What are bio-identical hormones?

More and more women I see are turning to Bio-identical hormones to manage a wide variety of symptoms during peri-menopause. Here is a little info for those considering this option, but haven’t yet taken the dive.

The term “bio-identical” means the hormones in the prescription are chemically identical to those made by the organs in your body. However, some TGA-approved products are also derived from plants.

Practioners favor bio-identical compounded formulations because they can prescribe the amounts you actually need, based on your saliva or blood tests, and not be limited to standard pharmaceutical dosing. Compounding allows us to combine hormones – such as vaginal estrogen + testosterone – for easier use. And if you happen to be sensitive to a cream prepared for topical or vaginal use, our compounding partners have a variety of options to choose from.

Is hormone replacement right for me?

Hormones may be prescribed for many reasons such as relief of hot flashes, night sweats, insomnia and vaginal dryness.

While hormones are sometimes prescribed for low libido, depression, help with weight loss, improved cognition and bone health, the results for these symptoms are less consistent and vary from person to person in both men and women.

How do I test my hormones?

Practioners use blood testing for estrogen, progesterone, testosterone and DHEA-S, occasionally some will blood-spot testing and saliva testing.

What side effects should I be aware of with hormone replacement therapy?

  • Abnormal bleeding: Occasionally, hormone therapy can stimulate the endometrial lining, leading to bleeding that can range from light spotting or (rarely) as heavy as a normal period.
    • The abnormal bleeding might result from:
      • The dosage of your prescription is too high, leading to endometrial hyperplasia
      • Uterine polyps
      • An infection in the uterus
      • Endometrial cancer

If you have vaginal bleeding, it is necessary for you to make an appointment with your healthcare provider, one who can do an in-office ultrasound and possibly an endometrial biopsy.

  • Breast tenderness: If you have been without adequate estrogen for an extended period of time, the estrogenic stimulation may lead to breast tenderness. This should subside within a few weeks. If not, that typically means the dosage of your estrogen prescription is too high OR you are low in iodine.

We fell strongly that women who are taking hormone replacement products need to have an annual thermogram as part of their overall health program. A thermogram is a heat-sensitive scan that can identify potential areas of concern at least seven years before an abnormality can be discovered by mammography. Breast health supplements, especially iodine, are very important for overall breast health.

Do I have to take both estrogen and progesterone prescriptions?

Sometimes, based on your symptoms, you will only be prescribed natural progesterone. Natural, bio-identical progesterone is a very different compound from synthetic, pharmaceutical progestins. Progestins are known to contribute to blood clots, high blood pressure, increased vaginal bleeding and are contraindicated during pregnancy. The exact opposite is true of natural progesterone. It is often recommend natural progesterone first before recommending the additional estrogen prescription.

That being said, except for small amounts of estrogen recommended for vaginal dryness or urinary incontinence,  natural progesterone is almost always to be taken along with estrogen hormone replacement.

To find out more information please contact me and I can refer you to a Bio-identical specialist in your area.

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