What About Bioidentical Hormones
Bioidentical hormones are made in a lab from chemicals found in plants. Theyre said to be more similar to hormones your body naturally produces than those used in HRT.
Researchers are still working to figure out if bioidentical hormones are a safe and effective way to treat menopause symptoms.
These supplements havent been rigorously tested on humans, so they could pose long-term health risks we dont know about yet. As of now, theres no evidence to suggest these are safer or more effective than traditional HRT.
If youre interested in bioidentical hormones, talk to a doctor. They can discuss your options and may be able to prescribe an appropriate pill, patch, or cream.
Estrogen Treatment: Topical Creams Gels And Sprays
- What are they? Estrogen gels , creams , and sprays offer another way of getting estrogen into your system. As with patches, this type of estrogen treatment is absorbed through the skin directly into the bloodstream. The specifics on how to apply these creams vary, although they’re usually used once a day. Estrogel is applied on one arm, from the wrist to the shoulder. Estrasorb is applied to the legs. Evamist is applied to the arm.
- Pros. Because estrogen creams are absorbed through the skin and go directly into the bloodstream, they’re safer than oral estrogen for people who have liver and cholesterol problems.
- Cons. Estrogen gels, creams, and sprays have not been well-studied. While they could be safer than oral estrogen, experts aren’t sure. So assume that they pose the same slight risk of serious conditions, like cancer and stroke.One potential problem with using this type of estrogen treatment is that the gel, cream or spray can rub or wash off before it’s been fully absorbed. Make sure you let the topical dry before you put on clothes. Always apply it after you bathe or shower.
Because the estrogen is absorbed right through the skin, don’t let other people in your family touch these creams or gels. If they do, they could get dosed with estrogen themselves. For the same reason, make sure your hands are clean and dry after applying the medication.
What Can I Do About Hot Flashes
Hot flashes occur from a decrease in estrogen levels. In response to this, your glands release higher amounts of other hormones that affect the brain’s thermostat, causing your body temperature to fluctuate. Hormone therapy has been shown to relieve some of the discomfort of hot flashes for many women. However, the decision to start using these hormones should be made only after you and your healthcare provider have evaluated your risk versus benefit ratio.
To learn more about women’s health, and specifically hormone therapy, the National Heart, Lung, and Blood Institute of the National Institutes of Health launched the Women’s Health Initiative in 1991. The hormone trial had 2 studies: the estrogen-plus-progestin study of women with a uterus and the estrogen-alone study of women without a uterus. Both studies ended early when the research showed that hormone therapy did not help prevent heart disease and it increased risk for some medical problems. Follow-up studies found an increased risk of heart disease in women who took estrogen-plus-progestin therapy, especially those who started hormone therapy more than 10 years after menopause.
The WHI recommends that women follow the FDA advice on hormone therapy. It states that hormone therapy should not be taken to prevent heart disease.
Practical suggestions for coping with hot flashes include:
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How Does Hormone Replacement Therapy Work
To make an informed decision if HRT is right for you, it is necessary to understand exactly how the treatment works.
When you go through menopause, your body will slowly produce less and less estrogen. Oestrogen actually refers to three types of reproductive hormone oestradiol, oestrone and oestriol. Produced mostly in the ovaries, but also in the adrenal glands and fat tissue, estrogen is responsible for controlling a womans menstrual cycle and physical development during puberty.
As you age and stop ovulating, levels of estrogen drop – this is a very gradual process, and it will not happen overnight. Unfortunately, as these levels drop, a woman will start to suffer from the symptoms of menopause, namely:
- hot flashes
- mood swings
- loss of libido
- vaginal dryness
- concentration problems
HRT artificially increases estrogen levels in your body so you never experience the symptoms of that deficit. Essentially, HRT is a hormone supplement that your body needs to stay healthy. Once a few years have gone by and symptoms ease, you can stop taking HRT.
Other Considerations Before Choosing A Hormone Patch
Generally, we recommend placing the estradiol patch on an area of skin on your torso or below the waist that is obscured by clothing they should not be applied to the breasts. Heat can make some patches release their estrogen too quickly, which can affect the dosage you receive, so it is recommended that you not use tanning beds or saunas while wearing an estrogen patch. Patches should not be exposed to other high heat or direct sunlight. The hormone patch should be applied to clean, dry skin. If you are someone who regularly applies body lotions or creams, you should not attempt to place a patch after applying moisturizer. It may affect how well the patch adheres to your skin and how the medication from the patch is absorbed.
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Progestin Or Progesterone Or Estrogen Hormone Therapy
This is referred to as combination therapy because it has both progestin and estrogen doses. This is for women that still have a uterus. Taking a combination of both progesterone and estrogen reduces the risk of getting endometrium cancer. Generally, progesterone is used in birth control, but it is useful in treating some menopause symptoms like hot flashes. This therapy is administered in various ways.
