CAN HORMONE REPLACEMENT HELP IF I’M ALREADY PAST MENOPAUSE?
The irreversible and permanent cessation of monthly menstrual cycles is referred to as menopause. In other words, menopause marks the end of the reproductive capacity of a female as a result of biochemical and hormonal changes in the body. The transition to complete menopause may take approximately 15 years (long before the actual cessation of menstrual cycles).
This period is marked by gradual but persistently declining levels of key reproductive hormones such as estrogen and progesterone. This results in a wide variety of disturbing symptoms such as:
- Persistent and/or unexplained fatigue or tiredness
- Changes in the rhythm, depth and quality of sleep
- Hot flashes
- Significant and noticeable changes in metabolism
- Weight gain
- Vaginal dryness, negative changes in libido
- Higher propensity to develop urinary tract infections and other opportunistic infections (such as candidiasis) due to changes in vaginal pH.
- Osteoporosis or weakening of bones due to abnormal changes in bone mineral density
- Higher risk of developing cardiovascular diseases due to loss of protective influence of estrogen
- Mood swings due to estrogen imbalance; the reaction between cortisol and DHEA is also believed to affect energy levels and mood
So what can you do to restore your normal quality of life?
Hormone therapies and supplements are exceptionally important after the onset of menopausal symptoms to restore the natural balance. Over the course of past several decades, several hormone replacement regimens and options have been introduced to allow menopausal women to live a productive life despite the loss of natural estrogen production.
Unlike conventional hormonal regimens, bioidentical hormone replacement therapy is unique because different combinations and concentration of hormonal preparations can be prepared to satisfy individual demands of the patients. Different forms of BHRT estrogen formulations that are currently available are estradiol, estrone and estriol. In addition, virtually any hormonal formulation can be prepared (or compounded) based on the patient requirements and hormonal needs.
Some indications that you should consider initiating BHRT are:
- Focusing on prevention: With physiological aging and loss of estrogen influence, the risk of developing certain diseases and health issues such as (but not limited to) arthritis, cardiac diseases, diabetes, and osteoporosis increases tremendously. Obviously this increases the need of initiating BHRT significantly to prevent these health issues through optimal hormonal balancing.
- Integrative approach: The effects and results of menopausal integrative approaches such as nutritional supplementation, exercise, and supplementation with vitamin D (in case of osteoporosis) can be improved with BHRT.
- Optimization of genetics and life style modification: Every woman is unique and different in terms of her life style choices, genetic make-up and nutritional choices. Her unique needs are therefore better served through customized BHRT as opposed to a single conventional regimen.
Why not Conventional HRT?
Conventional hormone replacement regimens are often associated with abnormal metabolism. This is mainly because synthetic formulations are metabolized differently in the human body, which increases the risk of accumulation in the adipose tissue stores. Research and clinical data indicates that excessive concentrations of estrogen can negatively influence the activity of uterine and breast cells and may lead to:
- Extra mitotic division
- Abnormal cell division
- Higher risk of malignant transformation of cells
A study reported in the Journal of Clinical Endocrinology and Metabolism (2) suggested that the combination of progestin with estrogen in conventional HRT can significantly aggravate the risk of breast cancer in females as evidenced by the results of two large, multi-center clinical trials. Additionally, according to another study reported in the Journal of the National Cancer Institute (3), HRT can increase the risk of hypercholesterolemia and cardiovascular diseases due to its effect on the metabolism of bad quality cholesterol (LDL).
In short, experts and healthcare providers recommend that women on conventional HRT require aggressive and periodic scrutiny in order to detect these early malignant changes and metabolic complications, which can evoke a sense of agitation and irritability in women.
How BHRT can help long after menopause?
BHRT usually takes about 2 to 6 weeks to produce positive results; however, depending upon the patient factors, it may require a longer period of time in some cases. Some health issues that are managed by BHRT long after menopause are:
- Depression, which is a mental health issue that is characterized by a persistent feeling of despair, sadness and guilt that does not go away. Menopause is very frequently associated with depression, anxiety and other mental health issues. Needless to say, poorly managed depression is a strain on relationships and can affect the personal, social and professional aspects of an individual’s life. It is believed that depression in most menopausal women is associated with long term estrogen deprivation.
- According to a study reported in the Psychosomatic Medical Journal, investigators suggested that menopausal women between the age of 45 and 54 years often develop hot flashes, problems sleeping, and mood and memory problems that can be adequately managed by BHRT.
Based on the results of a new study conducted in 296 women over a period of 7 years (2003 – 2010), investigators concluded that compounded BHRT therapy significantly improves the quality of life in females with impaired natural production of estrogen and progestin. The results were significant after only 6 months of initiating the therapy (4):
- 25% reduction in emotional lability in the study sample
- 25% improvement in the symptoms of irritability
- 22% improvement in the symptoms of anxiety
- 14% and 6% improvement in the symptoms of hot flashes and night sweats respectively.
When to start BHRT after menopause?
It is imperative to mention that age has never been an obstacle for these treatments; it’s never too early or too late to start BHRT. The ideal age to start BHRT varies depending upon the indications and individual requirements. Most healthcare providers believe that BHRT should be commenced just before the menopause (in the peri-menopausal period). On the other hand, some believe that BHRT should be adopted only if the symptoms of menopause are severe or are interfering with the normal quality of life. In either case, it is ideally recommended to seek help and consultation from your primary care provider seek help and consultation from a primary care or physician experienced in bio-identical Hormone Replacement Therapy.
The best way to determine if you are hormone deficient or require BHRT is a blood test to assess hormone levels. Call our clinic today to schedule a free lab test