Bioidentical Hormone Therapy for Menopause

What is bioidentical hormone therapy and how does it help? Could there be more frustrating and confusing phrases in the health vocabulary of women today? Countless books, TV programs, and commercial products have been offered to women aged 30-50, extolling the benefits of natural bioidentical hormone therapy while trying to help them with menopause, a truly major life event.

Not only do women constantly battle the problems associated with their changing bodies, they have to deal with them earlier in their lives.

Whereas their mothers and grandmothers tackled these menopausal problems in their late 40s, more and more women have to confront them sometimes as much as ten years earlier.

Doctors theorize that possible environmental factors such as environmental toxins and even substances called “xenoestrogens” have contributed to this earlier menopausal crisis in women, interfering with the body's ability to normally produce and secrete hormones in the right amounts and at the right times.

Ask yourself: Do any of these symptoms of menopause sound familiar?

You're in your late 30's or early 40's. You start noticing you've gained weight in your midsection that might not have been there before.

Everything that used to work to control your weight just simply doesn't work anymore. Excerise, watching your diet, nothing.

Maybe you've noticed some abnormal bleeding. The duration, timing or the frequency has changed. Your period seems distinctly different - maybe there's more cramping or clotting or it's lighter than usual. You might even have skipped a period or two or more.

You and others around you notice your mood goes on a roller coaster ride. One minute you're depressed, feeling hopeless.The next, you're feeling anxious.

You worry constantly: worry about growing old, worried whether you have some serious disease. If you haven't had children yet, you worry if you'll ever be able to have them.

You have changes in your sex drive. You're just not interested anymore. You feel unattractive. Your vision seems to be changing, things are blurry that used to be clear.

Even your hair is changing, getting drier and coarser. And your skin is also dry and thin and more prone to bruises. Acne which you haven't had for 20 or 30 years starts to reappear. And hair starts growing in funny places.

Of course, all of these things didn't pop up overnight. The process started gradually and over months or years has finally taken its toll. You looked in the mirror and felt enough is enough, it's time to fix all of this once and for all using bioidentical hormone therapy.

With proper medical care, there are simple and safe solutions to the menopause!

Remember all of these changes are simply caused by changes in your hormone levels.The secret to successfully getting through menopause is knowing what's going on in your body and where you currently are in the whole process.

By using a combination of detailed history and comprehensive hormone testing, we can help you understand what your body is doing and what you can do to fix the problems.

By taking a detailed history, we can pinpoint when your problems started, or if there were any significant precipitating events, such as stress from change in relationship, a divorce, loss of loved one, death of parent, children going off on their own or a job change.

Warning: Most doctors don't understand or have access to the precise hormonal testing needed to treat your menopause.

Maybe your regular doctor has ordered standard hormonal testing before and maybe even explained the results to you. But if you're still having problems there is a very good reason for this.

What most doctors don't tell you, (and what most don't even know) is that there are actually three different major types of estrogen that a women produces and secretes. And these three estrogens have to be in a proper ratio relative to each other and relative to progesterone and testosterone for you to feel normal.

The traditional blood tests - LH (Luteinizing hormone) and FSH (Follicle Stimulating Hormone) that doctors most commonly order lack sensitivity and specificity to check specific amounts of each hormone and the important hormonal ratios.

By knowing where you've been and where you are, we can help you know where to go! That means using bioidentical hormone therapy for the best results.

We offer you more specific and sensitive testing of major hormones such as all three estrogens, progesterone, testosterone, growth hormone, DHEA (the mother of all hormones and pregnenolone (the grandmother of all hormones).

Depending on your specific needs, we order and check many things that your doctor may have overlooked such as a full blood chemistry and blood counts, not the typical abbreviated, cut-rate version you're used to.

In addition, we can also check the balance between the different glands in the body, look at the immune system, dietary intake, absorption and digestion, and when appropriate, we test for toxic environmental exposures as well as test for food or chemical sensitivities.

