Gynecology - Hormone Issues
There is so much controversy surrounding the issue of hormone replacement therapy. Before menopause, the problem of PMS (Pre Menstrual Syndrome) is an issue that is real but difficult to find a cause for it, and thus even more difficult to cure the problem. Our approach is to treat PMS symptomatically with diet supplements and use selective medication for specific symptoms, and we have met with some success.
At menopause, Hormone Replacement Therapy (HRT) is a controversial subject, among physicians, media and celebrities, and even more so, confusing for the public. There are real risks with HRT: breast cancer risk and blood clots are two of the most common concerns. However, without HRT, the risk of emotional instability, depression, hot flashes, insomnia, vaginal dryness with painful intercourse, and lack of a sense of well being are equally real and of concern to many women.
The increasingly popular use of Bio-Identical hormones can also be controversial. This type of hormone replacement therapy refers to the use of hormones that are molecularly identical to endogenous hormones produced by the body. While there have been claims that Bio-Identical hormones offer greater health benefits than the traditional HRT without any associated risk, these claims have not been scientifically substantiated. We would be happy to prescribe Bio-Identical hormone replacement therapy for those patients who are interested as an alternative to the traditional HRT. We are working with a local specialty pharmacy to compound the Bio-Identical hormones to ensure quality.
We take a sensible approach to balancing risk and benefits in counseling patients with regard to hormone issues and HRT, balancing quality of life and long term risks. Most women can manage their menopausal hormonal issues satisfactorily using this approach. In general terms, except for obvious contra-indicating risk factors, most women can go on a short course of the lowest effective dose of HRT, Bio-Identical or otherwise, to maintain health and well being and then gradually go off over months and thus have a very smooth transition into their menopausal years.