Talk To A Hormone Replacement Specialist
Dr. Karen Clark of Chapel Hill Gynecology is a certified menopause practitioner and specializes in several types of hormone replacement for women and men. If you have questions about hormone replacement therapy, contact Chapel Hill Gynecology today. Chapel Hill Gynecology is open for office visits as well as telemedicine visits. Call 960-2720 to schedule an appointment.
How Do The Hormones Used In Mht Differ From The Hormones Produced By A Womans Body
The hormones used in MHT come from a variety of plants and animals, or they can be made in a laboratory. The chemical structure of these hormones is similar, although usually not identical, to those of hormones produced by womens bodies.
Non-FDA-approved hormone products, sometimes referred to as bio-identical hormones, are widely promoted and sold without a prescription on the Internet. Claims that these products are safer or more natural than FDA-approved hormonal products are not supported by credible scientific evidence. The FDA provides more information about these products on its Menopause page.
Do Bioidentical Hormones Really Work
Yes, they work for some people. You will have different results depending on your symptoms and health history. Talk with your healthcare provider about bioidentical hormones and what form may work best for you. In some cases, your healthcare provider may recommend against using bioidentical hormones in favor of a more traditional hormone replacement therapy option.
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The Most Common Menopause Symptoms
Women can experience a variety of symptoms and conditions related to changes in sex hormone levels and aging. Some of the most common menopause symptoms include:
- Irregular periods: As perimenopause begins , periods can come and go, plus get heavier or lighter at times. This can sometimes continue for several years during menopause
- Hot flashes and night sweats
- Mood swings, irritability, anxiety or depressive symptoms
- Vaginal dryness and decreased sex drive
- Increased abdominal fat and weight gain
- Insomnia and changes in sleep quality
- Thinning hair and dryer skin
- Going to the bathroom more often
- Breast changes
- Changes in the uterus, ovaries and cervix
- For some, a higher risk for certain other age-related diseases
What Are The Symptoms Of Menopause
Every womans period will stop at menopause. Some women may not have any other symptoms at all. As you near menopause, you may have:
- Changes in your periodtime between periods or flow may be different.
- Hot flashes getting warm in the face, neck, or chest, with and without sweating.
- Night sweats that may lead to problems sleeping and feeling tired, stressed, or tense.
- Vaginal changesthe vagina may become dry and thin, and sex may be painful.
- Thinning of your bones, which may lead to loss of height and bone breaks .
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A Guide To Different Types Of Hormone Replacement Therapy
During menopause and perimenopause, estrogen production in the body slows and hormone levels fluctuate, which can cause wide-ranging symptoms such as irregular periods, hot flashes, and mood swings. Hormone replacement therapy is used to treat hormonal imbalances and the resulting symptoms by putting female hormones back in the body.
There are various types of hormone replacement therapy used to treat symptoms of menopause. Heres what you need to know about hormone replacement therapy options.
Are There Alternatives For Women Who Choose Not To Take Menopausal Hormone Therapy
Women who are concerned about the changes that occur naturally with the decline in hormone production that occurs during menopause can make changes in their lifestyle and diet to reduce the risk of certain health effects. For example, eating foods that are rich in calcium and vitamin D or taking dietary supplements containing these nutrients may help to prevent osteoporosis. FDA-approved drugs such as alendronate , raloxifene , and risedronate have been shown in randomized trials to prevent bone loss.
Medications approved by the FDA for treating depression and seizures may help to relieve menopausal symptoms such as hot flashes . Drugs that have been shown in randomized clinical trials to be effective in treating hot flashes include venlafaxine , desvenlafaxine , paroxetine , fluoxetine , citalopram , gabapentin , and pregabalin .
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How Hormone Replacement Therapy Helps Women Through Menopause
Just because menopause is a natural part of a woman’s cycle of life doesn’t mean its always an easy transition. From hot flashes and sleep problems to irritability and mood swings, it can be a challenge both physically and emotionally. Often hormone replacement therapy can help.
Here at OB/GYN Specialists in Denton, Texas, Dr. Daniel McDonald, Dr. Marc Wilson, and family nurse practitioner Lindsey Council offer high-quality pro-life women’s health care in a warm supportive environment. Whether youre pregnant, seeking well-woman care, or suffering from an issue like infertility or pelvic pain, were here to provide personalized care without rushing through the appointment or pressuring you into medications or procedures you’re not comfortable with.
Wild Yam For Menopause
Wild yam extract is naturally rich in diosgenin, a plant compound structurally bioidentical to progesterone found in the body. Bringing progesterone levels back in balance will help to offset estrogen dominance and its related symptoms, including hot flashes and low libido. Wild yam extract may be especially helpful for hair loss in perimenopause and menopause.
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What Are The Risks Of Hrt
Breast cancer risk differs depending on the type of HRT and a womans personal history of breast cancer.
Based on results from the very large Womens HealthInitiative studies, combination HRT increases breast cancer risk and this increase in risk lasted for more than 10 years after the women stopped taking HRT.
