As women move through their forties and into their fifties, they often begin to experience changes not only in their menstrual cycles but also in their feeling of well-being. Women will talk of difficulty sleeping, increased moodiness, vaginal dryness, lack of sex drive, joint achiness, hot flashes, night sweats, and a feeling of brain fogginess. These symptoms are often a sign of changing hormone levels. Bioidentical hormone replacement therapy is one option in managing these symptoms.
Bioidentical and synthetic hormones are very different. A bioidentical hormone has a molecular structure that is identical to the hormones naturally produced. A synthetic hormone (such as Premarin) has a molecular structure similar to but not exactly the same as the hormones produced by a woman’s body. For that reason, many women find that bioidentical hormones are easier to tolerate and offer fewer side effects.
Hormone therapy typically involves replacing estrogen, progesterone, and/or testosterone. Based on a woman’s symptoms and hormone test results, an individualized approach to replacement is available. At Willow Creek Women’s Clinic, we have partnered with Women’s Health America to offer this service to our patients. To begin, we educate each woman about the role of these three vital hormones.
“Estrogen” is often used as a catch-all term when in fact, there are many types of estrogen produced in our bodies. Three types, estradiol, estriol, and estrone are the major players for women at this stage of their lives. Estradiol is the most potent form of estrogen and is available in several commercially manufactured products. Estriol is known as the “forgotten” or “weak” estrogen but has important benefits to women suffering from vaginal dryness/ and or incontinence. It is not available commercially in the United States and therefore must be compounded by a pharmacist. Estrone is the predominant estrogen in post menopause and is manufactured by a woman’s fat cells. It, too, is only available through a compounding pharmacy.
Progesterone and estrogen work closely together to balance each other. When that balance is disrupted, women may experience mood swings, sweet cravings, depression, weight gain, bloating, and breast tenderness. Bioidentical progesterone is available commercially and through compounding pharmacies and is important to use in conjunction with estrogen in women who have a uterus. Progesterone stabilizes the lining of the uterus and thereby decreases the risk of endometrial cancer.
Testosterone is produced in men and in substantially smaller amounts in women. Both men and women experience a decline as they age. Women will often report decreased sex drive, less sexual satisfaction, decreased bone density, and a loss of sense of well-being associated with a lower testosterone level. It’s not unusual to include testosterone supplementation in a complete bioidentical hormone replacement program.
There are many forms of bioidentical hormone therapy, including oral tablets, creams, patches, and suppositories. It’s important to keep a few points in mind when deciding on the system that is best for you. First, patches may be a good choice if you have an elevated cholesterol level and oral tables not such a good choice. Oral tablets must be metabolized in the liver and thus can raise cholesterol and triglyceride levels. However, patches would not be a good idea if you have sensitive skin and have reacted to other adhesives in the past. Vaginal creams are very effective in treating urinary and vaginal problems, but may not protect against bone loss.
Linda Poirier FNP-C has over 10 years of experience working with women and Women’s Health America to develop individualized bioidentical hormone replacement therapy programs. This has been a rewarding and exciting part of her practice to watch women reclaim the vitality they once experienced. You can learn more about this program by visiting the following website: www.womenshealth.com. Please call to schedule an appointment if you would like to explore this option.