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Is hormone supplementation after menopause an anti-aging,
health-enhancing therapy or is it excessively risky and best avoided?
What are you to make of conflicting claims, confusing statistics and
differing "expert" opinions? How can you decide what is best for your
optimum present and future health?
I propose a series of steps that can help you clarify the issues and
aid you in making a decision about hormone supplementation at or after
menopause:
1. Assess How You Feel:
If you are having no or minimal menopausal symptoms, it is usually not
necessary or desirable to use hormone supplementation. But if the
quality of your life is severely impacted by hot flashes, insomnia,
fatigue, decreased libido, anxiety/depression, memory loss, difficulty
concentrating, vaginal dryness, bladder problems, joint pain or other
symptoms that result from declining estrogen levels, you may want to
use the lowest effective dose of natural estrogen and progesterone that
relieves symptoms. "Bioidentical" or "natural" forms of estrogen,
progesterone, and testosterone (consisting of hormones with the
same molecular formulas as those naturally found in the human body)
derived from plant sources are felt to be best. These include
commercially available estradiol (in the form of tablets, patches,
creams, or mist sprays) and estrogen or Di-Estrogen formulas compounded
by special pharmacies, progesterone (in capsules and creams from
pharmaceutical companies and compounding pharmacies), and testosterone
(available only from compounding pharmacies as creams, capsules or
sublingual tablets).
2. Evaluate Your Risk Factors:
It is helpful to assess your risk of heart disease, osteoporosis,
Alzheimer's disease and breast cancer when considering whether or not
to use hormones. This assessment should include a review of your own
medical history, your lifestyle habits, and your family history, in
addition to certain laboratory tests. In particular, you should
consider cholesterol screening with HDL, LDL and triglyceride levels,
CRP level, mammography and bone density screening. This is a complex
topic and is best dealt with via private consultation with an expert in
the field.
3. Become Informed: There
is an ever-higher mountain of information about menopause, hormones and
alternative treatments. It is important to read, attend workshops and
lectures, and join with other women to share information on this
subject. And while there is much information available, there is
also much misinformation. Many claims are made without adequate
research to back them up, and without studies examining the actual
safety and efficacy of various hormone regimens. As recently as 10
years ago medical doctors urged post-menopausal women to use hormones
to prevent disease, while alternative health practitioners warned women
to avoid the use of hormone therapy. Interestingly enough, currently
there is a nearly complete reversal: Alternative practitioners often
promote the use of "bioidentical" hormones as an anti-aging therapy,
while many conventional physicians discourage the use of hormone
supplementation due to possible increased risks of cancer and other
conditions in hormone users. At this time, there is insufficient
research on the relative risks and benefits of long-term replacement
with low-dose natural or bioidentical hormones to provide a definitive
answer to the question of whether any or all women should undertake
such therapy.
4. Find a Health Care Partner:
There are physicians, nurses, and other health practitioners who are
well-informed, experienced and interested in the concerns of women in
mid-life. Keep searching until you find one who listens to you, gives
individual attention, and with whom you can develop a true partnership.
5. Consider a Trial Period of
Hormone Supplementation: If you have troublesome menopause
symptoms it is generally safe to try hormone supplementation for a
short period (usually 2-3 months) to see how your body responds. Often
your system will let you know if hormones are what you lack--you need
only listen. It is not dangerous to start hormones and then stop,
although a gradual discontinuation is usually easier on the body than
an abrupt one. I have often witnessed women who were unable to make an
intellectual decision about hormone supplementation have their bodies
make the decision for them when they took the hormones for a trial
period. Most often hormone supplementation taken for symptom relief can
be discontinued after 1-5 years.
6. Try Alternatives:
Herbal therapy, Chinese medicine, acupuncture, dietary modifications,
lifestyle changes, bodywork, mind-body techniques, etc., are safe and
are worth pursuing either as alternatives to or in conjunction with
natural hormone supplementation.
Dr. Andrea Bialek is a Gynecologist with a private
practice in Santa Rosa, CA. She combines the best of conventional
medicine with a holistic approach to assist each woman in her quest for
wellness. For more information, call (707) 539-7309.
Related Info:
Menopause: Symptoms & Common Sense
Solutions
Hidden Signs of Heart
Attack in Women
Living Well: A Guide to Anti-Aging
Do You Have Thyroid
Problems?
The
Truth About Hormone Replacement Therapy
Balancing Your
Energy Hormones
Preventing
Osteoporosis
Feeling Fat, Fuzzy or
Frazzled?
The Hormone Question
Reduce the Effects of
Aging with Natural Supplements
Estrogen, Menopause, and Your Thyroid
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