Menopause and Hormone Replacement Therapy
Questions and answers
What is menopause?
Menopause is a natural and normal transition in any woman’s life that ceases to have twelve consecutive menses. There may be also a “surgical menopause” that a woman goes through after hysterectomy at an earlier age.
As natural and normal as it may sound, for many women, statistically for about 75% of North American women, menopause comes with many physical and emotional changes, sometimes really dramatic changes. More than 52% of over 50 million women in the USA going through menopausal changes seek medical help because of many uncomfortable symptoms.
What kind of help is available for all these women?
The main answer coming from most of the health care practitioners will be: Hormone Therapy.
What is Hormone Therapy and why women need it?
First, we have to understand what happens in our body as we age and reach menopause. During our reproductive years our body produces, among others, two major steroid sexual hormones: estrogen and progesterone. While estrogen can be produced from a variety of sources within the body and externally, progesterone can only be produced internally. Estrogen’s main role during reproductive years is to replenish, prior to the ovulation, the inner lining of the uterus that was lost during the cycle. Progesterone further prepares the uterus and the breast for a potential pregnancy.
Both estrogen and progesterone also affect other organs and systems in the body, such as: the brain, the endocrine system, the immune system, etc. When these hormones are present in the normal levels, they balance each other’s activity providing the body with a harmonious functioning.
During and after menopause, as the ovulation stops, so does the production of progesterone, where as estrogen is still available: from the adrenal glands that can convert other hormones into estrogen in fat and other tissues. Also we are exposed to many chemicals in the environment that behave like powerful estrogens. So, during these menopausal years, women may have normal or elevated tissue levels of estrogen and very low levels of progesterone. The discrepancy in the production of these two hormones leads to hormonal imbalance, which, in light of latest data from the experts, appears to be the main cause of the menopausal symptoms.
Therefore the logical medical approach to help alleviate menopausal symptoms should be to re-balance the hormones through Hormone Replacement Therapy.
What kinds of Hormone Therapies are available and how are they different?
For the last four-five decades conventional Hormone Replacement Therapy (HRT) has been the default choice for menopause symptom management, consisting in powerful drugs manufactured by pharmaceutical companies, mimicking the functions of the two major hormones: estrogen and progesterone. A massive recent study revealed major shortcomings of this conventional HRT, having researchers stop the study, before its intended end, as the negative effects outweighed the expected benefits.
As millions of women on the therapy where left helpless after these results have been exposed and many other millions joined the group of sufferers as they entered menopause, the search for other options has begun. Having access to technology, many women started searching for literature and educating themselves, and shortly learned that there is a more appealing alternative to conventional HRT: bioidentical hormone replacement Therapy (BHRT).
As controversial as it may be in the scientific world, BHRT is gaining more and more interest, prominence, and demand from the patients, as-if done properly- it addresses the menopausal issues from a logical perspective. This perspective provides patients with customized solutions when re-balancing the hormones with products that have identical chemical structures like the human body makes. These Bio-identical hormone products are synthesized in an FDA approved lab, from plants like wild yams or soy beans.
How does a woman get Bioidentical Hormone Replacement Therapy (BHRT)?
First step would be to find a knowledgeable health care practitioner, who usually is within one the following specialties: integrative medicine, functional medicine, holistic medicine, advanced medicine, anti-aging medicine, complementary and alternative medicine, internal medicine, and sometimes ob/gyn. For most of these practitioners the goal is to treat a patient as a whole so they address not only hormonal issues, but also other factors that will lead to balance and wellness, such as: diet and proper nutrition, exercise, relaxation techniques, etc.
Any of these practitioners works in close collaboration with a compounding pharmacy,
as this the only way to get BHRT prescription products.
No two women undergo identical menopause experience; the combination of symptoms, the degree of the severity of the symptoms, the variety of hormones involved in the imbalance, the level of each deficient or dominant hormone, will be unique to each patient.
Only after a proper and thorough assessment, based on the symptoms and supporting lab tests (saliva testing), the practitioner will provide a customized plan that will include a customized hormone formulation with Bio-identical hormones to be prepared by the compounding pharmacist.
What is a compounding pharmacy?
Pharmacy compounding is the art and science of preparing customized medications based on a doctor’s prescription, to meet patients’ unique needs. Based on practitioner’s or patient’s preferences, the compounded formulation can be made in any combination, form, shape, strength, or route of administration, whether it is a tablet, capsule, sublingual drops, cream, gel, solution, suppository, etc. Meeting the uniqueness of the need and the preference, compounding improves compliance, therefore improves the outcome.
Is BHRT indicated only for menopause?
No, both men and women can encounter hormonal imbalances at any age. If diagnosed properly, the imbalance can be addressed with BHRT.
A few examples of female hormonal imbalance at other ages would be: PMS, migraine, acne, heavy bleeding, depression, mood swings, irritability, sleep disturbances, weight gain, fatigue, etc.
Men go through similar hormonal changes mainly noticeable during andropause, the male equivalent for menopause.
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