So you’ve been on bioidentical hormone replacement therapy for a few years. Everything was peachy. You felt good. Hot flashes stopped. You could sleep through the night. Your moods were stable. No more brain fog.
But now you’re having hot flashes again. And night sweats. And you can’t sleep. And you’re peeing yourself every time you laugh. Which is no laughing matter! And your emotions are all over the place. Feels like puberty all over again. But worse, because you have no sex drive and your vagina is dry as a desert.
Oh, my goodness! Can your bioidentical hormones and replacement therapy (BHRT) stop working? YES!
But don’t worry there’s something you can do about it...
First, let’s discuss why your bioidentical hormones might stop working.
Your hormones work by getting into your cells via little doorways called receptor sites. Here’s a sex steroid receptor site.
When your receptor sites are no longer sensitive, your hormones can’t get in. We call that receptor site resistance. You may be familiar with insulin resistance. Your cells can become resistant to your sex hormones too.
Why?
Well, your cells never were exposed to the same amount of hormones all the time. When you’re still in your reproductive years having regular periods, your hormones fluctuated throughout your cycle. And at least three days a month starting on the first day of your period, you got a break from estrogen, progesterone, and testosterone. That’s nature’s way of preventing resistance.
Here’s an example of how cell receptor site resistance works.
Let’s say you’re sautéing onions. Your partner walks into the kitchen and says, “Hey, you’re burning the onions!”
You check and sure enough the onions are burning. Why did your partner notice and you didn’t? Because your olfactory receptor sites were saturated by the odor of cooking onions. And your partner’s olfactory receptor sites were completely open, so they smelled what you couldn’t. The same goes for hormone receptors.
It’s just like opiates. You keep using pain meds all the time and you quickly develop tolerance, so you need more and more to get an effect. Eventually they don’t work.
Take a Break
So the moral of the story is... to prevent receptor site resistance, you need to take a break. Specifically three days off every month. That will clear your receptors and allow your hormones to keep working for you. Otherwise, you have to keep using more and more to get an effect, and eventually your hormones will stop working.
So what if it’s too late? Your BHRT doesn’t work anymore. If you’re under 60, then taking a three-week break from your hormones will help clear your receptor sites. Then restarting them should give you similar relief as when you first began your hormones.
Support cell receptivity
You can also increase your dose of Genesis Gold® by 4gm (about a teaspoon) over your body weight (4gm per every fifty pounds) to enhance cellular receptivity and help you metabolize your sex hormones more safely. Whenever I take a break, I add a teaspoon of Sacred Seven® amino acids to my Genesis Gold® to help mitigate the hot flashes and moodiness associated with hormone withdrawal.
Why suffer? I know it’s hard to be off your hormones for a few days, but developing resistance is even harder. So best to prevent it by taking a three-day break from your BHRT every month.
What if you’re over 60 and all of a sudden your BHRT isn’t working?
Well, that’s a little different. Older women still need a three-day break. But now they’re in adrenopause. I like to refer to it as the second menopause. During the ten to fifteen years of menopause, your adrenal glands usually produce enough DHEA that converts into testosterone and then into estrogen, effectively supplementing your BHRT.
Over 60, stressed out
Once your adrenals slow down with age or poop out from stress, it feels like you don’t have enough sex hormones on board. You begin having hot flashes, night sweats, and insomnia all over again. So not only do you need to clear your sex hormone receptors, you need to add adrenal support.
Taking Genesis Gold is an excellent way to support your adrenals. If stress is high, you may need to take a little extra-adrenal glandular for a few weeks. Just don’t take glandular longer than a few months. Glandulars stop working and your liver will treat them as a toxin.
BHRT is NOT WORKING
- Hot flashes
- Night sweats
- Insomnia
- Depression
- Anxiety
- Brain fog
- Low libido
- Dry vagina
BHRT IS WORKING if...
You sleep through the night without night sweats.
Your body temperature is normal, no hot flashes.
You have a good sex drive and a juicy vagina to go with it.
Your moods are stable, neither depressed or anxious.
Your memory is good.
Q: Why do bioidentical hormones stop working?
A: Bioidentical hormones can stop working when the body’s hormone signaling system—especially the hypothalamus—is no longer responding properly.
