Wednesday, April 17, 2024

Who Prescribes Hormone Replacement Therapy

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Menopause Symptoms Impact Health And Work

The real reason why women are being denied Hormone replacement therapy – BBC London

Menopause symptoms arent limited to hot flashes and night sweats. Other symptoms of menopause include difficulty sleeping, difficulty concentrating, mood swings, depression, headaches, racing heart, vaginal dryness, decreased recent memory and decreased energy. For some women, these symptoms begin years before menopause.

Hot flashes are uncomfortable, but they are also related to other issues. Hot flashes can disrupt sleep and may cause mood changes, difficulty concentrating, and impairment of short-term memory. In one study, frequent hot flashes and night sweats were associated with a 50% increased risk of cardiovascular disease. And, if these hot flashes and night sweats persisted over time, then there was a 77% increased risk of later cardiovascular disease.

Given the health and career impact of menopause symptoms, its a problem that many clinicians are not well-informed on the current thinking regarding hormone therapy. Bluming explains that part of the problem stems from the fact that menopause education is currently offered to less than 25% of residents studying obstetrics/gynecology. This may also explain why some practitioners still refuse to prescribe hormones. Given that over 50 million women in the United States are over the average age of menopause , one would think menopause care would be a higher priority.

Is Progesterone Replacement Therapy Ever Prescribed On Its Own

Weve talked a lot about combining estrogen and progesterone replacement therapy to treat menopause symptoms. However, you might be wondering if progesterone is ever used on its own for menopause. This isnt a very common treatment plan because most menopause symptoms are due to low estrogen levels. However, some studies have found that progesterone alone can help reduce hot flashes, night sweats, sleep disturbances, and other common symptoms of menopause. Still, estrogen replacement therapy is currently the most effective option for treating these symptoms for menopausal women, which makes it the go-to treatment solution.

Which Doctors Prescribe Hormone Replacement Therapy

Many doctors can help with hormone replacement therapy, but the first line of command is your primary care provider. This could be an internal medicine doctor, family medicine doctor, nurse practitioner, or physician assistant. All of these care providers are helpful in diagnosing if low hormone levels may be a problem for you. This is done through a hormone test with urine, blood, or saliva.

The primary care provider can either create a treatment plan for you or refer you to a specialist for further treatment. They may refer because they do not have experience with hormone replacement therapy or do not feel comfortable creating a safe and effective HRT treatment plan.

An endocrinologist is one option that your primary care doctor may refer you to. An endocrinologist is a doctor that specializes in the glands of the body that release hormones. They know about each hormone individually, how the hormones are related to each other, as well as how the body regulated the amount of each hormone in the body. Their whole job relies around hormones and glands so they have extensive knowledge about how to help with hormone replacement therapy.

Read Also: Does Low Estrogen Cause Weight Gain

How Is Mht/hrt Used

The main hormone used in MHT is oestrogen. In women who have not had a hysterectomy, progesterone needs to be taken at the same time to reduce the risk of endometrial cancer.

Some women benefit from a low-dose testosterone replacement to improve low libido, lack of energy and fatigue.

Other forms of MHT are Tibolone or Duavive tablets.

MHT can be taken as:

Are Other Kinds Of Drugs Used In Hrt Safe

brief prescribing guide for hormone replacement therapy (HRT)

Researchers arent sure, but it is possible that other HRT drugs arent safe to use, either. Women who use them could be at higher risk for breast cancer , blood clots, heart attacks, and strokes. Even so, many doctors believe that short-term use of HRT to control menopausal symptoms is still safe for most women. Women who have a history of heart disease or blood clots are at the highest risk and should most likely not receive HRT.

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Heres The Current Thinking On Hormone Therapy

Many doctors don’t discuss the option of hormone therapy with menopausal patients.


Menopause symptoms arent only uncomfortable, but they can also impact a womans health, relationships and career. Although hormone therapy can reduce or eliminate menopause symptoms, most menopausal women dont take advantage of hormones because of a decades-old study that warned of serious health risks. Although the thinking on hormones has changed, some women remain confused and afraid, and some medical doctors refuse to prescribe hormones. Now, the CEO of a telehealth startup, celebrities, medical doctors and others are trying to raise awareness about how the thinking on hormone therapy has evolved over the last twenty years.

Oncologist Avrum Bluming and social psychologist Carol Tavris are among those trying to raise awareness. They wrote Estrogen Matters to clarify some of the misunderstandings surrounding hormone therapy. Our goal in writing the book and subsequently answering the dozens of emails we receive from women around the world is to educate women and the medical profession about the symptoms and medical ramifications of the menopauseand, in particular, the role of estrogen in ameliorating symptoms and prolonging womens lives, Bluming says.

What Are The Risks Of Mht/hrt

The main risk is that some types of MHT lead to a slightly increased risk of developing breast cancer or thrombosis . However, it can prevent other conditions such as osteoporosis, heart disease, fractures, diabetes and some types of cancers.

