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The Hormone Question
by Andrea Bialek, M.D.

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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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