Hrt And Surgical Menopause
So what is surgical menopause? Its menopause that develops suddenly after the ovaries the main producers of the hormone estrogen are surgically removed.
The removal of the ovaries is called an oophorectomy. The procedure is often combined with a hysterectomy removal of the uterus but not always. And in fact, women who only have their uterus removed will not go into surgical menopause. Their ovaries are still making estrogen. Theyll go into menopause naturally when they get older, although sometimes a bit earlier than usual.
Estrogen plays a key role throughout the body. It affects the brain, the bones, the skin, the heart, the blood vessels, and more. While estrogen levels lower gradually during natural menopause, they plummet with surgical menopause. That sudden drop in estrogen can lead to menopausal symptoms that can be quite severe.
Hormone therapy after surgery either with estrogen and progestin or with estrogen alone is a way to counteract the supply of estrogen youve lost. Women who have both the uterus and ovaries removed usually just get estrogen replacement therapy alone. But women who have only the ovaries removed need both estrogen and progestin. Thats because estrogen alone can increase the risk of cancer in the uterus. Adding progestin removes this risk.
Rarely, if ever, will both ovaries be removed without the uterus. Often, only one ovary may be removed, which will negate the need for HRT at the time of surgery,
What Are The Treatments For High Estrogen
The treatments your provider recommends will depend on whats causing your high estrogen levels. In some cases, lifestyle changes may help. If high estrogen levels increase your cancer risk or worsen cancer you already have, your provider may recommend more aggressive treatments.
There are few medications that directly decrease estrogen. Usually, whats needed is to identify the underlying cause and treating this first.
Making some lifestyle changes may help lower your estrogen levels. Your provider may recommend that you:
Your provider can adjust your prescription if the hormones youre taking are causing high estrogen. You may need medicine if you have cancer spreading in response to estrogen exposure.
- Aromatase inhibitors: Aromatase inhibitors are used to treat breast cancer. They prevent your fat cells from making estrogen. Aromatase inhibitors include Anastrozole , Exemestane and Letrozole .
- Gonadotropin-releasing hormone agonists: GnRH agonists stop your ovaries from releasing estrogen.
Shortage Of Some Hrt Products
There are ongoing supply problems with some HRT products. For some products this is because of irregular supply while for others it’s a longer-term shortage. There are lots of different reasons why medicines can be in short supply. Work is happening with the pharmaceutical manufacturers who make the medicines to help the situation.
If your pharmacy cant supply the specific HRT product you’ve been prescribed, they may supply an alternative product. This will usually have the same ingredient, but may be made by a different manufacturer. Your pharmacy might also reduce the amount they provide you with to help ensure that as many women as possible can get access to their required medication.
Disruptions in the availability of HRT will be worrying if it has been prescribed for you. However, there are always alternative options. If you are concerned about this, contact your GP, pharmacist or specialist doctor to discuss the best treatment options for you.
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The Side Effects Of Too Much Testosterone A Patients Perspective
If youve listened to the radio, picked up a fitness magazine, or simply talked to some guys at the gym, theres a good chance youve heard of Testosterone Replacement Therapy. Its out in the public eye, and with good reason! More energy, better libido, fewer aches and pains, less body fat, more muscle who doesnt want that?
As with any medical treatment, however, theres a risk/reward factor to consider. Almost any medicine can bring some bad with the good, and TRT is no exception. The potential benefits need to be weighed against the potential adverse effects, and the recipient needs to be well aware of what the side effects of too much testosterone can entail.
First, lets make this clear carefully supervised Testosterone Replacement Therapy is night and day different from some guy injecting himself with copious amounts of questionable steroids. Testosterone Replacement Therapy is a medical treatment that includes careful monitoring and intense focus on maintaining proper dosage, done by medical professionals specialized in exactly that. Finding that proper dosage is keywhile low testosterone can have a number of disagreeable symptoms, too much testosterone can also have side effects.
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Is Estradiol Synthetic Or Bioidentical
BioidenticalBioidentical hormones have the same molecular structure as the hormones made by your body. Synthetic hormones do not have the same molecular structure as the hormones in your body, but your body converts them to a usable form.
Who should not take bioidentical hormones?
Certain women should not undergo hormone replacement therapy of any type until detailed studies on safety have been performed. You are not considered for bioidentical therapy if you have a personal history of breast cancer or stroke, or if you have a blood clot.
Who can take estrogen only HRT?
Now estrogen-only HRT for younger postmenopausal women for up to six years appears to carry fewer long-term risks, and to offer greater benefits, than previously thought.
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How Long Does It Take For Estrogen To Take Effect
How long does HRT take to work? It usually takes a few weeks before you will feel the initial benefits of HRT and up to three months to feel the full effects. It may also take your body time to get used to HRT. When treatment begins you may experience side effects such as breast tenderness, nausea and leg cramps.
