Dear Pharmacist,
How does the doctor know how much estrogen to prescribe?

The doctor doesn’t know the exact amount at the beginning . The doctors have protocols and guidelines as to where to start and with what dose, but it also depends upon you, the patient, to help with these decisions. Are you having severe hot flashes? Night sweats? Is insomnia your main problem? Vaginal discomfort? Emotional ups and downs?

Communication is the key to treatment. You have to describe your symptoms to your doctor so she/he has a place to start. Take in your symptom diary. Prescribing estrogen for night sweats is certainly different than prescribing it for vaginal atrophy. Your doctor will treat your symptoms until they are relieved with the lowest possible dose of estrogen . Make sure to give them your feedback both positive and negative. Be collaborative!


Meet Deborah Kerr. She's a huge advocate for patient-focused healthcare. After twenty years of store management in community pharmacy, and ten years of corporate management for independent pharmacy, she developed an itch. The more she scratched, the more it spread. Why does menopause take so many women by surprise? Why does it have the ability to impact relationships, and families, and workplaces. It's insidious. She found herself shouting, "there has to be a better way".

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