Oral progestins come in the form of a pill, such as medroxyprogesterone acetate, commonly referred to as Provera. There are also synthetic pills such as norgestrel or norethindrone. However, most experts prefer using natural progesterone to treat their patients rather than synthetic progestin. This is because it contains no adverse side effects and is an excellent option for persons with elevated cholesterol levels.
Intrauterine progestin. This method is not approved in America. It is, however, sold as low-dose intrauterine devices with different brands such as Skyla or Mirena. If, as you get to premenopause, you have an IUD, your physician may advise you to retain it until the menopause period gets completed.
Is Hormone Replacement Therapy Suitable for Everyone?
- Cancer especially endometrial, uterine or breast cancer,
- If you have blood clots
- Liver or heart disease
- Have suffered a heart attack previously
- If you suspect or know you are pregnant
- If you have suffered a stroke
- Tenderness or swelling of the breasts
- Sudden mood swings
Other Treatments For Menopausal Symptoms
Studies have shown that some prescription medications can reduce hot flushes and sweats. These treatments may be an option if HRT cannot be used for health or other reasons, and should be discussed with a doctor.
The herbal medicine, black cohosh, may take the edge off hot flushes and sweats, but there is no data to support long-term use. There is also a rare liver condition that may be associated with the use of black cohosh.
Other complementary and alternative medicines have not been shown to be effective for menopausal symptoms when compared with dummy or placebo treatment in research studies.
Commercially available vaginal moisturisers may reduce vaginal dryness if used regularly. Consult your doctor about what will work best for you.
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Menopause Supplements Vs Hormone Replacement Therapy
Hormone Replacement Therapy is still the gold standard when it comes to treating the different symptoms of menopause. It is still the most effective and provides the fastest relief to different symptoms. However, it comes with several substantial risks thus it is not for many women.
Also, most women choose not to have HRT because of the various dangers related to the treatment option. For instance, HRT increases risk of breast cancer so it is not a viable option for high risk women. It also increases risk of stroke, heart disease and ovarian cancer. This is the main reason many women choose alternative treatments like the use of menopause supplements.
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.
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Find A Gynecologist Near Me
Womenâs health issues can be sensitive, especially those dealing with hormones. The changes in women due to menopause can cause discomfort in the majority of us. While most women seek ways of coping with menopause symptoms without getting a doctor’s advice, expert advice from an experienced gynecologist is the best thing to do. Your doctor will evaluate your symptoms, explore various treatment options, and advise you on how to maintain proper health. If you are looking for a Los Angeles doctor with a specialization in womenâs health, get in touch with All Women’s Care at .
Risks Of Hormone Replacement Therapy
Hormone therapy is a viable option for relatively young and healthy women up to age 59 or within ten years of menopause. Although, there are risks involved. It’s critical to talk to your doctor about these risks before starting therapy.
The following risks are associated with HRT:
- Blood clots in the legs and lungs that could result in a stroke.
- Endometrial cancer if you are taking estrogen-only replacement therapy and you still have your uterus.
- Breast cancer if you are taking estrogen and progesterone combination therapy for five or more years. This risk decreases after hormone therapy is stopped and is not associated with estrogen-only therapy.
You are less likely to experience any issues if you follow these suggestions:
- Start treatment with the lowest dose that works for you for the shortest possible time.
- Have your doctor closely monitor your treatment and address any concerns you are having.
- Take progesterone and estrogen if you still have your uterus.
- Stay up-to-date with your doctor visits, mammograms, and pelvic exams.
- Stick to localized estrogen therapy if the only troublesome symptom youre experiencing is vaginal dryness or painful sex.
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Types Of Hormone Replacement Therapy
There are three types of hormone replacement therapy. These are:
- Estrogen-only: This type of treatment typically comes in pill or patch form and doctors often prescribe them at low doses to be taken daily. Estrogen can also be prescribed as a cream, gel, spray, or vaginal ring to help . If the uterus is still present, progesterone must be prescribed to prevent cell changes of the uterine lining that may lead to cancer.
- Progestin-only: Some women may take progestin-only medications in addition to estrogen-only treatments. Progestin-only treatment options come in pill form and are also generally given in daily low doses, says Felice Gersh, MD, an OB-GYN and founder of the Integrative Medical Group of Irvine. Progestins are added to protect the uterus against cell changes that may occur from estrogen alone.
- A combination of estrogen and progestin: Just as the name suggests, these medications combine doses of estrogen and progestin and typically come in pill or patch form.
