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Hormonal Therapy

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 What is Hormone Replacement Therapy ?

Its the use of hormones to replenish the ones that your body does not produce in sufficient amounts after menopause. Estrogen, progesterone, testosterone are the ones commonly given although there are other hormones that can be also replenished after menopause depending  on your symptoms and your medical conditions. The art of prescribing hormonal therapy is to define the right amount of hormones needed to relief symptoms and to prevent chronic conditions after menopause but also to understand what your body is doing with these medications, how are they being metabolized, what nutrients, minerals and amino acids  are needed for proper response, and how to prevent or diminished side effects.

When should you consider Hormonal Replacement Therapy?

If you are plunged into early menopause due to surgery or cancer before your chronological menopause is due, you should consider hormone therapy as long as its not contraindicated. Once you have all the appropriate laboratory test, including nutritional status measurements, talk to your doctor about initiating therapy, as this might be an option for you. After natural menopause, if you have symptoms of hot flashes, night sweats, dry vagina, pain during sex, forgetfulness, osteoporosis or other menopause symptoms affecting your quality of life, consult your doctor to see if hormonal therapy is right for you.

When not to take Hormone Replacement Therapy ?

Smokers, heavy drinkers, morbid obesity, patient with a high risk for stroke or myocardial infarction, abnormal uterine or vaginal bleeding or history of breast cancer should not take hormone therapy or should discuss with your doctor other non hormonal alternatives until the cause of your symptoms or medical problems is investigated or resolves. With the exclusion of breast cancer, some of the conditions mentioned above, hormone therapy can still be used if non oral alternatives are prescribed. Always consult with a menopause expert before using hormonal therapy, especially if you have a medical condition, since a complete health evaluation must first be elaborated and individualized according to your needs. For breast cancer patients, breast cancer survivors or patients with other estrogen|progesterone dependent tumor, special considerations must first be considered and reevaluation by your oncologist will be required.

What kind of hormones should you take ?

There is no need to suffer from menopausal symptoms, low libido, painful sex, etc when there are multiple alternatives to help alleviate these symptoms. There are multiple therapies used for menopause and you can choose between synthetic hormones, bio-identical hormones, FDA approved bio-identical hormones or even soy derivatives that can be converted to estrogen inside your body. When choosing the therapy that is right for you, your physician must explain to you the role of synthetic progestin, natural progesterone, various estrogens available (estriol, estradiol, estrone) that have on different body systems and how they are metabolized , in order to prevent undesired effects or negative outcomes. A menopause practitioner should answer all these questions easily and should give you enough time to ask pertinent questions regarding alternatives available.

 Do you need Progesterone if you don’t have an uterus ?

This is a debatable topic and can be confusing to women. The North American Menopause Society and the College of Obstetrics and Gynecology  do not endorse the use of synthethic progestins or natural progesterone if you don’t have an uterus. Proponents of bio-identical hormones like the American College of Anti-Aging Medicine endorse the use of natural progesterone (not synthetic progesterone) even if you don’t have an uterus, as this helps to balance all hormones as opposed to estrogen. Discuss these alternatives with your menopause physician to determine what is best for you.

 Is Progesterone different from a Progestin ?

Natural progesterone as well as synthetic progestin are synthetized in a laboratory. Their difference its that natural progesterone has the exact same molecular composition as your body produces. Synthetic progestin or natural progesterone, they both protect the lining of your uterus, which is the main reason why most doctors prescribe to any patient receiving estrogen for menopause symptoms. The Women’s Health Intitiative, a study that was terminated in 2002 due to its adverse effects, showed that synthetic progestin can cause adverse effects like breast cancer, stroke and heart disease. Proponents of natural progesterone refer that since natural progesterone has the exact same molecular composition as the one your body produces, this side effects or complications are not seen. Ask your menopause healthcare practitioner for more on this topic.

For how long should I take Hormone Replacement therapy?

The North American Menopause society and the College of Obstetrics and Gynecology suggest that women should take the smallest amount of estrogen and hormone replacement therapy to alleviate the symptoms of menopause. Others proposed to continue hormonal therapy to help with other symptoms of menopause not easily detected or diagnosed like Alzheimer disease, heart disease prevention , low bone mass, weight changes, skin changes etc. This is a very individualized part of your hormonal regimen and will be discussed at Texas Menopause.

What is the best hormonal therapy for you ?

Various alternatives and options are available for you. Do not suffer through menopause due to lack of information or fear. Whether synthetic hormones, bio-identical hormones, soy derivatives, herbs or natural remedies are used for you symptoms or prevention of medical conditions, talk to your doctor what would be the best therapy for you and individualize it to meet your needs.

 Government FDA approved Menopause therapy: ( Hormone Replacement Therapy)

**Bioidentical: defined as compounds that have the same chemical and molecular structure as hormones that are produced in the body (Composed of 17 Beta Estradiol)

Oral Estrogen:

checkmark2512Estrace**

checkmark2512Premarin

checkmark2512Cenestin

checkmark2512Enjuvia

checkmark2512Ogen

checkmark2512Menest

checkmark2512Duavee (Synthetic oral estrogen with Bazedoxifene indicated in women with a uterus)

Estrogen Patch

checkmark2512Alora**

checkmark2512Climara**

checkmark2512Minivelle**

checkmark2512Vivelle | Vivelle dot**

 

Transdermal Estrogen Gel

checkmark2512Elestrin**     Estrasorb**     Divigel**

 

Estrogen Spray

checkmark2512Evamist**

 

Vaginal Estrogen

checkmark2512Vagifem
checkmark2512Estrace**
checkmark2512Premarin
checkmark2512Estring**

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Oral Estrogen and Progesterone combination ( Some include Bio identical natural estrogen with synthetic progestin )

checkmark2512Premphase

checkmark2512Prempo

checkmark2512FemHRT

checkmark2512Activella

checkmark2512Angeliq

checkmark2512Prefest

 

Estrogen and Progesterone Patch

checkmark2512Combipatch

checkmark2512Climara Pro

 

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Other government approved non hormonal therapies

checkmark2512Osphena (Non estrogen oral therapy indicated for moderate to severe painful intercourse due to menopause)

checkmark2512Relizen ( Non hormonal therapy for hot flashes made from purified pollen extracts)

checkmark2512Brisdelle ( Non hormonal option to reduce moderate to severe hot flashes during menopause )

Texas Menopause: Leading organization for Menopause & Hormonal Therapy in Texas

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