Saturday, September 23, 2023

Who Can Prescribe Hormone Replacement Therapy

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Does It Cause Weight Gain

Bioidentical Hormone Replacement Therapy (BHRT)

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.

There are various ways of delivering hormone therapy, and the different types 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:

  • tablets
  • vaginal rings
  • skin patches

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.

The Health Risks And Benefits Of Hrt

In 1991, the U.S. National Institutes of Health launched the Women’s Health Initiative , a set of studies involving healthy post-menopausal women that was carried out in 40 U.S. centres. The WHI included a clinical trial to evaluate the risks and benefits of the two types of HRT and to see how they affected the incidence of heart disease, breast cancer, colorectal cancer and fractures in post-menopausal women. The trial was divided into two arms:

  • One arm involved more than 16,000 post-menopausal women aged 50 to 79 who had not had a hysterectomy. They took pills daily that were either a combination of estrogen and progestin , or a placebo .
  • The second arm involved more than 10,000 women who had received a hysterectomy and who took estrogen pills alone or a placebo.

In July 2002, after an average 5.2 years of regular follow-up, the NIH prematurely ended the combined HRT arm of the WHI trial. An independent monitoring board, which regularly reviewed the findings, concluded that there were more risks than benefits among the group using combined HRT, compared with the placebo group. The study found that changes in the incidence of disease per 10,000 women on combined HRT in one year were:

  • Seven more cases of coronary heart disease
  • Eight more cases of strokes
  • Eighteen more cases and a twofold greater rate of total blood clots in the lungs and legs
  • Eight more cases of invasive breast cancer
  • Six fewer cases of colorectal cancer
  • Five fewer cases of hip fractures

They Specialize In Hormone Health

Plenty of doctors administer hormone medications, but not all actually specialize in hormones. Thats why your primary care physician or your gynecologist may not be the ideal person to go to if you are interested in HRT while these doctors are technically qualified to prescribe such medications, they may not have the specialized knowledge of a practitioner who focuses primarily on hormonal health.

Before choosing a doctor, ask which health concerns they deal with on a daily basis. A hormonal health expert primarily treats:

  • Hypogonadism
  • Other disorders of the endocrine system

You want to partner with a doctor who spends the bulk of their time treating patients with similar concerns to yours. That way, theyre more likely to be familiar with your symptoms, understand your treatment options, anticipate your bodys reaction to various medications, and be familiar with the most up-to-date research in the field. We consider this the starting point for a good hormone replacement therapy experience.

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What Kind Of Doctors Prescribe Testosterone Therapy

  • There is no such thing as non-prescription testosterone, or over the counter testosterone.
  • Genuine testosterone therapy is only available with a doctors prescription.
  • Any doctor can prescribe testosterone, but it is best to get your testosterone prescription from a doctor whose practice is dedicated to hormone replacement therapy in adult males.

Why do you think you need a prescription for testosterone? Do you think you may be suffering from low testosterone? If you are a man who is over 35 and you are:

  • Feeling tired almost all of the time
  • Feeling irritable or angry more often than you would like
  • Having sleep problems
  • Reduced muscle mass
  • Reduced strength

If you are experiencing any or all of the above, you are correct in assuming that low-T could be the cause, and a prescription for testosterone therapy may be the solution. However, do not be fooled by the ads you may hear on the radio, or see online, or in so-called muscle magazines, there is no such thing as non-prescription, or over-the-counter testosterone. The only way to get authentic testosterone therapy is with a doctors prescription. So, the question then becomes, what kind of doctor can write you a prescription for testosterone therapy?

Do not be fooled by the ads you may hear on the radio, or see online, or in so-called muscle magazines, there is no such thing as non-prescription, or over-the-counter testosterone. The only way to get authentic testosterone therapy is with a doctors prescription.

What Are Some Commonly Used Postmenopausal Hormones

Can Anti

The following list provides the names of some, but not all, postmenopausal hormones.


  • Pills, Brand names: Cenestin®, Estinyl®, Estrace®, Menest®, Ogen®, Premarin®, Femtrace®.
  • Creams, Brand names: Estrace®, Ogen®, Premarin®.
  • Vaginal ring, Brand names: Estring®, Femring® .
  • Vaginal tablet, Brand names: Vagifem®. Imvexxy®
  • Patch, Brand names: Alora®, Climara®, Minivelle®, Estraderm®, Vivelle®, Vivelle-Dot®, Menostar®.
  • Spray, Brand name: Evamist®.
  • Modest improvement in joint pains.
  • Lower death rate for women who take hormone therapy in their 50s.

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Location Of The Clinic

This is simple. The nearer you are to the clinic the better. The reason being no one wants to take a long drive to the clinic every time he is supposed to go get his regular testosterone treatment. Apart from the physical location of the premises, the mode of transport plays a part in the selection. If the means of getting there is unreliable then high chances you will not fancy getting the services from that clinic.

