Subcutaneous
Hormone Implants:
Relief
for Persistant Menopausal Symptoms and Sexual Dysfunction
HRT
Therapy
Part 1: Hormone Replacement Therapy,
Panacia or Poison?
Part 2: Hormone Replacemnet Therapy
Is a Personal Choice
Part 3: What Is Optimum Hormone Replacement?
How
To Find A HRT Program That Works For You...
Part 1: Finding An Ideal Regimen
Part 2: Unpleasant Side Effects
Part 3: Progesterone, Progestins
& Progesterone Cream
Sex:
Sex and Menopause
Menopause:
Menopause Overview
Hysterectomy:
Hysterectomy Overview
Ovarian Failure Following Hysterectomy
I Want To Know If I Should I Keep My Ovaries
HRT
& Hormones:
About HRT
Ask
Dr N:
Questions & Answers
Hormone Replacement Therapy is a Personal Choice
When it comes to the question of whether to use hormone replacement therapy the answer is always one of personal choice.
The key to making the appropriate decision is based on both the knowledge of what menopause represents in terms of its potential impact on health, quality of life and sexuality and an understanding how hormone replacement options differ in their potential benefits and risks.
Without this knowledge, a woman cannot effectively participate in her own healthcare decisions. In essence, she becomes the passive recipient of her doctor’s store of knowledge and individual bias.
Acquiring the necessary information may be difficult for most women as the physician is the source she usually turns to for information. Doctors may have only scant knowledge of the menopausal process, its global nature, or the extent of its potential impact on health and quality of life. In addition, most physicians are not aware of what constitutes an optimum hormone replacement regimen.
Menopause 101
A “natural menopause” is characterized by cessation of the monthly menstrual cycle and occurs because of an expected age-related failure of the ovaries to continue to produce estradiol, the biologically-active form of estrogen. Most often, this will occur between the ages of 48-52. It is the rise in the estradiol level at puberty that is responsible for the physical and mental metamorphosis from a young girl to an adult female. This includes all the changes that that we characterize as “secondary sexual characteristics.”
An early or “premature menopause” is one that occurs prior to age 40 and can be the result of genetic factors or autoimmune processes. An “induced menopause” can be due to surgical removal of the ovaries with or without a hysterectomy, by chemotherapy or radiation.
After menopause, estradiol concentrations in the blood fall to their prepubertal level. The aging process is accelerated as the hormonally-dependent tissues that have relied on estradiol for their support begin to regress and their ability to function optimally is compromised. Virtually every organ system is affected including the vagina, bladder, brain, skin, skeleton and cardiovascular.
Hormone Deficient
Many women think in terms of “going through menopause.” What they usually mean is that they have stopped having symptoms such as hot flashes, sweats and insomnia. However, unless a menopausal woman chooses to use hormone replacement she will spend the remainder of her life in a hormone-deficient state. The central issue for most menopausal women is whether to use hormone replacement.
Menopause - assuming it is a “natural menopause” - is normal. There is no “right choice” for everyone. Whether a woman chooses to live in a hormone-deficient state or use hormone replacement is a personal decision. In most cases, menopausal symptoms such as hot flashes, sweats and insomnia will disappear within 2 years. However, long-term consequences of estrogen deficiency cannot be predicted on an individual basis, but many women on the surface do not seem to be affected.
If a woman has experienced a premature or induced menopause the effects are magnified. Those who have had their ovaries removed are at greatest risk of osteoporosis, cardiovascular disease and atrophic changes of the vagina, urinary system and skin especially when this occurs prior to an expected natural menopause.
Women who choose to use hormone replacement have a better quality of life according to a recent pole conducted by The Gallup Organization. This is not meant to imply that postmenopausal women who are not on hormone replacement are incapable of a fulfilling life and sexual experience. They are capable of both. We have all heard about “Aunt Sadie” who never touched a hormone, or any other medication for that matter, yet lived to age 94, remained “sharp as a tack,” had a sexually satisfied boyfriend thirty years younger, drove a car every day and mowed her own lawn. However, the point is that it is unlikely that anyone, regardless of gender, can function optimally in a hormonally deficient state.
Appropriate Hormone Replacement Therapy known as HRT, remains a viable and important health care option for postmenopausal women.
What is OPTIMUM HORMONE REPLACEMENT?
In this section, Dr N discusses optimal hormone replacement regimens.
Appointments
with Dr. Nosanchuk can be made by contacting Caroline
(248) 644-7200 from 10:00am to 6:00pm Monday - Friday (EST).
This web site is for educational purposes only. It is not intended to suggest a specific therapy for any individual and must not be construed to establish a physician/patient relationship.