Current international recommendations say that the benefits outweigh the risks in women who are having significant symptoms from menopause, and that MHT is effective and safe for most healthy women.

Some women have side effects such as nausea, fluid retention, bloating, breast tenderness and swelling, and irregular bleeding. These often go away with time.

MHT may not be suitable for you if you have or have had:

The risks of MHT depend on your age, the type and dose of hormone therapy you take, duration of treatment, and your medical history.

Talk to your doctor to find out which risks apply to you. If you are unable to take MHT, your doctor may suggest other medications that may be helpful.

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Effects Of Hormone Replacement Therapy

Almost all the respondents agreed with the statement that HT increases the risk of breast cancer . Three of our statements contained sense of wellbeing and quality of life specifically that HT results in a better sex life, delays aging of the skin and makes women more attractive. The GPs had strongest belief in the effect of HT on womens sex life: 72% agreed with this statement.

Table 1

The attitudes of GPs regarding statements about the effects of hormone therapy. Number and percentage for different response categories


Increases risk of breast cancer

Increases life expectancy of women

Implies undesirable medicalisation of a natural life phase in women

Four of the statements contained contentions about the preventive effects of hormone therapy. Treatment provides protection against colon cancer, prevents Alzheimers dementia, provides protection against cardiac infarction and extends life expectancy. 67% accepted that treatment does not provide protection against cardiac infarction, 11% continued to believe that this was the case, and 22% neither agreed nor disagreed with the statement. The numbers who agreed and disagreed that HT prevents Alzheimers dementia were equally divided.

Doctors were asked to give their views on the claim that HT is an unfortunate medicalisation of a natural phase of life in women. 24% neither agreed nor disagreed with this statement. Of those who adopted a position, 58% did not agree, while 42% agreed.

Table 2

Forms Of Hormone Therapy

Testosterone & Testosterone Replacement Therapy (TRT) | Dr. Peter Attia & Dr. Andrew Huberman

HT comes in different forms. You may need to try different types before finding one that works best for you.

Estrogen comes in:

  • Pills or tablets, taken by mouth
  • Skin patches, applied to the thigh or belly
  • Vaginal creams or vaginal tablets to help with dryness and pain with sexual intercourse

Most women who take estrogen and who still have their uterus also need to take progestin. Taking both hormones together lowers the risk of endometrial cancer. Women who have had their uterus removed cannot get endometrial cancer. So, estrogen alone is recommended for them.

Progesterone or progestin comes in:

  • Vaginal suppositories
  • Intrauterine device or intrauterine system

The type of HT your doctor prescribes may depend on what menopause symptoms you have. For example, pills or patches can treat night sweats. Vaginal rings, creams, or tablets help relieve vaginal dryness.

Discuss the benefits and risks of HT with your provider.

Recommended Reading: How To Increase My Estrogen Levels

Continuous Combination Hormone Replacement Therapy

Continuous combination hormone therapy means you take both estrogen and progesterone replacement therapy for treatment. This option is where you take both bioidentical hormones every day to reduce symptoms and health risks during menopause. This often makes treatment simpler and easier to use for many people, as the treatment is the same each day. Continuous HRT also reduces or eliminates vaginal bleeding, which can occur with cyclical hormone therapy.

The Best Hormone Replacement Therapy Doctors Have 5 Things In Common

Over the past several decades, hormone replacement therapy has become commonplace. The growing popularity of this innovative treatment is driven by a host of factorsthe increase in mass media advertising, the discussion of HRT on social media platforms, growing accessibilitybut the end result is that ever-increasing numbers of individuals are relying on HRT to mitigate the effects of hormonal change. Among men alone, testosterone replacement therapy prescriptions quadrupled between 2003 and 2013.

But despite the prevalence of HRT, you may not know where to look for the best quality treatment. How do you pick a practitioner who will help you get optimal results? How do you know who to trust?

Hormone medications may be easy to prescribe and simple to administer, but theyre also incredibly complex to get right. Finding the perfect hormone balance for each individual can be difficultand failing to find it can leave you with untreated symptoms or disruptive side effects that compromise your quality of life. Thats why its essential to seek out the best hormone replacement therapy doctors near you before starting treatment. By connecting with the right practitioner, you can ensure the greatest chance of success and experience the full benefits of HRT.

Read Also: How To Control Hormonal Fluctuations

What Should I Do If I Am Taking Hrt

If youre taking HRT, do not panic. Visit your doctor before making any changes to your therapy. They will consider your menopausal symptoms and your risk for developing certain diseases. Your doctor will give you advice about the pros and cons of continuing HRT. Some of your options may include stopping treatment altogether, taking a lower dose of medicine, or switching to another type of treatment.

When To See A Doctor

Pin on Hormone

If you are having symptoms of menopause, you should see your doctor. Your doctor can evaluate your symptoms. Together, you can work out a plan to manage symptoms. This plan could involve using HRTs for a short time.

