT regiment.

Being perimenopausal, she is likely experiencing other imbalances, which ultimately lead to estrogen dominance. Good chance at this stage her iron level and B12 is declining, and the process will effect the cortisol production with the adrenals, and quite possibly aldosterone. Both of these factors will inhibit T3 into the cells. It would be good to have her post all of her labs, including a complete thyroid panel with free T4, free T3, reverse T3, TSH, and antibodies. Synthoid is a synthetic T4 only medication. Back to the A4M doctors, most up to date in anti aging will offer NDT, like Armour, which is natural T4,T3,T2,T1 & calcitonin (harvested from pigs, but effective in humans. Ratios are a little different, but that can be adjusted with T4 if needed). Reverse T3 compared to free T3 will help let her know if T3 is active or pooling.

Have her read up on Dr. Uzzi Reiss. His book, Natural Superwoman, is the type of material she is looking for. Rhythmic protocols tend to work nicely when administering progesterone and keeping the body in a steady pattern. It takes a little patience with administering the correct amounts of medication throughout the cycle pattern of the month, and taking the break as detailed by the physician. Static protocols are easier to manage, but it doesn't allow the body to mimic a normal function. Still, that works for plenty just fine. It's just one's preference.

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## Times Roman

> Her free T is close to 2% of the serum. That is about the right range, which is factored with SHBG. A lot of A4M physicians with female BHRT experience will aim to get serum levels in healthy females in the 40ng/dl to 65ng/dl range. Her 2% free test would be very good once the serum is in the optimal zone. 4mg to 6mg per week of testosterone cypionate keeps me in that 50ng/dl range. I prefer the Keto7 DHEA, not wanting additional androgen conversion downstream, which is unwanted in maintaining effective balance with my BHRT regiment.
> 
> Being perimenopausal, she is likely experiencing other imbalances, which ultimately lead to estrogen dominance. Good chance at this stage her iron level and B12 is declining, and the process will effect the cortisol production with the adrenals, and quite possibly aldosterone. Both of these factors will inhibit T3 into the cells. It would be good to have her post all of her labs, including a complete thyroid panel with free T4, free T3, reverse T3, TSH, and antibodies. Synthoid is a synthetic T4 only medication. Back to the A4M doctors, most up to date in anti aging will offer NDT, like Armour, which is natural T4,T3,T2,T1 & calcitonin (harvested from pigs, but effective in humans. Ratios are a little different, but that can be adjusted with T4 if needed). Reverse T3 compared to free T3 will help let her know if T3 is active or pooling.
> 
> Have her read up on Dr. Uzzi Reiss. His book, Natural Superwoman, is the type of material she is looking for. Rhythmic protocols tend to work nicely when administering progesterone and keeping the body in a steady pattern. It takes a little patience with administering the correct amounts of medication throughout the cycle pattern of the month, and taking the break as detailed by the physician. Static protocols are easier to manage, but it doesn't allow the body to mimic a normal function. Still, that works for plenty just fine. It's just one's preference.


wazzup BW....
....riding season is almost here! =)

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## GirlyGymRat

sadly its not uncommon for OBGYNs to skip labs completely or do partial BW. Test cream was ordered for me after a hysterectomy and did absolutely nothing for me. my lidibo and energy issues were addressed with generic version of estratest. libido restored but not without consequences. hormonal acne is small price to pay! 

Bengal Womans advice is strong. i am going to download the book. Thx for sharing. Nice to see you around! Been missing your awesome posts!  :Smilie:

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