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Bio-identical Hormone Replacement Therapy

By: Harvey S. Bartnof, MD
Posted: June 9, 2008, from the December 2006 issue of Skin Inc. magazine.

When Gail arrived at my office, she was not a happy person. She said that she had not slept through the night for more than a year. Night sweats were waking her up every couple of hours, and she had difficulty falling back asleep. Because she was not feeling rested, work was becoming increasingly difficult, and Gail’s boss was noticing some decline in her productivity. “And I get hot flashes every three hours during the day,” she said tearfully. It was as if she were carrying a 50-pound weight on her back. “My clothes get all sweaty, and it’s embarrassing,” she added. Her husband did not understand the full impact of what Gail was going through. They hadn’t had sex for six months, and that was putting a strain on their relationship. Gail was only 47 years old at the time.

Declining quality of life

Many people do not realize the significant increase in life expectancy that humans have experienced in the past 200 years. In the year 1801—when Thomas Jefferson was president—people only lived an average of 35 years. Today in the United States, individuals live an average of 78 years. And yet, quality of life declines for many, beginning during middle age. Symptoms of this include loss of energy and stamina, loss of muscle and bone mass with an increase in fat mass, loss of cognition and memory, decline of mood and sense of well-being, and loss of sexual vitality. One major culprit for these conditions is a reduced level of hormones—naturally occurring substances in the body that are required for the normal function of cells. Severe hormonal deficiencies may be life-threatening. The replacement of these hormones improves quality of life.

Hormone replacement therapy (HRT) for women may include estrogens, progesterone, testosterone, dehydroepiandrosterone (DHEA), thyroid and others.

A natural alternative

Gail’s unfortunate situation is not unusual, although her menopause may have been more severe than that which is experienced by most women. Yet, up to 75% endure some symptoms of menopause1, including hot flashes, night sweats, insomnia, mood swings, fatigue, headaches, “foggy brain,” declining libido, aching joints and increased fat around the midsection2, which is a risk factor for heart disease3. I explained to Gail that there is a more natural and safer alternative available.

The results of the Women’s Health Initiative—a major 15-year research program that was established to address the most common causes of death, disability and poor quality of life in postmenopausal women—showed that women who took Prempro* (conjugated estrogens/medroxyprogesterone acetate tablets) had an increased risk of heart disease, breast cancer and stroke. Those who took conjugated estrogens tablets alone had an increased risk of stroke, blood clots and—if the patient was older than 65—Alzheimer’s disease.