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If you are confused about women's hormone (estrogen) replacement therapy, it is perfectly understandable. Every headline a woman reads seems to contradict the either previous headline or her own doctor. Some sources refer to "menopause," and others to "perimenopause," and yet others to hormonal imbalance. Women's different health situations bring on other questions, such as, "I don't need hormones, do I, since I've had a hysterectomy?", "but, I still have my ovaries, is it different for me?", "I know, it is just PMS" "I am too young, can't birth control pills fix my irregular cycles?" I could go on, but, you get the point. The sad thing about the whole thing is that there are many women who are experiencing real symptoms of hormonal imbalance who are not getting the right information and ultimately not getting the right help. They get symptoms such as hot flashes, weight gain, fatigue, depression, memory lapses, headaches, low libido, tender breasts, abnormal periods, uterine fibroids, and leaky bladders to name a few. Those who do seek help from a doctor or other healthcare professional usually get offered a standard of three options 1) They are given a prescription for synthetic hormones, most commonly Premarin, Prempro, or a number of birth control pills. Some feel better for a small amount of time but they also develop other side effects to these hormones that are foreign to the woman's body. As a result, most women discontinue these hormones. 2) If synthetic hormones are not prescribed, the healthcare practitioner might instead prescribe antidepressants. These are even promoted on television as a treatment for hormonal problems. Unfortunately, instead of treating the underlying cause they treat only some of the symptoms, but may create others. Some practitioners even offer to "remove the offending organ" and suggest a hysterectomy, which yes, is a solution to abnormal bleeding, but not a solution to anything else. So what can a woman do? Women need to know that there are other options. An option with the goal of balancing a woman's hormones no matter in what decade of life they are. A bio identical hormone program can be your individualized solution to your symptoms. Its goal is not only to relieve the symptoms, but to address the underlying cause of the symptoms. It is not set up to mask the symptoms, but to replace the hormones that are deficient or make sure they are in proper balance. To understand how bioidentical hormones work, we must understand what hormones are and how they can lead to symptoms if they are out of balance. Hormones are chemicals released by glands in the body. These chemicals send messages to different tissues in the body. Most hormones are delicately balanced with each other and work in a wonderful concert. However, if there is an excess of one hormone, it can effect how it and other hormones impact the various tissues they are trying to send messages to. The same is true if there is a deficiency of one or more hormones. Let's move on. Women's bodies were created for reproduction and two main hormones dominate the woman's reproductive abilities. Puberty is the transition into reproductive age. This period usually starts around age 10-13 and ends around age 17. Hormonal fluctuations during this time lead to the maturation of the child into a fully mature reproductive woman. Once mature the hormones stabilize and optimally hormonal balance becomes cyclical as noted by regular menstrual cycles. Perimenopause is the transition out of reproductive age and it is also marked by hormonal fluctuations over several years. This may start as early as age 30, or as late as 40. Finally there is Menopause, the period of time when the woman is no longer reproductive. So what are the hormones that we need to know about. Let's start with estrogen. We usually think of estrogen as one hormone, however, there are actually 3 estrogens that the human female produces. These are: 1) estradiol (the strongest estrogen), 2) estrone, and 3) estriol (the weakest, but, most abundant and also the most protective). Progesterone is the other critical hormone in a woman's body. See table1 and table 2 for the functions of these two natural hormones. The estrogens and progesterone are involved in an intricate balance. For some women this balance is maintained for most of their reproductive years and the transition to menopause may be smooth. For most women, however, factors in their lifestyle tip the balance one way or another and symptoms develop. Not life threatening symptoms develop such as would occur if the hormone insulin was deficient or in excess, but symptoms that nevertheless indicate sub-optimal health. Some of these symptoms can be measured using diagnostic testing such as weakening bones can be tracked via densinometry tests. However, because many of the hormones messages are to the brain, these symptoms can cause changes in mental sharpness, memory, libido, and altered reactions to stressors. Eventually these may lead to anxiety and an overall decrease in the sense of well-being as well as changes in that woman's household relationships. The hormone imbalances can be very subtle and gradual. Consequently, the changes in the woman may be attributed to other causes, sometimes inappropriately, as when a woman is diagnosed with depression simply because of the number of complaints she voices to her doctor. So, the question remains; what are Bio Identical hormones and how can they help? Bio Identical hormones are hormones compounded by compounding pharmacies (Advant-Edge Pharmacy). Though these hormones are made in a lab from plant extracts, they are the exact same molecule as produced in the woman's body, thus, they are biologically identical, thus, the term Bio Identical. Now, let's look at the synthetic hormones made by the pharmaceutical industry. They produce hormones that come from natural sources, but, they are not natural to the woman's body. The most popular estrogen tablets are derived from the urine of pregnant mares. Though, you do get estrogenic effects, you also get all of the other estrogens natural to a horse which haven't ever been part of any woman's natural hormone production. Beware of the liberal use of the word "natural". Companies will go out of their way to use the word natural in pertaining to their product. Just because they make it from natural sources, doesn't mean it is natural to the woman's body. Let's continue with "natural". The hormones made by the body have specific receptor sites to which the hormones attach in order to exert its effects. These receptor sites are very specific in their shape to match the hormone, which will activate it. Without this exact match, the effects which are supposed to be produced will not occur or not occur completely. The most common analogy for a hormone to attach to a receptor and then exerting its effects is to a lock and key. Not any key will fit any lock and unless you have the right key to the right lock, then and only then will the key work.(Try using your house key to turn on your car; won't work.) Once the hormone attaches to the receptor site and exerts its effect, the body needs to get rid of it. The body does this by enzymes which recognize these natural hormones and breaks them down (into metabolites) to where the body can dispose of them. This natural process is interrupted when synthetic hormones are used in two different ways. First, the synthetic hormones don't fit the receptor site exactly in the woman's body, but, it does just enough to exert an effect. Second, the bodies natural enzyme system doesn't recognize the synthetic hormone as normal, but, does its best to break them down. This break down may not occur completely or at all and some of these metabolites can hang around causing unnecessary side effects and also can be cancerous. In summary, Bio Identical hormones are a way to replace a woman's natural hormones when her hormones become out of balance. If you feel this therapy is right for you, consult with you doctor or if you have more questions, make an appointment with the woman's health pharmacist at Advant-Edge Pharmacy. How do you get started in Bio Identical Hormone therapy? The first thing is to be knowledgeable about it so that you are certain this is the right thing for you. An appointment with you woman's health pharmacist at Advant-Edge Pharmacy can help. The second thing would be consult with your doctor. It is your health so it is important that you take an active role in your therapy. Become part of your own health care team and get involved in choices. Third, get a saliva test to measure whether or not your hormones are at an appropriate level or in balance. The woman's health pharmacist at Advant-Edge Pharmacy can assist you with this step. Fourth, make sure there are frequent follow-ups to assess your progress. Fifth, do the things that are equally important such as proper diet and nutrition, proper exercise, and stress reduction. Are Your Hormones Making You Sick by Eldrid & Ava Taylor Natural Hormone Replacement by Jonathan Wright, MD



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