Sunday, August 7, 2022

Alternative To Hormone Replacement Therapy Menopause

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Prevention And Alternative Treatment:

Menopause: Hormone Replacement Therapy

There are alternatives to hormone management of menopausal symptoms. Exercise, healthy lifestyle, and proper sleep also help symptoms. Calcium supplementation and exercise can help with bone health issues related to menopause. Arbor ObGyn does not prescribe compounded or bioidentical hormone replacement medications.

Please call to schedule a consultation to help decipher the best treatment for you.

What Should Women Do If They Have Menopausal Symptoms But Are Concerned About Taking Mht

Women who are seeking relief from hot flashes and vaginal dryness should talk with their health care provider about whether to take MHT, the possible risks of using MHT, and what alternatives may be appropriate for them. FDA currently advises women to use MHT for the shortest time and at the lowest dose possible to control menopausal symptoms. The FDA provides additional information about the risks and benefits of MHT use for menopausal symptoms on its Menopause & Hormones: Common Questions fact sheet.

What Are The Types Of Hormone Therapy

There are two main types of hormone therapy :

  • Estrogen Therapy: Estrogen is taken alone. Doctors most often prescribe a low dose of estrogen to be taken as a pill or patch every day. Estrogen may also be prescribed as a cream, vaginal ring, gel or spray. You should take the lowest dose of estrogen needed to relieve menopause symptoms and/or to prevent osteoporosis.
  • Estrogen Progesterone/Progestin Hormone Therapy : Also called combination therapy, this form of HT combines doses of estrogen and progesterone .

Read Also: Can Bioidentical Hormones Cause Weight Gain

Choosing The Right Hrt For You

It is important to find the correct HRT to help your symptoms.

A low dose of HRT hormones is usually prescribed to begin with. If you need to, you can increase your dose at a later stage.

Once you’ve started HRT, it’s best to take it for a few months to see if it works well for you. If not, you can try a different type or increase the dose. It’s really important that you talk to your GP if you have any problems with HRT.

Black Seed Oil For Metabolism And Bone Density

Postmenopausal Hormone Therapy

The oil of the black cumin seed is a good seed oil. Used for thousands of years as a medicinal herb, it has remarkable effects on oxidative stress, inflammation, and even allergy symptoms, but it also shows promise as a treatment for menopause.

  • Menopausal women who took black seed powder saw a reduction in metabolic syndrome, improving both blood lipids and blood glucose. Notably, there was no change in body weight, indicating a powerful effect of the black seed alone.10
  • Black seed oil supplementation improved biomarkers related to bone density in postmenopausal women.11

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What Questions Remain In This Area Of Research

The WHI trials were landmark studies that have transformed our understanding of the health effects of MHT. Its important to note that women who were enrolled in the WHI trials were, on average, 63 years old, although about 5,000 of them were under age 60, so the results of the study may also apply to younger women. In addition, the WHI trials tested single-dose strengths of one estrogen-only medication and one estrogen-plus-progestin medication .

Follow-up studies have expanded and refined the original findings of these two trials. But many questions remain to be answered:

  • Are different forms of hormones, lower doses, different hormones, or different methods of administration safer or more effective than those tested in the WHI trials?
  • Are the risks and benefits of MHT different for younger women than for those studied in the WHI trials?
  • Is there an optimal age at which to initiate MHT or an optimal duration of therapy that maximizes benefits and minimizes risks?

When To See A Doctor

Anyone experiencing symptoms of a hormonal change or imbalance should see a doctor as soon as possible. Early intervention may help prevent complications.

People should also see a doctor if their condition does not improve while taking a medication or herbal supplement, or if they experience side effects associated with these treatments.

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Also Check: How To Heal Hormonal Cystic Acne

Hrt For Breast Cancer Survivors

It is advisable for women with a history of breast cancer to avoid HRT unless other treatments are ineffective, and their quality of life is made intolerable by menopausal symptoms. In these circumstances, HRT should only be prescribed in consultation with the womans breast surgeon or oncologist.

