Hormone Replacement Therapy (HRT)
Hormone replacement therapy (HRT) is one of the FDA-approved treatments for relief of menopausal symptoms in women. Testosterone Replacement Therapy (TRT) is FDA approved for treatment for andropause (Low T) symptoms in men.
What is Menopause & Estrogen Replacement?
Menopause is the permanent end of menstruation and fertility, defined as occurring 12 months after a woman’s last menstrual cycle.
Menopause is a natural biological process. The physical and emotional symptoms of menopause often range in severity, most of which can be successfully treated. Hormonal changes cause the physical symptoms of menopause, however women may often experience emotional symptoms also. Menopause doesn’t mean our quality of life has ended — we still have almost half of our life to live. Menopause does not have to affect our femininity or sexuality. Many women may find it liberating to stop worrying about periods. Even though menopause is not considered an illness, we encourage women to research bio-identical hormone replacement options for any symptoms of menopause.
Today treatment options range from lifestyle adjustments to hormone replacement therapy. Technically, you don’t become menopausal until one year from your final menstrual period. In the United States, this occurs on average at by age 51. The signs and symptoms of menopause, often appear before the one-year anniversary of your final period.
The signs and symptoms of menopause are usually enough for most women to determine they have begun going through the menopausal transition. We encourage women to have a simple blood test done which will check levels of follicle-stimulating hormone (FSH) and estrogen (estradiol). As menopause occurs, FSH levels increase and estradiol levels decrease. Your practitioner may also recommend a blood test to determine your level of thyroid-stimulating hormone, because hypothyroidism can cause symptoms similar to those of menopause. Menopause itself requires no medical treatment. Instead, treatments focus on relieving your signs and symptoms and on preventing or lessening chronic conditions that may occur with aging.
Estrogen, Progesterone and Testosterone replacement therapy remains the most effective treatment option for relieving menopausal symptoms. Depending on lab results and personal and family medical history, a bio identical hormone replacement practitioner may be the expert for managing your menopausal symptoms.
Estrogen is produced in the ovaries and adrenal glands. There are three types of estrogen found in a female’s body, estrone, estradiol and estriol. The levels of all of these hormones fall dramatically at the onset of menopause. Symptoms of menopause include hot flashes, insomnia, vaginal dryness, bladder problems, difficulty concentrating and anxiety. With time, many of these symptoms may diminish. Unfortunately, disease processes such as cardiovascular disease, stroke, osteoporosis, and Alzheimer’s increase in the absence of estrogen. The rapid bone loss after menopause has been attributed to the decline in the production of estrogen, which is essential for bone growth. In addition, the loss of estrogen results in the development of heart disease, which is the number one killer of both men and women. Postmenopausal women on estrogen have a 70% decrease in mortality from heart disease. Estrogen has also been shown to lower total blood cholesterol and raises HDL, the good cholesterol. Not only does estrogen protect vessels of the heart, it also protects vessels of the brain and may protect against Alzheimer’s disease. Estrogen can protect women against many of the diseases of aging. Post menopausal women on estrogen typically feel better and stay healthier.
Unfortunately, most of the estrogen prescribed today is still in the form of a synthetic estrogen. Synthetic estrogen is not natural to the human body. The healthy trend these days is to avoid the synthetic estrogens and prescribe natural bio-identical estrogen. Human receptor sites were designed to accept natural estrogen and not a synthetic. A recent article in the New England Journal of Medicine proved by meta analysis that long term use of synthetic estrogen increases the formation of breast cancer. In recent research trials, it has been shown that natural estrogen, when taken in conjunction with natural progesterone, protects against breast cancer similar to the way it protects against uterine cancer.
Symptoms of Menopause in women include:
- Fatigue / Loss of energy
- Weight Gain
- Hot Flashes
- Low Sex Drive
- Vaginal Dryness
- Irritability & Mood Swings
- Anxiety and Depression
- Decreased Memory & Focus
- Night Sweats
What Is Low Testosterone/Low T?
Low testosterone occurs when a man doesn’t produce enough of his own Testosterone. As many as 13 million men in the United States may have low testosterone and only 5-10% of these men will seek treatment. Symptoms in men may begin as early as the 30s and 40s, and most often, by their fifties. The good news is there are treatment options available for Low T.
Testosterone is an important male hormone. It is the hormone responsible for the development of male characteristics during puberty. It is also essential for maintaining healthy sexual function, energy, mood, and body composition. Testosterone assists the male body in building protein and is crucial for normal sexual drive, physical stamina, and producing erections.
