Monday, August 15, 2022

What Is Hormone Replacement Therapy For Women

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Implications For Clinicians And Policymakers

How does Hormone Replacement Therapy work | Women’s Health Tips with Dr. Levin

This study delivers more generalisable estimates of the different risks of breast cancer associated with specific progestogen components of HRT, while confirming no increased risks from short term use of oestrogen only, estradiol-dydrogesterone, and tibolone. Increasing duration of use was generally associated with increased risk, with tibolone and estradiol-dydrogesterone showing the smallest risks. The frequency of prescribing for treatments including dydrogesterone was, however, much lower than for those including norethisterone, medroxyprogesterone, or levonorgestrel.

C Why We Never Recommend Testosterone Pellets

Testosterone pellets are problematic at best.

Although these are created by compounding pharmacies and can possibly be manufactured to suit women, they generally dont work as advertised.

Pellets dont work well because they dont have a true time-release mechanism.

Although they are supposed to be absorbed over time, they actually send your testosterone levels soaring, increasing the risk of side effects for a few months.

They then leave you deficient for the remaining months.

Talk to a TRT expert and get back to feeling the way you’re supposed to.Now serving patients in all Texas cities.

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.

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Venous Thrombosis And Hrt

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.

Balancing Mens Hormone Levels

Menopause: Should you take hormone replacement therapy ...

Men suffer from hormone deficiencies for many reasons, but the most common is the aging process. Just as women go through a life stage called menopause, men do as well its just less known. Male menopause is called andropause and typically affects men during their late 40s to early to mid-50s. This life stage is defined by a significant shift and steady decline in testosterone levels which leads to the onset of many different symptoms, including:

  • Low libido
  • Depression and anxiety
  • Sexual dysfunction

While many men may just accept this as a normal part of life, know that it doesnt have to be. Seeking out treatment for hormone deficiencies, whether youre walking through andropause or you simply have genetically low testosterone, can help make a significant difference in the quality of your life. Increasing testosterone levels will lead to many benefits, including:

  • Increased lean muscle mass
  • Improved overall vitality and well-being
  • Improved sexual performance

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Enhancing Healthcare Team Outcomes

Patients undergoing menopause require management from an interprofessional team that also includes the pharmacist and nurse. To improve patient outcomes, clinicians should not empirically prescribe hormone replacement therapy. These hormones correlate with a variety of adverse effects, including an increased risk of breast cancer, stroke, heart disease, and deep vein thrombosis. The duration of treatment of these hormones should not be more than a few years, and close monitoring is required. If the female has mild symptoms of menopause, then education should be provided about the benefits and harm of these hormones. The pharmacist should consult with the prescriber on the exact agent and dosing, while also examining the patient’s medication record. Nursing needs to be very aware of signs of adverse events, and monitor closely on subsequent visits, alerting the clinician of any concerns. This interprofessional team approach will drive the best outcomes with HRT.

How Does The Treatment Process Work

This process uses bioidentical hormones to balance the hormone system, but you may be wondering how the treatment process works. First, we will schedule your consultation to learn more about your specific symptoms, goals, lifestyle, and medical history. During this appointment, we will also perform the necessary diagnostic testing to obtain your exact hormone levels, which will help us confirm your deficiency.

Once we confirm your deficiency and learn more about your needs, we can create the best treatment plan with the right hormone administration method and dosage to meet your specific needs. In doing so, we will discuss your lifestyle, your preferences, and the best treatment plan. Youll be able to choose from the different forms of bioidentical hormone administration, including:

  • Injections
  • Patches

Customizing Your Treatment

The same treatment plan doesnt always work for everyone, which is why its a good thing that there are so many different options. Some people dont like taking oral tablets and opt for a method that works better with their lifestyle. Others prefer injections or creams.

It depends on the individual and what works best for their lifestyle. However, if at any point you feel as though youre not happy with your chosen treatment method, we can adjust your treatment plan as needed and try something different until you find what works with your lifestyle. The end goal is to alleviate symptoms, balance your hormones, and help you feel your very best.

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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.

What Are Bioidentical Hormones

Women’s Health_ Hormone Replacement Therapy

Bioidentical hormones are synthetic hormones that come from completely natural sources like soy, plants, and yams and are identical in molecular structure to the hormones that your body creates naturally. These hormones, when administered to the body in the correct dosage, can restore balance to the system. The body views these hormones as its own and uses them to improve everything from your symptoms to how you feel on a daily basis.

