In this episode, we’re answering a thoughtful (and very relatable) listener question from Kari,who’s been struggling with unexpected body pain and inflammation after starting hormonetherapy. She wonders if she might be hypersensitive to estrogen—something most doctorsdon’t talk about. Dr. Valorie Davidson and Dr. Robert Maki unpack why this happens and what to do if yoususpect your body is reacting to estrogen differently than expected.   In this episode, we discuss: Why some women experience increased pain, fluid retention, or inflammation onestradiol—especially starting at higher doses too quickly. The importance of starting low and increasing slowly, especially for sensitiveindividuals How Dr. Davidson’s personal experience with estrogen sensitivity helped shape herapproach The role of the liver’s phase 1 and phase 2 detox pathways in clearing estrogenmetabolites Why form, dose, and timing of hormone therapy (cream vs. patch, AM vs. PM) canaffect results What to consider when adjusting your Biest ratio (80:20 vs. 90:10) or RhythmicDosing HRT   ✉️ Here’s Kari’s full question:“I used Biest 80:20 for 3 years and suddenly stopped absorbing. I’m not sure why,but I do know I didn’t always use it the same time every day. From the moment Iwent on hormone therapy I’ve had body pain and thought I had fibromyalgia. Whenmy estrogen dropped due to the absorption issue I realized the body paincompletely went away. I then went on a patch because my doc said we shouldchange the method. Immediate body pain again and even worse. Terrible. I was on0.025 and it was tolerable, but after raising it to 0.05 it got really bad. I think I mayask to go on the compounded cream again—maybe change the site that I apply itand be more consistent. I’m very frustrated because no one talks about a subset ofpeople that are very sensitive to estrogen. They only talk about it making joint paingo away. Do you think I should use 90:10 instead? What would you recommendthat I do? I’m so sad and frustrated.”    If you have a question, please visit our website and click Ask the Doctor a question.   Want more insights like this?  Be sure to subscribe to our newsletter for hormone Q&As, educational guides, and real-world strategies to help you feel like yourself again—especially during perimenopause and menopause. Join the Progress Your Health Newsletter   Stay Connected Instagram: @drvalorie TikTok: @drvaloried Join the Hormone Community: Click here to subscribe   Disclaimer: All content in this blog, including text, images, audio, video, or other formats, was created for informational purposes only. This video, website, and blog aim to promote consumer/public understanding and general knowledge of various health topics. This content is not a substitute for professional medical advice, diagnosis, or treatment. Please consult your healthcare provider with any questions or concerns you may have regarding your condition before undertaking a new healthcare regimen. Never disregard professional medical advice or delay seeking it because of something you have read on this website. If your healthcare provider is not interested in discussing your health concerns regarding this topic, then it is time to find a new doctor.