For a long time now, women have turned to hormone replacement therapy (HRT) to ease the uncomfortable symptoms of menopause. About 90% of women suffer from these symptoms, such as hot flashes and night sweats. HRT is the go-to solution to curb the discomfort that happens to women at a certain time in their 40s and 50s. But recently, Bioidentical Hormone Replacement Therapy (BHRT) has become popular as the more natural solution to HRT, especially that there have been concerns about the potential side effects of the latter.
So what is Bioidentical Hormone Replacement Therapy and is it the right treatment for your menopausal problems? BHRT, just like HRT, comes with its own sets of benefits and risks. Your doctor will evaluate your condition and personal medical history in determining if you should take bioidentical hormone replacement therapy for women instead of the more conventional HRT.
This therapy uses bioidentical hormones, which are derived from plants and are identical or similar to the chemical and molecular structure of the hormones that women naturally make in their ovaries during their reproductive years. These hormones are synthesized from a plant chemical extracted from soy and yams. Women who are looking for a "natural" alternative hormone therapy may opt for bioidentical hormones to use in their treatment.
A wide range of products in the market are now made of bioidentical hormones. Some of these products are FDA-approved and commercially available. There are also compounded preparations that are not FDA-regulated. There are two kinds of bioidentical hormone products: those made by pharmaceutical companies and those formulated especially for you by a compounding pharmacist, who will use your hormone testing as a basis for your compounds.
On the other hand, the traditional hormone therapy replaces the estrogen and progesterone made by the ovaries that women lose as they age and tend to produce fewer hormones. This therapy, which comes in the natural forms of estradiol, estriol, and estrone, helps women deal with hot flashes, night sweats, and vaginal dryness that comes with menopause.
In this case, estrogen acts like fertilizer on the lining of the uterus and should be counterbalanced by progesterone. This is why women who still have their uterus are made to take both hormones when undergoing HRT. The plant hormones in most BHRTs mimic estriol, progesterone, dehydroepiandrosterone, and melatonin hormones.
By using the term "bioidentical," pharmacies are promoting their compounded products as safer, since they are more natural, although both the FDA and the Endocrine Society recognize the term more of a marketing term since it's not exactly based on scientific evidence. Just like commercially manufactures hormones, bioidentical hormones have their own set of side effects, thus it's not necessarily "safer" than the traditional HRT.
According to a national study conducted by the Women's Health Initiative in 2002, there is an increased risk of breast cancer, stroke, heart attack, and other problems in postmenopausal women who are under HRT. But it also points out that not all postmenopausal women possess the same risk of developing one of these health issues. This is why a thorough consultation with your doctor is key to know if and which hormone therapy is best for you.
One advantage of compounded medications is availability. It can be created in different forms - oral, sublingual, transdermal, implants, injections, or suppositories. You have more options when it comes to how you would like to take the hormone preparation, with the approval of your doctor, of course. Compounded medications can be custom-made for you based on your doctor's recommendations.
However, compounded medications are not regulated by the FDA, which naturally sparks concerns about their safety. Overdosing and underdosing can happen since there are no standard controls for dosing and quality. This can be tricky if you still have a uterus and on a combination estrogen and progesterone treatment - if your hormones are not balanced, you run the risk of developing hyperplasia or uterine cancer.
Because of this, the FDA passed the Compounding Quality Act, which allows an entity that compounds sterile drugs to register as an outsourcing facility, which in turn must meet certain conditions for compliance. You can check your pharmacy or online distributor if they are participating in a recognized quality verification program before you buy compounded hormones from them.
Are you becoming more irritable as you age? Are you gaining weight suddenly, seeing muscle loss, or experiencing fatigue? These may be signs of menopause and it can make the change uncomfortable for you. BHRT can help address these problems and ease the discomfort that menopause symptoms bring. Here are the most common signs that you may need BHRT.
