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Well this one’s a talker!
Dr. Felice Gersh is a dual board-certified OB-GYN and integrative medicine physician here to talk about Rhythmic Physiologic Dosing (RPD) – and what she believes is wrong with the current approach of “low, static” dosing of hormone therapy.
As I’ve learned, there are multiple ways to prescribe hormone therapy and
they often contradict each other.
In my efforts to explore them, I had Dr. Felice Gersh on the Hotflash inc Podcast this week. Dr Gersh is a dual board-certified OB-GYN and integrative medicine physician who has been in the trenches of women’s hormonal health for decades.
She was there when the first patches came on the market. She was there before the Women’s Health Initiative changed everything. And she has been watching, adapting, and refining ever since.
What she’s doing is called Rhythmic Physiologic Dosing — RPD — and it’s based on a deceptively simple question: if you’re going to replace hormones, why wouldn’t you try to mimic how a healthy young woman’s body actually produces them?
For Dr Gersh and those who prescribe like her, this is is hormone therapy for longevity. She takes me through the logic, the doses, the safety, the studies (there aren’t many) and what she’d like to see in the future.
This is a genuinely fascinating hormone conversation and I’m sure it’s going to be triggering for a lot of people.
Highlights
07:40 – What “regular” HRT looks like vs. RPD
12:00 – Her argument why “lowest dose” makes no sense
15:00 – Why measuring estradiol blood levels matters
19:52 – Yes, you will have a bleed — that’s the point
21:00 – Growth factors, the brain, mitochondria, and estradiol
27:00 – The case for endometrial ablation as an option for RPD patients
31:31 – Vaginal and rectal progesterone — why it matters 38:00 – Progesterone intolerance — what’s going on
43:39 – The tissue hormone argument — and why it doesn’t pick up the slack
54:47 – Is this safe?
55:35 – The future: hormone pumps and new ovaries
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Disclaimer
This podcast is for informational purposes only and is not a substitute for medical advice. Always speak with a qualified healthcare professional before making changes to your treatment, supplements, or lifestyle.
