Menopause Management

Menopause Management

 Many women seek out treatment for the symptoms of menopause.  During the time in which a woman's hormone levels are beginning to change is called "Perimenopause" and this is a time where you have extreme fluctuation in hormone levels which creates symptoms of hot flashes, insomnia, brain fog, etc.

This is the time when many women seek out hormone therapy to help control their symptoms and improve their quality of life.  Utilizing bio-identical hormones which are natural hormones in the exact type and amount that the body normally produces can help control these symptoms of menopause and they also provide many health benefits besides symptom control.

For example, estrogen protects against osteoporosis, heart disease and memory loss.  Progesterone has a calming effect.  It enhances mood and also protects against osteoporosis, heart disease and breast cancer.  Testosterone builds muscle and promotes muscle tone as well as increasing libido and energy.  There are many good reasons to explore taking bio-identical hormone replacement as you reach perimenopause and menopause.  Bio-identical (natural) hormone replacement is very different from hormone replacement of the past that utilized synthetic hormones such as premarin (R), prempro (R), and provera (R).  Bio-identical hormone replacement is founded on the concept of individualized dosing.  Every woman is different and using a one size fits all regimen is not appropriate for women.  Every patient needs to undergo testing to determine their baseline hormone levels and then based on these results, patients are started on a conservative initial dose of bio-identical hormones.  Doses are then slowly adjusted until the symptoms are under control and the lab studies show them to be at an optimal level for health.

Performing the lab studies takes the guess work out of prescribing hormones and it allows for routine monitoring.  Previously, when women were prescribed synthetic hormones, they were never tested to determine their initial levels, and were not tested to determine which dose was ideal.  Additionally, dosing was standardized.  It did not allow for customization for each individual patient.  This is another one of the benefits of bio-identical hormone replacement.  Regarding the safety of bio-identical hormones and the results of the women's health initiative (WHI) study, there is a lot of confusion in the media and with physicians themselves, regarding the safety of hormone replacement therapy.  The Women's Health Initiative study demonstrated that when medroxyprogestrone acetate (MPA) was added to Premarin (R) (which was termed "Prempro") there was a substantial increase in the risk of heart attacks and strokes in women taking the hormones.  MPA has clearly been shown to negate any cardio protective effects of estrogen and it additionally promotes cardiovascular disease.  However, natural progesterone has the opposite effect.  It maintains and augments the cardio protective effects of estrogen and decreases the risk of heart attack and stroke.

Additionally, a number of studies demonstrate that synthetic progestin, such as Provera (R), increase breast cell proliferation making it pro carcinogenic and increases the risk of breast cancer.  Natural progesterone as opposed to MPA has a strong anti-proliferative effect on breast tissue (cancer preventive).

The studies indicate that with respect to the risk of breast cancer, heart disease, heart attack, and stroke, natural bio-identical hormones offer a safe and more conservative approach to hormone replacement.

The bottom is that it is critical that women be given information that there are alternatives to the unsafe synthetic hormones.  Your health and quality of life do not need to suffer when we have available safe and natural alternatives.  Bio-identical hormones do not have the negative side effects of the synthetic hormones and in no way pertain to the conclusions of the Women's Health Initiative study.  Bio-identical hormones are a safe and more conservative approach that does not carry the risks associated with Premorin (R) and Provera (R).

If you have questions, please feel free to call 518-786-7000 ext. 243  to speak to Dr. Allison Pontius or email her at drpontius@ymail.com and she will be more than happy to help you.

Thank you.