It happens to all of us, you read the instructions then you lose them or can’t remember exactly what they said when you need to apply your cream.
This is one of the most common questions I am asked, so I devised a simple regime for myself that I thought would be helpful to share with you, and of course you can adapt it to suit your own needs.
Firstly, do remember that everyone is different and your response will be as unique to you as are your symptoms and their severity. Some women require more hormone cream to help alleviate severe symptoms, while others can use less.
However it does make sense that everyone starts off with the same dosage and then monitors their symptoms. So if you are new, make sure you begin with the recommended double dose of a quarter teaspoon twice daily for the first month of use to establish good hormone levels.
After the first month if your symptoms are coming under control you can go on to the maintenance dose of an eighth teaspoon and once they are fully controlled then try cutting back on the amount each month and monitor your symptoms.
If your symptoms return then go back to a slightly higher dose as that is what you need at that time and again try cutting down later in a few months.
You start using the cream from days 14-28 of your cycle if menstruating regularly (depending on your cycle length) or for 24 days on and 6 off each month if periods are irregular or stopped. You would stop using the cream during the 24 days if you get a bleed and recommence when it stops.
A simple application routine
All hormone creams should be applied with a light hand, they do not need to be rubbed in vigorously, and the latest findings indicate that it is best to use both thin skinned and fatty tissue areas for maximum hormone absorption.
Suggested application areas
The best application areas are: the face, neck, palms of the hands, inside of the upper arms, lower back or inner thighs for thin skinned areas and buttocks, lower arms, outer thighs and stomach for fatty areas.
These areas are used as they vary in absorption rate. The fatty areas have slower absorption and therefore stay longer in the body, but the thin skinned areas are absorbed faster and are effective sites to use for hot flushes in particular.
So if your flushes are mainly during the day, use the thin skinned area in the morning, but if they happen at night then apply to the fatty tissue area in the morning.
You also need to apply to a different area each day, so you rotate round the body. Also, for maximum effectiveness, apply to a thin area in one application and a fatty area in the next one. Keep up this alternating pattern.
As an example, apply it twice to your left arm on Monday (upper arm is fatty tissue and lower inside arm is thin tissue) and then work down your body one side and back up the other as in the example below:
Monday: left arm lower inside morning and upper arm evening.
Tuesday: left thigh outside morning and inside evening.
Wednesday: left side of stomach morning, left buttock in the evening.
Thursday: right thigh outside morning and and inside evening.
Friday: right side of stomach and right buttock as before.
Saturday: right arm lower inside morning and upper arm as before.
Sunday: face and neck
You do not have to follow this routine exactly, just make sure you cover the different areas so you get the maximum hormone absorption to deal with your symptoms.
An alternative method
Many women suffering from vaginal dryness, or who have skin absorption problems, find it helpful to apply the cream internally to the vagina as either the only site to use or as as part of the above regime. This method is particularly recommended by Dr Mercola of the USA. He comments:
“If you apply the cream to your mucous epithelial membranes that line your uterus and vagina you obtain a virtually ideal administration system as hormones absorbed through your vaginal membranes enter the very same pelvic plexus of veins that your ovaries normally empty into.”
With this method you do not need to take a monthly break, but many women find they prefer to mix the two methods. By using skin in the morning and vaginally at night you can then take a much shorter break of only 3 days, rather than 6 as in the skin method.
Application routine for men
As more men are using bioidentical progesterone cream to offset the flushes from cancer treatment, or to proactively oppose oestrogen dominance, they have a slightly different method.
They would use the following sites in rotation: face, throat, back of the neck, inside thighs, inside upper and lower arms, stomach and palms of the hands. This give you 7 sites for a different area each day and the cream only needs to be applied once daily.
Do I really ned a break?
The answer to this is yes if you are using skin application. Whatever your circumstances, whether you have had a hysterectomy or very irregular periods, it is very important to take the break to allow the skin receptor sites time to rest and prevent the chance of you overusing any single one.
If you do not take the break you run the risk of actually absorbing less hormone to deal with your symptoms as once that site is ‘full’ it can’t take the hormone and use it as it can when applied in rotation.
If you find you are forgetful and don’t always remember to apply twice daily in rotation then perhaps vaginal application might be better for you.
You will find your own method, but I hope this proves helpful as a place to get started.