What is Bioidentical Hormone Replacement?
Bioidentical hormones are produced from plant sources without changes in the chemical structure that renders most synthetic drugs toxic in some way. There are many products available over the counter that women try on their own. The problem is that women frequently find that they either get too much or not enough of the hormones they need. I have seen many women who took too much Estrogen and ended up with heavy, irregular bleeding. So be cautious and try one product at a time, preferably with the help of a professional.
In my practice, when a woman desires bioidentical hormones, I combine all three estrogens with progesterone and testosterone to achieve an optimal balance. Since every woman is unique and her experience of menopause is different there is a particular combination that is right for her. Most women will experience no weight gain in using bioidentical hormones and no breast tenderness if the right dosage is prescribed.
The years preceding menopause, when the ovaries are still functioning but the hormone levels may be decreased, can be troubling. Many women experience heavy, irregular bleeding, bouts of mood changes, and depression. Some women report that they can’t stop eating and are gaining weight. When evaluating these symptoms the practitioner and the woman must consider other possible causes such as fibroids, diabetes, hypo or hyperthyroid, use of steroids, and effects of diets such as the Atkins diet.
When hormone levels check out to be normal, perimenopause may be managed with herbs and lifestyle modifications, though sometimes a woman will need more intervention. Lifestyle modifications include: decreased consumption of sugar, caffeine, alcohol, and beef.
Progesterone can regulate the bleeding and return the cycle to normal. It is important to use progesterone correctly for a normal bleeding pattern. Progesterone often helps with mood changes and mild hot flashes.
Believe it or not, some women go right into menopause without any disturbing symptoms. Most women, however, do experience symptoms that bring them into the health food store (where they often get too many expensive products) or to the doctor’s office.
Hot flashes are frequently the most disturbing to women since this phenomenon can be embarrassing if you are in the middle of working or having a party. Hot flashes seem to be more pronounced during stress or after consumption of alcohol or caffeine.
If your symptoms are severe and you are considering hormones, the following information might help you decide on the type that is right for you.
Current information is that the ovaries produce three different Estrogens: Estriol- the protective estrogen that is excreted primarily during pregnancy; Estradiol- the most potent form of estrogen and the one in most synthetic formulas, and Estrone (the one produced in larger amounts by fat cells). In addition to the three estrogens, the ovaries also produce Progesterone and Testosterone.
Most synthetic hormones given to menopausal women contain Estradiol and Progesterone. Possible side effects may include: water retention, breast tenderness, risk of developing breast cancer, and the remote possibility of developing uterine cancer. There are now many different synthetic estrogen products, some supposedly more natural than others. You can discuss the different ones with your doctor.
Libido Changes in Menopause
Many women experience decreased libido as they approach or go through menopause. There may be various reasons for this, such as a lousy partner or pain experienced due to vaginal dryness. There is not much I can do about the partner except try to educate them (if they are willing) but there is much that can be done to relieve vaginal dryness.
If vaginal dryness is mild, there are vaginal suppositories that are made from Vitamin E and contain no estrogen for women that either do not want or cannot take estrogen. You may also try squeezing the Vitamin E out of a capsule and into the vagina. Other treatments include Estriol natural vaginal cream or synthetic estrogen cream.
The actual desire for sexual activity often returns when the hormones are replaced—especially when testosterone is included in the formula.