February 9, 2016

February 2016

Customized Hormone Replacement Therapy

Today’s women prefer natural hormones. In a national survey of 1,009 women aged 40 and older, 83% said they would prefer to use hormones that are similar to their own body’s hormones.

Goals of Customized, Natural HRT

  • Alleviate the symptoms caused by the natural decrease in production of hormones by the body
  • Give the protective benefits which were originally provided by naturally occurring hormones
  • Re-establish a hormonal balance

The three types of hormones typically prescribed for customized hormone replacement therapy are estrogens, progesterone, and androgens. The precise components of each woman’s therapy need to be determined after physical examination, medical history, and laboratory testing are considered. Close monitoring is essential to ensure that appropriate dosage adjustments are made.

Estrogens:

  • are often prescribed in combination to re-establish a normal physiologic balance
  • relieve menopausal symptoms, including vaginal thinning and dryness
  • may increase HDL “good” cholesterol and decrease LDL “bad” cholesterol
  • help to decrease blood pressure and reduce plaque formation on the arterial walls
  • reduce the risk of colorectal cancer
  • may improve mood, energy levels, and sleep patterns
  • may reduce the risk of developing or the severity of type 2 diabetes
  • may improve memory and cognitive function
  • reduce bone loss

Progesterone:

  • is commonly prescribed for perimenopausal women to counteract “estrogen dominance”
  • alone, or with estrogen, may improve Bone Mineral Density
  • minimizes the risk of endometrial cancer in women who are receiving estrogen
  • is preferred by women who had previously taken synthetic forms of progesterone known as progestins, according to one Mayo Clinic study
  • may enhance the beneficial effect of estrogen on lipid and cholesterol profiles in post-menopausal women (in contrast to synthetic medroxyprogesterone acetate)

Androgens, such as testosterone, are prescribed for women to:

  • enhance libido
  • provide cardiovascular protection (lower cholesterol)
  • enhance bone building (increase calcium retention)
  • improve energy levels and mental alertness

Recently, attention has turned to the addition of the androgens testosterone and dehydroepiandrosterone (DHEA) to estrogen replacement therapy to alleviate recalcitrant menopausal symptoms and further protect against osteoporosis, loss of immune function, obesity, and diabetes.

Every woman is unique. Therefore, it is a sensible approach for the patient to work together with health care professionals to customize hormone replacement therapy. HRT can be customized in the needed strength and dosage form and administered via the most appropriate route to meet each woman’s individual needs.

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