Confused about bio-identical hormones during menopause?

Controversy and clinical insights into the health effects and breast cancer

Today on Couch Talk I am talking with Dr. Edwin Lee. He is a past Couch Talk guest and one of the best physicians I know.

And we’re talking about one of my favorite topics, the use of bio-identical hormones in the treatment of menopausal symptoms in women.

Dr. Lee believes that the best way to treat hormonal imbalance is by natural bio-identical hormone therapy. Natural hormones are the exact and identical hormones that are made in your body (versus synthetic hormones which are not chemically structured the same as in your body).

He feels that the use of bioidentical hormones with estradiol, estriol, progesterone and or testosterone in women is essential, whereas the use of testosterone in men is crucial to prevent early mortality.

Dr. Lee combines functional medicine to determine the root problem with the use of bioidentical hormones to help his patients achieve wellness – along with an emphasis on improving on diet, lifestyle and nutrition.

Listen to the interview:

A great way to kick of Breast Cancer Awareness Month!

It’s the start of Breast Cancer Awareness month, so this Couch Talk interview was very well timed!

We talked a lot about our own patient and clinical outcomes over our decades of combined practices in using bio-identical hormones to treat hot flashes, depression, anxiety, mood swings, vaginal atrophy and other symptoms commonly seen in menopause. We also talked a lot about the confusion relating to breast cancer risk.

In this interview you will learn,
  • Why Dr. Lee tells his menopausal patients that menopause itself is a dangerous disease with a higher rate of Alzheimer’s or dementia, heart disease and osteoporosis…and what he feels they can do to prevent all of this.
  • The importance of both an individual patient’s ability to detox and their current lifestyle (diet, exercise, sleep, etc.) in determining the right menopausal treatment plan for them.
  • Why he doesn’t recommend oral estrogen therapy (Premarin, Prempro) ever be used.
  • Why bio-identical progesterone is truly the “wonder hormone” that helps with sleep, anxiety, irritability, PMS…and more…and how it is protective against breast cancer (and could save your marriage!)
  • Why oral synthetic progesterone (Provera) is a bad choice, clearly linked to increase the risk of strokes and heart disease.
  • Why just taking a hormone is never enough (hint: you need to improve your lifestyle decisions)!
  • What plant-based estrogen SERM (Selective Estrogen Receptor Modulator) Dr. Lee has recommended that helps with hot flashes (and is safe)

And we covered so much more!

Why is it that less than 1% of women who have taken HRT therapy in his clinical practice have developed breast cancer (compared to 11% of women developing breast cancer in the general population)?

We discussed both of our clinical observations as to what the answer to this might be.

Finally, we talked about our “polite disagreements” with the American Association of Clinical Endocrinologists (of which Dr. Lee is a member) recently stating in a position paper that they do not recommend the use of bio-identical hormone therapy in many cases… What? Well...we both feel that endocrinologists already use bio-identical hormone therapy all of the time for standard care with insulin, cortisol, thyroid, progesterone, testosterone, transdermal estradiol, etc.! So what is going on in this position paper? Is it the definition of what is “synthetic” versus “natural”? Is it a bit of bias from the Big Pharm companies? Such an interesting discussion with my favorite endocrinologist!

Meet Dr. Edwin Lee

A little bit about Dr. Edwin Lee, and I hope you’ll listen to our interview in the audio posted above!

He’s board-certified in internal medicine, endocrinology, diabetes and metabolism, and has completed special training in regenerative and functional medicine.

He is an author and an international speaker and educator. Dr. Lee founded the Institute for Hormonal Balance in 2008.Currently, he is the Assistant Professor of Internal Medicine at the University of Central Florida College of Medicine.

In addition to writing his books, including two awesome children’s books, one called, Your Awesome Brain, and the other is Your Amazing Heart—I highly recommend these—he’s written, for those of us that really want to get a better understanding on hormones, a couple of other books.

One is called Feel Good, Look Younger: Reversing Tiredness Through Hormonal Balance, and the book, Your Best Investment: Secrets to a Healthy Body and Mind

Dr. Lee has also published many articles on internal medicine and endocrinology. He is an author in the fourth edition of Textbook of Critical Care. He’s an active member of the Age Management Medicine Group and the American Association of Clinical Endocrinology.

