Hormone therapy – Estrogen combined with progesterone is called hormone therapy.
Estrogen therapy – Estrogen given alone is known as estrogen therapy.
Hormone therapy using synthetic hormones – A synthetic hormone is a patented molecular compound created in the lab that mimics natural hormones. Premarin™ and Prempro™ are examples of synthetic hormones.
Bioidentical hormone replacement therapy – Some hormones are chemically created to be identical in molecular structure to the hormones women make themselves. Most bioidentical estrogens come from soy, while progesterones are made from yams.
The natural process of menopause takes several years, during which hormone levels can vary greatly. In up to 85 per cent of women, lower estrogen levels are associated with hot flashes, sweating, insomnia, and dryness and discomfort of the vagina. Other symptoms may include:
Three out of four women experience some symptoms of menopause, with one in four having more severe symptoms. Most lessen over time. If you are uncertain about whether you are beginning menopause, tests can help.
When it comes to managing menopause, one approach does not fit all. Hormones are just one part of the whole woman. Diet, exercise, lifestyle, relationships, and stressors are all important factors that, along with hormones, affect health.
The following tips may help in dealing with symptoms of menopause.
The transition into menopause is different for each woman. Consider your personal health history as you and your doctor weigh the benefits and risks of hormone therapy. For some women, estrogen, progesterone and possibly testosterone may help with symptoms associated with menopause.
Estrogens, which come in different forms, affect about 300 different tissues.
The ovaries make most of the estrogens in the body. Other tissues, such as fat cells, skin and muscle, form them as well. Estrogens are needed for female organs to develop and for the reproductive process. They are also involved in tissues in the central nervous system, the bones, the liver and the urinary tract. Estrogens may be natural, synthetic or made from plants.
Taking estrogen mainly relieves hot flashes, night sweats and dryness of the vagina. Estrogen replacement therapy comes in a variety of forms:
Progesterone is the other major female hormone. It thickens and prepares the lining of the uterus for a fertilized egg. Progesterone is referred to by several names. Progestogen includes medications made from plants that act much like a women’s own progesterone. Progestogen includes:
Taking progesterone mainly reduces the risk of cancer of the uterus when used along with estrogen. The actions of estrogen and progesterone balance and keep each other in check.
Progestogens are available in the following forms:
Testosterone, an androgen, has been nicknamed the hormone of desire. Adding testosterone to estrogen builds fat-free body tissue. While estrogen encourages fat in the abdominal area, testosterone counteracts this effect.
Testosterone replacement increases sexual desire, masturbation, sexual intercourse and sense of well-being.
Combined estrogen and androgen therapy may be recommended to women who lack androgen while on estrogen therapy. Testosterone is available in the following forms:
Hormone therapy is approved for the following uses:
Hormone therapy should generally not be prescribed for women with the following conditions:
Using estrogen and progesterone for less than five years does not appear to be associated with significant risks. Hormone therapy may be started by women who have recently entered menopause. It should not be used by women who started menopause many years ago.
The lowest possible dose of estrogen and progesterone to control symptoms should be used.
Due to the disappointing findings of the Women’s Health Initiative, many women have decided against conventional hormone therapy using synthetic hormones such as Premarin™ and Provera™. Synthetic hormones are patented molecular compounds that mimic the action of our own hormones.
Some women have looked for other solutions. One new treatment that has received a lot of media coverage is bioidentical hormone replacement therapy (BHRT). Unfortunately, the term ‘bioidentical’ is used in two different ways. This has confused both consumers and health care providers.
Most health care providers use the term bioidentical hormone therapy to describe hormones that are chemically created to be identical to our natural hormones. Estradiol, progesterone and testosterone are all examples. These hormones are approved and available with a prescription.
Other health care providers and some pharmacies use the term bioidentical hormone therapy to refer to medications custom mixed to fit an individual patient’s needs.
Many women are led to believe that bioidentical hormones are somehow better or safer than other hormones. However, until clinical trials show otherwise, it is wise to assume that all hormone medications have a similar balance of benefits and risks.
Bioidentical hormones prepared as an individual prescription may offer benefits for women who cannot use a product already available.
Risks may also be associated with using custom mixed bioidentical hormone replacement preparations.
“Unlike commercial drug manufacturers, pharmacies are not required to report adverse events associated with compounded drugs,” says Steve Silverman, Assistant Director of the Office of Compliance in the FDAs Center for Drug Evaluation and Research. “Also, while some health risks associated with BHRT drugs may arise after a relatively short period of use, others may not occur for many years. One of the big problems is that we just don’t know what risks are associated with these so-called ‘bioidenticals.’”
Individually mixed bioidentical hormone preparations are not tested. We do not know if they absorb properly or provide predictable hormone levels in blood or tissue. As well, women may not receive consistent amounts of medication with each prescription refill.
Some pharmacies promote bioidentical hormones as natural, risk-free and able to prevent or cure a host of medical conditions. To create a hormone, plant or animal based hormones are put together in a process requiring several steps. Bioidentical hormones are not natural or in their natural state when they are used.
There is no evidence that compounded hormones have fewer side effects or different risks than commercially available products. There is also no proof that they offer any specific unique health benefits.
You may prefer hormone therapy that has been custom mixed for you at a pharmacy. Take these steps to make certain that the drug you are taking is safe.
Contact your doctor and your pharmacist if your condition gets worse while using compounded medications, especially after refilling the prescription.
While growing old is not for sissies, the good news is that we have a variety of tools to make the most of the aging process. For some women, bioidentical hormone replacement therapy is one of these tools.