Important Questions To Ask About Menopause Hormone Medicines
- Are hormones right for me? Why?
- What are the benefits?
- What are the serious risks and common side effects?
- How long should I use hormone therapy?
- What is the lowest dose that will work for me?
- Are there any non-hormone medicines that I can take?
Want more information about menopause? Check the FDA website at: www.fda.gov/menopause
The drug and risk information in this booklet may change. Check for the latest facts on each product listed in this booklet.
Should Testosterone Be Prescribed On Its Own Or With Hrt
The NICE Menopause Guideline and the BMS recommend that a trial of conventional HRT is given before testosterone supplementation is considered.
Oral estrogens, especially conjugated estrogens, can reduce the effectiveness of testosterone by increasing sex hormone binding globulin levels. Switching women with HSDD from oral to transdermal estrogen can be beneficial as this can increase the proportion of circulating free testosterone without requiring exogenous testosterone.
It is important that any symptoms of vulvovaginal atrophy are also adequately treated if testosterone is being considered for HSDD. Although studies have shown that testosterone can be beneficial in women not using concomitant estrogen containing hormone therapy, the incidence of adverse androgenic effects such as acne and excess hair growth is higher this strategy is therefore not usually recommended in routine clinical practice.
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.
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Does It Cause Weight Gain
Some people worry that hormone treatment might lead to weight gain, but there is no evidence to support this.
Eating a healthful diet and getting plenty of exercise can help manage the weight gain that commonly affects both females and males in midlife.
provide different combinations and amounts of hormones.Common types include:
Estrogen-only HRT: A doctor may recommend this if a person has had their uterus and ovaries removed, in which case progesterone is not necessary.
Cyclical, or sequential, HRT: This may be a good option if symptoms occur before menopause the dosage can align with the menstrual cycle.
Continuous HRT: After menopause, a doctor may prescribe a continuous combination of estrogen and progesterone.
Local estrogen: Vaginal tablets, creams, or rings can help with urogenital symptoms, including vaginal dryness and irritation.
The doctor will prescribe the lowest possible dosage that addresses the persons symptoms, and arriving at this dosage may take some trial and error.
Ways of delivering HRT include:
When a person no longer needs the treatment, the doctor will describe how to stop it gradually.
Various lifestyle adjustments can help manage the symptoms of menopause.
They include:
Also, it is a good idea to ask the doctor about nonhormonal treatment options.
Always speak to a doctor before using any supplements.
Why Do Estrogen Levels Fall
There are many reasons why estrogen levels fall, including:
- Anorexia nervosa
- Extreme exercise or training
Drugs that block estrogen include clomiphene, which tricks the body into thinking it has decreased levels of estrogen. Also, women experience low levels of estrogen immediately after childbirth and also during breastfeeding.
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Types Of Studies Of Hormone Therapy And Cancer Risk
Different types of studies can be used to look at cancer risk from menopausal hormone therapy .
Randomized controlled trials: In this kind of study, a group of patients get the drug being studied , and another group gets a placebo . Results from this kind of study are powerful because which group a patient is in is based on chance. This helps assure that the groups are similar in all ways, such as risk for cancer, except for the drug thats being studied. This is the best way to see the effects of a drug. These types of studies can also be double-blinded, which means neither the people in the study nor their doctors know which group they are in. This lowers the chance that thoughts or opinions about treatment could affect the study results. Unfortunately, these kinds of studies are costly, which limits the number of people in the study, how long the study can continue, and the number of studies done.
A major drawback of observational studies is that the people getting the treatment being studied may have different cancer risk factors than the people who arent. Plus, the treatment can differ between the people being studied. This makes it less clear that the differences seen are only due to the drug being studied and not other factors.
When observational studies and randomized controlled trials have different results, most experts give more weight to the results of the randomized controlled trial.
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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Are There Side Effects And Risks
Adverse effects of testosterone in women are uncommon if levels are maintained within the female physiological range. The commonest are excess hair growth, acne and weight gain which are usually reversible with reduction in dosage or discontinuation. Alopecia, deepening of voice and clitoral enlargement are rare with physiological testosterone replacement.
More data are required for the long term effects on cardiovascular and breast outcomes but the short term data from a recent meta-analysis are reassuring.
Testosterone For Womens Health
Testosterone is best known as an essential male sex hormone, but its more nuanced than its reputation suggests.
