Dearest:  It would take an hour to give you tonight's guest's credentials, so 
briefly, Erika Schwartz, M.D. is a healthcare pioneer, a woman's physician, a 
researcher and expert on all things hormonal. Dr. Schwartz is the author of two 
books, "Natural Energy," and "The Hormone Solution." She has appeared on TV shows 
like The View and has been quoted in Newsweek, Vogue, The Wall Street Journal, USA 
Today and Self Magazine, fielding queries about hormones and stress, hormones and 
aging, hormones and the life cycle.

Montefiore Medical Center sponsored and aired a four-year television program produced 
and hosted by Dr. Schwartz, Health Horizons, the first program in the greater 
metropolitan NY area directed at bridging the information gap between physicians and 
patients.

Dr. Schwartz has a true passion and commitment to empower and educate women to be
the healthiest they can be. She's been practicing medicine for 20 years and 
specializes in women's health.  

 
Dr. Erika, it's great having you back in Power Surge. 
 
 
Erika Schwartz, M.D.:  I am blushing. 
 
 
Dearest:  Nah 
 
 
Erika Schwartz, M.D.:  You are too kind. 
 
 
Dearest:  Don't blush. 
 
 
Erika Schwartz, M.D.:  OK,  I'll just answer all questions. 
 
 
Dearest:  I'd like to start off with a little free association, if you're game. 
I'll give you a word or phrase (i.e., name of a medication, medical condition,
et al), and you tell me the first thing that comes to mind. Also, if you'd care
to elaborate on it, please feel free to do so. 
 
 
Erika Schwartz, M.D.:  Good 
 
 
Dearest:  Ok.  Dr. Erika, you can give me a one word answer, or a description, 
whatever comes to your mind. 
 
#1: PremPro 
 
 
Erika Schwartz, M.D.:  A bad synthetic drug that spent too much time in our systems 
and consciousness  and has stopped us from getting informed on issues of hormones.  
 
 
Dearest:  #2: synthetic hormones 
 
 
Erika Schwartz, M.D.:  Substances foreign to our bodies, impostors that replace our 
hormones and often times  wreak havoc in our systems. 
 
 
Dearest:  #3: Bio-identical hormones 
 
 
Erika Schwartz, M.D.:  Hormones that are molecularly identical to our own hormones,  
that gently supplement or boost the missing or out of balance hormones in our bodies. 
They look and act exactly like our own hormones but are made from yams and soy oils 
and are processed and concentrated by pharmaceutical processes to allow our bodies
to use them as their own hormones. 
 
 
Dearest:  #4: Premenopause, perimenopause, postmenopause 
 
 
Erika Schwartz, M.D.:  Labels given by conventional medicine to times in our lives 
when our hormone balances aren't working well and thus need to carry a diagnosis
to get treated.
 
 
Dearest:  Labels for what?  Elaborate, please. 
 
 
Erika Schwartz, M.D.: I personally believe these labels should be eliminated and we 
should focus on how we feel regardless of age or label/diagnosis. 
 
 
Dearest:  Thanks, Dr. Erika :) 
 
 
Erika Schwartz, M.D.:  My pleasure.
 
 
TMM:  I am having hard time adjusting the dosage of estrogen and progesterone. 
(I increased the estrogen too much and I got too revved up and raised my blood 
pressure last month so I was more cautious this month but) I tend to get a lot
of panic attacks along with other symptoms (dizziness, shortness of breath,
weakness, palpations) ESPECIALLY the last week before my period. Is a panic
attack an indication of too much progesterone or too or too little estrogen? 
 
 
Erika Schwartz, M.D.:  A panic attack is the result of an imbalance between many 
hormones.  Estrogen and progesterone are only two in a rather complex dance.  Your 
balance of estrogen and progesterone is very important and I hope you have a good 
physician helping you figure out how best to accomplish the dosing.  Estrogen alone  
may increase the anxiety yet progesterone alone may not be the balancer you need.  
Get some good help.  
 