Q: Does increasing hormone dosage fix the problem?
A: Increasing dosage doesn’t always help and may worsen imbalance if hormone signaling, not hormone levels, is the underlying issue.
Q: What is hormone resistance?
A: Hormone resistance occurs when tissues stop responding effectively to hormones, even when levels appear adequate.
Q: How does the hypothalamus affect hormone therapy?
A: The hypothalamus regulates hormone signaling throughout the endocrine system, so dysfunction can interfere with how hormones are received and used.
Q: Can stress affect how bioidentical hormones work?
A: Yes. Chronic stress can disrupt hypothalamic signaling and alter how the body responds to hormone therapy.
Q: Is it normal for hormone therapy to stop working over time?
A: Some people experience reduced effectiveness over time, often due to changes in signaling, stress load, or overall hormonal regulation.
Q: What should you consider if hormones stop working?
A: It may be helpful to evaluate lifestyle factors, stress, sleep, and hypothalamic support rather than focusing only on hormone dosage.
Do you have an email address in which I ca contact you? I am having issues with my bhrt and would like to speak with you. Merrel Bowles. 770-827-1985
You can get information regarding patient consults here https://genesisgold.com/full-circle-family-health/
Hello I have few question can u. Contact me at my email please
I am a 69 year old female that had a hysterectomy at age 28. I have been on and off hormones since hysterectomy. the creams stop working,so i tried the pellets insertion of Bio-identical hormones in my buttocks. worked for almost 2 years but have stopped. Recently had new insertion of pellets. had bloodwork done 6 weeks following insertion of pellets. All hormone in bloodwork show that they are too high. I am experiencing symptons of hot flashes, cant sleep, heart palpitations, vaginal dryness, NO LIBIDO. I am married and my husband and i still have a decent sex life. what can I do to help my receptor sites so the hormones will work better. I cant get off of them since they are inserted in my buttocks. I do know that I will not be getting them until at least 6 months. My doctors said i was hormone sensitive and nothing he could do. Can you help
The best way for me to help you is for you to sign up for my Menopause Action Plan workshop https://genesisgold.com/mapworkshop/
I’ve been on pellets for about 5 years. When I started, gained 10 immediately which was muscle. Great, because I lost muscle and weight from having no hormones. Now my estrogen and testosterone are too high and I’ve gained an additional 10! Plus big puffy bags under my eyes. Also, twice I’ve expelled my pellet. The last one I expelled was 3 months old and only halfway dissolved.
I am not a fan of pellets for menopausal hormone replacement therapy
Here’s my take on pellets from my Menopause Action Plan book, have you read it?
https://genesisgold.com/books/menopause-action-plan/
Twenty years ago, I had a few patients interested in trying pellets for hormone replacement therapy, so I did a little research. Pellets use bioidentical hormones, and are created in a compounding pharmacy so I could individualize the dosing. Pellets weren’t good at delivering progesterone, so we still had to use progesterone in a different form, usually transdermally.
The issue I found with pellets is first, you need to have them injected every few months. Number two, we cannot control the amount of hormones you’re going to absorb. Even though pellets are compounded to the prescriber’s recommendation, some women’s bodies suck the hormones out quickly, giving them super high levels initially, which may give them extreme side effects, but then the effects wear off. Some women barely get any hormone from the pellets, and so it lasts a long time in their system. We can’t control it. So if it’s not going to work for you, you’re stuck with those pellets until they dissolve, which could take three to five months.
Although I’m not a big fan of pellets as a form of hormone replacement therapy, it’s an easy way for providers who don’t know much about how to prescribe hormone replacement therapy to send their patients’ blood work to the pellet company and have the pellets compounded for that particular patient. The problem is that blood work does not always reflect your hormone needs, determined by your symptoms, your risk factors, or your history. Your pituitary FSH and LH are more reflective of how much of each hormone you need at any particular point in the change. I don’t go by your blood levels of estrogen, progesterone, and testosterone to determine the dose of hormones you’re going to need, because your tissue levels and what’s floating around in your blood are two different things. Since the dosages cannot be adjusted for at least three months, I don’t use pellets in my patients.