Testosterone also contributes to several metabolic functions including bone formation, liver function, prostate gland growth and production of blood cells in bone marrow. Testosterone levels vary by age. If your levels are below 300 ng/dL, your physician may diagnosis low testosterone. While only a blood test can determine your testosterone level, men should always consult their physician if they are experiencing symptoms.
The signs and symptoms of Low T may be difficult to distinguish from the changes that occur with normal aging, or those caused by other medical conditions. Often times the symptoms of low testosterone are subtle and very similar to those caused by other medical conditions. This may complicate diagnosing low testosterone. Symptoms are usually explained as “getting older”, when in reality, the real medical problem may be low testosterone. Low testosterone may occur with other common medical conditions. If you have any of the following medical conditions, it is important to have your testosterone levels checked:
- Erectile Dysfunction
- Long term use of pain opioid medications
Symptoms of Andropause in men include:
- Low Sex Drive
- Erectile Dysfunction
- Irritability & Mood Swings
- Depression & Anxiety
- Weight Gain
- Reduce Muscle Mass
- Joint Pain
- Brain Fog
- Prostate Problems
- Decreased Cognitive Function & Memory
Bioidentical hormones are processed hormones designed to mimic the hormones made by your body’s glands. Taking bioidentical hormones can help people who experience symptoms of low or unbalanced hormones. This is often the case for people experiencing symptoms of peri-menopause, menopause, or andropause.
Both the FDA-approved and compounded hormones come in various doses and forms (pills, creams, gels, sprays and vaginal inserts). Be sure to talk to your healthcare provider to find out which type of BHRT is right for you.
Hormones are chemicals made by your endocrine glands. They are messengers that tell other parts of your body how and when to work. Hormones affect many systems and functions in your body. Even the slightest imbalance can cause symptoms that interfere with your day. Healthcare providers may recommend hormone replacement therapy as a treatment for these symptoms.
Bioidentical hormone therapy (BHRT) uses processed hormones that come from plants. Estrogen, progesterone and testosterone are the most commonly used bioidentical hormones.
Some prescription forms of bioidentical hormones are premade by drug companies. The U.S. Food and Drug Administration (FDA) has approved certain types of bioidentical hormones. Other forms of bioidentical hormones are custom-made by a pharmacist based on a healthcare provider’s prescription. These are compounded (or mixed) bioidentical hormones.
Replacing these lost or low hormones is the goal of bioidentical hormone therapy or conventional hormone therapy. Once hormone levels are increased, most people see their symptoms improve. However, there is not much evidence to support that bioidentical hormones are equal to conventional hormone therapy. We can discuss your options for hormone replacement with you based on your symptoms and health history.
The amount of time it takes for bioidentical hormones to work varies. Some people may feel mild relief within a few weeks. Most of the time, it takes about three months to feel the full effect of any type of hormone therapy.
History of Bio-Identical Pellet Therapy
Pellets for hormone replacement have been around since the late 1930’s. However, their popularity declined in the 50’s and 60’s with the growth of the U.S. pharmaceutical industry and the availability of the synthetic, oral hormone called Premarin. Premarin is derived from pregnant horses’ urine, which contains large quantities of estrogen-like chemicals. Premarin and the progestin, Provera, were the two hormones utilized in the Women’s Health Initiative that linked certain forms of hormone replacement with an increased risk of thromboembolic disease, stroke, and breast cancer. Fortunately, pellet therapy never went away, and it is now recognized as a thorough way to manage symptoms related to hormone deficiency.
Pellet therapy is the most natural way to replenish hormone levels for women and men. Implants, placed under the skin, consistently release small, physiologic doses of bioidentical hormones just like those found normally in your body providing optimal therapy. This method is simple, convenient, and has one of the best safety records. Although we offer many bioidentical hormone replacement options, we believe pellets are the best hormone replacement therapy for women. When hormones are absorbed rather than swallowed, they go directly to the tissues and are not altered by the liver. This is called the “first pass effect.”
- The hormones are absorbed directly into the bloodstream avoiding the liver and gastrointestinal system.
- Continuous availability of the hormones 24/7
- Your body controls the release of the hormone. You absorb more hormone during exercise and stress, and you absorb less hormone when you are at rest.
- Convenience – the pellets typically last 3-5 months.
- You don’t have to apply creams or gels daily.
- Studies show this method to be best for mental clarity and sexual function.
- Great for bone density