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Brief History Of Hormone Therapy

Estrogen has been used to treat symptoms of menopause since the 1950s and 1960s. By 1975, estrogen had become one of the most commonly prescribed drugs in the United States.

In the mid-1970s, studies demonstrated that postmenopausal women who used estrogen therapy alone had a significantly increased risk of endometrial cancer. Researchers found that adding progestogen to estrogen provided protection against uterine cancer. As a result, progestogen was added to HT regimens prescribed for women with an intact uterus.

Over the years, HT became a popular treatment, as it was recommended not only for treating menopausal symptoms but also for providing long-term protection against osteoporosis and related fractures, heart disease, and even Alzheimer disease. However, in 2002, the Women’s Health Initiative , a large-scale study conducted by the National Institutes of Health , was stopped early because evidence linked HT to a slightly increased risk of stroke, heart disease, and breast cancer. As a result of this study, many women turned to nonUS Food and Drug Administration approved compounded bioidentical HT , or natural HT, as a perceived safer alternative. However, no clear evidence suggests that custom CBHT formulas are safer or more effective than FDA-approved HT products. Physicians may wish to use custom formulas for those patients who cannot tolerate standard HT.

Why Do Women Need Testosterone Therapy

When you think about hormone replacement therapy for women, the first thought that usually comes to mind is the typical estrogen therapy that is used to treat menopausal symptoms. However, when a woman is going through menopause, along with estrogen depletion, she is also losing her ability to produce adequate amounts of testosterone. A woman with low testosterone, will have trouble producing new blood cells, maintaining her libido or sex drive, and will find it harder to build muscle and burn fat.

When this is the case she will show the signs of low testosterone. The signs and symptoms of low testosterone in woman include:

  • Feeling tired or sluggish
  • Mental fog
  • Loss of bone density

Current research indicates that women who are on estrogen replacement for menopausal symptoms, can also benefit when testosterone therapy is added as an adjunct to estrogen replacement in these women. Testosterone, when used in this way, seems to specifically help with the sexual wellness issues typical of post-menopausal women. According to Dr. Alan Malabanan, assistant professor of medicine at Harvard Medical School, Studies of postmenopausal women have found that taking testosterone increases sexual desire and pleasure compared with a placebo .

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Women Naturally Produce Testosterone When That Production Drops It Needs To Be Replaced

Estrogen and progesterone are most often associated with womens hormone imbalances due to their connection to age-related menopausal change and its associated hormonal fluctuation, which every woman will eventually go through.

Women are also familiar with high testosterone in proportion to the female sex hormones but seem surprised to find they could suffer from the oppositelow testosterone.

In fact, womens bodies naturally produce testosterone just like mens bodies, but at about 1/10th the level.

Its a major misconception that, because testosterone is a male hormone, only mens bodies require it. The truth is that testosterone plays a huge role in womens reproductive cycle and their health.

That means women can also suffer from low testosterone, and, just like men, the best remedy for relief of symptoms associated with female low testosterone is through Testosterone Replacement Therapy .

  • Anxiety
  • Hair loss

This isnt even a complete list. Whats difficult to grasp is that most of these are common symptoms of all hormone imbalances, and while the focus is usually just on your estrogen or progesterone levels, what you really need is balance is all three hormones, including testosterone, to feel well.

If your body has stopped producing a normal amount of any of these critical hormonestestosterone, estrogen, or progesteronehormone replacement therapy to rebalance them may be the only recourse.

A The Case For Testosterone Injections For Women

Hormone Replacement Therapy Buckhead: HRT for Women

We almost exclusively recommend testosterone injections with doses at about 1/10th of what a man would receive.

While it is quite common for other healthcare providers to recommend compounded testosterone medications like creams and gels, we recommend weekly testosterone injections instead because it allows for a more precise calculation of the dosage.

Testosterone injections are absorbed at a much higher percentage through the muscle than topical supplements are absorbed through the skin, meaning your body can utilize a more exact amount of what we give it.

This enables us to find an exact amount thats right for you not too high and not too low .

Thats why we use a rigorous testing method to figure out what the right amount of testosterone is for you.

The dose is targeted slightly above the normal range because levels fall consistently throughout the week. The goal is to keep your levels within an optimum range. Unfortunately, no method yet exists to permanently keep levels in an optimum range.

