HORMONE REPLACEMENT THERAPY

The fluctuating hormone levels associated with menopause cause a number of debilitating symptoms, such as hot flashes, insomnia, irritability, vaginal dryness and bone loss. To manage these symptoms, many women desire to replace the hormones that are no longer being produced by their bodies.
Women who still have a uterus must take a combination of estrogen with progesterone. Women who have had a hysterectomy are able to take estrogen alone.

Benefits of HRT:
Relieves hot flashes and insomnia
Prevents the rapid bone loss that occurs in early menopause
Relieves vaginal dryness and painful intercourse
Risks of HRT:
Increases the risk of stroke and blood clots
Combined: increases the risk of breast cancer
Estrogen only: increase risk of uterine cancer
You should not take HRT if you have a history of:

  • Blood clots
  • Stroke
  • Heart attack
  • Breast or uterine cancer
  • Undiagnosed vaginal bleeding

If you are healthy, you can use HRT to alleviate many of the symptoms of menopause. Usually these hormones are taken during the menopause transition and discontinued once the hormone levels have stabilized (less than 5 years).

There are two forms of HRT currently available: a traditional prescription from a pharmacy or a “bioidentical” hormone from a compounding pharmacy. Hormones produced by pharmaceutical companies may be made from plants, animals, or from other chemicals. They are regulated by the FDA and come in standardized doses. Bioidentical hormones are hormones that are identical to hormones produced in the body. They are not found in this form in nature, but are synthesized from a plant chemical that is extracted from yams and soy. Bioidentical hormones are made in a compounding pharmacy according to your doctor’s specifications.

Advantage to bioidentical hormones:

  • Greater dose flexibility
  • Availability of low-dose preparations
  • Possible lower cost
  • Replicate the hormones that are made by the human body: estradiol, estriol, estrone, and progesterone

Disadvantage to bioidentical hormones:

  • Not regulated by the FDA
  • Not tested for purity, potency or safety

While bioidentical hormones are not necessarily safer or better than traditional ones, they have the advantage that their doses can be more easily titrated to alleviate a woman’s symptoms. Talk to your doctor if you have questions about which regimen may be right for you.