There are only three progestin-only medications currently approved by the US Food and Drug Administration . They are:
- Prometrium, pill
- Aygestin, pill
But there are many more estrogen-only and combination medications approved by the FDA. Here’s a look at a few different medications that are available for these two types of hormone replacement therapy:
| Estrogen-only | |
|
Vivelle, patch |
Taking Estrogen With A Progestin Vs Estrogen Alone
Treating menopausal symptoms with estrogen and progestin together is known as estrogen-progestin therapy or combined hormone therapy. Although estrogen alone improves the symptoms of menopause, it increases the risk of cancer of the uterus . Adding a progestin to the estrogen lowers the risk of endometrial cancer back to normal. Because of this, EPT is given to women who still have a uterus . EPT can be given 2 ways:
- Continuous EPT means the same dose of estrogen and progestin is taken each day. Women often prefer continuous EPT because it rarely leads to menstrual-like bleeding.
- Sequential EPT means different amounts of each hormone are taken on specific days. There are different ways to do this. For example, estrogen can be taken by itself for 14 days, then estrogen plus progestin for 11 days, then neither hormone for 3 to 5 days. Other schedules involve taking progestin only every few months. This lowers the amount of progestin that you are exposed to. Monthly regimens are also thought to result in hormone levels that are more like the natural menstrual cycle. Cyclical EPT can produce bleeding like a menstrual period, but it can occur less often than monthly.
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Hrt: Which Type Is Right For You
As a woman going through the menopause, you have decided that you would like to try hormone replacement therapy to relieve unpleasant symptoms.
This is a good start because HRT is very effective in combatting night sweats, hot flushes, mood swings and more, and overall is very safe. The next step is to choose the right type of HRT for you.
HRT comes in different forms, including tablets, gels, patches and pessaries, and many women feel confused by the options available to them. However, choosing the right dose and delivery of HRT will be of huge benefit in helping you deal effectively with your menopausal symptoms.
It is important to consider, with your doctor or other medical professional, your age, medical history and overall health when deciding which type of HRT to try. We are all individuals and just because one type of HRT works for someone else does not mean it is best for you. It may be a case of trial and error, trying different options before making a final choice.Knowing more about HRT, the different forms and who they are most suited to will help. See our guide below to point you in the right direction:
Why Is It Called A Hot Flash
A hot flash is a wave of heat experienced throughout the body, especially the face, causing redness, sweat and occasionally swelling. This is a common side effect many women experience during perimenopause and menopause signaling the reduction of estrogen production by the ovaries. Hot flashes can be uncomfortable and unpredictable in nature. Coupled with other symptoms of fatigue, irritability, joint pain and headaches often associated with menopause. Hot flashes are certainly an unwelcome event.
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Who Is Hormonal Therapy Most Suitable For
Despite the risks to one’s health, systemic estrogen remains one effective treatment in women experiencing menopausal symptoms. When one is healthy, the benefits of hormonal therapy outweigh the risks one may get exposed to. Aside from being healthy, when you experience the following, then you qualify for hormonal replacement therapy. These are:
- When you begin to experience hot flashes, whether moderate or severe, as well as other symptoms of menopause.
- You have experienced a loss of bone density, and the different forms of treatment don’t go well with you or are not beneficial
- When you stop having your menses before you are forty, which is the onset of premature menopause. Also, when you experience premature insufficiency of ovaries typically before you are forty.
If you have experienced early menopause, especially if you had your ovaries removed, you are at risk of the following conditions unless you take estrogen therapy before you are 45. These are:
- Risks of osteoporosis
- High chance of developing heart disease
- Suffer from an earlier death
- Developing symptoms similar to Parkinson’s
- Getting depressed or anxious
For women experiencing premature menopause, the benefits of hormonal therapy outweigh the potential risks. Most of the dangers in hormonal therapy are associated with when menopause began, the kind of menopause, and your age. Speaking with your doctor about the risks is important because they differ in women.
Can I Take Menopausal Hormone Therapy After Breast Cancer
When women reach menopause, some choose to take PHT, which is made up of female hormones to help reduce menopause symptoms. But there have been concerns about women who have had breast cancer using PHT, because of the known link between estrogen levels and breast cancer growth.
A well-designed clinical trial found that breast cancer survivors taking PHT were much more likely to develop a new or recurrent breast cancer than women who were not taking these hormones. Because of this, doctors generally do not recommend PHT if a woman was previously treated for breast cancer.
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Cardiovascular Disease And Hrt
Women over 60 have a small increased risk of developing heart disease or stroke on combined oral HRT. Although the increase in risk is small, it needs to be considered when starting HRT, as the risk occurs early in treatment and persists with time.
Oestrogen used on its own increases the risk of stroke further if taken in tablet form, but not if using a skin patch. Similarly, tibolone increases the risk of stroke in women from their mid-60s.
Women who commence HRT around the typical time of menopause have lower risks of cardiovascular disease than women aged 60 or more.