A womans ovaries and adrenal glands produce about 20 times less testosterone than a mans testes. Yet from bone health to fertility, testosterone influences female health just as much as estrogen and progesterone. Its the preconceived notions about testosterone that lead most of us to fear testosterone therapy for women rather than embrace it.
For me personally, Jenn explains, I was a little scared to use testosterone because I thought, as a woman, Im going to grow a beard, Im going to take on these masculine traits.
Jens definitely not alone. We talk to women every day who dont trust the use of testosterone, usually for one of these three reasons:
- Fear of becoming manly with a deep voice, more hair, and buff muscles
- Incorrect association between the type of testosterone used in illegal steroids and natural hormone therapy
- Misinformation from health care providers who have strong but potentially misleading opinions about testosterone therapy
The truth is that testosterone works intricately with other hormones in the female body to create a strong and powerful core infrastructure. The benefits of testosterone arent merely frills like decor and artwork theyre the foundation and frame of the body you call home.
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Menopause And Low Testosterone Level
If you are going through menopause or your testosterone level is low, then you may notice a few side effects. You may know that menopause and testosterone can affect both your mental and physical health. To maintain balance, the experts may suggest you take hormone replacement therapy. You may wonder if this therapy is safe for everyone and the answer is yes. It does not only maintain a balance between the hormones but also reduce fracture in postmenopausal women and prevent bone loss.
Although hormone therapy is safe, there are a few risks to this treatment. It mainly depends upon various factors such as the dose, how long the medication is taken and the type of hormone therapy. To get the best benefit out of it, the expert must evaluate the condition of the patient.
When Should Testosterone Be Avoided Or Used With Caution
- During pregnancy or breastfeeding
- Active liver disease
- History of hormone sensitive breast cancer off label exceptions to this may be agreed in fully informed women with intractable symptoms not responding to alternatives
- Competitive athletes care must be taken to maintain levels well within the female physiological range
- Women with upper normal or high baseline testosterone levels / FAI
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Who Is Testosterone Therapy Not For
Wed be irresponsible not to discuss the groups of women who need to avoid testosterone therapy or carefully discuss hormone replacement therapy with their doctors before proceeding.
Women in the following categories should not receive testosterone therapy at all:
- Pregnant testosterone is toxic to the fetus
- Planning to get pregnant soon testosterone can cause severe birth defects
- Currently breastfeeding testosterone may suppress lactation
- Treating active cancer all of your energy and resources need to focus on eliminating cancer from your body
There are also gray areas that require deep discussion before committing to testosterone therapy. Most importantly, the gray area of having a family history of an inheritable, hormone-sensitive cancer.
Dont cannonball right into the pool wait to understand your risk profile and discuss the potential risks and benefits with the professionals best equipped to determine the impact of testosterone therapy on your health.
As long as you are thoughtful about testosterone therapy, account for all potential downsides, and understand your path forward, you can experience the benefits. Life is all about mitigating risks and maximizing the upside!
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 .
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Revitalize Your Mind And Body: The Benefits Of Testosterone Therapy For Women
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Its no secret that testosterone plays an integral role in male health from libido and muscle mass to fertility. Weve all heard commercials for Low-T treatments promising to restore male vitality.
Testosterone replacement therapy can transform a mans health, but weve greatly overlooked the influence of testosterone on female health.
Since testosterone has gained such a strong reputation as a mans hormone, the effects of low testosterone on a womans health are frequently dismissed. This has caused too much unnecessary suffering in women with low or suboptimal testosterone levels.
My talented partner, Nurse Practitioner Jen Justus, and I are ready to set the record straight. The truth is, testosterone is just as important for women as it is for men. However, few women realize that testosterone therapy could be the answer to their unexplained symptoms like weight gain and fatigue.
Types Of Hormone Replacement Therapy
Estrogen-only hormone therapy and combination hormone therapy are the two main types of hormone replacement therapy. If you still have your uterus, your doctor will suggest combination therapy because progesterone reduces your risk of endometrial cancer.
If you have had a hysterectomy and no longer have a uterus, you typically will not need progesterone. This is important to know because taking estrogen alone has been shown to have fewer long-term risks compared to combination hormone therapy.