 
Dearest:  TMM, what kind of estrogen and progesterone are you taking?
 
 
TMM:  E3-3mg E2-1.5mg Progesterone 200mg (in duragels) per day, all natural.  
 
 
Erika Schwartz, M.D.:  You are taking a lot of both estrogen and progesterone.
I would reconsider the balance.  
 
 
TMM:  OK, I will talk to my doctor. Thank you very much.  
 
 
Erika Schwartz, M.D.:  My pleasure, hope you feel better fast.  
 
 
TMM:  I wasn't aware they were high (These are topical).   
 
 
Jan9:  I had a hysterectomy 3 years ago and was on 5mg. estradoil and now the
doctor has me tapering off them. I am now on .5mg and I get hot flashes day and 
night. I also use progesterone cream should I start taking Revival? What course
of action should I take? Sorry this is my first time! 
 
 
Erika Schwartz, M.D.:  Jan9, you need both estradiol and micronized progesterone.
You need to have them balanced.  Taking soy protein alone will not help. 
 
 
Jan9:  Why not natural progesterone? 
 
 
Erika Schwartz, M.D.:  Taking a combination of soy, estradiol (in lower doses) and 
progesterone will accomplish the goal. 
 
 
Dearest:  Okay, Dr. Erika, you mentioned estradiol and micronized progesterone.
Why, when you prescribe natural hormones, don't you include estriol?  
 
 
Erika Schwartz, M.D.:  Estriol is a weak estrogen most abundant during pregnancy.  
All the studies on Estriol have failed to demonstrate significant benefit over 
estradiol.  Estradiol is the estrogen most abundant in young women in their 20s
and early 30s when women are the healthiest so I work with the ideal estrogen and
by staying with only one estrogen, the studies I undertake are more meaningful over 
the long term. 
 
 
Cabo:  What is micronized progesterone?  
 
 
Erika Schwartz, M.D.:  Micronized progesterone is the most commonly used form of 
natural progesterone - it is in minute particles - hence the name micronized and
it supposedly gets absorbed the best into the human system. 
 
 
Dearest:  Are there any real benefits from using over the counter natural 
progesterone creams?  
 
 
Erika Schwartz, M.D.:  Depending on the symptoms you are trying to treat?  If you
are young and just have PMS or bloating before your period and mood swings, OTC 
progesterone has its place.  As we age, OTC progesterone becomes less efficacious 
because we need higher doses and combinations with estrogen to obtain the right 
balance. 
 
 
Dearest:  As our estrogen levels decrease, you mean, yes?  
 
 
Erika Schwartz, M.D.:  Actually, progesterone levels decrease before. 
 
 
Dearest:  In short, it's less effective as our estrogen levels decrease. Ok. thanks.
 
 
LMichelin3:  I am on Vivelle dot .01 and Prometrium 100 mg. due to POF (premature 
ovarian failure) and all the symptoms of menopause. I had constant bleeding for 60 
days. D&C (dilatation and curettage) found polyps. My bleeding continued. I bleed 
every 6 days. I have Hepatitis C.  I am 41 and need help please.
 
 
Erika Schwartz, M.D.:  You need to have the hormones cycled.  If you take both all 
the time, you may never stop bleeding. 
 
 
LMichelin3:  Cycled? 
 
 
Erika Schwartz, M.D.:  So ask your doctor to cycle your hormone regimen.  Cycled 
means following the natural monthly cycle, like three weeks on and one week off.  
 
 
Isie:  I just had surgery to remove large fibroid tumor and polyps.  Could that have 
caused the anxiety I have been having?  The tumor did not show on needle sonogram.
He didn't find it until surgery which was February 5th. I was taking Estrus and 
prometrium but have stopped since surgery.
 
 
Erika Schwartz, M.D.:  The fibroids are hormone related tumors.  Anxiety is caused
by hormone imbalance. You are right. They are connected. 
 
 
Jimi:  Welcome Dr. Could you please explain the importance of DHEA and Melatonin
and the effects of long term stress, menopause and the aging process. 
 
