What do you think about hormone replacement therapy and the use of bio-identical hormones? What a great question! After the large national study called the Women's Health Initiative (WHI) many women were left frightened and confused about hormone therapy (HT). The WHI was terminated early because it found that postmenopausal women who took Prempro (a pill containing estrogen and progestin) were at increased risk for breast cancer, heart disease and blood clots. Some providers advised their patients to go off all hormone therapy immediately. This sudden withdrawal from hormones led to severe hot flashes in some women and the urgent need for symptom relief. Here are some of my thoughts about HT:

v     Avoid using HT unless you are having moderate to severe hot flashes. In other words, if your symptoms are interfering with your life then hormones should be considered.

v     Start by trying bio-identical hormones. Bio-identical means that they are similar to the hormones made in your body. There are bio-identical hormones available by prescription (thus covered by most insurance plans) and in many different dosages and formulations such as pills, patches and creams.

v     Know the difference between bio-identical hormones and compounded hormones. Compounding is when individual doses are made and put into different formulations such as creams, drops, etc. Unfortunately, there is not much science behind compounding though it is very popular among alternative providers. Many alternative providers also offer saliva testing to monitor hormone levels and adjust dosages accordingly. In clinical research studies, neither saliva nor blood hormone testing have been found to be helpful for monitoring hormone therapy. Also, saliva testing is not covered by insurance so it can be very expensive.

v     The bottom line with hormones, only use them if you need them. If you use them try to use bio-identical, use the lowest dose possible and use them for the shortest period of time possible (<5 yrs). There are also a variety of other medications, herbs and supplements that have been found to be safe and effective for menopausal symptoms -hormones are not your only option.

v     Look at the whole picture; take a holistic approach to menopause! It is important to encompass nutrition, physical activity and mind/body health into your treatment plan. 

If you are interested in an evidence-based holistic approach to menopause, give me a call. We can develop a comprehensive plan that will empower you to achieve optimum health during the menopause transition.