Most women find menopause to be an uncomfortable experience.
Drastic reductions in the production of estrogen lead to issues with vaginal and dermal dryness, insomnia, emotional lability, hot flashes, night sweats, chills, and weight gain. Sustained low estrogen levels are associated with osteoporosis, heart disease, cancer, diabetes, and Alzheimer's.
It's hard to understand why some doctors don't believe that these symptoms and related risk factors are worthy of menopausal hormone therapy. Many misunderstandings about thevalue ofhormone pellets for women seem to stem from a cursory reading of the findings of the Women's Health Initiative Study. Summary statistics don't tell the whole story.
The Women's Health Initiative Study has been foundational for medical treatment of symptoms of menopause for over 20 years.
The Women's Health Initiative followed 27,347 women from 1993 to 1998. Included in the study were 10,739 women who had undergone hysterectomy and 16,608 women who had not. In each group, half were given Premarin and half were given a placebo.
The research team looked at the effects synthetic hormone replacement had on hot flashes, mood changes, night sweats, sleep disturbances, depression, breast tenderness, and joint pain. They looked for correlations of synthetic hormone replacement with diagnoses of urinary incontinence, cancer, dementia, fractures, and gallbladder disease.
The study found that women in both groups who received Premarin were 12 percent more likely to be diagnosed with a serious disease. When synthetic hormone replacement was stopped, the risk of diagnosis with a serious disease subsided.
However, this number does not tell the whole story.
Premarin use was associated with an increased risk of death for women aged 70 and older. Women in their 50's who were on both estrogen and progesterone replacement were less likely to suffer serious illness or death. Replacement of either estrogen or progesterone reduces the risk of developing type 2 diabetes by as much as 19 percent, and either form of hormone replacement therapy reduces the risk of developing gallbladder disease or urinary incontinence by 50 to 60 percent.
Moreover, the Womens Health Initiative Study found that the preferred form of delivery of estrogen replacement is continuous, while the preferred form of progesterone replacement is cyclical. Only women who received continuous progesterone replacement therapy had an elevated risk of cancer, diabetes, and heart disease.
The Women's Health Initiative Study supports the use ofhormone pellets for women as part ofmenopausal hormone therapy. More specifically, it supports the use of bioidentical hormone pellets in the treatment of menopause symptoms.
Bioidentical hormones are, as their name suggests, chemically identical to hormones produced by a woman's body. Naturally occurring in plants such as soy and dioscorea (sweet potato), bioidentical hormones exactly replace the hormone production lost during menopause.
Bioidentical hormones can be formulated as pellets for insertion under the skin with a trocar in an office setting. The bioidentical hormone in these pellets does not have to pass through the digestive tract into hepatic circulation.
There is no concern about compliance, since the hormone in the pellets is formulated for slow release over a period of three to six months. After baseline lab measurements confirm that pellet therapy is changing blood titers as desired, the patient only needs to come two or three times a year to repeat the trocar procedure.
Pellets for menopause symptom treatment deliver a continuous dosage of replacement hormone. That's desirable for estrogen replacement, but contraindicated for progesterone replacement.
Just as progesterone levels rise after ovulation and fall after menstruation, progesterone replacement should not be an everyday event. Continuous delivery forms such ashormone pellet therapy are not desirable for progesterone replacement. However, progesterone gels can be used to deliver the hormone 14 days out of every 28.
Pellet therapy allows for more precise management of hormone replacement. Compounders can createtestosterone pellets for women in lower dosages and in dosages not possible with their synthetic counterparts.
Pellet therapy also allows for more predictable management of hormone replacement, especially for testosterone replacement. Subdermal pellet therapy does not cause the extreme variation in bloodstream titers of testosterone observed with monthly injections. Of course, trocar insertion of testosterone pellets is within the standard of care for men.
Many patients are concerned about the relative safety of bioidentical and synthetic hormones. They need to know that bioidentical hormone replacement is custom compounded. They receive exactly the dosage of hormone replacement they need. This is not always possible with synthetic hormones.
Many patients wonder when they will be ready formenopausal hormone therapy. They need to understand that their symptoms are strong indicators of the potential benefits ofhormone pellets for women, but blood work is necessary to establish the right dosage and to confirm that the body is responding to treatment.
When providers explain trocar insertion to their patients, many will ask if hormone creams, either bioidentical or synthetic, will offer the same benefits. Patients need to know that dermal administration of hormone replacement has the advantage of bypassing the digestive tract and absorption into the liver, but the effective dosage is variable. Perspiration, tight clothing, loose or fricative clothing, and skin irritation from other causes interfere with the amount of hormone that is absorbed.
Women may also wonder whetherpellets for menopause will affect their sex drive. By making coitus more comfortable,pellets for menopause support increased interest in sex that may be achieved through a combination of means.
Some patients will want to know whethertestosterone pellets for women andtestosterone pellets for women are the same product. The main difference is the dosage.Testosterone pellets for women offer a much lower dosage.
Finally, patients will want to know when they will notice changes. Most women need 28 days to achieve the changes possible through bioidentical hormone replacement therapy. Laboratory testing during the first 28 days of therapy will confirm how the body is responding to therapy.
Not to be overlooked in hormone replacement therapy for women going through menopause is testosterone replacement therapy.
For many years, doctors were not sensitive to the signs of testosterone deficiency in mature women, such as muscle weakness, fatigue, weight gain, and loss of libido. Testosterone, after all, was identified as a hormone more obviously critical to men's hormonal health, and, at any rate, women make only about a quarter of their testosterone in their ovaries, the rest in their adrenal glands.
Losing about a quarter of testosterone production, however, can make a huge difference in how a woman feels. The only way to know for sure that testosterone deficiencies are resulting in symptoms is to do blood testing. Women who are still menstruating should not have testing done mid-cycle, since testosterone levels are temporarily elevated about the same time as ovulation. Once the need for testosterone replacement has been established, bioidentical testosterone replacement with pellets can be more precisely tailored to each woman's needs.
Bioidenticalhormone pellet therapy serves as a true long-term solution. After treatment is established, insertion of pellets by trocar two or three times a year provides reliable estrogen replacement.
There aretestosterone pellets for women and men.
Trocar Supplies specializes indisposable medical tray kits and trocar wrap kits for insertion of extended-release bioidentical hormone pellets. Trocar Supplies trocar kits are engineered for minimal risk of herniation and infection and minimal discomfort from the insertion procedure.
Want to know more? Call us today at (937) 478-0469 orcontact us online.