 
Erika Schwartz, M.D.:  DHEA is a hormone precursor meaning from it many hormones
are made.  Melatonin is a neurotransmitter hormone meaning it is a brain hormone.
As we age, all hormone levels drop and stress accelerates the decline, or wear and 
tear, on our hormones and bodies and minds. 
 
Menopause is a time that is arbitrarily designated as the time we stop menstruating. 
Actually our hormones don't just disappear the day we stop having our periods.  They 
decrease over time. 
 
Diet, exercise, lifestyle, stress management, sleep.  Everything contributes to 
either staying young and healthy well into our old age or getting sick and infirm.
 
 
Dearest:  Thank you, Dr. Erika. What an excellent answer! 
 
 
Erika Schwartz, M.D.:  You're welcome. 
 
 
Moozie:  I'm 44, 3 years post, severe anxiety, chest pains, not on hormones yet,
are my symptoms normal? 
 
 
Erika Schwartz, M.D.:  Your symptoms sound like they are ruining your life, how
could that be normal?  
 
 
Moozie:  Yes, they are.  
 
 
Erika Schwartz, M.D.:  You need help.  Find a doctor to work with you and make sure 
you don't have an underlying medical problem and then start you on natural hormones 
and a plan to balance your life and allow you to enjoy it.  
 
 
Dearest:  Erika, what if a doctor won't work with a woman on natural hormones?
Will you work with them?  
 
 
Moozie:  Are these symptoms of menopause ? 
 
 
Dearest:  Moozie, email me at Dearest@aol.com for the symptoms. 
That would take another hour alone. 
 
 
Erika Schwartz, M.D.:  Of course I will.  I also help interested physicians learn
how to use natural hormones. 
 
 
Dearest:  Moozie, if you're suffering from severe anxiety, of course they can be 
symptoms of your anxiety and menopause. 
 
  
Moozie:  What about chest pains? 
 
 
Dearest:  Moozie, you need to be checked by a doctor to rule out any other health 
issues, but you can have chest tightness and pain from severe anxiety.  However,
I wouldn't immediately attribute chest pain to that until you're given a clean
bill of health, right, Erika?  
 
 
Erika Schwartz, M.D.:  You are right Dearest and I would strongly recommend everyone 
gets checked out when they have symptoms to make sure there are no medical problems 
overlooked. 
 
 
Dearest:  Right. I always recommend that in Power Surge - not to assume everything
is from menopause. Other health issues can develop during menopause, too. Thanks. 
 
 
Carrie:  What do you think of the herbal supplement named New Phase? Is it possible 
to have an allergic reaction to herbal supplements such as this?I am certain I did.    
 

Erika Schwartz, M.D.:  Herbals are not any different than drugs or medications.
They can cause allergic reactions.  If you don't feel well when you take any type
of medication stop taking it. 
 
 
Carrie:  I had an enlarged uterus, bleeding. 
 
 
Dearest:  Erika, did you want to comment on Carrie's last remark about having an 
enlarged uterus and bleeding?  
 
 
Erika Schwartz, M.D.:  Carrie, when you bleed a lot, it is a result of too much 
lining in the uterus and hormone imbalance.  Have an ultrasound to rule out any 
problem and then do get natural hormones to minimize the problem.
 
 
Carrie:  I had 4.  After a month the uterus had returned to normal. 
 
 
Erika Schwartz, M.D.:  You had 4 what? 
 
 
Carrie:  Thank you, I found a good Doctor who gave me some. I had 4 ultrasounds done. 
 
 
Erika Schwartz, M.D.:  Good  
 
 
Diamond:  I am planning to take the MCAT in April 2005 and hopefully be accepted
in Med school, Class of 2009. I am 51 now and a senior at UTC, is this an impossible 
dream? I know I would be a good MD, Family Practice and Women Issues and how
they relate to nutrition. Thanks, Dr.Erika!  
 