Evidence has not conclusively shown that HRT will increase the risk of breast cancer recurring in a woman with a history of the disease. However, oestrogen and progestogens may stimulate some types of cells in the breast and some types of HRT use have been associated with an increase in the risk of breast cancer in women without a history of breast cancer.

Troubleshooting And Making Adjustments

Non-Hormonal Alternatives for Menopause

As explained above, you can obtain a prescription for bioidentical hormones by requesting any one of the standard-dose, FDA-approved bHRT products. If you find that one brand of bHRT doesnt work well for you, you can always ask to try a different one, or even a different combination.

What to avoid:

  • Combination patches like Climara Pro or the CombiPatch .
  • Combination pills like Prempro, Premphase, Estratest, Activella, FemHRT, and Angelia .

*Please note: If Prometrium is unavailable or you are allergic to it, then a combination patch is a reasonable alternative and a better choice than a combination oral formula.

Sometimes a woman does best with a brand-name form of bHRT used in combination with a compounded bioidentical cream, lotion, gel, or lozenge. For example, she might use a trademark estradiol patch each week, together with a compounded prescription-strength progesterone cream during the second half of her cycle, mixed with a small amount of testosterone. Shes unique, and so are you.

But there are situations where a bioidentical version from a compounding pharmacy is more desirable. Among these are the following situations:

These are all prime examples of why the service that compounding pharmacies provide is essential to our well-being.

1 Davis, P. 2008. Use of oral contraceptives and postmenopausal hormone replacement: Evidence on risk of stroke. Curr. Treat. Options Neurol., 10 , 46874. URL : http://www.ncbi.nlm.nih.gov/pubmed/18990315 .

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How To Use Premarin

Read the Patient Information Leaflet if available from your pharmacist before you start using this medication and each time you get a refill. If you have any questions, ask your doctor or pharmacist.

Take this medication by mouth with or without food as directed by your doctor. You may take it with food or right after a meal to prevent stomach upset.

If you are taking the extended-release tablets, do not crush, chew, or dissolve them. Doing so can release all of the drug at once, increasing the risk of side effects. Also, do not split extended-release tablets unless they have a score line and your doctor or pharmacist tells you to do so. Swallow the whole or split tablet without crushing or chewing.

The dosage is based on your medical condition and response to treatment.

Take this medication regularly to get the most benefit from it. To help you remember, take it at the same time each day as directed. Follow your dosing schedule carefully. Do not increase your dose or take this medication more often or for a longer time than directed.

Tell your doctor if your condition does not improve or if it worsens.

Information For Your Doctor To Read Includes Ams Information Sheets:

If you have any concerns or questions about options to manage your menopausal symptoms, visit your doctor or go to the Find an AMS Doctor service on the AMS website.

NOTE: Medical and scientific information provided and endorsed by the Australasian Menopause Society might not be relevant to an individuals personal circumstances and should always be discussed with their own healthcare provider. This Information Sheet may contain copyright or otherwise protected material. Reproduction of this Information Sheet by Australasian Menopause Society Members, other health professionals and their patients for clinical practice is permissible. Any other use of this information must be agreed to and approved by the Australasian Menopause Society.

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Making A Choice About Your Treatment

There will be choices to make about the type of treatment you wish to receive. You will probably have a lot of questions and may wish to discuss your options with family and friends. To begin with, try to get answers to three key questions:

  • What are my options?
  • What are the pros and cons of each option for me?
  • How do I get support to help me make a decision that is right for me?

For more information about working with your healthcare professional to make the right choice for you, please visit the NHS Shared Decision Making website.

What Is Known About Hormone Therapy And The Risk Of Heart Disease

Hormone Replacement Therapy (HRT)

Scientists continue to learn about the effects of HT on the heart and blood vessels. Many large clinical trials have attempted to answer questions about HT and heart disease. Some have shown positive effects in women who started HT within 10 years of menopause some have shown negative effects when started greater than 10 years of menopause. Some studies have raised more questions about the potential benefits of HT.