How To Start Hormone Replacement Therapy

This article was co-authored by our trained team of editors and researchers who validated it for accuracy and comprehensiveness. wikiHow’s Content Management Team carefully monitors the work from our editorial staff to ensure that each article is backed by trusted research and meets our high quality standards.There are 13 references cited in this article, which can be found at the bottom of the page. This article has been viewed 78,822 times.Learn more…

The decision to start male-to-female hormone replacement therapy can be an exciting choice. For many people, hormone treatment is the first step to transitioning physically into a female body. First, you will need to find a doctor who can prescribe you female hormones. You will take these hormones by patch, pill, or injection. As your body begins to change, you may need to manage side effects or reduce unwanted features. After a few years on hormones, you can begin to consider surgery.

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Hormone Therapy And Cardiovascular Disease

The incidence of cardiac disease is heightened in postmenopausal women. This finding has been linked to a causative pathogenic role of ovarian hormone deficiency.

When the concept of HT was initially introduced, it was believed that replacing ovarian hormones would reduce the observed increase in the risk of cardiovascular disease. However, this expected result has not been unequivocally demonstrated in various trials over the years.

The WHI study revealed an increased annual risk of heart attacks of 7 per 10,000 women who took combined therapy as opposed to women who took estrogen alone, in whom no significant difference was noted. Subsequent re-analysis showed similar results for breast cancer, demonstrating no increased risk in the fifth decade, though the risk rose with advancing age.

Two important clinical trials have been conducted to examine the relationship between cardiac disease and HT: the Postmenopausal Estrogen/Progestogen Interventions Trial and the Heart and Estrogen-Progestogen Replacement Study .

PEPI investigators looked at the effect of estrogen alone and combination therapies on bone mass and key risk factors for heart disease. They found generally positive results, including a reduction in low-density lipoprotein cholesterol and an increase in high-density lipoprotein cholesterol by both types of therapy.

Meet Dr Vivienne Guy Nd

Bioidentical Hormone Replacement Therapy | Amen Clinics

Dr.Vivienne Guy is a licensed naturopathic doctor in Ottawa, certified IVIT and BHRT Practitioner, speaker, health & wellness educator with over 11 years of clinical experience. She is sought after to find the answers to health concerns that others have not been able to find. With each person, she helps them set realistic and manageable goals for their own health being mindful of the busyness of everyday life. Being a working mom with two children, Vivienne understands the daily challenge of work life balance. Her own experience allows for insight into her clients needs. While offering the full scope of Naturopathic Services, she has a special interest in hormone balancing and in IVIT

She received her undergraduate Bachelor of Science Degree from the University of Waterloo and then went on to graduate from the Canadian College of Naturopathic Medicine, in Toronto. She is a registered member of the College of Naturopaths of Ontario. She is a member of the Canadian Association of Naturopathic Doctors and sits on the Board for the Ontario Association of Naturopathic Doctors.

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Research Credentials And Experience

Take time to research the doctors credentials and experience. Look for a doctor who is board certified and cares for women in menopause on a regular basis. The more experience a doctor has treating your condition, the better prepared he or she is to advise you on the best type of hormone replacement based on your individual circumstances.

Also, confirm that the doctor is in good standing with state and federal agencies and that he or she has no history of malpractice claims or disciplinary actions.

Youll find all this information on

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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Are You In Menopause

Menopause is technically defined as the point when youve gone 12 months without having a period . Most people in North America usually experience menopause between the ages of 40 and 58. But menopause-related hormone changes can begin as early as your 30s and 40s a time that is sometimes called perimenopause.

During perimenopause, you may notice some changes in the frequency and length of your periods. You may also have some menopause symptoms. When your periods stop, you have completed menopause. For many people, this is a process that can take several years.

There are a wide variety of symptoms that can occur during menopause. Hot flashes are especially common. Other symptoms include:

  • Sleep problems

  • Dry skin, eyes, or mouth

  • Frequent urinary tract infections

  • Mood changes or anxiety

  • Poor concentration or brain fog

Unfortunately, theres no simple test to confirm whether you are in perimenopause or menopause. Hormone tests can sometimes be helpful, but they dont always give you a straight answer especially since your hormone levels can vary naturally throughout the month.

Many people are able to identify that they are in menopause based on their age and symptoms. It can be helpful to talk it over with your provider, to confirm that your symptoms are related to menopause instead of another condition .

What If You Have Low Estrogen

10 Things to Know About Hormone Replacement Therapy

Having low estrogen levels in women is one of the most common reasons for hormone replacement therapy in women. Low estrogen most commonly occurs during menopause and can make the quality of life for these women decrease. Nobody wants to experience hot flashes or night sweats if they dont have to, so hormone replacement may be able to minimize these symptoms.