Higher-dose combination HRT increases breast cancer risk more than lower-dose combination HRT.
Combination HRT also increases the likelihood that the cancer may be found at a more advanced stage. Combination HRT is linked to increased breast density, which can make it harder for mammograms to detect breast cancer.
Breast cancer risk appears to be higher with daily progesterone than with less frequent progesterone .
This increase in risk applies to bioidentical and natural hormone products as well as synthetic hormones. Bioidentical means the hormones in the product are identical to the hormones your body produces. Bioidentical hormones are derived from plants, so theyre sometimes called natural. Synthetic hormones are made in a lab and are also chemically identical to thehormones in your body. It’s important to know that many herbal and bioidentical HRT products fall outside the jurisdiction of the United States Food and Drug Administration and so aren’t subject to the same regulations and testing that medicines are.
Safety Note About Natural Remedies
Always remember that natural does not necessarily mean safe. Many herbal, plant, and dietary supplements interact with medications or may have a negative impact on medical conditions. Natural approaches are not risk-free, and the more you know, the better you can choose treatments that will keep you safe and well.
Before deciding to use alternative and complementary remedies for your menopause symptoms, check with your medical professional and read up on possible side effects and cautions for any remedy you are considering.
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Treatment Of Menopausal Symptoms With Hormone Therapy
Hormone replacement therapy is widely recognized as the most effective way to mitigate the negative effects and impacts of the aging process. Furthermore, over the last 20 years or so, HRT that uses bioidentical hormones has picked up a lot of momentum due to the fact that it effectively manages the symptoms of hormonal imbalance without the potential side effects of synthetic hormone therapy . Instead of being made synthetically, bioidentical hormones have been meticulously designed to have the same composition as the natural hormones found in the human body, and that process begins with using natural origins like yams and soy. Synthetic hormones are often mass-produced in pre-determined strengths before they hit the market in an effort to maximize profits. Bioidentical hormones, on the other hand, are engineered for each individual person at an FDA-monitored compounding pharmacy based on a trained professionals assessment of that individuals hormone level testing. Why accept impersonal products in the form of synthetic hormones when you can instead augment your body with bioidentical hormones that have been carefully engineered to be indistinguishable from the hormones that are already in your body?
The Psychology Of Menopause
Hormone shifts can affect moods. It can be disturbing to find yourself feeling uncharacteristically nervous or depressed or having memory lapses. Sometimes these feelings can even strain your relationships with others. It helps to know that the psychological effects of menopause are temporary. In all likelihood, youll soon get back on an even keel. Here are the most common psychological accompaniments of menopause.
Anxiety. Women who have never had a problem with anxiety before may become more self-conscious and worried about minor events. In some cases, panic attacks occur. Mental health professionals have a variety of effective treatments. Many people feel much better just knowing what the condition is. The most important piece of advice is not to let anxiety restrict your activities. When anxiety or panic disorders cause people to avoid stressful situations, the result can be an ever-tightening leash that keeps them from enjoying life. Anxiety can lead to avoidance of many aspects of normal life. Prompt treatment prevents this.
Poor Memory and Concentration. Some women find that menopause brings occasional memory lapses, often related to reduced ability to concentrate. This can be upsetting and annoying, but fortunately it seems to go away on its own with time.
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What Are Bioidentical Hormones
Bioidentical hormones are processed hormones designed to mimic the hormones made by your bodys glands. Taking bioidentical hormones can help people who experience symptoms of low or unbalanced hormones. This is often the case for people experiencing symptoms of perimenopause or menopause.
Hormones are chemicals made by your endocrine glands. They are messengers that tell other parts of your body how and when to work. Hormones affect many systems and functions in your body. Even the slightest imbalance can cause symptoms that interfere with your day. Healthcare providers may recommend hormone replacement therapy as a treatment for these symptoms.
Bioidentical hormone therapy uses processed hormones that come from plants. Estrogen, progesterone and testosterone are the most commonly used bioidentical hormones.
Some prescription forms of bioidentical hormones are premade by drug companies. The U.S. Food and Drug Administration has approved certain types of bioidentical hormones. Other forms of bioidentical hormones are custom-made by a pharmacist based on a healthcare provider’s prescription. These are compounded bioidentical hormones.
The compounded forms have not been tested and approved by the FDA. Though it is often advertised that products that are made from plants are “natural” choices, they are altered in a lab so are no longer natural when done with processing.
Conventional hormone therapy vs. bioidentical hormone therapy
Symptoms Of Low Estrogen
Estrogen plays a critical role in your reproductive health, but its also important for bone health and the production of mood-stabilizing hormones.
The most common reason for low estrogen is perimenopause, the natural transition to menopause.
This usually occurs in women in their 40s, though it can vary. During this time, your body may have sudden surges and production, which can cause symptoms including:
changes in metabolism
If you notice symptoms, consult a doctor before making changes to your diet and lifestyle.