Based on the data, the American Heart Association issued a statement for use of HT. They say:

  • Hormone therapy for the sole purpose of preventing heart disease is not recommended.

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Shortage Of Some Hrt Products

There are ongoing supply problems with some HRT products. For some products this is because of irregular supply while for others it’s a longer-term shortage. There are lots of different reasons why medicines can be in short supply. Work is happening with the pharmaceutical manufacturers who make the medicines to help the situation.

If your pharmacy cant supply the specific HRT product you’ve been prescribed, they may supply an alternative product. This will usually have the same ingredient, but may be made by a different manufacturer. Your pharmacy might also reduce the amount they provide you with to help ensure that as many woman as possible can get access to their required medication.

Disruptions in the availability of HRT will be worrying if it has been prescribed for you. However, there are always alternative options. If you are concerned about this contact your GP, pharmacist or specialist doctor to discuss the best treatment options for you.

A Note From Cleveland Clinic

The decision to take hormone therapy needs to be a very personalized one. Hormone therapy is not for everyone. Discuss the risks and benefits of hormone therapy with your healthcare provider at an office visit specifically dedicated for this conversation. Youll need the time to address all the issues and answer questions in order to arrive at a decision that is best for you. Factors considered should be your age, family history, personal medical history and the severity of your menopausal symptoms.

Be sure to talk about the pros and cons of the different types and forms of HT as well as non-hormonal options such as dietary changes, exercise and weight management, meditation and alternative options.

Also Check: How To Balance Female Hormones For Acne

What Are Common Side Effects Of Testosterone Pills

Using OTC testosterone pills regularly can cause your body to build a tolerance to these substances. Over time, your body may stop producing testosterone on its own and come to rely on OTC supplementation. Testosterone boosters may also permanently lower your sperm count, causing major problems with infertility.

Other side effects of OTC testosterone pills may include:

  • Shrunken testicles
  • Male pattern balding and hair loss
  • Development of male breasts, a condition known as gynecomastia
  • Increased risk for prostate cancer
  • Increased risk for blood clots
  • High blood pressure
  • Kidney problems
  • Liver damage and failure

If you are experiencing any of the above testosterone supplements side effects after using testosterone booster pills, you may want to ask your doctor about safe alternatives.

Venous Thrombosis And Hrt

Hormone Replacement Therapy (HRT) in menopause

Venous thromboses are blood clots that form inside veins. Women under 50 years of age, and women aged 50 to 60, face an increased risk of venous thrombosis if they take oral HRT. The increase in risk seems to be highest in the first year or two of therapy and in women who already have a high risk of blood clots. This especially applies to women who have a genetic predisposition to developing thrombosis, who would normally not be advised to use HRT.

Limited research to date suggests the increased risk of clots is mainly related to combined oestrogen and progestogen in oral form, and also depends on the type of progestogen used. Some studies suggest a lower risk with non-oral therapy or tibolone.

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Evaluation For Hormone Therapy

All candidates for HT should be thoroughly evaluated with a detailed history and complete physical examination for a proper diagnosis and identification of any contraindications.

Baseline laboratory and imaging studies before administering HT include the following:

  • Hemography

  • Fasting lipid profile

  • Blood sugar levels

  • Serum estradiol levels: In women who will be prescribed an implant and in those whose symptoms persist despite use of an adequate dose of a patch or gel

  • Serum follicle-stimulating hormone levels: To monitor women taking oral preparations for symptomatic control, especially those with premature menopause

  • Ultrasonography: To measure endometrial thickness and ovarian volume

  • Electrocardiography

  • Papanicolaou test

  • Mammography: Performed once every 2-3 years and annually after the age of 50 years

Endometrial sampling is not required in routine practice. However, the presence of abnormal bleeding before or during HT should prompt consideration of ultrasonography to check endometrial thickness , followed by outpatient Pipelle sampling and hysteroscopy. In women with a tight cervix, formal hysteroscopy and dilation and curettage under general anesthesia are advised.

