Hormone Replacement Therapies. Aren t They All the Same?

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1 Hormone Replacement Therapies Aren t They All the Same?

2 Contents 2 INTRODUCTION: What is Hormonal Imbalance? 3 4 CHAPTER 1: Bio identical Hormone Replacement Therapy 5 6 BHRT for Women 7 BHRT for Men 7 BHRT Delivery Methods 8-10 Symptoms that Indicate a Lack or Imbalance 11 Pellet Therapy vs Hormone Tablets, Creams & Patches 12 CHAPTER 2: Conventional Hormone Replacement Therapy CONCLUSION: The Bottom Line 15

3 Introduction: What is Hormone Replacement Therapy? 3 Hormonal imbalance is a fairly common problem in both men and women, especially after the age of 40, when the hormonal changes associated with menopause and andropause begin. Since hormones play essential roles in virtually all vital body systems and processes, imbalances can produce a wide range of symptoms. Among the most frequently reported are the following: mood swings irritability hot flashes insomnia fatigue feeling depressed Forgetfulness and difficulty concentrating are common, as are unexplained weight gain, skin changes, muscle loss and hair loss. Reduced sex drive is common, as are erectile dysfunction in men and vaginal dryness or painful intercourse in women.

4 Introduction: What is Hormone Replacement Therapy? 4 Hormone replacement therapy, or HRT is generally considered the most effective means of treating these symptoms. However, HRT is a rather general term that covers a variety of treatment options. For instance, two distinct types of hormone therapy exist today, conventional HRT which treats symptoms with hormone drugs, and BHRT, which resolves imbalances with bio identical hormone supplements. Under both of these categories, a variety of hormone products are prescribed with varying delivery methods. Knowing the details of the different options can help you make informed decisions on which method may be best for you

5 Chapter 1: Bio identical Hormone Replacement Therapy 5 Bio identical hormone replacement therapy, or BHRT, involves the use of natural, plant based hormone supplements to address hormonal imbalances or deficiencies. Bio identical hormones are identical on a molecular level to hormones naturally present in the body. This compatibility with natural body chemistry allows these hormones to be absorbed and utilized in exactly the same way as the body s own native hormones, gently restoring hormonal balance. Visit the Learning Center For Additional Information

6 Chapter 1: Bio identical Hormone Replacement Therapy 6 BHRT is typically administered by means of an individualized treatment plan, developed to address the specific symptoms and concerns of each patient. Medical providers determine those needs by means of a thorough examination, during which a patient s general health and specific symptoms are evaluated. In addition, hormone levels in the body are tested and hormone supplements are prescribed. These supplements are custom formulated by a compounding pharmacy to address the specific imbalances or deficiencies present in each individual treated. Patients are monitored as BHRT progresses, with hormone testing and symptom assessment done regularly to ensure optimal hormonal balance is achieved and maintained. Side effects of BHRT in women can include breast tenderness, spotting, bloating and cramping. Both men and women have reported headaches, mood changes and new or increased acne outbreaks. These issues often resolve themselves as the body adjusts to BHRT,or can be resolved through dosage adjustments.

7 Chapter 1: Bio identical Hormone Replacement Therapy 7 BHRT for Women BHRT for women typically includes supplementation of estrogens, progesterone, and testosterone. Often, two forms of bio identical estrogen are included in BHRT supplements, which are estradiol and estriol. Used in combination, these estrogens can efficiently increase overall estrogen in women experiencing abnormally low levels. Micronized, bio identical progesterone is used to balance the effects of estrogen in the system, whether they result from estrogen supplementation or high levels of native estrogen, a hormonal imbalance referred to as estrogen dominance. Quite often, women can be deficient in testosterone making low dose bio identical testosterone replacement necessary to balance body chemistry. BHRT Men for BHRT for men most often involves bio identical supplementation of testosterone and DHEA levels. Production of testosterone, the primary male sex hormone, and DHEA, a hormone precursor that enables synthesis of testosterone and other vital hormones declines with age, often causing hormone deficiencies or imbalances.

8 Chapter 1: Bio identical Hormone Replacement Therapy 8 BHRT Delivery Methods Bio identical hormone supplementation is done by means of a variety of delivery methods. Among the most common of these are pills or capsules, hormone creams, gels, patches, sublingual tablets, injections and pellet insertion. No one delivery method is best for every patient, and each has its own advantages and disadvantages.