What Women Should Discuss With Their Doctors
While the data is clear that ET is safe and effective for healthy women in their 40s and 50s, women in their 60s should take an individualized approach. The North American Menopause Society recommends that at age 60, patients discuss all their risks with their doctor, acknowledging that around 42% of women continue to have symptoms that impair sleep and health between ages 60 and 65 ³ The American College of Obstetrics and Gynecologists does not include age-based recommendations for or against ET or HT in their practice guidelines, stating that systemic hormone therapy, with estrogen alone or in combination with progestin, is the most effective therapy for vasomotor symptoms related to menopause. They recommend that the lowest dose of HT be used for the shortest amount of time to reduce symptoms, and that regardless of age, HT be individualized. Dr. Archer says doctors should also consider the beneficial role of estrogen on bone density when considering whether to place a woman on ET for menopausal symptoms.
Women who should not take ET for menopausal symptoms at any age, says Dr. Matteson, include those with porphyria cutane tarda and should generally not be used by women with current, past or suspected breast cancer undiagnosed genital bleeding untreated pre-cancer changed of the uterus previous or current venous thromboembolism active or recent arterial thromboembolic disease untreated high blood pressures or active liver disease.
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When You Have Too Much Estrogen
Women can have too much estrogen. When this happens, the following can occur:
- Weight gain, typically in your waist, hips, and thighs
- Light or heavy bleeding during your periods
- Intensified premenstrual syndrome symptoms
- Fibrocystic breasts
- Fibroids in the uterus
- Tiredness and fatigue
- Loss of sexual desire
- Feeling depressed or anxious
When mens estrogen levels are too high, they can have enlarged breasts , infertility, and difficulty maintaining an erection.
Based on what your doctor determines is causing your high estrogen levels, he or she may prescribe a medication, suggest surgery, or recommend dietary changes to help lower your estrogen levels.
There Are Three Main Types Of Estrogen
Estrone, estradiol, and estriol are the three main types of estrogen.
Estrogen helps initiate physical changes that happen to girls during puberty, such as the start of their menstrual cycles and developing secondary sex characteristics, including breasts and body hair.
Estrogen helps regulate the menstrual cycle during a womans childbearing years and controls the growth of the uterine lining.
Estradiol is most common in women of childbearing age. During pregnancy, estriol is produced by the placenta, and estrone is the only hormone your body produces after menopause .
In men, estrogen is important to the growth of healthy bones and the development of the male reproductive system. However, not much more is known about estrogens role in men.
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Induced Causes Of High Estrogen Levels
High levels of estrogen can also be attributed to environmental triggers, medications, and treatments, such as:
- Hormone replacement therapy . Estradiol levels could climb to levels that are fundamentally disproportionate throughout estrogen therapy. Not only could this increase a womans chance of blood clotting problems, but it also puts her at risk of contracting endometrial cancer, strokes, breast cancer, and more.
- Consumption of exogenous hormones. Another trigger of high estrogen levels includes usage of certain prescription drugs such as steroid medications, ampicillin, phenothiazines, tetracyclines and medications containing estrogen, such as birth control pills.
- Environmental pollutants. Xenoestrogens are man-made chemicals in the environment that mimic natural estrogen when ingested, altering normal hormone functioning and increasing estrogen levels. Theyre found in beauty products, pesticides, plastics, commercial meats, and more.
Is Hrt The Same As Birth Control
No. Although women who take birth control pills are also taking estrogen and progestin, the effect is not the same. Women who take birth control pills have not been through menopause and need higher levels of hormones to prevent ovulation. HRT is not a high enough strength to stop ovulation.
After menopause, estrogen levels are low and HRT is used at a low dose to restore hormone levels to a more normal level.
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Reduce Hot Flashes And Night Sweats
Low levels of estrogen in your body can cause hot flashes, a sudden intense flushed feeling accompanied by sweating, dizziness, nausea or weakness. These can occur during the day or night and disturb quality of sleep. Increased fatigue contributes to feelings of irritability and mood swings. According to a study published in the June 2010 issue of Menopause International, hormone replacement therapy is an effective treatment for hot flushes in 80 percent of cases 2. Non-hormonal treatments are available, but they do not provide the same degree of relief that estrogen does. Fears concerning elevated cancer risks associated with HRT, and the fact that not enough is known about the exact causes of hot flushes, limits development of additional alternative treatments.
- Low levels of estrogen in your body can cause hot flashes, a sudden intense flushed feeling accompanied by sweating, dizziness, nausea or weakness.
- Fears concerning elevated cancer risks associated with HRT, and the fact that not enough is known about the exact causes of hot flushes, limits development of additional alternative treatments.