There are two ways a woman can receive hormone replacement therapy systemically or locally:
- Systemic hormone therapy is mainly taken in a pill, injection, or patch. It works by releasing hormones into the bloodstream and reaching the organs and tissues that need them. This type of therapy can help systemic symptoms like hot flashes, vaginal dryness, and mood changes.
- Local hormone therapy is a cream, ring, or suppository used on a localized area and doesnt get into the bloodstream. Its mainly used to help women suffering from vaginal dryness due to the loss of estrogen by rebuilding the vaginal lining and promoting lubrication. Fewer risks are associated with localized hormone therapy, but it does not help prevent or alleviate systemic symptoms like hot flashes.
here to get a closer look at the main hormones within a womans body and their important roles.
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What You Need To Know About Testosterone And Menopause
Testosterone is often thought of as ‘the male hormone’, but it is also an important sex hormone in women and it declines with age. We ask the experts about the impact of testosterone deficiency and whether supplementation is worth considering at menopause.
Reviewed byDr Sarah Jarvis MBE
04-Nov-20·6 mins read
Testosterone is one of a group of hormones known as androgens, which in larger quantities produce male traits and reproductive characteristics. However, women also produce testosterone, along with the sex hormones oestrogen and progesterone, and it is vital to well-being.
Embrace A Holistic Approach To Hormone Replacement Therapy
Dont take your symptoms lightly. Whether youre chronically fatigued or unusually moody, testosterone deficiency could be at the core of your misery.
Give your symptoms the attention they deserve by finding a provider who will listen to you. Really listen to you, not just nod, smile, and rush you out the door in 10 minutes.
Advocate for your health and wellness by requesting comprehensive testosterone tests. Your provider needs to assess your free testosterone and total testosterone to gain a full picture of your hormone levels. Free testosterone is the active testosterone your body uses to perform, so its the most important level to optimize.
But dont just settle for a testosterone test. Get all of your levels checked, including your thyroid levels.
Hormones dont exist in a vacuum. The many hormones in your body work in a complex matrix of interconnectivity to optimize your health you cant just improve one and ignore the others. Even a quick tweak here or there can generate powerful, synergistic downstream results.
Not everybody needs or wants to pursue bioidentical hormone therapy, but do your research, dig into the studies, and find someone you trust to help you make this decision. You dont have to continue suffering because youre not sure where to turn.
The answers are out there, and practices like Brentwood MD are here to give you the support, compassion, and guidance you need to revitalize your mind and body.
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How Should Testosterone Gel/cream Be Used
The testosterone gel/cream should be to applied to clean dry skin and allowed to dry before dressing. Skin contact with partners or children should be avoided until dry and hands should be washed immediately after application. The area of application should not be washed for 2-3 hours after application.
Why Are Athletes At Risk For Low Levels Of Estrogen
Women with low body fat often do not produce sufficient amounts of sex hormones. This can be a problem for women such as athletes, models, and gymnasts. It can also be a problem for women with eating disorders. These women can experience a cessation of menstruation, known as amenorrhea. They may also develop osteoporosis — thin bones — and fractures as well as other conditions more common in older women after menopause.
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What Are The Consequences Of Low Testosterone In Women
The effects of low testosterone in women have been greatly debated over many years. Firstly, and most importantly there is no blood level that can be used as a cut-off to diagnose low testosterone in women.
Some studies have indicated that there may be an association between low sexual desire and low testosterone, but this has not been a consistent finding in all studies.
Is There Any Benefit Of Testosterone Therapy
A complete review of all the published studies published in 2019 has shown that postmenopausal women who experience a reduction in sexual desire, that causes them personal concern or distress, may benefit from testosterone therapy. This review also revealed that there is not enough evidence yet to show that premenopausal women will benefit from testosterone therapy.
Low sexual desire with associated distress has been also termed Hypoactive Sexual Desire Disorder . As there are many reasons why women might experience HSDD, if you are experiencing what you think is HSDD you should talk to you doctor and explore the full range of possible causes. It is only after doing so that testosterone therapy should be considered.
Some women are being treated with testosterone for reasons other than HSDD. IMS brought together a team of leading experts to review the evidence base of testosterone therapy and published our recommendations in a global Consensus Statement . The review found no clear evidence that testosterone improves wellbeing or mood and should not be used only for this purpose. The Statement concluded that there is not enough evidence one-way or other to support the use of testosterone for any symptoms or medical condition other than HSDD.
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