Hormone Options for Menopause

Many women go through perimenopause and menopause not knowing how many options there are for management. Some are hesitant at the thought of using hormone replacement because of possible (or perceived) cancer risks. Sometimes, physicians are hesitant to be aggressive in treating because they either do not understand or disregard the seriousness of the symptoms and the SEVERE impact on a woman’s quality of life.



Hormone use is certainly not for everyone- those with female cancers or strong family history of female cancers usually are not good candidates. However, there are millions of women who have extreme symptoms and do not get the care they need. Only about 10-15% of women in the US use hormone replacement therapy (HRT).

It is always necessary to weight the risks, benefits, pros and cons of using HRT but it can be a salvation for a woman with profound changes in her body. The hormone shifts affect every cell in the body - not just breasts, ovaries and uterus.
The hormones Estradiol, Progesterone and Testosterone can be delivered in different ways AND with different timing. Estradiol is available as a regular pharmaceutical prescription (from your CVS or Walgreens type pharmacy) in a gel or a patch. Progesterone is available in a pill. (There is no FDA approved form of testosterone for women.) These options are in fact bioidentical, meaning the same exact molecules that your body produces. **NON bioidentical hormones are still available as the medication PremPro or Premphase. These are NOT recommended due to increased risk of cancer, strokes and heart disease.

Through compounding pharmacies, custom dosing of bioidentical hormones is available, as well as many different delivery systems (oral, sublingual, cream, gel, suppository). Then, the options are to take the same dosages every day (static dosing) OR to mimic the monthly changes seen in younger women (rhythmic dosing).

An experienced functional or integrative medicine provider can help navigate these options for the very best outcome. It DOES sometimes take a bit of time and adjusting to get there, but it can be VERY worth the effort.

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