Hormone replacement therapy (estrogen and/or progesterone) may be used to "transition" through perimenopause and/or treat menopause. New data implies that hormones should be used short term (no longer than 3, 5 or 10 years.) Alternatives such as vitamins and herbs are available, but many are unproven or less effective than hormones in relieving the symptoms of perimenopause and menopause.
Ask yourself why you are on the hormone, then find the lowest dose of this hormone to take or an "alternative." Remember that "natural/bioidentical" and "synthetic" are NOT mutually exclusive. For example, estrogens are "naturally" occurring hormones in our bodies which are made in a laboratory possibly from plant sources. While many vitamins, herbs, and alternative medicines are extremely beneficial, they also may have side-effects (e.g., weight changes, cholesterol alterations, allergic reactions), complications, drug interactions, or be taken too long. All choices should be individualized and discussed with a healthcare provider.
"Bioidentical" hormones mean essentially the same thing as "natural" and/or "physiologic" hormones. Many "bioidentical" products are already available as prescriptions or over-the-counter (e.g. estradiol patches, cremes and pills, progesterone cream.) Salivary testing for these hormones is expensive and unproven. My opinion is that compounded hormone formulations may be helpful if FDA-approved products are unavailable or are ineffective. These too should be used in the LOWEST possible doses in order to be used safely.
For further information: www.menopause,org, www.ASRM.org, www.ACOG.org, www.4woman.org
POSSIBLE BENEFICIAL EFFECTS
Bones
Skin
Vagina
Lipids
Colon Cancer
Heart
Brain
Mood
Sleep
Sex drive/libido
(Bone)
POSSIBLE NEGATIVE EFFECTS
Uterine Cancer
Heart Disease
Stroke/Blood Clots
Bloating
Gall Bladder
Breast Tenderness
Ovarian Cancer
Bleeding
Breast Cancer
Bone Loss
Weight Gain
(Lipids)
Liver
Weight Gain
Acne
Hair Growth/Loss