Hormones to Treat Menopause Might Be Safer Than Once Thought
Is hormone therapy for menopause a safe option for women?
Recent research indicates that (bioidentical) hormone replacement therapy (BHRT or HRT) is both safe and effective when prescribed carefully.
Earlier studies pointed to risks of serious health consequences like breast cancer and stroke with HRT.
Despite a long history of health benefits reported in research to both conventional HRT and bioidentical forms of HRT, one big study, the Women’s Health Initiative, questioned the safety of hormone replacement.
Here we’ll discuss the safety and effectiveness of Bioidentical Hormone Therapy for menopause in light of more recent research.
How safe is hormone therapy for menopause?
People thinking of trying BHRT will be curious about the science behind it, and practitioners should be prepared to answer questions and offer this as a possible treatment.
Plenty of research exists to show that, when administered carefully and properly, BHRT (and possibly conventional HRT) should reduce symptoms of menopause and may even offer health benefits.
Concerns about the safety of hormone replacement therapy sprung primarily out of the controversial results from the Women’s Health Initiative Trial (WHI), which involved 30 000 women in two groups.
One group took a combination of estrogen and progestin, and the others took estrogen-only therapy.
The study stopped early because there were worries about breast cancer (group one) and stroke (group two).
(This article discusses the errors of the trial and where HRT went wrong)
Hormone Therapy May Lower Death Rates
A 2017 study published in JAMA and reported by the AARP discussed that mortality outcomes weren’t significantly higher in either group and that they may be lower or at least neutral.
What’s perhaps more surprising is that dementia rates were lower in the estrogen-alone category.
This was the case more so for women who were already in a lower-risk category for specific health issues (namely younger women).
But more importantly, it pointed to the need for a more careful and customized approach when treating menopausal women — and everyone else — with HRT.
Part of this is that the practitioner must have a clear picture of existing risk factors for health problems such as cardiovascular disease, stroke, and certain types of cancer.
About Hormone Therapy for Menopause
Menopausal women are probably the most significant group which can tap into the benefits of bioidentical hormone therapy.
While there is certainly interest in this type of therapy, many people don’t yet know that data indicated that this may be a safe and effective option that can help them reduce and manage intense symptoms of menopause and other symptoms of aging.
BHRT programs also allow practitioners to do more to monitor menopausal women as they move through a longer-term health plan.
This type of monitoring, along with repeated hormone testing, can help practitioners adjust prescriptions appropriately and immediately identify changes that need to be made.
Menopause is primarily due to an overall decline in estrogen — over the long term, it’s a decline; however, levels can fluctuate during perimenopause and even into menopause.
Factors (other than aging) that can worsen or trigger estrogen decline include:
- Cancer therapies
- Ovarian insufficiency
- Adrenal fatigue
- HPA Axis Dysfunction
- Extreme diet or poor diet
- Excessive exercise
Bioidentical hormones may bring women struggling with menopausal symptoms more favorable or at least equally effective results than conventional hormone therapies.
Bioidentical Hormone Therapy for Menopause: Prescribing Estrogen
Bioidentical hormones may be more effective than non-bioidentical hormones for sleep, mood, and vasomotor symptoms.
When administered properly, data indicates BHRT does not have the same side effects demonstrated with non-bioidenticals.
Because estrogen affects so many different systems in the body, a sudden drop or even fluctuations can be associated with health problems associated with menopause, including:
- Cardiovascular disease
- Cognitive decline
- Urinary incontinence
- Frequent UTIs
- Low libido
- Vaginal dryness
- Weight gain
- Hot flashes
- Night sweats
- Dry skin, eyes, hair, and nails
- Hair loss
- Brain fog and memory problems
- Sleep problems
- High blood pressure
- Food cravings
Prescribing estrogen is not just a one-and-done type of thing and should not be treated as such.
Instead, symptoms should be monitored carefully through perimenopause and menopause to offer the best treatment.
Administering BHRT for Menopause
Earlier treatments used in the WHI study used non-bioidentical hormone treatments, and those problems were partly related to poor administration and dosing.
We know that BHRT may possibly be a safer and more effective hormone therapy for menopause, but this requires:
- A proper diagnosis
- Regular Hormone testing
- A longer-term health plan
- An understanding of the patient’s history
- A clear assessment of a patient’s risk profile
- Customized prescriptions
- Assessment of patient lifestyle factors which may exacerbate menopausal symptoms
Last but not least, both patients and practitioners should be interested and willing to participate in regular discussions and consider this a long-term investment.
The highly individual and tailored approach is, in part, what makes BHRT potentially more effective and possibly lower-risk.
Want to Offer BHRT in Your Practice? Let’s talk!
More and more patients — especially menopausal women — want to have conversations about wellness and understand alternative options to standard prescriptions and standard treatments.
They want to have in-depth conversations with practitioners who can offer customized wellness programs to meet hormone-related health goals.
Drop me a line — I’d love to hear from you!
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