A natural part of aging? Yes. However, many people, including doctors would like you believe that you have to live with it. Then as symptoms get worse and your lack of sleep makes you even more of a basket-case, your doctor may write you for sleeping pills; sleeping pills leading to metabolites that create a "morning after hangover". Even worse, you may be prescribed medications that further distort your remaining hormone levels. So after having the babies and ensuring the survival of the species you are just suppose to sit back and accept the inevitable. Accept sagging skin, sleepless nights, fragile bones, hot flashes, headaches, vaginal dryness, loss of sex drive, loss of mental focus and multitasking skills?
For those who decide that these symptoms are unbearable, they often resort to synthetic pharmaceutical hormone replacement products. These synthetic hormones are the ones that the Women's Health Initiative (WHI) utilized, and were found to lead to increased cardiovascular and cancer risk.
Fortunately, Bio-similar hormone therapy (BHRT) offers a more alternative solution. They not only offer potential relief from menopausal symptoms, but they can also offer increased quality of life in several areas.
Aging skin is often the result of declining estrogen levels. Collagen matrix formation is dependent on health estrogen levels. When estrogen levels decline, the collagen matrix suffers, and the result is seen in the face. The "falling face" or increased nasal-labial creases occur with age. Firm and supple skin is replaced with sagging dry skin, flattening of upper lips, loose sagging cheeks and the infamous "turkey neck".
Why live with the changes while safe available therapies are available? *
Several methods of physiological BHRT exist. Creams, patches, drops, pellets and gels are just some of the common ways to approach this therapy. I prescribe all the different forms.
Hormones that are supplemented in women:
Estrogen, Testosterone, Progesterone
Please remember that the WHI Study determined that estrogen replacement therapy resulted in a slight increase in risk of breast and uterine cancer, as well as stroke. This study utilized conjugated estrogens and medroxyprogesterone. The hormones we utilize are bio similar estradiol and progesterone. hormone pellet hormone replacement therapy Testosterone Pellets
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Bio-similar hormone therapy, (sometimes referred to as Bio-identical hormone therapy), can be administered in several different ways.
For those who don't wish to have hormone pellets inserted hormones can be administered through creams, gels, patches, injections and capsules.
Oral hormone administration should be avoided except in the case of progesterone supplementation. Oral estrogens experience metabolic first pass effect and are broken down by the liver soon after ingestion. Oral testosterone, whether given alone, or in combination, undergoes similar first pass metabolism. Furthermore, methyl testosterone has been linked to hepatic carcinomas.
Topical administration avoids first pass metabolism by the liver, however other issues arise. Besides having to apply to the skin on a daily basis, topical administration can be messy and problematic. In the instance of topical testosterone application, an enzyme exists in the skin that can metabolize it into 5-DHT. This can lead to undesirable side effects. In women, it can lead to undesirable hair growth.
Injections of testosterone can be given. The recommendation is to give deep intramuscularly. The injection is given every 7-14 days. For those faint of heart, the injection route may not be palatable. Typical form is Testosterone Cypionate, which is either in cottonseed oil or sesame seed oil. The injection technique may also give a "peak-and-valley" of testosterone levels, with the peak coming immediately 24 hrs after the injection with a slow progression towards the "valley" over the course of the week. This method doesn't keep a static level and may result in symptoms returning towards the end of the week.
Hormone Pellet Insertion Route
This method has a smoother delivery of hormone, hormone pellets. These very small heat fused hormone pellets are placed under the skin in the fatty tissue. Men typically need pellets inserted every six months. Women need pellets every 4-6 months. Hormone level testing is done before therapy to determine necessity, and every 6 weeks for the first 6 months, then every 6 months thereafter if levels remain therapeutic.
Insertion under the skin in the buttocks: The area is numbed, a small incision is placed and a special customized trocar is used to insert the hormone pellets. Both estradiol and testosterone pellets can be placed in this manner. However, not all pellets are created equal. Pellets are processed utilizing a "heat-fusion" method that makes them more uniform and more predictable in their hormone release pattern. The favorable thing about pellet therapy is the smooth stable release of hormone, and the need to only place them 2-3 times a year. No messy creams or gels, and no irregular hormone levels from oral or injectable administration.
Note: Testosterone replacement is not for those seeking to become parents, male or female. Testosterone decreases sperm count in men. It also is ill advised for women who may be pregnant as it can affect the sexual differentiation of the developing fetus.
Bio Identical Hormones
Schedule an consultation to discuss your options and which therapy may pertain to you.
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