If you are currently taking HRTs, you should already be under the close care of your doctor. Be sure to keep following up with your doctor. Report any unusual symptoms.

Read Also: What Birth Control Does Not Have Estrogen

What Else Can I Do To Manage My Menopause Symptoms

Your doctor can recommend a variety of lifestyle modifications to ease your transition to menopause. You may benefit from adding moderate physical activity to your day. Taking a walk or going to a group exercise class with a friend can help you manage your weight and retain muscle tone, while also giving you a fun social activity.

You may also want to adjust your diet. Spicy foods, caffeine, and alcohol can trigger hot flashes can make your menopause symptoms feel more extreme. You should also make sure to eat calcium-rich foods, or take supplements as prescribed, as your risk of osteoporosis increases as you age.

If your menopause symptoms are interfering with your life, call or make an appointment online.

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.

Read Also: How To Test My Hormone Levels

Obgyns Located In Murrieta Ca & Temecula Ca

More than two-thirds of women experience hot flashes during menopause. While hot flashes are disruptive, you may experience a wide range of menopausal symptoms as your hormone production slows. At Platinum Womens Health in Murrieta and Temecula, California, James Neal, MD, and Florence Villa Quinata, MD, offer hormone replacement therapy to restore your hormonal balance, relieve menopause symptoms, and enhance your quality of life. Call or make an appointment online today to find out how hormone replacement therapy can ease your symptoms.

They Have A Wide Range Of Resources At Their Disposal

Bioidentical Hormone Replacement Therapy: It is not just for women!

One way to differentiate between middle-of-the-road hormone doctors and higher-quality practitioners is which specialized resources they have at their disposal. Do they offer full-scale lab testing for urine, serum, and saliva samples? Do they offer a comprehensive spectrum of treatment options? Do they maintain partnerships with high-end compounding pharmacies and pharmacists? Can they provide you with pharmaceutical grade supplements as needed? A practice that has a wide range of resources available in-house will be better equipped to meet all of your needs.

One of the treatment options to look for is bioidentical hormone replacement therapy . With BHRT, your treatment can be fully tailored to your needs, which means that even patients who have not had success with conventional hormone therapies may be able to find meaningful symptom relief. Excellent BHRT providers partner with the finest compounding pharmacies in the United States to provide customized hormone medications and are able to continuously adjust doses or hormones accordingly to ensure efficacy and tolerability. Having this option available to you can be invaluable as you begin your journey toward optimal health.

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Get Individualized Care From An Experienced Hormone Doctor At Herkare Womens Clinics

Our professionals at HerKare are here to help you improve your health and quality of life through personalized treatment plans. We understand the need for individualized care tailored to you and your lifestyle. Our providers work hard to find underlying causes of your symptoms and identify treatment solutions that work well for you. If youre experiencing menopause symptoms, know that our team is here to help you find relief. Book an appointment today at one of our convenient locations to talk to our doctors about your symptoms and treatment options!

Types Of Hormone Replacement Therapy

Hormone replacement therapy is made with either one or two types of hormones:

  • Estrogen only, which helps reduce night sweats, hot flashes, vaginal dryness, and urinary discomfort, in addition to bone loss that’s associated with aging, and is recommended for people who have had their uterus removed
  • Estrogen with added progesterone, which helps protect against the risk of endometrial cancer in people who still have a uterus

Each is available in different formulas and dosages.

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They Provide Plenty Of Individualized Attention

One of the greatest benefits of seeking top-of-the-line medical care is individual attention. Ask your potential hormone doctor how much time they typically spend with a patient during consultation and follow-up appointments. Then, consider if thats enough time to truly understand your medical background, symptoms, concerns, and questions.

Youre an individual with unique needs that deserves personalized solutions. Understanding those needs, evaluating your treatment options, and monitoring your progress are all essential components of caring for your healthand they take time. By prioritizing doctors who offer plenty of time and individualized attention, youre making sure that your concerns will be heard.

What Is Hormone Replacement Therapy


To start off with lets cover what hormone replacement is. Hormone replacement is the process of taking hormone medications that are very similar to your bodys natural hormones to get them back into the normal range.

Hormone replacement therapy is for people who have low levels of a certain hormone so that they can be replenished. It is not to boost effects in people that have normal levels of hormone in their body, as this could cause problems with the levels being too high.

It can also be used for many types of hormones including estrogen, testosterone, human growth hormone, progesterone, and more. The treatment plan for hormone replacement therapy should be carefully created and monitored by a healthcare professional.

Read Also: How To Deal With Hormonal Breakouts

What Should I Know About Storage And Disposal Of This Medication

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from heat and moisture .

Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA’s Safe Disposal of Medicines website for more information if you do not have access to a take-back program.

It is important to keep all medication out of sight and reach of children as many containers are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location â one that is up and away and out of their sight and reach.

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