Ht Indications Contraindications And Adverse Effects/risks

Indications

Indications for hormone therapy can be symptomatic or preventive. However, the application of HT to prevent sequelae of menopause is controversial, although some consensus has been reached regarding the use of HT to relieve symptoms.

The following are common clinical indications for prescribing HT:

  • To relieve vasomotor symptoms

  • To improve urogenital symptoms

  • To prevent osteoporosis

Contraindications

No absolute contraindications of HT have been established. However, relative contraindications exist in certain clinical situations, such as patients with the following findings:

  • A history of breast cancer*

  • A history of endometrial cancer*

  • Porphyria

  • Endometriosis

  • Fibroids

* Note that many clinicians do not prescribe HT for women with a previous history of breast or endometrial cancer.

Adverse effects and risks

Possible transient adverse effects are as follows:

  • Nausea

  • Bloating, weight gain , fluid retention

  • Mood swings

  • Breakthrough bleeding

  • Breast tenderness

Potential risks of HT in postmenopausal women include the following:

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How Long Should I Take Hormone Therapy

In general, there is no time limit to how long you can take hormone therapy. You should take the lowest dose of hormone therapy that works for you, and continue routine monitoring with your healthcare provider to reevaluate your treatment plan each year. If you develop a new medical condition while taking HT, see your provider to discuss if its still safe to continue taking HT.

Do Local Formulations Of Menopausal Hormone Therapy Have Different Risks

Hormone replacement therapy (menopause)

Both systemic and local treatment options for MHT are available in the United States. Which option a woman receives depends on the menopausal symptoms the treatment is meant to address. Systemic MHT is usually prescribed to treat hot flashes and to prevent osteoporosis. Systemic MHT with combined estrogen plus progestin or with estrogen alone can be given as oral medications as transdermal patches, gels, or sprays and as implants.

Local MHT is prescribed to treat genitourinary symptoms such as vaginal dryness. Local MHT contains low-dose estrogen only and is prescribed to women regardless of their hysterectomy status. Local MHT with low-dose estrogen alone includes creams, tablets , and rings.

Findings from the Womens Health Initiative Observational Study showed that, among women with an intact uterus, those who used vaginal estrogen and those who didnt had similar risks of stroke, invasive breast cancer, colorectal cancer, endometrial cancer, and pulmonaryembolism/deep vein thrombosis .

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Alternatives To Hormone Replacement Therapy During Perimenopause

Posted on July 24, 2021 in Perimenopause / Menopause

Its no surprise that a womans body changes when she enters perimenopause, and it can be overwhelming to see an abundance of treatment options to manage the symptoms. Its important to understand your options and decide which one is best for you. This decision is different for every woman. Some prefer hormone therapies and some prefer trying other methods first.

Heres a look into some non-hormone therapies for perimenopause:

Symptoms And Effects Of Menopause

Menopause is the time in a womans life when menstruation ceases, signaling the end of her reproductive ability. The timing of menopause varies widely, but this event often occurs naturally in women in the fourth or fifth decades of life, at a mean age of 51 years. Certain medical or surgical conditions may induce the cessation of menses before this age. If menopause occurs before the age of 40 years, it is considered premature.

The STRAW classification proposed by the American Society for Reproductive Medicine depicts the natural transition in a female’s life from the reproductive years to the time of menopause.

The reproductive years are divided into early, peak, and late and are characterized by regular menstrual cycles . This is followed by the stage of menopausal transition, which earlier on is characterized by a variable cycle length that is more than 7 days different from normal. During the latter stages of this transition phase, women experience intervals of amenorrhea of more than 60 days. When this duration of amenorrhea lasts for up to 12 months, it is classified as postmenopause. The stage of perimenopause spans from the beginning of the stage of menopause transition up until the completion of 1 year following the final menstrual period.

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