Most Common Hormone Therapy for Menopause

When a woman approaches menopause her body goes through many changes that are caused by a reduction in estrogen and progesterone, hormones produced mainly in the ovaries. These hormones are important for a number of processes in our bodies, most especially the regulation of menstruation and the creation of strong, healthy bones. During menopause the ovaries reduce the production of both hormones, the immediate effects of which are the typical symptoms of menopause: hot flashes, night sweats and vaginal dryness. Hormone replacement therapy is the prescription most physicians recommend to ease these symptoms and, hopefully, prevent osteoporosis and other diseases.

The Need For Estrogen Replacement

• A loss of estrogen in a woman's body not only causes symptoms such as hot flashes, vaginal dryness and night sweats, but can also lead to cardiovascular disease and osteoporosis, a disease characterized by weak bones. In fact, according to Paul Mystkowski, an endocrinologist at Virginia Mason Medical Center in Seattle, the most common cause of osteoporosis in women is an estrogen deficiency.

  In an effort to replace the loss of critical hormones that deplete from our bodies during menopause, hormone replacement therapy, or HRT, is usually prescribed.

Traditional Hormone Replacement During Menopause

• Hormone Replacement Therapy, or HRT, for decades has been the most commonly used technique to relieve the symptoms of menopause. The therapy involves a combination of the hormones progestin and estrogen into drugs such as Premarin (estrogen only) and Prempro (a combination of estrogen and progestin). Millions of women have found relief utilizing these drugs. In 2002, however, the Women's Health Initiative published the findings of a study on the health effects of HRT. What they found turned the pharmaceutical world on its head and has left many women wondering where to turn for estrogen replacement.

The Women's Health Initiative

• Back in 1991, the National Institutes of Health launched the Women's Health Initiative (WHI) to specifically study the health issues of postmenopausal women. They undertook a set of clinical trials involving more than 150,000 healthy women. One of these studies looked at the effects of hormone therapy, specifically the estrogen-plus-progestin therapies in use at the time. In 2002, the studies were abruptly halted when it became apparent that traditional HRT causes an increase in heart attack, breast cancer and stroke in women.

HRT Today

• The FDA has not announced any plans to pull drugs such as Premarin from the market. In fact, during the year after the WHI study was released, the FDA came out with new recommendations for women seeking relief from the symptoms of menopause: "Use the lowest dose and take it for the shortest amount of time."

Bioidentical Hormones

• Bioidentical hormones have been around for years but only recently, with celebrity endorsements from Suzanne Somers and Oprah Winfrey, have they been brought to the attention of mainstream America. Usually made from plants, the chemical structure of these hormones is identical to those made in the body.

  The primary difference between pharmaceutical and bioidentical hormone replacement therapy is that the latter involves custom-compounding of the hormones for the individual patient.

Bioidentical Hormone Replacement Therapy

• This therapy involves customizing hormone prescriptions. A physician will determine a specific combination of bioidentical estrogen and progestin, on an individual basis, which are then compounded, or combined, by a compounding pharmacist. Known as BHRT, this therapy has come under fire from the FDA. Although the bioidentical hormones are FDA approved, the custom compounds are not.

  So far, there is no evidence that BHRT is superior to conventional hormone replacement therapy. Menopausal women are now faced with a dilemma: take the traditional route to symptom relief and risk the increased possibility of disease; take the newer, less-studied avenue of BHT; or do nothing.