Based on our history and test results, we can then formulate an individualized, specific, and manageable plan of action to replace and rebalance your hormones.

Most importantly, we use the safest, highest quality and most effective bio-identical hormone replacement therapy available today!

So take back your life from the disheartening and frustrating symptoms of menopause, and really start living life again!

We are more than happy to answer any questions you might have about bioidentical hormone therapy and menopausal treatment. If you have any questions, please call us at:

(303) 488-0034

to ask any questions or set up an appointment. We look forward to helping you achieve your goals.

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Most recent evidence that pharmaceutical companies just don't get it!

This article describes the supposed benefit of using a patch or gel over a pill but neglects to mention that what you put in the patch or gel is even more important!

WALL STREET JOURNAL February 21, 2007

In a twist in the debate about the safety of menopause hormones, new research suggests the real problem may not be the hormone itself, but the fact that it's typically swallowed as a pill.

This week, the medical journal Circulation offers some of the strongest evidence yet that the risks of hormones are dramatically reduced when the drugs are absorbed through the skin in patches and gels rather than taken as pills. The study by French researchers showed that one of the most serious risks associated with hormone use -- blood clots -- could be virtually eliminated if women switch to a skin-delivery system like the patch. It's estimated that more than four million U.S. women use menopause hormones to relieve hot flashes and other symptoms. Although hormone drugs come in pills, patches, creams, gels and rings, the vast majority of U.S. women use the pill form.

More From the Journal · Hormone Patch Shows Benefit Over Pill · Anxiety High as Parents Move for Better Schools · Your Vote Can Count In Company Elections Among the 881 women studied in the Circulation report, researchers found that women who took hormone pills were four times as likely to suffer a serious blood clot. Women who used hormone patches or gels were at no higher risk for blood clots than women who didn't take hormones at all. The research, collected from a continuing study called ESTHER (which stands for Estrogen and Thromboembolism Risk), was funded primarily by French government health agencies but also received some support from drug companies that make patch treatments. The women studied were taking either estrogen only or an estrogen-and-progestin combination.

Although hormone patches are popular among European women, the sticky, tan or clear patches aren't widely used in the U.S. The most popular brands include Climara, made by Berlex of Wayne, N.J., and Vivelle-Dot from Novogyne, a joint venture of Novartis and Noven Pharmaceuticals. Estrogen gels and creams, which are rubbed on the arms and legs, also aren't big-sellers. Part of the reason is that doctors here are simply more accustomed to prescribing hormones in pill form. Another issue is that the patches, typically worn on the abdomen or buttocks and changed once or twice a week, can irritate the skin, get dirty or collect lint around the edges. For some women, the bigger issue is that they don't want such a visible reminder of their menopause treatment.

"Many women think a pill is just easier," says Alan M. Altman, assistant clinical professor of gynecology at Harvard Medical School, who says more than 80% of his own patients use the patch. "When you wear a patch, some women feel there is a tattoo on them that says 'I'm post-menopausal.' " He has received consulting fees from hormone makers, including patch makers.

But the latest research adds to the evidence that patch or other skin-delivered therapy can dramatically reduce some of the most serious risks of menopause hormones. The Circulation study also noted that blood-clot risk varied depending on the type of progestin used, although the highest-risk types studied aren't typically used by women in the U.S. Even so, the fact that women in France had different risks depending on the type of progestin and delivery system they used signals that far more research is needed to understand the differences in the various hormones now prescribed to women.

A spokesman for Wyeth, maker of the best-selling pills Premarin and Prempro, couldn't be reached for comment on the study, which came out on a holiday. However, the company has said in the past that the main advantage of Premarin and Prempro compared with new drugs is that they are the most-studied hormones available to women.

While the evidence is strong that hormone patches lower blood-clot risks, doctors warned that the new data don't address other risks and benefits of hormones.