 
Erika Schwartz, M.D.:  I believe as long as you can breathe you should do everything 
you want especially when you can help. 
 
I wish you the best of luck and I am sure you will be an asset to the medical 
profession. 

 
Diamond:  Very encouraging, Thanks so much! 
 
 
Dearest:  Very ambitious of you, Diamond. Lots of luck! 
 
 
Erika Schwartz, M.D.:  With love to you. 
 
 
Debrikkia:  Do the same remedies that apply to those who are going through natural 
menopause, apply to those of us who have gone through surgical menopause many
years ago? Can the same remedies work?  
 
 
Erika Schwartz, M.D.:  Deb, natural hormones work at all ages and times.  If you need 
help balancing your hormones it doesn't matter if your problems are surgically 
induced or induced by Mother Nature. 
 
 
CathyJ:  Dr Erika, could u please tell me if menopause can affect your eyes not to 
focus right? Through the day they act up like when u first open your eyes in the 
morning, but it happens to me all day on and off. 
 
 
Erika Schwartz, M.D.:  Deteriorating eyesight is par for the course in the aging 
process.  Menopause or not, our eyesight fades. 
 
  
DBYKAY:  Dr. Erica, I was showing and feeling all the changes in life but the blood 
work showed nothing. How can this happen?  
 
 
Erika Schwartz, M.D.:  Blood work shows nothing.  There is no blood test on the 
market that correlates our symptoms to real hormone levels so you have to rely on
how you feel when you make decisions to treat your symptoms.  No one but you lives
in your body so you have to learn to read your body's messages to stay healthy. 
 
 
GGc0ok:  Is there a bio-identical natural estrogen cream for internal use?  If so, 
what is it?  
 
 
Erika Schwartz, M.D.:  GG what do you mean by internal? 
 
 
GGc0ok:  To use for atrophic vaginitis, I'm all dried up. 
 
 
Erika Schwartz, M.D.:  You need to balance your hormones internally into your system 
not your vagina.  When your hormones are in balance in your blood stream, they will 
restore your vagina to a moisturized environment.  In addition, you can also use 
topical testosterone and combinations of estradiol and micronized progesterone around 
your vagina, but you need to attack on all fronts if you want to get rid of the dried 
up feeling.  
 
 
Dearest:  Erika, is the testosterone available in the  Natural Hormone Pharmacy? 
 
 
Erika Schwartz, M.D.:  Yes, it is. 
 
 
Dearest:  Wonderful. 
 
 
Patty:  I am on Estraderm patch since total abdominal hysterectomy in 2000.  Is it 
safe to stay on patch forever? 
 
 
Erika Schwartz, M.D.:  Not estraderm.  It is a synthetic estrogen like the one in 
Premarin and Prempro.  You also need progesterone even if you have no uterus.
 
 
Patty:  Why?  I was told it was a plant estrogen. I was told no uterus, no need for 
progesterone.
 
 
Erika Schwartz, M.D.:  It is a derivative of estradiol, not quite the same thing.
It doesn't come from horse's urine but is isn't natural either.  The problem is that 
while you have no uterus, you still have breasts, brains, heart, muscles and bones, 
and they all NEED progesterone!! 
 
 
Patty:  Is it safer? 
 
 
Erika Schwartz, M.D.:  Estraderm?  Not much.  If you have other options, why not
use them? 
 
 
Patty:  What would you recommend?  
 
 
Erika Schwartz, M.D.:  Estradiol and micronized progesterone in transdermal cream 
form in a dose to be determined by your weight and symptoms.
 
 
Dearest:  She recommended natural hormones, naturally compounded not mass 
manufactured by a large pharmaceutical company. 
 
 
Dancern22:  I am 51 and in menopause. I use Revival daily and also Remifemin daily. 
My PAP smear showed inflammation. Is this due to menopause (vaginal PH)?   
  
