Although science learns something new everyday, no one denies hormones play a pivotal role in the menopausal transition. And, because of that, the menopausal experience is as individual as the women undergoing the changes.
The debate between using hormone replacements or not is unending, as is the controversy between synthetic and bioidentical. For the purposes of tonightâ€™s rather short blog, I will not delve deeply into this topic. Maybe that will be one for another night if there is interest. Let me just say thisâ€¦Iâ€™ve been on bioidentical hormones for at least six years, and theyâ€™ve worked well.
Admittedly, in the past several months Iâ€™ve had increasing hot flashes despite working with my practitioner and my compounding pharmacist. When I first started taking the hormones my blood tests indicated I was in estrogen dominance, but had very low progesterone and testosterone levels. When I added those I felt zippier and happier than I had in some time.
Eventually, as my estrogen leveled and then began its decline, my practitioner became unwilling to keep me on testosterone. To be honest, I miss it. And that brings me to another point. I believe it is extremely important to have a practitioner you trust and who sees you as the individual you are. If you have a doctor who has a “one hormone fits all attitude,” Iâ€™d be a little concerned. There are a lot of factors that go into making the decision to augment with hormones, and it is an important conversation. Donâ€™t short-change yourself with a doctor who doesnâ€™t have time to get to know you.
Iâ€™ll share a quick story about a woman who is twenty-nine years old. She recently told me she has yet to have a good experience with a doctor. Like me, this woman has had a long history of irregular periods. I suggested she have a hormone panel taken to see if there is any obvious cause. After she had done that, the doctor refused to give her the numbers. All she was told was they were “within normal ranges.” What does that mean? Normal for who? Based on what?
This young woman is pretty feisty and direct in most areas of her life, so Iâ€™m not sure why she let it go. At her last physical she told the doctor (yet another doctor) about her irregular periods. Without taking any blood or saliva tests he said, â€œOh, you have polycystic ovaries and need to go on birth control pills.â€ When she said she had no intention of going on birth control pills he said, â€œWell, youâ€™ll probably have a difficult time conceiving, if you conceive at all, and then will likely get cancer.â€
It infuriated both of us that he said this without running one test on her or looking for any other causeâ€¦for example, did she have cysts in her ovaries? Let me say this againâ€¦you need to trust your practitioner!
As to bioidentical vs. syntheticâ€¦ the information changes constantly. I just watched a documentary called HotFlash Havoc (https://www.youtube.com/watch?v=Jn8Son9Tm2c).
It claims it is not affiliated with any pharmaceutical companies, and I havenâ€™t had time to check on that yet. Let me just say the message from the film makers is that the Womenâ€™s Health Initiative Study started with good intentions. However, over time fingers got into the pot, so to speak, that shouldnâ€™t have.
Many expertsâ€”and they spoke on camera so they werenâ€™t nameless mystery expertsâ€”felt the study was aborted in 2002 because of misleading information. The loud media blitz said the study on premarin and prempro indicated the use of synthetic hormones equated to a higher risk of getting breast cancer.
The critics of the results insist the numbers were skewed. The test results came from a rather small group of women who did not start on the hormones until they were in their 70â€™s. Another conflict was that the study was looking at how replacement hormones protected women from heart disease and found that hormone replacement did not significantly do so. Here’s an interesting note: according to the filmmakers, the study was done by those promoting statins for heart disease â€¦a major player in the market.
The documentary is yet another voice in the debate on hormone replacement therapy, and I believe in listening to information as it becomes available. Then make an educated decision based on your circumstances and quality of life desires.