Hormone Replacement Therapy – What you Need to Know
Let’s face it. Being a woman isn’t easy. As early adolescents we fear the day when our cycle starts, and then as we move into our 40’s, we dread the day that hot flashes begin. With all these changes we start to wonder if hormone replacement therapy is right for us.
Menopause is indicated when a woman has not had a cycle for a full year. The phase before that, known as perimenopause, can last for years. Typically, perimenopause comes with hot flashes, cycle irregularity, vaginal symptoms, and moodiness. But who wouldn’t be moody?! The average age of menopause is 51.4 years, and some women follow their mother’s timeline. In an effort to help with these symptoms, physicians started replacing estrogen and progesterone, giving women what they were missing. It wasn’t too long ago that women were automatically given a prescription for hormones when this time began. And it was only decades ago when women were prescribed high doses of estrogen that were later found to be unsafe.
The benefits of hormone therapy vary by which route you use. Estrogen can be delivered systemically (to the whole body) through pills, patches, creams, pellets, and troches. When your body receives estrogen systemically, it can help with hot flashes, osteoporosis, vaginal dryness, mood and sleep. Estrogen can also be delivered in low dose vaginal products that mostly help with vaginal dryness, pain and itching; for some women vaginal estrogen can help with hot flashes. If you still have your uterus, your doctor will typically prescribe progesterone to protect your uterus lining. Progesterone also has multiple routes of delivery. However, if you have had a hysterectomy (removed uterus), you may not require progesterone. Some physicians also prescribe DHEA and testosterone, both of which are hormones; some women find these helpful and others feel worse on them. Using DHEA and testosterone in women is more controversial in the medical community, and can have other adverse effects like unwanted hair growth, aggressivity, breast tenderness, and yes, HOT FLASHES, when given at too high of doses. It’s important to find out which hormones are right for you. Hormones can be prescribed in bioidentical and synthetic forms through your pharmacy or trusted compounding pharmacy. We tailor what we prescribe to each woman’s needs. Hormones can also be found in over the counter supplements. Please check any hormone support supplements you are taking to ensure you aren’t getting any unwanted hormones!
The risks and benefits of hormone therapy vary widely; it’s important to balance them. Hormone therapy can help with what can be a difficult transition in a woman’s life. But what are some of the risks? Clinical studies have shown that hormones can increase the risk of some serious conditions, including: heart disease, stroke, blood clots and breast cancer. These risks are more pronounced in women over 60 years of age. The risks also vary by how the hormones are delivered and what dose you are taking, as some preparations are riskier than others. All of these risks are considered when deciding to use hormone therapy, and it is important to talk with a trusted doctor to answer your questions and to decide which formulation and dose is best for you. It is also very important that you follow-up with your physician periodically to reevaluate your therapy. No woman is the same. All of our bodies vary, and the delivery system and dose your friend uses may not work for you. If It is decided that you are not a candidate for hormones, or if you prefer to go the non-hormonal route, there are multiple supplement preparations that can ease your symptoms without the risks. We have many women that pick this option. Even healthy lifestyle approaches, like keeping cool, limiting alcohol and caffeine intake, and practicing deep breathing can ease hot flashes naturally. For vaginal concerns there are over the counter and compounded lubricants that can help. Being informed is what’s most important. So, if you are wondering if hormone therapy is right for you, ask your doctor, and have it custom tailored to you.
At Cibolo Family Medicine we pride ourselves in providing custom-tailored care for each patient. Our unique practice focuses on quality patient care, with a personal physician. From newborns to the elderly, we strive to improve the way that healthcare is delivered to women and men. We encourage anyone interested in learning more about our practice to call and make an initial consultation with one of our physicians, or visit our website at www.CiboloFM.com.