Can You Take HRT If You’ve Had Endometriosis? | PYHP 167

In this episode, Dr. Valorie Davidson and Dr. Robert Maki respond to a great listener question from April, who’s navigating hormone replacement therapy (HRT) while dealing with a history of endometriosis, polyps, and chronic cramps.  April’s experience is all too familiar: spotting, cramping, hormone experimentation, and the frustrating search for symptom relief. So, can women with endometriosis safely use HRT—especially estrogen?  The answer: Yes, but it has to be customized.  �� In this episode, we cover:  Why HRT is absolutely possible for women with endometriosis—but must be individually tailored  The difference between static vs. rhythmic dosing and why rhythmic HRT may be better tolerated for some women  Dr. Davidson’s personal story of having endometriosis, cysts, and polyps—and how she now uses rhythmic dosing herself without flaring  The important role of progesterone in managing endometriosis and minimizing estrogen reactivity  How to approach spotting, cramping, and cyst formation during HRT ● Why estrogen isn’t the enemy—but why it must be dosed thoughtfully  ✉️ Here’s April’s full question:  “Hi—I am a 57-year-old woman in perimenopause. My question is: is it possible for women with endometriosis or adenomyosis to do HRT?  I started oral progesterone 2 years ago, got as high as 300 mg, but didn’t get much symptom resolution. Switched to a progesterone troche—50 mg morning and night. About 3 months ago, I added testosterone (0.25 mg once daily, 5 days/week) and Biest 80/20 (1 ml daily, can go up to 2 ml).  Everything was good for a while, but now the cramping and spotting have returned. I’ve had heavy bleeding as long as I can remember. My main complaint is menstrual cramps throughout the month—not just during my period. I do not have fibroids, but I’ve had many cysts and polyps over the years and have had many ultrasounds and transvaginal ultrasounds because of this.”    If you have a question, please visit our website and click Ask the Doctor a question.   Want more insights like this?  Be sure to subscribe to our newsletter for hormone Q&As, educational guides, and real-world strategies to help you feel like yourself again—especially during perimenopause and menopause. Join the Progress Your Health Newsletter   Stay Connected Instagram: @drvalorie TikTok: @drvaloried Join the Hormone Community: