I started bioidentical estradiol in Oct 2011 at the lowest dose of the Viville dot. After two weeks, my symptoms weren't better so my doctor upped the dosage to next level. That pretty much took care of things. Then I was to add in progesterone and that was and is still a balancing act. I started on an oral prometrium and hated it so switched to a compounded cream. Again I started low and worked up. I am still trying to figure out the right dosing for this. Until things are worked out, I test every three months but what I've found is that you also have to take into consideration your symptoms.

For me, I find the progesterone messes with me so I may end up cycling this one. Progesterone cream seems to build up in me and throws all my hormones into a flurry. So now I know what to look for and back off. The problem with hormone replacement is that your levels are never static naturally so a static dosing of the replacement of them is not an exact science.

My OB/GYN is overseeing this for me and she prefers bio-identical hormones. You can find a doctor who deals with them by calling a local compounding pharmacy and asking them for some doctor names. It can take time to find the right product and dose that works for you. And since you have thyroid issues, it may take a while longer.

But start low and go slow.

Regarding testing..... some doctors only believe in blood serum test while others prefer to monitor levels once on HRT via saliva tests. I'm doing both and find even though I may fall into a normal range, that does not always translate to being the right balance for me. So you really have to advocate for yourself.