Ideally, hormone replacement therapies should be taken at the beginning of your menopause, specifically within 10 years of your last menstrual period. Doing so will help control the symptoms that come with the hormonal imbalance and help prevent osteoporosis. The older you start taking hormone treatment, the higher the chances of risks such as blood clots and strokes. Staying on estrogen longer may also increase the risk for Alzheimer's disease as a postmenopausal woman.
Doctors address these risks by giving the lowest dose of hormones that are enough to help deal with menopausal symptoms. They usually advise women who are past their 60s to wean off the hormones, which can be difficult for a patient since hormones can make them feel great.
BHRT is used to increase hormone levels to ease the symptoms of perimenopause or menopause. When you age, your hormone levels drop which results in developing moderate to severe menopause symptoms such as hot flashes and night sweats, mood changes, memory loss, weight gain, sleep issues, and vaginal dryness. BHRT helps with these issues and also reduces the risk for tooth loss, cataracts, and diabetes. In some cases, the treatment can even help with improving your skin's elasticity and hydration.
The FDA hasn't approved any compounded bioidentical hormones yet even though it has approved some preparations of bioidentical estradiol and progesterone. It cannot claim to be safer or more effective than the traditional HRT since it hasn't been confirmed by reputable and large-scale studies. The FDA urges caution when it comes to using compounded BHRT products.
In general, hormone replacement therapy may increase your risk of some conditions and diseases. These include blood clots, stroke, heart disease, gallbladder disease, and breast cancer. When taking BHRT, you may experience certain side effects, such as acne, bloating, weight gain, mood swings, fatigue, and an increase in facial hair in women.
Bioidentical hormone therapy or other forms of hormonal treatment is not for everyone. For reasons that the doctor will explain, you may not be the right candidate for it. It could be your current condition or medical history. You should not take any hormone therapy medications without the approval of your doctor.
You can take BHRT via cream, gels, patches, implanted pellets, or injections. Your doctor will help you decide which is the best form for you, depending on your medical history and lifestyle. Once you begin treatment, your doctor will monitor and evaluate your body's response. Monitoring hormone levels via blood and saliva tests are not enough, according to the FDA. It's because these tests only reveal your hormone levels during that moment you took the test and your levels can vary throughout the day.
The FDA also recommends taking the lowest possible dose in the shortest possible time while getting the results that you need.
If for any reason that your doctor discourages you from taking hormone treatment, you will have to resort to natural ways to alleviate the symptoms. These non-hormonal products will not produce the results that hormone products do, but at least you don't have to deal with the risks associated with hormone therapy. You can hope for at least 40% in improving symptoms, both in frequency and severity.
You can try Brisdelle, which has paroxetine, the active ingredient in an antidepressant, although this one has a much lower dose. Another option is Fosteum, which is made from soy. Studies have shown that Fosteum may help to improve bone density. Both of these medications are FDA-approved so you don't have to worry about safety.
You can also turn to herbal remedies such as Relizen, which is made from tree pollen, and Estrovera, which is made from rhubarb. If you decide to take these, allow three full months to evaluate their effectiveness. Acupuncture can also help reduce the frequency and intensity of hot flashes.
A change for the better in terms of lifestyle will also help you immensely. If you smoke and drink lots of alcohol, now is the perfect time to stop or at least curb it drastically. Not only are these bad for you physically, but they can also increase your anxiety and depression.
Exercise not only combats weight gain and muscle loss, but it also stimulates the brain chemical norepinephrine, as well as increasing your endorphins, which will elevate your mood. This should be complemented with a healthy diet, especially since certain foods can affect your mood and not just your body.
Let Revitalize You MD help you decide the right course of treatment for your menopausal symptoms. We offer not just excellent hormone therapies, but also other medical procedures that will improve your body and boost your self-esteem. Our staff consists of highly experienced and licensed medical professionals who will not compromise your safety at all costs. Call us and book your appointment so we can discuss your hormone therapy options.
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