 
Erika Schwartz, M.D.:  Dancern, not sure. It could be from the combination of 
hormones you are taking or from some type of mechanical irritant.  I am sure your 
doctor is going to repeat the PAP smear after treating you with an antibiotic for
a couple of weeks. I would also evaluate your hormone regimen at that time. 
 
 
DoloFrnk:  I'm on natural HRT, (55) postmeno.  Can you tell me, should I totally rule 
out the standard blood testing for hormonal levels in military health care system, 
which is the only way they test? I'm on e2 .125, e3 .5 and p 100mg (oral).  Is this 
likely to counter breast tenderness? 

I can't tell if a progesterone level of 8.53 as being high is too high and maybe 
causing the tenderness for about a week where I didn't have any before? No bleeding. 
I switched from natural progesterone cream to the micronized, oral capsule combined 
with the 80% estriol, and 20% estradiol, trying to find the right balance is the 
trick when only blood tests are what the military doctors go by. My blood level
for estrogen was about 126. Should I just go by symptoms or the lack of?   
 
 
Erika Schwartz, M.D.:  The blood tests aren't going to be of any help, so you are 
right, go by symptoms.  But if your breasts are tender, do not ignore the symptom. 
 
 
DoloFrnk:  I can't seem to get military to pay for saliva testing.  
 
 
Erika Schwartz, M.D.:  I believe you might want to reevaluate the amount and type
of estrogen you are getting.  Saliva testing doesn't work any better than blood. 

 
Jan9:  Should I get off estradoil since my doctor recommended it?  It's not a cream 
and do I need a prescription for the transdermal creams?  
 
 
Erika Schwartz, M.D.:  All natural hormones in dosages that really work are available 
by prescription only.  Estrogen cannot be obtained in over the counter preparations 
at all. I don't know why your doctor recommended you go off estradiol. 
 
 
Jan9:  I think it was all the hype about hormone replacement therapy. 


LMichelin3:  My Physician said that I would stop bleeding when I get used to the 
hormones. Does cycling involve blood hormone levels? Any Chicago referrals. 
 
 
Erika Schwartz, M.D.:  You will stop bleeding when your system decides to stop 
bleeding. 

Cycling does not involve blood tests.  It involves understanding what your body is 
experiencing and knowing how to react to keep yourself in balance and feeling good. 
 
 
SuperGrammieJean:  After having a baby in my 20's I developed severe panic attacks 
and anxiety.  Could this have been caused by a hormone imbalance?  
 
 
Erika Schwartz, M.D.:  Of course.  Most post partum blues is the result of rapid 
decline in hormone levels and too little progesterone left behind.  A little 
progesterone goes a long way to prevent the need for antidepressants in a healthy  
woman who gets sad after she has a new baby. 
 
 
Dearest:  Erika, when you think about it, isn't it ridiculous that they'll put women 
on Effexor, Prozac, Paxil, Neurontin, all sorts of anti-seizure medications and anti-
depressants and anti-anxiety pills when all they might need is some form of natural 
hormone supplement? 
 
 
Erika Schwartz, M.D.:  You said it!!!!! 
 
 
Dearest:  Why on earth are women being prescribed anti-seizure medication for 
menopause. I do not know. 
 
 
Erika Schwartz, M.D.:  I spend my life taking young women off those poisons!!! 
We take them, that's the problem.  We don't say NO! 
 
 
Dearest:  Some of us don't. Many are empowered to say no now! 
 
 
Erika Schwartz, M.D.:  Thank God. I hope more as we do our work. 
 
 
Jimi:  Could you explain exactly what is happening we we have a hot flush or flash as 
you call them in the US and are these damaging to our system if occurring regularly?  
And is there any connection between them and anxiety or panic and the adrenals?  I 
have had a lot of trauma over a long period of time and now feel depleted. I wish we 
had access to this info twenty years ago. I am 50. Using natural compounded 
progesterone and DHEA cream for 3 weeks.   
 
