When the most common symptoms of menopause—hot flashes, night sweats, vaginal dryness, and disruptive sleep patterns—cause discomfort, or worse, tormenting pain, women think HRT (Hormone Replacement Therapy) is the answer to relief.
From the 1960s, until the mid-nineties, doctors were liberal with HRT prescriptions to treat these and other menopausal symptoms, such as anxiety, irregular periods, psychological problems, and prevention of bone loss. Until the estrogen hit the fan!
In 2002, the medical world was rocked like an earthquake. A series of government-run clinical trials (Women’s Health Initiative or WHI) on the risks and benefits of hormone therapy was discontinued. Researchers had discovered that long-term use of synthetic estrogen and progestin in HRT increased the risk of heart disease, stroke, blood clots and breast cancer. Fearful patients called their doctors asking what they should do.
AND THEN THE AFTER-SHOCK
It got worse.
• Subsequent studies found HRT also increased the risk of Alzheimer’s, dementia, and asthma.
• An April 2007 JAMA (Journal of the American Medical Association) study determined the risk of stroke increased in HRT users by more than 30 percent, and that age or years at the onset of menopause was not a factor.
• In 2010, new research found that combined estrogen-progestin HRT increased the risk for more severe forms of breast cancer and increased a woman’s chances of dying from the disease or other causes.
DIFFERENT DOCTORS = DIFFERENT OPINIONS
Today’s medical community tends to be divided in its views about prescribing HRT. Cardiologist Nieca Goldberg, MD, feels that younger women who go on hormone therapy because of severe menopause symptoms should not worry that HRT can be “detrimental to their heart.” Dr. Steven Goldstein, MD, professor of medicine at NYU Medical Center, concurs, saying “We have strong evidence to show that if it is less than 10 years since you started menopause, the use of HRT on a short-term basis is not likely to harm you.”
But Julia Smith, MD, director of the Lynne Cohen Breast Cancer Program at the NYU Medical Center describes the controversy as “complex” and “still not fully explained or explainable.”
BIOIDENTICAL COMPOUNDING: AN ALTERNATIVE APPROACH
Prescription compounding is the art and science of preparing customized medications. When a regular prescription doesn’t meet a patient’s specific health needs, the pharmacist combines, mixes, adjusts or alters the ingredients or physical form of a drug.
Many women choose Bio-Identical Hormone Replacement. With custom-compounding, the ingredients can be plant-based, which some believe are preferable to the synthetic ingredients found in traditional HRT products.
Andrea Dominic, RPh and Steve Hoyt, RPh are licensed pharmacists at San Ysidro Pharmacy in Santa Barbara, CA with more than 20 years experience in Bio-Identical Hormone Replacement. San Ysidro Pharmacy is accredited by the Pharmacy Compounding Accreditation Board, established to ensure the quality of compounded prescriptions.
“Compounding pinpoints the individual patient’s needs,” says Andrea Dominic, RPh. “There is no one-dose-fits-all when it comes to hormone replacement. The levels needed to relieve symptoms can fluctuate and dose adjustments are sometimes necessary. Unlike synthetic hormones, the structure of the bio-identical hormone is exactly the same as what is circulating in the body, so the body knows how to metabolize it.”
CONSULT YOUR PHYSICIAN AND MAKE EDUCATED CHOICES
Some women may not need HRT. When vaginal dryness is the primary problem, for example, a hormone-free product such as Aloe Cadabra® vaginal lubricant and moisturizer, may be preferable. Aloe Cadabra® is all-natural; made of 95% quality organic Aloe Vera; is estrogen-free; FDA-cleared; and contains 100 percent food-grade ingredients.
“Gone forever are the days when a doctor routinely prescribes HRT for every woman over 50,” says Dr. Smith. “Today, the decision to go on hormone therapy, even short term, must take into consideration a host of individual health and lifestyle factors.”
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