They may recommend hormone replacement therapy . Studies have found that HRT is safe for many but not all women.
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Can Increase The Risk Of Blood Clots
Studies have shown that HRT may raise your risk of blood clots and stroke. This risk may be highest for people over 60 or who started menopause over a decade ago. The longer you take HRT, the greater the increase in your risk.
Because of this risk, health experts recommend the lowest possible HRT dose for the shortest period of time for people over 60 or who are 10 years past the onset of menopause.
Bioidentical Or Natural Hormones
Bioidentical hormones are hormone preparations made from plant sources that are promoted as being similar or identical to human hormones.
Practitioners claim these hormones are a “natural” and safer alternative to standard HRT medicines.
However, bioidentical preparations are not recommended because:
- they are not regulated and it’s not clear how safe they are there’s no good evidence to suggest they’re safer than standard HRT
- it’s not known how effective they are in reducing menopausal symptoms
- the balance of hormones used in bioidentical preparations is usually based on the hormone levels in your saliva, but there’s no evidence that these levels are related to your symptoms
Bioidentical hormones are not the same as body identical hormones. A body identical hormone, or micronised progesterone, can be prescribed to treat menopausal symptoms.
Many standard HRT hormones are made from natural sources, but unlike bioidentical hormones, they’re closely regulated and have been well researched to ensure they’re as effective and safe as possible.
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The Fda Takes Action Against Unfounded Claims But Is It Enough
The National Women’s Health Network has long urged the FDA to exercise better oversight of alternative hormone products, petitioning the agency throughout the years to do more to ensure that women get reliable and accurate information about these products.
In January 2008, the FDA took action against misleading marketing claims about natural hormones sold by compounding pharmacies, instructing these pharmacies that the safety and effectiveness claims they were making about bio-identical hormone products “are unsupported by medical evidence, and are considered false and misleading by the agency.”
The FDA identified several specific misleading claims, including statements that natural hormones are “better” or “safer” than conventional hormone therapy and that natural hormone can treat or prevent Alzheimer’s disease, stroke, and cancer.
The FDA also said that the use of the term “bio-identical” implies “a benefit for the drug, for which there is no medical or scientific basis.” The agency also warned that selling products containing estriol is a violation of Federal law because the FDA has never approved this product.
While the NWHN was encouraged by these actions, we remain concerned that they are insufficient to protect women’s health. We urge the FDA to do more, including to publish regulations about the appropriate labeling and advertising of pharmacy-compounded hormone therapy products.
- These products have not been approved by the FDA
How Does My Healthcare Provider Select My Dose
People on hormone treatment are watched very closely by their healthcare providers. The goal is to relieve symptoms with the lowest dose possible for the shortest amount of time. Depending on your healthcare provider, you might have routine blood, urine or saliva tests to check your hormone levels. Your healthcare provider may adjust your dose based on your changing hormone needs.
The FDA recommends against using hormone levels to guide the dosing of hormone therapy in women, as normal levels fluctuate day to day. In particular, salivary hormone levels are known to fluctuate and have not been shown to be related to menopausal symptoms.
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Reduce Refined Sugar And Processed Foods
In fact, one study found that diets high in refined carbs may increase the risk of depression in postmenopausal women .
Diets high in processed foods may also affect bone health, especially if these foods are replacing the nutrients you need from a daily balanced diet.
A large observational study found that among women ages 50 to 59, diets high in processed and snack foods were associated with poor bone quality .
Diets high in processed foods and refined carbs are associated with a higher risk of depression and worse bone health in postmenopausal people.
Eating regular meals may be important when youre going through menopause.
Irregular eating may make certain symptoms of menopause worse and make weight management more difficult.
A yearlong weight management program for postmenopausal women found that skipping meals was associated with 4.3% less weight loss .
Irregular eating may cause some symptoms of menopause to worsen. Skipping meals may also hinder weight loss and management during postmenopause.
Where Does Evidence About The Health Effects Of Mht Come From
The most comprehensive evidence about the health effects of MHT comes from two randomized clinical trials that were sponsored by the National Institutes of Health as part of the Womens Health Initiative :
- The WHIEstrogen-plus-Progestin Study, in which women with a uterus were randomly assigned to receive either a hormone pill containing both estrogen and progestin or a placebo. The median duration of treatment was 5.6 years.
- The WHI Estrogen-Alone Study, in which women without a uterus were randomly assigned to receive either a hormone pill containing estrogen alone or a placebo. The median duration of treatment was 7.2 years.
More than 27,000 healthy women who were 50 to 79 years of age at the time of enrollment took part in the WHI hormone therapy trials. The goals of these trials were to see if MHT prevents heart disease and bone fractures in postmenopausal women and to determine if MHT affects risks of breast cancer and, for women with a uterus, endometrial cancer. Both trials were stopped early , when it was determined that both types of therapy were associated with specific health risks, but long-term follow up of the participants continues to provide new information about the health effects of MHT.
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