{"id":1000,"date":"2016-07-20T10:59:17","date_gmt":"2016-07-20T17:59:17","guid":{"rendered":"https:\/\/www.seasidemedicalpractice.com\/dev\/\/dev\/?p=1000"},"modified":"2016-07-20T10:59:17","modified_gmt":"2016-07-20T17:59:17","slug":"hormone-replacement-therapy","status":"publish","type":"post","link":"https:\/\/www.seasidemedicalpractice.com\/dev\/hormone-replacement-therapy\/","title":{"rendered":"Hormone Replacement Therapy"},"content":{"rendered":"

Hormone Replacement Therapy<\/em><\/strong>
\nControversy Demystified<\/strong><\/span><\/p>\n

Menopause can be a scary time in a women\u2019s life.\u00a0 Not everyone will experience the jarring transition, but all women feel a<\/em> change of some kind.\u00a0 Going from a hormone level of 100 to 0, is like a race car coming to a screeching halt. Just this week, a colleague of mine lost a patient of his to suicide, a 51 year old mother of a teenage son, with a tiresome case of major depressive disorder.\u00a0 I asked whether she had hit menopause, he said yes but many years ago.\u00a0 What started her downward spiral though was the change in her skin since the onset of her menopause.\u00a0 Her once beautiful face began to look aged and she became very self conscious, developing an obsession with her appearance.\u00a0\u00a0The thought of her, a mother, wife, partner in the prime of her life, who suddenly felt the world was too much to bear, saddens me deeply. Especially since there may have been a simple solution. Enter: Hormone Replacement Therapy.<\/p>\n

Menopause is a period in a woman\u2019s life, where ovaries fail to produce estrogen.\u00a0 They are done, irreversibly done.\u00a0 There are estrogen receptors on practically every cell of your body, and its decline sets\u00a0a ripple effect from your inner most core to the outer most skin.\u00a0 There are even estrogen receptors in men, with an important function of managing the libido.\u00a0 \u00a0In the exam room, we often speak of treating the obvious symptoms of menopause: hot flashes, weight gain, memory fog, sleep disturbances, skin changes, diminished libido, vaginal dryness, joint pains, hair loss, and\u00a0depression.\u00a0 We have many drugs and potions to address single symptoms, or a myriad of symptoms. \u00a0However, the reasons which compel me to use hormone replacement therapy are for the not so obvious conditions; <\/span>cardiovascular disease<\/strong> and <\/span>breast cancer<\/strong>.\u00a0 While there are many studies that have proven the benefits of hormone replacement therapy on prevention of, or slowing progression of heart attack and breast cancer in post menopausal years, there are equally as many refuting it.\u00a0 Why there is so much controversy blows my mind.\u00a0 Perhaps the reason being the male dominated world of medicine oversimplifies the health issues of women who tend to be complex creatures. \u00a0Whatever the reason, it cannot be overlooked.<\/span><\/p>\n

The consensus amongst breast cancer and menopause experts is that the longer the exposure to estrogen, the higher the chance of breast cancer.\u00a0 They base it on knowledge that beast cancer increases by about 3% if you are 55 or older when you reach menopause.\u00a0 Then surely hormone replacement therapy sounds very scary to a menopausal woman who\u2019s been told by her doctor to start estrogen and progesterone as a means to ward off uncomfortable hot flashes and vaginal dryness.\u00a0 Unfortunately, what we don\u2019t fully appreciate is that estrogen levels start declining a decade before you even reach menopause.\u00a0 And it\u2019s the rate of change that leaves the breast cells hungry for more estrogen to stay alive and vibrant as menopause strikes. \u00a0 Breast cells soak up their receptors with any type of estrogen like compound they can find, whether it\u2019s one of 50+ natural estrogen metabolites, phytoestrogens (found in plants such as soy), or xenoestrogens (found in environment, BPA and other harmful hormone disruptors).\u00a0 What the hungry cells don\u2019t consider is that not all activating hormones are alike, and some lead to abnormal proliferation which can lead to cancer.<\/p>\n

In essence, it\u2019s not the longer the exposure to estrogen that raises the risk of breast cancer, but the longer your breasts are starving for natural estrogens.<\/em><\/strong><\/p>\n

My theory in treating women as they begin the process of ovarian failure, is to mitigate the decent, thereby reducing activation of estrogen receptors with potentially harmful estrogen metabolites.\u00a0 I can say without a shadow of a doubt, that no study has shown treatment with bio-identical estrogen and progesterone increases risk of breast cancer in post-menopausal women. \u00a0If you\u00a0read\u00a0carefully for yourself the golden study of HRT and breast cancer, <\/span>The Women\u2019s Health Initiative<\/a> published in 2002, you\u2019ll find that the culprit was progestins (synthetic progesterone) in raising risk of breast cancer.\u00a0 Even then, the risk of aggressive breast cancers was less in treated groups, and more interestingly, the equine conjugated estrogen-only arm actually reduced incidence of breast cancer. Again pointing to the fact that it\u2019s better to have some estrogen and progesterone around than none at all.<\/span><\/p>\n

