Diamond Research Foundation a non-profit 501(c)(3)

Transitioning to gonadal hormone replacement for women and men before and after gonadal failure

Maintain your health and well-being by supplementing gonadal hormones as the gonads begin to fail and replace gonadal hormones when the gonads have completely failed.

Talking to your doctor about gonadal hormone replacement before and after gonadal failure

As the levels of gonadal hormones begin to fall, called hypogonadism (peri-menopause in women), illness and loss of well-being begin to appear. For women and men this begins about age 30 when progesterone and testosterone levels begin to decline. The symptoms of hypogonadism are the same in women and men.

As the gonads continue to produce less and less hormones hypogonadism progresses to profound hypogonadism (menopause in women). Treatment should begin with gonadal replacement. For gonadal hormone replacement you can use pre-packaged products i.e. Androgel or Prometrium or hand-made (compounded) creams as all of them are FDA approved. Gonadal failure causes multiple hormones deficiencies so complete replacement regimens include replacement of all of the gonadal hormones.

The following information is a summary of observed physiologic levels of gonadal hormones while the gonads are functionaing appropriately. Like treatment for all other replacement regimens, levels are age independent. It is never too late to start treatment and a person is healthier with treatment than without. Whether you are supplementing or replacing, the final ratio of gonadal hormones should remain the same.

As new data becomes available on gonadal replacement products and healthy levels, this table will be updated.

Treatment is life-long

If at any time you stop treatment the ill health of hypogonadism will return. Untreated hypogonadism will complicate any other medical condition.

For testosterone and estradiol replacement use only skin cream, gel or lotion. Estradiol:estrone ratio should be 1:1. If lozenge or drops under tongue are used ensure this ratio is maintained. If not, use transdermal methods.

The only reason to use any oral estrogen is to significantly lower free testosterone and increase SHBG. As sex hormone binding globulin increases all free androgens become less available by approximately 50 %.

All oral estrogens are also anti-androgens.

Progesterone is an important gonadal hormone for women and men and the lack of a uterus should not deter treatment. Transdermal application is better than oral.

Using sub-physiologic or below normal levels does not treat hypogonadism.

Always start with the lowest dose and increase as needed to physiologic levels.

Estradiol:Estrone ratio should be approximately 1:1

Estradiol:Testosterone should be approximately 1:10 for women and 1:200 for men

Transitional estradiol replacement products
To be used prior to ovarian failure

Replacement estradiol products and dosages
To be used after ovarian failure

Oral estrogen/anti-androgen preparations

Premarin, Prempro, Cenestin, Estratab, Menest, Estratest, all birth control pills, any estrogen containing pill