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Bio-identical Hormone Replacement Therapy: What You Need to Know


Few areas of health care are as plagued by competing claims and confusion as hormone therapy, but when approached with a holistic perspective under medical supervision, bio-identical hormone replacement therapy can be life-changing.


Conventional hormone therapy has been the subject of several high-profile news stories, and more research needs to be done on its long-term effects. Bio-identical hormones offer an alternative to conventional hormone therapy. But, because our body’s responses to hormones vary widely, it’s important to always work with a healthcare practitioner to determine the right treatment for you.


Here are some answers to common questions about bio-identical hormone therapy (BHRT).



What Is Bio-identical Hormone Therapy?


The chemical structure of bio-identical hormones is identical to that of the hormones your body produces naturally - hence their name. The hormones are derived from plants and can be produced in a factory or by a compounding pharmacist.


The most commonly prescribed types of bio-identical hormones are testosterone, estrogen, and progesterone. These hormones are delivered to the body in many forms, including patches, pills, pellets, creams, gels, sprays, and troches



Who Benefits From Bio-identical Hormone Therapy?


Women may benefit from bio-identical hormone therapy. Women often start when they enter the peri-menopause years to help maintain hormonal balance. Up to 2.5 million women in the US use BHRT, by some estimates two-thirds of all women taking hormonal therapy, to help with menopausal symptoms.



What Conditions Does BHRT Help With?


As we age, the production of several important hormones declines. The effects of these dropping hormone levels can be profound. Women can experience:


● Weight gain

● Brain fog

● Fatigue

● Depression

● Hair loss

● Hot flashes

● Foggy thinking

● Insomnia

● Loss of libido

● Vaginal dryness

● Bone loss

● Dry skin


BHRT can reduce the systems of declining hormone levels. It can also provide some preventative protection against conditions like osteoporosis.



What Are The Risks Of BHRT?


When assessing the risks of BHRT, it’s important to consider your overall health. Smokers, for example, have a higher risk of blood clots. Anyone who has been diagnosed with breast cancer in the past should avoid BHRT..


This makes the decision whether or not to take hormones highly personal. Research shows that menopausal women benefit from an overall examination of their health when they’re prescribed BHRT. Typically, they experience more in depth, personal care during the process


BHRT comes in conventional therapies, regulated by the FDA and obtained from a regular pharmacy or as compounded from a compounded pharmacy which

isn’t regulated by the FDA, so it’s important to work with a provider who is an expert in hormone therapy. It’s generally smart to start with a low dose and see how your body responds.



Are There Alternatives To BHRT?


Anyone concerned about the long-term effects of BHRT, or anyone in a high-risk group, may want to explore natural alternatives for hormone support instead. Here are some effective strategies.


Eat plenty of protein and enjoy a balanced diet. Crash diets can slow testosterone production.

Supplement smartly. Some natural supplements have been shown to support hormone levels. As always, work with your healthcare provider.

○ Black cohosh can help ease hot flashes and other menopausal symptoms

○ Vitamin D and zinc have positive effects on testosterone.

Watch your alcohol intake. Alcohol can exacerbate symptoms of hormone imbalances, such as hot flashes.

Include strength training. Lifting weights can improve testosterone in men. Although this is less of an impact in women, strength training can improve symptoms of menopause and reduce the risk of osteoporosis.

Get enough sleep Hormonal imbalances can wreak havoc on sleep, but at the same time, lack of sleep can affect hormone production. Work on creating a restful evening routine to encourage sleep.

Watch your stress levels. Stress increases production of cortisol, and cortisol and testosterone can contradict each other - as your levels of one rise the other decreases. If it’s hard to reduce situational stress in your life, try stress-reducing activities like time in nature and meditation.

Non-hormonal prescription therapies. Medications such as Veozah 45 mg and paroxetine 7.5 mg are FDA approved for treatment of hot flashes.



It’s important to work closely with an experienced healthcare provider - like us. We can review treatment protocols with you, answer any questions, and develop a personalized plan tailored to you. Just give us a call!




Sources:


Pinkerton JV, Santoro N. Compounded bioidentical hormone therapy: identifying use trends and knowledge gaps among US women. Menopause. 2015 Sep;22(9):926-36. doi: 10.1097/GME.0000000000000420. PMID: 25692877; PMCID: PMC454772


Files JA, Ko MG, Pruthi S. Bioidentical hormone therapy. Mayo Clin Proc. 2011 Jul;86(7):673-80, quiz 680. doi: 10.4065/mcp.2010.0714. Epub 2011 Apr 29. PMID: 21531972; PMCID: PMC3127562.


Pentti K, Tuppurainen MT, Honkanen R, Sandini L, Kröger H, Alhava E, Saarikoski S. Hormone therapy protects from diabetes: the Kuopio osteoporosis risk factor and prevention study. Eur J Endocrinol. 2009 Jun;160(6):979-83. doi: 10.1530/EJE-09-0151. Epub 2009 Mar 25. PMID: 19321660.


Gass ML, Stuenkel CA, Utian WH, LaCroix A, Liu JH, Shifren JL; North American Menopause Society (NAMS) Advisory Panel consisting of representatives of NAMS Board of Trustees and other experts in women's health. Use of compounded hormone therapy in the United States: report of The North American Menopause Society Survey. Menopause. 2015 Dec;22(12):1276-84. doi: 10.1097/GME.0000000000000553. PMI


Thompson JJ, Ritenbaugh C, Nichter M. Why women choose compounded bioidentical hormone therapy: lessons from a qualitative study of menopausal decision-making. BMC Womens Health. 2017 Oct 2;17(1):97. doi: 10.1186/s12905-017-0449-0. PMID: 28969624; PMCID: PMC5625649.


Franco OH, Chowdhury R, Troup J, et al. Use of Plant-Based Therapies and Menopausal Symptoms: A Systematic Review and Meta-analysis. JAMA. 2016;315(23):2554–2563. doi:10.1001/jama.2016.8012


Mazaheri Nia L, Iravani M, Abedi P, Cheraghian B. Effect of Zinc on Testosterone Levels and Sexual Function of Postmenopausal Women: A Randomized Controlled Trial. J Sex Marital Ther. 2021;47(8):804-813. doi: 10.1080/0092623X.2021.1957732. Epub 2021 Jul 27. PMID: 34311679.


Timón Andrada R, Maynar Mariño M, Muñoz Marín D, Olcina Camacho GJ, Caballero MJ, Maynar Mariño JI. Variations in urine excretion of steroid hormones after an acute session and after a 4-week programme of strength training. Eur J Appl Physiol. 2007 Jan;99(1):65-71. doi: 10.1007/s00421-006-0319-1. Epub 2006 Oct 19. PMID: 17051372.





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