It is best used when started in early menopause and not in the later stages. This is safer and is able to address the symptoms better because they are usually more prominent in this time. Taking estrogen does have a risk of increased blood clot which can increase the risk for things like heart attack and stroke, so this should be considered, especially if you have a family history of these conditions.

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Doctors Failing To Prescribe Low

Sandra Tsai

Doctors across the country are still prescribing higher-dose menopausal hormone therapy pills, despite clinical evidence that low doses and skin patches work just as well and carry fewer health risks. Thats what researchers at the Stanford University School of Medicine found in a study published online Dec. 2 in Menopause: The Journal of the North American Menopause Society.

Doctors have been treating the symptoms of menopause with hormone therapy for decades. During menopause, the ovaries decrease their estrogen production, and women experience symptoms to varying degrees for some, symptoms are non-existent while for others they are debilitating. In the United States last year, formulations of estrogen and progestin hormones helped more than 6 million women who had symptoms such as hot flashes, sleep disturbance and irritability.

Randall Stafford

The latest findings from Stanford researchers show that as of 2009, physicians practices werent keeping up with this clinical evidence about lower hormone doses, which the U.S. Food and Drug Administration recommends. Were disappointed, said the papers senior author Randall Stafford, MD, PhD, associate professor of medicine at the Stanford Prevention Research Center. Yes, there was an increase in the use of low-dose preparations, but it was not sizeable.

Information about Stanfords Department of Medicine, which also supported the research, is available at .

  • Sascha Zubryd

Treatment For Pituitary Issues

If the cause of low testosterone stems from issues with the pituitary gland, it may be possible to restore fertility through the use of pituitary hormones. If the pituitary gland is simply underactive, the hormones would reinstate the pituitary-hypothalamus-testes feedback loop and revive sperm production.

If, however, the pituitary is disrupted as a result of a tumor, surgery, medication, or radiation treatment, a hormone replacement therapy may be required.

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Is Hormone Replacement Therapy Safe

You cannot make a blanket statement about if something is safe for everyone because there will always be exceptions. When hormone replacement therapy is done in the right patient, with the proper treatment plan, and managed by an attentive healthcare provider it is generally safe.

There are many benefits, but there are risks as well. The risks depend on the specific hormone, dose, and way you are taking them so you will need to talk with your doctor about the risks that you would be more likely to experience.

Also, even though there are risks involved there are ways to reduce some of these risks with lifestyle modifications like eating a well balanced diet, losing weight if obese, exercising and staying active, and even taking other hormones prescribed by your doctor alongside the primary hormone. For example, taking testosterone with human chorionic gonadotropin can reduce risks of testicular atrophy, while taking progesterone with estrogen can reduce risks as well.

How To Talk To Your Doctor About Low Testosterone

Know Before You Say No: Hormone Replacement Therapy & Menopause | Sandra Rice, MD

It may not be easy to speak to a doctor about wanting to get a prescription for testosterone therapy.

Some men find it embarrassing, and think they are less of a man to need testosterone therapy. This is often the case because one of the first and most common signs of low-t is loss of sex drive, and/or erectile dysfunction, and they often fail to seek treatment because of this self-consciousness. This is all the more reason why you should seek your testosterone treatments from a doctor who specializes in hormone replacement for men. As well as being better equipped to interpret all of your symptoms, he will be more conscious of the self-esteem issues that could also come along with low-T. Still when talking to any doctor about low-T, you must be confident enough to tell him or her all about your symptoms. Remember, youre speaking to a professional who is very familiar with these issues. Dont be afraid to raise the issue with your doctor. Youre not alone! Youre not the first to have the same problem! This may be the most important visit to your doctor that you will ever have!

Do not leave anything out because you believe it may not be important, or may be embarrassing. In the long run, doing so, will only keep you from getting the best testosterone therapy prescription possible.

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Ethical Principles That Do Not Support Psychiatric Administration Of Hormone Therapy

Ethical analysis based on the principles of nonmaleficence and justice suggests that Dr. Lao should think twice before providing hormone therapy for gender-transitioning adolescents.

Nonmaleficence. Although there are strong arguments in favor of Dr. Lao being trained to provide gender-affirming medical care, specifically hormone therapy, the ethical principles of nonmaleficence and justice weigh on the other side of the balance. Nonmaleficenceto do no harmis a complicated standard to uphold in this case. Much has been made of potential iatrogenic harms of estrogen-based hormone therapy in late adolescenceincluding increased risk of deep vein thrombosis, prolactinomas , and loss of fertility for those who do not undergo cryopreservation prior to hormone initiation . While these medical complications can be severe, recent studies have found the incidence of adverse effects of hormone therapy to be low overall , and the potential harms of any treatment must be weighed with the potential gains in mind.

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