Bio-identical HRT

It is an inevitable part of life that as we age, our bodies change, and for the most part, we do the best we can to feel ourselves at each stage of the journey. For women, starting the menopause can test this to the limit, with the appearance of physical and emotional symptoms that are wide-ranging and often difficult to handle.

The menopause usually occurs in your 50s, but early onset menopause can affect women as young as 30 when falling levels of the hormones progesterone and estrogen can lead to a range of symptoms, including:

Mood change

Irritability

Hot flushes

Night sweats

Vaginal dryness

Change in body shape

Although the physical changes can be hard to cope with, it’s often the emotional changes that can have the most impact on day to day life. Some women decide that the symptoms are manageable, but others find that they need some help, maybe because mood swings are affecting family life or disrupted sleep is having an impact on their work day.

Traditionally, there are some natural remedies that have been used to help with the symptoms of the menopause. Black cohosh for example for the emotional symptoms and evening primrose oil for relieving breast pain and helping with mood swings. A diet high in plant-based phytoestrogens can also have positive effects, and I recommend introducing soy products as well as increasing intake of whole grains, dried beans, peas and fruits. These natural remedies can help, but often symptoms are having such a negative impact on a woman’s well-being that another solution needs to be found.

The symptoms of the menopause are caused by a natural drop in oestrogen and progesterone and Hormone Replacement Therapy (HRT) does just what it says on the tin to address this imbalance and restore the levels of female hormones. HRT also protects bones from premature aging, which is particularly important if you’re experiencing early onset menopause or have a family history of osteoporosis. The decision as to whether you want to pursue HRT is a personal one based on whether the symptoms are enough of a problem in your day to day life.

There are very few genuine contraindications for HRT, but if you have previously suffered from a blood clot, heart disease or stroke, have a family history of cancer or suffer from bad migraines on the contraceptive pill then traditional HRT may not be for you and you should discuss your options with your doctor. There have been many studies into the effects of HRT and it has been shown to slightly raise the risk of breast and ovarian cancer, which is why it is not recommended for those with a family history of these diseases. Despite these risks, the proven benefits of the treatment mean that it is an effective hormone treatment and when used on a short-term basis (during the menopause), the minimal risks are judged to be outweighed by the positive results.

When you look into HRT options online, there are many aspects to consider. HRT can be taken in pill form or in a patch or gel that is applied directly to the skin and absorbed more quickly into the bloodstream. Usually HRT in tablet form contains a compound that is broken down by the body into the female hormones whereas the patches and gels introduce compounds that are very similar to natural progesterone directly into the body.

Alongside these considerations, ‘bio-identical’ hormones have entered the market, billed as a safer alternative to traditional hormone replacement therapy, using natural ingredients in personally tailored quantities. Conventional HRT uses synthetic or animal-derived compounds that are therefore slightly different to the hormones occurring naturally in the body, whereas bio-identical hormones are biochemically the same as those produced by the body. The appeal of this ‘natural’ treatment is clear, but despite the elevated treatment cost, there is currently little evidence available to show that bio-identical hormones are any more effective and there are significant concerns about their safety.

Where conventional HRT is strictly regulated and subject to purity and production controls, with set levels prescribed, bio-identicalhormones are not subject to the same controls, as the levels prescribed are often determined by salivary hormone levels. In fact, the National Institute for Health and Care Excellence (NICE) guidelines on the diagnosis and management of the menopause state that the effectiveness and safety of bio-identical hormones is unknown and neither the American Congress of Obstetricians and Gynecologists or the British Menopause Society recommend them.

With this in mind, I would recommend conventional HRT, over ‘bio-identicall’ HRT to any woman considering hormone treatment for menopausal symptoms, based on the current research and legislation. There are a range of HRT options available, and it’s important to discuss these thoroughly before making any decisions.

To discuss the menopause and HRT, contact Yvonne on liebermanpa@gmail.com