2026-05-19 - How to Find Relief Call with Dr. Tracy Page Transcript
In this live Q&A call, Dr. Tracy Page, a functional and integrative medicine physician, answers audience questions about perimenopause and menopause management. The discussion covers the role of intrauterine devices (IUDs) and progestin, the importance of progesterone replacement for sleep and mood, testosterone’s impact on vitality and libido, estrogen thresholds for symptom relief, comprehensive thyroid testing (TSH, free T3/T4, reverse T3, antibodies), adrenal support (DHEA), vitamin D optimization, PMDD and neurotransmitter balance, recommended lab panels (hormones, thyroid, insulin, lipids, CRP), fasting protocols for labs, practical dosing ranges for bioidentical hormones, safety considerations (beard growth, clotting risk, blood thickness), GLP‑1/GLP‑2 weight‑loss agents and their interaction with thyroid disease, and how to navigate primary‑care providers versus functional‑medicine specialists. Dr. Page also shares clinic logistics (licensure, telehealth, expansion) and provides actionable take‑aways: check FSH to decide on IUD removal, keep estrogen >60 pg/mL, aim for progesterone ~300 mg nightly, keep free testosterone in the middle‑high physiological range, monitor thyroid “four‑tires” plus antibodies, maintain vitamin D 70‑80 ng/mL, and use a 12‑hour fast for hormone panels. The tone is conversational, supportive, and optimistic, encouraging women to take ownership of their labs and hormone health.
Topics
IUDs, Progestin, and Hormone Decision‑Making in Perimenopause
Explains how intrauterine devices deliver local progestin, their limited systemic effect, and how FSH levels guide whether to keep or remove the IUD during menopause transition.
Progesterone Replacement: Sleep, Mood, and Dosage Guidelines
Details why progesterone is the primary sleep‑promoting hormone, recommended nightly doses (100‑300 mg), timing relative to irregular periods, and its interaction with estrogen and testosterone.
Testosterone in Women: Vitality, Libido, and Safe Dosing
Describes the physiological decline of testosterone, its effects on energy, focus, and sexual desire, and provides safe physiological dosing ranges (2.5‑10 units) while addressing concerns about facial hair and blood viscosity.
Estrogen Thresholds for Symptom Relief and Brain Health
Advocates maintaining estradiol >60 pg/mL (ideally 60‑100) to alleviate hot flashes, improve sleep, support cognition, and reduce disease risk, countering outdated WHI findings.
Comprehensive Thyroid Panel – The ‘Four Tires’ Approach
Recommends testing TSH, free T3, free T4, reverse T3, plus TPO antibodies to capture hidden thyroid dysfunction that can mimic menopausal symptoms.
Adrenal and Vitamin D Support: DHEA and 70‑80 ng/mL Target
Highlights DHEA as an adrenal reserve indicator and vitamin D as a ‘happy hormone’, with suggested optimal serum levels and their impact on fatigue and mood.