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HRT for Women

Estrogen is the most important hormone in a women’s body.  Nearly every cell responds to estrogen.  As we age, we have a progressive decline of progesterone followed by estrogen and testosterone.  When hormone levels drop, some women may benefit from boosting their hormone levels to reduce menopausal symptoms.  If a patient has a uterus, and depending on her menopausal status, FVPS may prescribe oral progesterone to prevent a buildup of tissue on the lining of the uterus.

Explore your options. Determine if bio-identical hormone replacement therapy is right for you by calling (920) 233-1540 to request your consultation.

Signs of Low Estrogen Levels

• Hot flashes
• Vaginal dryness
• Urinary problems
• Thinning hair and skin
• Sleep problems
• Night sweats
• Moodiness
• Concentration and memory difficulties
• Abdominal fat accumulation
• Osteoporosis

How Long Should I Use HRT?

To relieve the short term symptoms, such as hot flashes and night sweats, treatment for one to two years may be enough. However, to gain protection against osteoporosis and heart disease, women need to take HRT for five years.

Risks

In 2002, the Women’s Health Initiative stated that HRT taken for over five years may increase risk of breast cancer and blood clotting. The studies were based on synthetic hormones, and the average age of the women at enrollment was 63. These details made a difference in their risk.

The pharmaceutical industry produces it’s main hormone drugs using animal hormones (often collected from pregnant horse urine) to create products that are structurally different than human hormones, but yet bind very strongly to human receptors. The drug, Premarin (PREgnant MARe’s urINe), binds to human estrogen receptors almost 20 times stronger than natural estrogen, and will block or interfere with a woman’s own estradiol.  Furthermore, it will build up over time the longer that Premarin is taken.

Mass production of non-human type hormones by drug companies is very profitable despite causing serious health issues and side effects.

Bio-Identical Hormones

Conversely, bio-identical hormones (especially well studied testosterone) have not been linked to increased cancer risk.  In fact, a recent study done in France on 80,000 women for 12 years showed no increased cancer risk in BHRT patients compared to women not taking hormones.  Since bio-identical hormones are naturally produced in humans, they cannot be patented regardless of their source.  Although large drug companies cannot significantly profit off the use and sale of bio-identical hormones, they can still patent a process needed to render it absorbable as a drug.

Experts have recently said that the 2002 study that originally linked HRT to increased breast cancer, thromboembolism and stroke, had key flaws which make it harder to establish a causal link between HRT and breast cancer. The International Menopausal Society released a global consensus statement in 2013 which reported that 18,601 – 91,610 excessive deaths can be attributed to estrogen avoidance in the last decade.

A 2019 Lancet study found that any type of hormone replacement therapy may increase the risk of breast cancer among average weight post-menopausal women, so patients should make their primary care providers aware if they elect to receive bio-identical hormones.  For some people, the slightly increased risk of breast cancer is offset by the greater quality of life while on BHRT. Obese women on BHRT do not appear to have a significantly increased risk of breast cancer. FVPS requires all patients to have a regular primary care doctor, and all female patients to be current on mammograms, pap smears, and bone density screening tests.

Side Effects

Rare possible side effects generally last a few days to weeks include:

• Breast tenderness
• Bloating due to fluid retention
• Headaches
• Nausea
• Acne
• Swelling of hands and feet
• Spotting or bleeding
• Mood swings with initial insertion
• Bruising

There are many combinations of HRT available, so if one doesn’t work, there are other options. Each method of treatment should be used for three months before deciding if it is suitable.

All women, who take HRT, should get annual wellness exams, mammograms, pap smears, and bone density tests.

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Benefits

HRT is approved for the relief of menopausal symptoms, and prevention of osteoporosis in at-risk women. It also improves muscle function, reduces heart failure and heart attack risk, lowers mortality in younger postmenopausal women, protects against brain aneurysms, and preserves brain function. A 2019 study found that any type of hormone replacement therapy may increase the risk of breast cancer among average weight post menopausal women, so patients should make their primary care providers aware if they elect to receive bio-identical hormones.

In 2013 Menopause International published new guidelines to provide helpful and pragmatic guidelines in the prescribing of HRT. New guidelines include the following key points:

• Using HRT is an individual decision.
• Providers should calculate HRT dosage on an individual basis.
• Physicians should evaluate every person on HRT annually for pros and cons.
• Providers should be not restrict the duration of HRT by arbitrary limits.
• HRT is more favorable for patients who start therapy before they are 60 years old, and within 10 years of menopause.
• Patients should be on HRT at least until the average age of menopause.
• Patients over age 60 should initially be on lower doses.
• HRT should begin within ten years of menopause.

“Bio-Identical Hormone Therapy has completely changed my life. The benefits are amazing! I do not miss the sleepless nights, hot flashes. or mood swings. My energy level is back, and I no longer have sore joints or muscle aches. As far as my libido, I feel like I am in high school again. Basically, I feel great all the time.” Patient 32030, age 53.

Best Candidates

Ideal candidates are under age 60 and are within 10 years of menopause. They have menopausal symptoms such as hot flashes and dryness. They are non-smokers with no history of breast or uterine cancer, or cardiovascular disease. This therapy is especially helpful to women who have had their ovaries and/or uterus removed. While estrogen levels lower gradually during natural menopause, they plummet with surgical menopause.

HRT may not be suitable for women who:

• Are pregnant
• Smoke or are alcoholic
• Have uncontrolled hypertension
• Experience severe migraines
• Have a history of thrombosis or blood clots
• Have a history of stroke
• Experience a history of heart disease
• Have a history of endometrial, ovarian, or breast cancer

Bio-identical hormones are at the forefront of regenerative and restorative medicine. If you would like to explore if bio-identical hormone replacement therapy is right for you, call (920) 233-1540 to request your BHRT consultation.