Two major forms of hormone replacement therapy exist, each with their own distinct advantages:
Systemic Hormone Therapy
Whether in a patch, gel, cream, sublingual, or spray, systemic estrogen treatments remain an effective solution for menopausal hot flashes, night sweats, and vaginal symptoms. While the FDA keeps estrogen treatments on the list of effective treatments for osteoporosis, medical doctors typically recommend other treatments to treat osteoporosis via synthetic estrogen medications and bisphosphonates, which have mixed results and are not prescribed at Apollo Health Clinic.
Also, progesterone and testosterone compounded topical creams and sublingual troches may be prescribed with specific dosing instructions. Progesterone can be used in a cream and a capsule as well and in severe deficiency cases can be prescribed in both forms for patients as needed to balance the progesterone-to-estrogen ratio commonly imbalanced in female patients, as you will see on your DUTCH Test.
Low-Dose Vaginal Products
Low-dose vaginal treatments of estrogen can effectively treat vaginal and urinary symptoms while minimizing absorption into the body, therefore are not the most effective treatment for hot flashes, night sweats, or osteoporosis for most women.
For women, vaginal suppositories of estrogens are used most commonly (they are called, Bi-est, Tri-est, or Estriol). These can also be prescribed as a topical application.
Who Should Consider Hormone Replacement Therapy?
While there are risks involved with systemic HRT with estrogen, progesterone, and testosterone treatments, it is still the most effective treatment for perimenopausal and menopausal symptoms. Also, it is safer than synthetic prescriptions of estrogen (i.e. – Enjuvia, Cenestin) and progesterone (i.e. – prometrium and provera), and synthetic combinations of estrogen and progesterone, such as Prempro.
For those experiencing the following, hormone replacement therapy may be right for you:
– Moderate to severe hot flashes
– Loss of bone mass without satisfactory results from other treatments
– Those experiencing premature menopause or premature ovarian insufficiency
Women who experience early menopause or those who have had their ovaries removed and don’t undergo BHRT until age 45 have a higher risk of osteoporosis, coronary heat disease, earlier death, Parkinson’s-like symptoms, and anxiety/depression, but early menopause often lowers the risk of many types of breast cancer.
Your age, type of menopause, and time since menopause play a strong role in determining the risks involved with BHRT.
Estrogen deficiency can be caused by Perimenopause and Menopause, or Premature ovarian decline.
Do you have any of the following symptoms? (If you answer yes to more than one symptom, then you could be estrogen deficient.)
- Bladder problems (more infections, urinary leakage)
- Brittle hair and nails
- Chronic fatigue syndrome
- Decrease in breast size
- Decrease in dexterity
- Decrease in memory
- Decrease in sexual interest/ function
- Difficulty losing weight, even with diet and exercise
- Elevated blood pressure
- Elevated cholesterol
- Heart attacks
- Increase in facial hair
- Increase in insulin resistance, which can lead to diabetes
- Increase in tension headaches
- Increased cholesterol
- Joint pain
- Low energy, especially at the end of the day
- More frequent migraines
- More wrinkles (aging skin)
- Panic Attacks
- Polycystic ovarian syndrome
- Restless sleep
- Stress incontinence
- Thinner skin
- Thinning hair
- Urinary tract infections
- Vaginal Dryness
- Vulvodynia (vaginal pain)
- Weight gain around the middle
Premenstrual Syndrome (PMS) is a perfect example of estrogen excess and is defined as a combination of mood swings, tender breasts, food cravings, fatigue, irritability and depression along with other symptoms. Premenstrual Dysphoric Disorder (PMDD) is defined as more severe PMS with at least one of the following symptoms, sadness or hopelessness, extreme moodiness, anxiety, anger or extreme irritability. If you are suffering from PMDD-like symptoms you may want to contact AHC for Neurotransmitter testing and treatment
Other conditions listed below can also be caused by estrogen excess. This often occurs in younger women in ages 18-45 roughly and with “estrogen dominance” occurring and the progesterone-estrogen ratio is imbalanced, which is why it is important to measure progesterone too.
Symptoms of Excess Estrogen
(If you answer yes to more than one symptom, then you could be estrogen dominant)
- Cervical dysplasia
- Decrease in sexual interest
- Depression with anxiety or agitation
- Elevated risk of developing breast cancer
- Fibrocystic breasts
- Heavy periods
- Hypothyroidism (high estrogen levels causes low thyroid hormone levels)
- Increased risk of developing autoimmune diseases
- Increased risk of developing uterine cancer
- Mood swings
- Panic attacks
- Poor sleep
- Swollen breasts
- Uterine fibroids (non-cancerous tumors of the uterus)
- Water retention
- Weight gain (especially in the abdomen, hips, and thighs)
Progesterone Deficiency in Women
Symptoms of Progesterone Deficiency
Progesterone deficiency is caused by a variety of factors and can occur for women of all ages. It is a very common hormone deficiency.
- Decreased HDL levels (the “good” cholesterol)
- Decreased libido
- Excessive menstruation (lasting longer than even days and very heavy bleeding)
- Migraine headaches prior to menstrual cycles
- Mood swings
- Pain and inflammation
Testosterone Deficiency in Women
It may come as a surprise to some people but women make testosterone in small amounts, and having low levels is far reaching.
If you have the following symptoms and conditions you may have low testosterone:
- Fatigue & Exhaustion
- Weight Gain regardless of exercise and dieting
- Decreased strength, endurance and muscle mass
- Decrease interest in sex
- Mood Swings
- Difficulty concentrating
- Hair loss
All of these female hormone imbalances are addressed at Apollo Health Clinic and treated by listening your story and symptoms, performing appropriate lab test results, and then creating your individualized treatment plan. A comprehensive hormone rejuvenation program should also include progesterone, DHEA, pregnenolone, and perhaps testosterone in select cases along with a Botanical medicine (link Botanical Medicine page) and Function medicine (internal link Functional Medicine page) care plan individualized for you with hormone levels checked in the blood and urineprior to treatment and at 3-6 month intervals as determined by your doctor at Apollo Health Clinic.Contact Apollo Health Clinic to learn more about your personal risks and benefits based on your medical history for the most personalized and safe treatment options for your hormone health concerns.