As we mentioned in the above section, once your symptoms begin to improve, we stop increasing the dose and begin a maintenance program of weekly injections.

Injections:

Talk to a TRT expert and get back to feeling the way you’re supposed to.Now serving patients in all Texas cities.

4.a.i Research Supports Testosterone Shots to Treat Menopause

Testosterone for women used to be a highly debated topic.

4.b.i Topicals Arent Designed for Women

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The Facts About Testosterone Replacement Therapy For Women

  • TRT for Women: How Do I Get Started?
  • At Testosterone Centers of Texas , we base our work on facts, the main one being that TRT is an effective treatment for many symptoms of testosterone deficiency, including anything from the classic lack of interest in sex and weight gain to anxiety and hair loss.

    What Is Known About Hormone Therapy And The Risk Of Breast Cancer

    Taking combined hormone therapy can increase your risk of developing breast cancer. Here are some important findings:

    • Taking combination hormone therapy showed a rare increase of absolute risk of less than one additional case of breast cancer per 1000 person years of use.
    • There was a nonsignificant reduction in breast cancer seen in women with hysterectomies on estrogen only therapy.
    • If youve been diagnosed with breast cancer you should not take systemic hormone therapy.

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    Hrt Today Key Points

    The balance of benefit to harm always needs to be assessed but appears to have shifted favourably for HRT. Users can be reassured provided:

    • HRT is taken for the correct reasons, i.e. to alleviate the symptoms of the menopause. It has a role in the prevention of osteoporosis but long term use is often required
    • The dose and duration of HRT use should be made on an individual basis after discussing the risks and benefits. No arbitrary limit should be set on duration of use
    • HRT users are assessed by their GP at least once a year.

    If women start HRT around the time of menopause the risk is very small and there appear to be cardiovascular and bone protective benefits. It is not usually appropriate for women over 60 to be starting HRT but as the WHI study shows, women initiating it over 60 years do not seem to be at increased risk of cardiovascular events or mortality.

    Many women seek advice on the effects of HRT on sexual activity and desire. Whilst there is no definitive answer, case studies indicate that the estrogen in HRT can help maintain or return sex drive. It will also help other menopausal symptoms such as vaginal dryness and pain with intercourse. If vaginal symptoms are the only problem, then the use of local vaginal estrogen or dehydroepiandrostenedione may be preferable. Separate factsheets on Sexual Health are available for download from the Womens Health Concern website.

    Your Guide To Hormone Replacement Therapy In Fort Collins Co

    What is Hormone Replacement Therapy (HRT)?

    As women age, they face vaginal discomfort, hot flashes, and hormone depletion caused by menopause. The Womens Clinic of Northern Colorado offers hormone replacement therapy to help Fort Collins, and Loveland, CO women manage menopausal symptoms and age more gracefully. Hormone replacement therapy is medication taken to replace the depleted hormones. The dosage and duration of therapy will vary according to each womans specific needs. Our dedicated womens healthcare specialists may recommend systemic hormone therapy in the form of a pill, gel, cream, patch or spray. Vaginal products are available in a cream, tablet, or ring form. Talk to our team about the many benefits and risks associated with this leading menopausal treatment to see if it is right for you!

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    Side Effects And Risks Of Bhrt

    While the FDA has approved some preparations of bioidentical estradiol and progesterone, it hasnt approved any compounded bioidentical hormones. There are claims that bioidentical hormones are safer and more effective than traditional HRT because theyre identical in structure to those produced in the body. But these claims have not been confirmed by large-scale, reputable studies. The FDA urges caution when using compounded products.

    Research has shown that hormone replacement therapy in general may increase the risk for certain conditions and diseases including:

    • patches
    • gels

    Talk to your doctor about which form may be best for you and your lifestyle. Youll likely need to be monitored regularly once you begin BHRT to evaluate your bodys response. However, the FDA cautions against monitoring hormone levels via blood and saliva tests. These only tell you your hormone levels at a moment in time and can vary widely throughout the day.

    The FDA recommends that if you do choose any form of hormone therapy that you use the lowest dose that produces results. The FDA also says you should use it for the shortest length of time possible.

    Learn More About Your Options

    Nore Health is committed to ensuring that every woman clearly understands her health and options during menopause. For more information about hormone replacement therapy and learn if it is a right choice for you, please contact our office. Our knowledgeable staff is here to answer your questions and provide the guidance you need to make the most informed decisions regarding your health.

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