9 Chapter 1: Bio-identical Hormone Replacement Therapy 9 Taking hormonal supplements orally in pill or tablet form has advantages in ease and simplicity. However, absorption is not very efficient since they must be processed by both the digestive system and the liver before they are released into the bloodstream. Since that process degrades hormones, significantly higher doses are necessary to produce the desired results as compared to other delivery methods. All estrogens taken orally, including bio-identicals, will increase the risks of blood clots, inflammation and raise triglycerides. Sublingual tablets or drops offer the simplicity of oral administration with more efficient absorption, since they are placed under the tongue and are absorbed into the bloodstream directly through oral tissues. However, there are some disadvantages as well, with some patients having difficultly tolerating the taste of sublingual hormones or the length of time some can take tablets to dissolve. Hormone creams, gels and patches allow bio identical hormones to be absorbed into the blood stream through the skin. Gels and creams used for transdermal delivery can be applied to the chest, abdomen or arms, and in women, some are applied inside the vagina. Patches are typically placed on the abdomen or thigh.

10 Chapter 1: Bio identical Hormone Replacement Therapy 10 While most people experience efficient absorption through transdermal methods, some do not. Additionally, creams and gels often must be applied several times daily, a difficulty for some patients, and skin irritation can also be an issue. Creams and gels can also be absorbed into clothing staining it, and has been known to cause unintended transfer issues to individuals that patients have come in contact with. Pellet therapy is an option that can be both very efficient in delivering bio identical hormones to the bloodstream and very convenient for patients. It involves the insertion of pellets under the skin, which automatically deliver a consistent supply of hormones for a period of three to six months. Disadvantages can include bleeding, bruising, possible itching at the procedure sight, and rarely pellet extrusion. Some patients use self-injections in BHRT therapy. While it is a very efficient delivery method, it is not for everyone. Side effects can include pain at the injection site or skin infection.

11 Chapter 1: Bio-identical Hormone Replacement Therapy 11 Symptoms that indicate a lack or imbalance of Lack of Sex Drive Loss of Energy Restless Sleep Tiredness Depressive Symptoms Anxiousness Mood Swings Night Sweats Poor Focus Joint / Body Aches & Pains Loss of Muscle Tone Chronic Fatigue Restless Legs Irritability Weight Gain High Cholesterol Memory Lapses Dry Skin Painful Intercourse Hot Flashes Palpitations Low Bone Density Muscle Aches Headaches Erectile Dysfunction Loss of Mental Clarity Low Libido Decreased Stamina

12 Chapter 1: Bio-identical Hormone Replacement Therapy 12 Pellet Therapy vs Hormone Tablets, Creams, & Patches PELLET THERAPY: ESTROGEN PATCH: TABLETS & CREAMS:

13 Chapter 2: Conventional Hormone Replacement Therapy 13 Conventional HRT uses synthetic or animal-derived hormone drugs to approximate the functions of the body s natural hormones, which can offer relief of hormonal imbalance symptoms. Hormone drugs are produced by pharmaceutical companies, typically in standardized doses and ratios. In general, medical providers prescribe the lowest possible dose first, then increase incrementally until a patient achieves an acceptable level of relief from hormonal symptoms. Most commonly prescribed for estrogen replacement in women are drugs called conjugated equine estrogens, or CEEs, which are isolated from the urine of pregnant mares. These are often combined with a synthetic version of progesterone, known as progestin. In men, synthetic versions of testosterone and DHEA are prescribed to address symptoms of andropause.

14 Chapter 2: Conventional Hormone Replacement Therapy 14 Synthetic and animal derived hormone drugs feature a different molecular structure and are not metabolized as efficiently as the body s own hormones, nor do they function in exactly the same manner in the body. Some scientists theorize that these differences may contribute to long term health effects that have been associated with conventional HRT. These effects include increased risk of blood clots, heart disease and some forms of cancer in women. In men, HRT can cause an elevated red blood cell count and has been associated in some research with increased infertility, although there has never been any research proving this. For these reasons, medical providers generally recommend that patients on conventional HRT take the smallest dose that works to relieve symptoms, for the shortest possible duration. Delivery methods commonly used in conventional HRT include many of the same ones used in BHRT, including oral administration, sublingual drops or tablets, and transdermal patches, creams, gels or suppositories.

15 Conclusion: The Bottom Line 15 The bottom line is that hormone replacement therapies are not all the same. If you are considering hormone replacement therapy, it is important to weigh your options carefully, and to know the potential risks and benefits of both having and not having treatment. Ensure that you discuss these points with your own personal provider, who is familiar with your specific health profile and circumstances. Be sure to ask plenty of questions when you speak to your medical provider, and don t be afraid to make your concerns and opinions known. After all, no one is more invested in your health and wellness than you, not even the most knowledgeable and accomplished medical provider.

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