Griffin Medical Group's Advanced Protocol

Advanced Protocol

Estrogen & Prgesterone Replacement Therapy

Griffin Medical Group - Center for Anti-Aging and Aesthetics only uses Bio-Identical Hormones.

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APPLICATION INSTRUCTIONS FOR
“Advanced Protocol”
Transdermal Hormone Creams

WHAT YOU SHOULD RECEIVE:
You should receive 2 mylar bags. One bag will contain multiple 3mL syringes of Estradiol with green caps. The other bag will contain multiple 3mL syringes of Progesterone with purple caps. Both hormones are in a cream base. Each syringe contains 3cc’s and each demarcated line on the syringe is “1 line” as listed on the dosing schedule.

HOW TO CALENDAR YOUR HORMONE APPLICATION DAYS:
If you are currently menstruating in regular cycles, then the first day of your period will be day one. Follow the dosing instructions accordingly.
*If your cycle lasts longer than 28 days, continue to take the “days 18-28" dosage daily until you reach day 1 again.
**If you begin your menstruating early, discontinue the Progesterone, and begin the dosing schedule as you are now on day one.

If you are no longer menstruating in regular cycles, then you will use the “Griffin Medical Group AP Protocol Calendar” which is based on the Lunar calendar. Several months of calendars should be included in the box with your hormones. You can also access the calendar through the GriffinMedical.com website. You will see Day 1 identified on the calendar. You will follow the dosing schedule and discontinue the application of Progesterone on Day 28. You will continue applying the Estradiol at the baseline dose (Days 1-5) until you either begin menstruating, or reach Day 1 on the calendar again.

APPLYING THE CREAMS:
Place the plunger on the palm of your hand and place your first and second fingers on the barrel of the syringe. Push the plunger carefully with the thumb of the same hand. Sometimes the plunger sticks and/or can release too quickly. Each individual demarcation line on the syringe is equivalent to “1 line” as indicated in the dosing schedule.

Make sure your hands and the application area are clean and dry. Deposit the prescribed amount of cream onto the bend of the arm. Then using the fingertips of your opposite hand, work the cream into the fatty portion of the underside of the upper arm until the cream is completely absorbed.

You can apply the cream to any soft, fatty portion of the arm, inner thigh, back of knees or pectoral area that is not sun damaged. The larger the application area, the better the absorption will be. DO NOT MIX Estradiol and Progesterone, or layer over any other creams.

On Day 14, begin applying the Progesterone in the same manner, but on the opposite arm (or leg). You want to remain consistent throughout the month with the application site, as you want to build up a hormone deposit at the application site. You may switch sides on alternating months.

REMEMBER:

* Do not bathe for 40 minutes after applying hormone creams.
* Do not exercise, or do anything to promote excessive sweating for 2 hours after application
* Hormones may be applied to upper inner arms, pectoral areas, inner thighs or backs of knees. Be sure to remain consistent throughout the month in order to build up hormone deposits at the application site.
* If you will be in direct skin contact with men, children or animals - cover the application site with clothing for1 hour after application.

INITIAL 3-6 MONTHS:

Women’s hormones are a complex and delicate balance. Usually it does take time to perfect this balance. The initial 3-6 months are an adjustment period. During this time of fluctuating hormone levels you can experience some side effects. These can include, but are not limited to the following;

• headache •dizziness •weight change/water retention •hypoglycemia •breast tenderness

•change in sleep patterns •change in digestive/bowel patterns •mood swings

By the end of the third month, adjustments in the dosing may be warranted to customize the protocol to your needs. Blood testing is conducted every 3 months throughout the first year to allow the doctor to correlate your symptoms, dosage and blood levels in order to optimize your specific treatment protocol.

BLOOD TESTING PROCEDURE:

Blood testing is done every 3 months during the first year, every 6 months during the second year and annually thereafter - AS LONG AS YOUR DOSING, SYMPTOMS AND LEVELS ARE STABLE. Blood testing on the Advanced Protocol is always conducted on Day 21. In order to ensure that your blood results are consistent for comparison from draw to draw - it is optimal to follow these guidelines:

* Either have blood drawn early in the morning and do NOT apply hormones until AFTER your blood has been drawn, or
* Apply your hormones in the morning to an area OTHER than where the blood will be drawn AND wait a minimum of 3-4 hours prior to having your blood drawn.

EARLY OR “BREAKTHROUGH” BLEEDING:

Experiencing “breakthough” bleeding, or bleeding before Day 21, is usually an indication of too little Estrogen in the Day 7-21 period. If you experience this early bleeding, discontinue the Progesterone and allow your cycle to begin. This first day of bleeding thus becomes Day 1. Apply your hormones accordingly starting over on Day 1. Call the office to notify the doctor of your early bleeding and inquire as to whether your dosing for Estradiol should be increased.

CONTRAINDICATED MEDICATIONS AND SUPPLEMENTS:

All medications and supplements sold over the counter to the public can impact the effectiveness of your hormones. Supplements and herbs prescribed to impact hormonal symptoms can have an effect on your hormone receptors and thus interfere with your hormone protocol. Products such as Evening Primrose Oil, Vitex Agnus Castus (Chastetree Berry), Black Cohosh, Estrovan, Lignans, Red Clover and Flax all have hormonal effects and could effect your hormonal therapy.

Medications that are contraindicated while on the Advanced Protocol include; Arimidex, Anastrazole, Letrezole, DIM (Indole -3-Carbinol), Aromasin, Exemestane, Fosamax, Raloxifen and Tamoxifen. The dosing of certain medications such as anti-depressants and statin medications, such as Lipitor may need to be reduced after a duration on the treatment protocol. Be sure to remain closely monitored on these medications by your prescribing physician.