Physiologic estrogen: my preferred approach to HRT for healthy longevity | Felice Gersh, MD

In this talk, I discuss both the typical low dose static approach to HRT and my preferred approach, physiologic cyclic.

I explain the benefits, short-comings, and downsides of the low dose static approach and the benefits and drawbacks of physiologic cyclic. Also, there IS data that dose matters and that cyclic is safe. Many of the cornerstone hormone studies, including the ELITE and KEEP studies, were done with cyclic hormones. It was the WHI that used low dose cyclic so how that became the go-to, well, it's because it's the easiest approach, not the best.

In this talk, I cover:
What physiologic means
Why we want enough estrogen to create growth factors
Why growth factors will grow the uterine lining
And how we can use that as a sign that growth factors are working throughout the body

And finally, why physiologic estrogen requires cyclic progesterone that induces a monthly period-like bleed. "If you grow it, you must shed it."

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I am a full time practicing doctor. I see patients in my office in Irvine, CA and worldwide via telemedicine. If you need more healthcare assistance than I can provide in a video series, please contact my office:
https://integrativemgi.com/​​

---- Contents of this video --------------------------

00:00 - What is physiologic estrogen?
03:11 - Basic benefits of low dose static HRT
07:09 - No monthly bleed
08:30 - Healthy longevity
10:21 - Benefits of physiologic dosing
12:45 - Replicating the menstrual cycle
14:46 - My approach to physiologic dosing
16:07 - Dose matters
17:16 - The uterus isn't a target of HRT; it's a bystander
20:40 - Grow factors and cellular rejuvenation
22:15 - The role of progesterone
24:50 - Low dose static is unnatural
27:46 - Physiologic recreates the body's natural hormonal state
30:07 - Studies that support cyclic