 
Dearest:  There's an excellent article in the Educate Your Body section of the Power 
Surge Web site called What's a hot flash. It describes the whole process you're going 
through.  You can read it at www.power-surge.com/educate.htm 
 
 
Erika Schwartz, M.D.:  Hot flashes are basically caused by sudden changes in hormone 
levels starting from our master gland in the brain- the pituitary.  Over time, they 
do wear us out and it is the way Mother Nature intended to get rid of us as we age. 
 
However, we are a new breed of women and Mother Nature's plan is not OK with us. So 
we found natural hormones, diet, exercise, stress management, SLEEP, and many 
supplements and vitamins to help us.  DHEA doesn't always work, you should be able to 
tell if it works within two weeks of starting it.  If you feel better, stay with it, 
if not, get naturals and the rest of the plan. 
 
 
Cindor:  What is your opinion about Flaxseed oil to alleviate night sweats and hot 
flashes? 
 
 
Erika Schwartz, M.D.:  Flaxseed oil is a good fatty acid source, it will help your 
body make hormones if it can.   If your body can no longer make the hormones you
will need supplementation from the outside. 
 
 
CathyJ:  Dr I have one more question.  My doctor tried me on all types of estrogen, 
and nothing worked for me. I take depakote and dilantin for seizures could that be 
why none of the estrogens worked for me? 
 
 
Erika Schwartz, M.D.:  Depakote and dilantin are very harsh drugs. But if you need 
them, you have to work around them.  You need to address all areas of your life to 
support and minimize the negative effects of the drugs.  I also do not believe you 
cannot take estrogen with progesterone. Maybe your doctor hasn't tried everything 
yet. I don't believe in giving up - EVER! 
 
 
Isla:  I'm not taking any medications, am 37 and have been experiencing 
'perimenopausal' changes for the last three years. Symptoms are mostly mild and 
manageable, (apart from intense heel pain). Are there any long-term health issues I 
need to be more aware of, or taking action on?  
 
 
Erika Schwartz, M.D.:  Yes. Learn your family history and make sure you are taking 
great care of yourself NOW, not in 10 years. 
 
 
Debrikkia:  You said that whether we have a uterus or not, we still need 
progesterone. I have been taking a bio-identical natural hormone replacement
for nearly 3 years. The doctor I am seeing now, is wondering why I am taking
any progesterone whatsoever since I have had a hysterectomy. Why would there
be a question there?  Sorry, by now, you may have already answered this question,
but I'd still like to hear it again.  
 
 
Erika Schwartz, M.D.:  You need progesterone because you have receptors for it
on every cell in your body. The cells need progesterone to function well. If you
have no uterus, you still have a heart, a brain, bones and muscles and they all
need progesterone, not to mention your breasts. 
 
 
Isla:  I worry about bone density at my tender age.  Can you reassure or is that
the family history? 
 
 
Erika Schwartz, M.D.:  Bone density is a disease of the makers of Fosamax.  If you 
have a family history and are totally sedentary. Yes, no worries.  
Worry will make you old and sick. 
 
 
MariaJ:  I'm 3 years since last period and feeling pretty good. Took tri-est for 
1 1/2 years and weaned off. Still take progesterone cream.  Do I need to take a 
break? Some say 5 days month or few weeks every once in awhile?
 
 
Erika Schwartz, M.D.:  Take a break every few months for about a week. 
 
 
Trish:  I am 49 and postmenopausal, started meno at 38. I have no, not low, sex 
drive, what should I be taking? 
 
 
Erika Schwartz, M.D.:  Estradiol, progesterone and testosterone and make sure you
are in a relationship with someone who really turns you on. 
 
 
Salaskie:  My naturopath has said that getting my adrenal glands functioning properly 
will get the anxiety attacks under control and help balance my hormones. What do you 
think?  
 
 
Erika Schwartz, M.D.:  The naturopath is probably right.

 
Dearest:  Erika, thank you for a very informative chat about natural methods of 
treating menopause and natural hormone therapy. I also recommend Dr. Erika
Schwartz's books, The Hormone Solution and her earlier book, Natural Energy. 


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