Find out more about Dr. Lee at


Would love to hear any questions that you might have for Dr. Lee…we’ll reach out to him for his response! Thanks for listening!

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16 thoughts on “Confused about bio-identical hormones during menopause?

  1. I really enjoyed listening to the Dr Lee podcast. I had a question about young girls who’ve not started their cycle yet. My 17 year old was given progesterone to start which they were able to make her start. They’d like for her to take birth control to start and stay regular which we aren’t willing to do. She we go somewhere to be seen for this or is it OK to wait it out. I hope this comment box was the place to post questions.

    1. My first question would be is how are her labs and how does she feel? Is she very underweight? Does she have a 21-OH deficiency. And if she doesn’t need birth control that probably is not the right answer. I would start with MightyMaca Plus as many of the ingredients are adaptogenic, make sure she is at a healthy weight, confirm with an endocrinologist that there aren’t any enzyme or developmental issues and enjoy these teen years!

  2. Thanks . I really enjoyed your talk. Please, I get to menopause at 36 after a surgery to remove an ovarian cyst. I have been experiencing vaginal dryness since then. I want to get marry and have children. Is it possible, If yes how?

    1. Thanks for your question. Well I cover my 7 keys to restorative health here: and that will be a good start. Detox regularly and you may benefit from MightyMaca and Purabalance PPr cream…something to consider as you follow an optimal lifestyle. If you haven’t tried Julva (my feminine restorative cream for the vulva) you might want to try it for vaginal dryness…I offer a 7 night trial for free at this link:

  3. I am 67 and had a complete hysterectomy at 39 and 6 months later was hypothyroid. A new endocrinologist has taken me off my compounded thyroid and put me on tirosin. I have gained weight and my hair is falling out. She says the compounded will cause a heart problem. I am interested in bio-identical hormones and thyroid. Do you know anyone near Katy, Texas who I can go see for evaluation.

    1. Hi Robin, sorry for the delay in responding… Look for a physician at the website Please try the recommendations in my articles as well. I wish you the best… I’ll be publishing an article relating to menopause and thyroid health in the near future…a very common problem for women.

  4. Hi Dr. Cabeca,
    I love listening to you and your guests. I would love to be a patient of yours. I am 45, menapausal and in the process of getting HRT by working with a compounding Pharmacy. I have no progesterone or estrogen according to saliva tests and blood tests. My thyroid is very low and I have high testosterone. I would love to find a Dr. that leans to a more natural approach. I live in Georgia, but can’t find a doc near me on the functional doc site. My OB Gyn approved for me to get Bio HRT but I am concerned I won’t be monitored closely or be encouraged in other lifestyle changes. I feel a little overwhelmed with all the data. What would you suggest I do? I thought about doing one of your programs too.
    Thanks for sharing all your expertise with us,

    1. Hi Jodie, sorry for the delay in responding. I’m glad you enjoy my Couch Talk interviews (I do too!)…I hope you will join us in Magic Menopause this coming year. Also look for a physician at the website

  5. Can I use bioidenticals if I have clotting disorders Protein S deficiency and Negative Leiden factor V? Due to these genetic conditions I have to take coumadin daily.

    1. Hi Lis…sorry for the delay in responding…
      You will have to speak with your doctor as only he/she knows your complete medical status and the medications you may be on, etc. Julva cream and MightyMaca are safe options. Take care…

  6. I am totally gun shy when it comes to HRT bioidentical or otherwise due to endometriosis which led to hysterectomy and bilateral oophorectomy in early 2016. Can Juvla alone, help restore my tissues and reduce painful intercourse? I bought some and will try anything that DOES NOT include HRT. Oh, I’m also doing keto diet to the extent I can manage it to reduce belly fat and keep cholesterol in check. thanks for considering this comment.

    1. Hi Again Theresa! So my same comments on your other post apply here… I’ll copy them again so they’ll be with your questions.

      Thank you for your questions. Julva should help and as well with ovarian removal I highly recommend adding progesterone 25 days per month such as my Purabalance PPr cream. Use 1/2 to 1 pump at bedtime. To answer your question regarding ketosis, yet it works, it is just harder for us, no surprise though right? Check your urine with my Keto-pH strips to see if you are alkaline then add intermittent fasting and see how you go. You’d really benefit from my Magic Menopause program too where we have weekly discussions. Please let us know how you do.

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