Several studies show that while menopause hormones relieve hot flashes and protect women's bones, they also may slightly increase risk for stroke and breast cancer. But clearly one of the most common health risks associated with hormones are blood clots, which can block blood vessels and cut off the blood supply to important organs. In the most serious cases a clot causes pulmonary embolism, which occurs when a blood clot travels to the lungs from another part of the body.

The reason hormones delivered through the skin by patch, gel or cream may cause fewer blood clots, doctors say, is that the drug doesn't have to pass through a woman's liver and instead enters the blood stream directly, much like her own natural hormones do. When a woman swallows a hormone pill, the drug must first be metabolized by the liver before it enters the blood stream. This "first pass" through the liver triggers some unwelcome side effects, stimulating the liver to produce too many triglycerides and blood-clotting factors, among other issues. The lower clotting risk of patch therapy hasn't been shown with birth control pills, likely because contraceptives use far higher doses of estrogen.

The differences in clotting risks between menopause hormone patches and pills has prompted questions about the results of another major study, the Women's Health Initiative. That much-discussed study was halted in 2002 after older women taking the combination hormone drug Prempro were found to be at higher risk for heart attacks, blood clots and strokes. Although the big concern about the WHI is that it studied older women long past menopause, another criticism is that it studied only conjugated equine estrogen pills, the most popular hormone used today, which is derived from the urine of pregnant horses. Hormone patches use 17-beta estradiol, which is a chemical match to the dominant estrogen found in premenopausal women.

Harvard professor JoAnn E. Manson, a WHI researcher who co-authored an editorial about the Circulation study, says the new data suggest that the balance of risks and benefits shown in the WHI might have been dramatically different if patches were studied instead. In the WHI estrogen and progestin study, at least 44% of the adverse events were related to blood clots, suggesting that a woman who uses a patch instead of a pill can eliminate nearly half the risks associated with the drugs, says Dr. Manson.

"If you're talking about women who are recently menopausal, the patch could be enough to very dramatically change the benefit-risk ratio," says Dr. Manson, who doesn't receive funding from any hormone makers.

While earlier studies have also shown that blood-clot risk is lower with hormone patches compared with pills, most experts say the message hasn't gotten to many doctors or women themselves. Part of the problem is that blood-clot data tend to get published in cardiology journals that may not be read by internal medicine doctors or gynecologists who typically prescribe hormone drugs.

Another problem is that no large clinical trials comparing oral, patch and other forms of hormone drugs have been conducted. Even the data from the Circulation study isn't considered conclusive because it's based on observational evidence, rather than a clinical trial where a specific treatment is studied against a placebo.

And it is too soon to say definitively that hormone patches are better than pills in every way. Because oral estrogens pass through the liver, they actually do a better job of raising a woman's good cholesterol, lowering her bad cholesterol and lowering blood sugar, suggesting there could be differences in heart and diabetes risk among pill and patch users.

"I very much would like to believe the patch is safer, but in order to know that we need better data," says Susan Hendrix, a WHI researcher and professor of obstetrics and gynecology at Wayne State University Medical School in Detroit. "Look at the numbers of women who need these therapies. ... I think there's a public outcry for the need for this kind of research."

More answers about the differences in risks and benefits of various hormone drugs and delivery systems will come from the Kronos Early Estrogen Prevention Study, or KEEPS, which is now recruiting women who are within three years of menopause. Women in the KEEPS study ( will be given different forms and types of estrogen and progestin, including patches and pills. The study, at eight major medical centers, is funded by a nonprofit institute in Phoenix. "Whether hormone therapy is in vogue or out of vogue, there will be many women with impaired quality of life who will be seeking treatment for menopause symptoms," says Dr. Manson. "We need to push for more research for women so they will have clear answers to these questions."

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Dr. Singer's goal is to provide you with the best and most effective medical care you have ever received. If you have a serious chronic condition, it may help you to know that it will take time to reverse a process that has developed over many years. There is no quick fix or magic bullet available for most chronic degenerative disorder. It takes a physician like Dr. Singer to apply good, scientific medical knowledge to help the healing process begin.

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