As for cardiovascular disease prevention, the story is similar.\u00a0\u00a0When you compare the incidence of heart attacks in men and women, you see a graph like this.\u00a0 The risk begins doubling after menopausal years and approaches that of men. \u00a0<\/span><\/p>\n

\"hormone<\/span><\/p>\n

With judicious use and careful monitoring of preferably bio-identical hormones replacement therapies BHRT, our aim is to mitigate the decent of estrogen and progesterone in a heart that was once protected with these hormones.\u00a0 \u00a0A recent Danish study<\/a> showed a whopping <\/span>50% reduction<\/strong> of heart disease and death\u00a0after 10 years on hormone replacement therapy begun at onset of menopause without \u00a0any increase in\u00a0risk of\u00a0cancers, including breast.\u00a0 This contrasts with the Women\u2019s Health Initiative study where hormone replacement was started a decade after menopause. \u00a0Here in the United States, medical societies do endorse HRT for menopausal symptoms, but suggest further investigation is needed\u00a0before\u00a0they recommend bio-identical hormones. \u00a0 In response to the growing demand of consumer\u00a0preference of natural over synthetic hormones,\u00a0Mayo Clinic initiated\u00a0a\u00a0study<\/a> on direct comparison of\u00a0BHRT with commercially available natural estrogens. \u00a0Dr. Kenna Stephenson’s \u00a02013 landmark study<\/a> on BHRT showed favorably significant effects on cardiovascular outcomes, depression scores, and menopausal symptoms.<\/span><\/p>\n

The British Menopause Society endorsed superiority of regulated bio-identical hormones over synthetic estrogen\/progestin in their 2013 Consensus Report on HRT<\/a> for management of menopausal symptoms.\u00a0 The data is out there, but our respectable, albeit stagnant societies are not willing to accept just yet.<\/span><\/p>\n

Our knowledge of hormone replacement therapies in post-menopausal\u00a0women is rapidly expanding. \u00a0New studies are emerging which prove that with proper use of hormone replacement therapies, in my opinion mainly with regulated bio-identical hormones, we are able to effectively and safely offset not only the obvious symptoms of depression, hot flashes and youthfulness, but more importantly\u00a0the deleterious heart disease and breast cancer\u00a0in women. \u00a0<\/span><\/p>\n

Click here<\/a> to view all the internal medicine services available at Seaside Medical!<\/p>\n

When a woman approaches the nonproductive years, it\u2019s as if evolution saw no reason to exist. \u00a0 All the signs of beauty, youth, and reproduction are driven by estrogen.\u00a0 Without it, we are doomed.<\/em><\/span><\/p>\n

Further Reading:<\/span>
\nBioidentical Hormone Therapy<\/em>. (n.d.). Retrieved July 24, 2016, from https:\/\/www.menopause.org\/publications\/clinical-practice-materials\/bioidentical-hormone-therapy<\/span>
\nHRT: Benefits and risks \u2013 what you should know<\/em> | Women’s Health Concern. (n.d.). Retrieved July 24, 2016, from https:\/\/www.womens-health-concern.org\/help-and-advice\/factsheets\/hrt-know-benefits-risks\/<\/span>
\n<\/span><\/p>\n

Get in touc<\/strong>h with Seaside Medical Practice
\nto schedule a HRT consultation with Dr. Yazdani<\/strong><\/p>\n

(310) 393-5000<\/strong>
\ninfo@seasidemedicalpractice.com<\/p>\n

\u00a0<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"

Hormone Replacement Therapy Controversy Demystified Menopause can be a scary time in a women\u2019s life.\u00a0 Not everyone will experience the jarring transition, but all women feel a change of some kind.\u00a0 Going from a hormone level of 100 to 0, is like a race car coming to a screeching halt. Just this week, a colleague […]<\/p>\n","protected":false},"author":1,"featured_media":24357,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_seopress_robots_primary_cat":"none","_seopress_titles_title":"The Most Effective Hormone Replacement Therapy (HRT)","_seopress_titles_desc":"Do you want to know what does hormone replacement therapy do to your body? It is used to relieve symptoms of the menopause. Request an appointment!","_seopress_robots_index":"","_et_pb_use_builder":"","_et_pb_old_content":"","_et_gb_content_width":"","footnotes":""},"categories":[83],"tags":[],"class_list":["post-1000","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-hormone-therapy"],"_links":{"self":[{"href":"https:\/\/www.seasidemedicalpractice.com\/dev\/wp-json\/wp\/v2\/posts\/1000","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.seasidemedicalpractice.com\/dev\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.seasidemedicalpractice.com\/dev\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.seasidemedicalpractice.com\/dev\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.seasidemedicalpractice.com\/dev\/wp-json\/wp\/v2\/comments?post=1000"}],"version-history":[{"count":0,"href":"https:\/\/www.seasidemedicalpractice.com\/dev\/wp-json\/wp\/v2\/posts\/1000\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.seasidemedicalpractice.com\/dev\/wp-json\/wp\/v2\/media?parent=1000"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.seasidemedicalpractice.com\/dev\/wp-json\/wp\/v2\/categories?post=1000"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.seasidemedicalpractice.com\/dev\/wp-json\/wp\/v2\/tags?post=1000"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}