Bio-identicals and Hormone Replacement Therapy (HRT)
What you need to know
Women today spend half their lives in menopause.
Menopause is a natural transition but the loss of ovarian function heralds an acceleration of the aging process. In particular, menopausal women note cognitive dysfunction often describing difficulties with memory and focus. They may experience bone loss, cardiovascular disease and menopausal symptoms like hot flashes and night sweats.
The aging process is a natural process. On the one hand there are the negative consequences of aging. This results from the natural process of pre-programmed cell death. Conversely, cells of a certain age are more likely to contain DNA damage that, when left unchecked, could develop into cancer. If a cell line is unable to die out it cannot effectively limit its damage. Therefore cell death can be a body’s means of protecting itself against cancer.
Balance
Benefits of Estrogen
By slowing the protective cell death process, some anti-aging therapies may allow tumors to develop. Medical science is always looking for therapies that effectively balance the safety mechanism of DNA repair and cell death while also slowing the aging process. Ideally, we wish to limit aging without increasing the risk of cancer.
HRT appears to have anti-aging properties. Estrogen reduces many health consequences of aging including osteoporosis, and bladder and vaginal tissue degeneration. Estrogen also acts on the cardiovascular system and the nervous system.
Better Information, Outcomes
The initial results of the Women’s Health Initiative (HI), which were released in 2002, indicated a greater risk to postmenopausal hormone replacement therapy (HRT) than previously thought.
Many experts now believe the study was over generalized and alarmist, overemphasizing the risk of HRT while minimizing the benefits. In the interim, additional studies (including HERS I, HERS 1I, and ESTHER) have clarified many of the WHI findings thankfully bringing those findings into proper perspective.
HRT can be given orally or trans-dermally. There are advantages and disadvantages to each method of administration.
The liver is the body’s organ that detoxifies substances that are eaten. Everything that is ingested goes to the liver first. Many medicines are seriously weakened because of this protective mechanism in the body.
Only 2-10% of an estrogen tablet that is taken by mouth finds its way into the body. This means that the oral preparations have to be far more potent to achieve the same effect as medicines that are applied to the skin. Transdermal preparations go directly into the bloodstream they do not affect liver function and require far lower doses. Transdermal preparations provide more stable blood levels of hormone. They do not increase triglycerides and do not increase the risk of blood clots. They appear to lower blood pressure. They provide higher testosterone levels, which means improved orgasm and libido.
Solutions
Customized for You
Oral estrogens are particularly useful for women who have localized reactions to patch adhesives or other objections to the trans-dermal approach. There are more oral products that combine estrogen and progesterone into a single delivery product.
Today we tailor HRT to the individual. We take into account a woman’s age; we minimize her dose and determine how to administer the medication. We offer hormone prescriptions and pellets that are “bio-identical” to a woman’s natural hormone production. We provide a woman with the smallest dose providing the greatest benefit.
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“Dr. Cova and her staff are great! I’ve always visited the cosmetic side of the house and today I saw her for a hormone replacement therapy consultation. She is very knowledgeable and confident in her ability to help me and she took the time to explain everything to me and answered all my questions!”
Paula in Dayton, OH