Hormone Replacement Options

What options do you have?

All women eventually reach menopause; there is nothing anyone can do to prevent or delay it. The average age of menopause is 51 but symptoms of estrogen and progesterone deficiencies usually occur long before. Women also suffer from falling testosterone, DHEA and thyroid hormones. When women's hormone levels start to fall they have four choices.

1.Take no action and suffer from the symptoms of low hormone levels. The most common symptoms are hot flashes, night sweats, sleeplessness, low libido, low energy, mood changes, mental fogginess and vaginal dryness.

2. Attempt to mask the symptoms with herbal remedies, anti-depressants and/or the birth control pill. Herbal remedies often offer nothing more than would a placebo and if they do help, the effects are usually short lived. Many physicians will prescribe anti-depressants and the birth control pill with little consideration. Antidepressants can prevent hot flashes and help with stabilize moods but the side effects include worsening libido and weight gain.

3. Take synthetic hormones that are foreign to the body. The body is not accustomed to recognizing these unnatural hormones that often adversely affect the body. Most women who take hormones take foreign hormones. The most commonly prescribed synthetic hormones are Premarin and Provera. Premarin is derived from pregnant mares urine, hence the name. Provera is a synthetic progesterone and it is not nearly as safe as natural progesterone. Premarin and Provera were the two hormones studied in the Women's Health Initiative (WHI). Synthetic hormones are often referred to as hormone replacement therapy (HRT) however, Dr. Bruice believes this should be referred to as hormone substitution therapy (HST).

4. Take bioidentical hormones, which is true hormone replacement therapy. Bioidentical hormones have the exact molecular structure of the hormones that a woman's body produces naturally. In other words, these hormones are no different from the hormones that a woman's body produce from about age 12 through 51. Bioidentical hormones are more effective in eliminating symptoms of menopause and are safer than synthetic hormones. In this day and age it is shocking that a physician would rather prescribe horse hormones than hormones with which a woman's body is familiar.

How to take your hormones.

Most hormones are prescribed in pill form. When hormones are absorbed by the stomach they go directly to the liver by the portal circulation. This results in the “first pass liver” effect which is an unnatural way to take hormones. When the ovaries make hormones they put them directly into the blood supply via the ovarian vein. Dr. Bruice believes in mimicking the body's natural physiology by adding bioidentical hormones directly to the bloodstream. This can be accomplished using sublingual troches or transdermal creams. Transdermal creams are Dr. Bruice’s first choice which offer slower absorption resulting in fewer peaks and valleys of hormone levels. It is important to take the hormones as prescribed on days of subsequent blood draws.

If you'd like to learn more about bioidentical hormone therapy, please contact Dr. Bruice at office@kentonbruicemd.com