I
have tried several types of hormone replacement therapy and I still
have severe menopausal symptoms. Is this just me, or do other women
have this problem?
It's
not just you. Most menopausal women do well while using the routine
methods of hormone replacement, but unfortunately 10% to 20% experience
persistent life-altering menopausal symptoms unresponsive to the more
commonly prescribed therapies. This occurs with greater frequency and
severity in those women who have had a hysterectomy irrespective whether
the ovaries have been removed, however it can and does occur following
a natural menopause. While some women who are hormonally deficient at
least on the surface seem to have few symptoms, others may suffer from
chronic sleep deprivation, depressed mood, severe hot flashes and sweats,
body aches, irritability, loss of libido, decreased quality of sex and
memory problems.
My desire
for sex is completely gone and this is causing problems in my relationship
with my partner. Is this because I am menopausal, or is it a normal
part of aging?
Loss of sexual interest following a natural or surgical menopause is
an under appreciated problem. The hormonal basis for the decrease in
sexuality is often incorrectly attributed to the aging process by affected
women and their partners. Unfortunately, in the context of an ongoing
relationship even a subtle decline in the level of sexual intimacy may
cause considerable distress for both parties and weaken the existing
emotional bond. Typically the cause of the problem is not recognized
as being hormonally related and is attributed to aging, or a problem
in the relationship. The problem is often compounded when the treating
physician mistakenly assumes the problem is due to an emotional, or
relationship disorder and suggests a referral to a therapist.
I would
really like to feel like myself again. Is there anything that can help?
Subcutaneous implantation of hormone pellets is the treatment of choice
in this group of menopausal women. This hormone replacement option is
almost always successful in relieving persistent menopausal symptoms
and restoring, libido, sexuality, quality of life and sense of well
being. The pellets used are derived from plant source and contain estradiol.
This form of estrogen is biologically identical to the natural estrogen
produced by the ovary. If the patient is testosterone deficient, a pellet
containing testosterone can be implanted as well. Testosterone is a
naturally occurring female hormone and is the hormone most closely related
to sex drive, energy levels and the maintenance of muscle mass. This
rarely fails to relieve even longstanding menopausal symptoms, or restore
sexuality.
How is this
done?
The procedure is performed in the physician's office with a minimum
of discomfort and takes only a few minutes. A small amount of local
anesthesia is injected into the area where the hormone pellets are to
be placed, usually the buttock. The hormone pellets are then inserted
into the subcutaneous tissue through an instrument designed for this
purpose. Pressure is applied to the site for 5-10 minutes. No sutures
are required as the actual incision is very small. As with any other
surgical procedure, postoperative infection, or bleeding is possible
but uncommon. The pellets, which contain the biologically identical
form of natural estrogen produced by the ovary are absorbed into the
blood stream producing hormone levels that are physiologic and remain
relatively constant day-to-day. As the hormones bypass the gastrointestinal
tract and are absorbed slowly it mimics natural ovarian secretion. Depending
on the metabolism of the individual and the number of pellets implanted
they last from 3-6 months and the procedure is repeated at that time.
I have never
heard of this method of hormone replacement, is it something new?
Actually, it has been available in the United States and other countries
for over 50 years. In general, it is offered by physicians who specialize
in menopausal issues. This method of hormone replacement was developed
by Dr. Robert B. Greenblatt, of the Medical College of Georgia, a pioneer
in menopausal medicine and a founder of the International Menopause
Society.
Have you
used this method in your patients?
I have offered this method of hormone replacement to my patients for
almost 20 years. I believe it is the most successful treatment for persistent
menopausal symptoms and decreased sexuality even when the problems have
existed for several years. It has been a wonderful hormone replacement
option for my patients, capable of restoring them to a previous quality
of life, sexuality and intimacy that they had given up hope of ever
regaining.
Detroit, Michigan.
He has been a specilist in the care and treatment of menopausal women
for over 30 years and is a founding member of the North Amerie.