Youre A Woman In Perimenopause Or Menopause
Menopause is the time when your periods end, and so does your fertility. The years leading up to menopause can cause a number of uncomfortable symptoms that can significantly affect your quality of life.
If you have hot flashes and night sweats, vaginal dryness, sore breasts, thinning hair, dry skin, and depression, BioTE bioidentical hormone therapy can help put your estrogen levels back into balance so these symptoms lessen, or perhaps resolve entirely.
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What Are 2020 Safer Analogs To Hormone Replacement Therapy And Weight Loss
The well-composed plan of HRT helps to prevent osteoporosis, controls body temperature, returns active sexual life, and works as a dietician. Hormone replacement therapy and weight loss reduce a patients food cravings and convert fat into energy. What are 2020 safer alternatives to hormone replacement therapy and weight loss for menopausal women?
Estrogens And Skin Biology
A number of studies have shown that estrogens have many important beneficial and protective roles in skin physiology . They have been shown to accelerate cutaneous wound healing , while a significant number of women notice an improvement in inflammatory skin disorders such as psoriasis during pregnancy . Estrogens also offer some degree of protection against skin photoaging and epidemiological studies indicate that the mortality rates from both non-melanoma skin cancers and melanoma are significantly lower in women.
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Bioidentical Hormones After Hysterectomy
These two studies provide convincing evidence of the health benefits of hormone replacement after hysterectomy. Although the patients in these two studies were given Premarin which is a natural hormone , we find that a cocktail of bioidentical hormones including estradiol, estriol, progesterone, DHEA and testosterone works as well or better than the horse hormones. Since all women are humans, we I consider it preferable to prescribe human hormones rather than hormones from pregnant horse urine .
Left Image: pregnant horse, courtesy of wikimedia commons. Why use horse hormones when human hormones are available?
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What Are The Benefits Of Estrogen Only Hrt
The benefits of oestrogen only MHT Oestrogen reduces the severity and frequency of hot flushes by around 85%. Oestrogen improves vaginal dryness. By reducing menopausal symptoms, oestrogen may improve sleep and quality of life. Oestrogen reduces the risk of post-menopausal bone fracture, including hip fracture .
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What Type Of Hormone Therapy Do You Need After A Hysterectomy
Although it may not always be needed, HRT is often recommended at least for a short time following an oophorectomy. The immediate drop in hormone production may not cause hot flashes and mood swings, but it may impact ones bones, heart, or brain functions.
In the following hormone replacement therapy guidelines, hysterectomy and oophorectomy needs are explained:
- Hormone therapy options following an oophorectomy and hysterectomy:
- Estrogen therapy
- Progesterone therapy women without their ovaries should not use synthetic progestin as that can increase certain side effect risks only natural or bioidentical progesterone therapy is advised
While those are the standard guidelines for hormone replacement, there are other options that every woman should know:
Understanding hormone replacement therapy and hysterectomy needs are crucial so that you ensure you are getting the right treatment.
Women who have their uterus intact and only undergo ovarian removal need progesterone to reduce the risk of endometrial cancer.
Can You Get Bioidentical Estrogen
The U.S. Food and Drug Administration has approved some forms of manufactured bioidentical hormones, including bioidentical estriol and progesterone.
What are the major risks of using estrogen alone for hormone replacement therapy?
The health risks of HRT include: Increased risk of endometrial cancer For women who have had a hysterectomy , this is not a problem. Increased risk of breast cancer with long-term use. Increased risk of cardiovascular disease (including heart attack
Is there an estrogen only HRT?
Oestrogen-only and combined HRT patches are available. Skin patches may be a better option than tablets if you find it inconvenient to take a tablet every day. Using patches can also help avoid some side effects of HRT, such as indigestion, and unlike tablets, they do not increase your risk of blood clots.
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Choosing The Best Type Of Estrogen Therapy
When deciding what type of estrogen therapy to get, work closely with your doctor. While oral estrogen has been around for a long time and is well studied, some modes of taking hormone therapy are not. They may have lower risks or different risks that we don’t know about yet. Your doctor should be up to date on the latest research.
Right now, the full risks of hormone therapy are unclear. So if you do decide to get ERT, experts generally recommend that you get it at the lowest dose for the shortest time possible. Talk to your doctor about how long you should expect to take ERT and how you can limit your risks.
Alzheimers Caused By Lack Of Brain
One study found that women who removed their ovaries before 40 and did not receive hormone replacement therapy have double the risk of Alzheimers disease.
This is because the sex hormone, estrogen, binds together with a receptor in your brain reducing the production of the protein amyloid-beta. This causes plaque to form on the brain of those with Alzheimers.
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