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Hormone Replacement Therapy FAQ's

Written by pharmacist  |  29. December 2001

What do the terms Pre and Peri Menopause mean?
Pre-Menopause refers to a set of symptoms experienced by women for 10-20 years before menopause. These may include: uterine fibroids, tender or lumpy breasts, endometriosis, PMS, difficulty conceiving or carrying a pregnancy to term, sudden weight gain, fatigue, irritability and depression, foggy thinking, memory loss, migraine headaches, heavy or light periods, bleeding between periods, or cold hands and feet. These symptoms are a result of hormone imbalances-most of them are caused by an excess of estrogen (estrogen dominance) and a deficiency of the hormone progesterone. Peri-Menopause means "right around menopause", signaling the year or two before, during, and after menstrual cycles end.
What are the symptoms of Menopause?
The average age for menopause in U.S. women is 52 years- 95% of women reach menopause between the ages of 44-55 years. Skipping 12 periods in a row officially confirms the milestone labeled menopause for most women. Some women (10-20%) simply stop having periods and have no symptoms but over 75% of women experience some or all of the following symptoms to varying degrees: Hot flashes and night sweats, stress incontinence, vaginal dryness, forgetfulness or fuzzy thinking, depression, and decreased libido. As the years after menopause go by, the risk of serious cardiovascular disease (blood pressure, heart attack, and stroke) rises dramatically. Cardiovascular disease is far and away the leading cause of death in postmenopausal women, dwarfing all other causes, including cancer. Osteoporosis risk also increases. Over 90% of people with osteoporosis are postmenopausal women.
What is Estrogen?
Human estrogen does not exist in the body as a single entity-it is actually an entire group or class of steroid hormones with very similar properties. The 3 major forms of estrogen that are active in the female body are Estrone (10-20%), Estradiol (10-20%), and Estriol (60-80%). Estradiol is the most powerful of the three and is the estrogen implicated in increased cancer risk. Premarin is a synthetic conjugated estrogen product made from the urine of pregnant mares. It is classified as a "conjugated equine estrogen". It contains primarily only one human estrogen, estrone (75-80%), plus equilin (6-15%), a form of estrogen found exclusively in horses, plus smaller amounts of estradiol, found in humans, and 2 other horse estrogens. Equilin can act like human estrogen in human bodies but Premarin is "natural" if a person is half horse, half-human! In addition, the amount of estrone in Premarin is much higher than the normal level for which the human body is designed. Cenestin is a new synthetic conjugated estrogen newly released by Duramed Pharmaceuticals. The company is marketing this newcomer as a "natural product" because it is plant derived. However, when one looks at the chemical formula of the 9 conjugated estrogens in Cenestin, none are bio-identical to human estrogen.
What is the difference between Natural and Synthetic?
Natural refers to plant-derived BIO-IDENTICAL HORMONES; those that are molecularly identical to those made by the human body. Plant-derived means chemically processed from precursors found in Yam and Soybean plants. Synthetic or Artificial or Patentable or Conventional compounds are usually not found in nature or at least not in humans. Synthetic Hormones (i.e.Premarin, Provera, and Cenestin) are chemically altered from human hormones and are NOT identical in structure or activity to the Natural Hormones they mimic or emulate. Bio-identical hormones in our bodies include Estriol, Estradiol, Estrone, Progesterone (not progestin), Testosterone, DHEA, Pregnenolone, and Androstenedione. As an example, Progestins (Provera-trade name) are more potent chemical analogs of Progesterone, meaning they have some progesterone-like effects but are not the same as Progesterone. Provera has potential side effects ranging from unpleasant to harmful. The most common side effects of taking progestins are bloating, painful breasts, mood swings, fatigue, depression, rashes and dry skin, weight gain, diarrhea/constipation, anxiety, joint and muscle pain, headaches, breakthrough bleeding, and birth defects if used by pregnant women.
Why use Natural Hormone Replacement Therapy?
Some of the benefits of NHRT include: Restore Hormonal Balance to the body Alleviate the symptoms caused by the natural decrease in production of hormones by the body Relieve the symptoms of Menopause: Hot flashes and Night Sweats Increased anxiety, depression and mood swings Vaginal dryness, Atrophy, and painful urination. Loss of concentration and memory Sleep disturbances Diminished sex drive and painful intercourse. Loss of muscle strength Urinary incontinence Prevent and Reverse Osteoporosis Reduce risk of Heart Disease Improve Lipid profile Reduce risk of endometrial and breast cancers Prevention of Alzheimer Disease and Senility Less unwanted side effects than synthetics Custom-designed to the Individual Patient's needs. Imitates the body's natural processes. Hugely improved compliance and strengthened self-image. The best, safest, and usually most effective choice when dealing with your health is to observe and copy Nature. As earlier stated the natural pattern of circulating estrogen in a woman's body is: 10-20% Estrone, 10-20% Estradiol, and 60-80% Estriol. Hence, Dr. Jonathon Wright ,author of the best-selling book Hormone Replacement for Women over 45 , introduced Tri-Est over 15 years ago to match our own body's estrogen. Tri-Est is one part Estradiol to one part Estrone, to 8 parts Estriol. By adding the smaller amounts of the stronger estrogens estradiol and estrone to the formula, symptoms such as hot flashes and night sweats could be alleviated more quickly. In addition, Tri-est gives a woman the potential protection against breast cancer of the estriol.
Where can I get Tri-est and other custom compounded prescriptions filled
S&P Prescription Compounding Services is a state-of-the-art licensed compounding pharmacy. Compounding allows a practitioner to prescribe and a pharmacist to prepare a customized medication or to place an available medication in a different dosage form to meet a specific patient need and improve compliance. Natural Hormones can be put in oral capsules, transdermal creams, oral troches, vaginal suppositories and creams. Our compounding pharmacists have received extensive additional training in compounding techniques. We have a support network that generates a constant exchange of ideas, innovations and techniques, and includes physicians, chemists and pharmacists who can research the feasibility of new formulations.
For More Info Call: 516-644-2470. We can send you or your physician information. Please include doctor's address on messages.

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