Menopause is defined as the absence of menstrual periods. It is also called the “change of life” for women. The change occurs gradually, sometime between age 30 and 60, most often about 45-50. Symptoms include changes in menstrual cycle, hot flashes, and unpredictable mood changes. Peri-menopause refers to the time when a woman notices that her hormones are starting to change in this way.

Does menopause have to be treated?

No, there is no necessary treatment for menopause. Women through the ages have gone through this hormonal change without medical treatment.


Why would I want to have my menopause treated?

Symptoms of menopause such as hot flashes and mood changes can often be easily treated with bio-identical hormone replacement therapy. Other symptoms such as loss of libido, vaginal dryness, and thinning of skin can also be treated. This kind of treatment has been shown to be safe for most women, and has been championed by people such as Suzanne Somers.

There is also research that has shown bio-identical hormone replacement therapy in men and women to:

  1. Lessen risk of Alzheimer’s disease and cognitive decline
  2. Lessen risk of heart and blood vessel disease
  3. Lessen risk of osteoporosis
  4. Slow progression of aging including age-related changes in appearance (less wrinkling and improved skin elasticity)


What about keeping calcium in my bones?

There are many things that are important for maintaining bone health. These include Vitamin D, weight bearing exercise, and particular calcium supplements that contain microcrystalline hydroxyapatite, and not calcium carbonate. There is also evidence that hormones estrogen and testosterone help keep calcium in our bones. Balancing your hormones with bio-identical estrogen, progesterone, testosterone, and DHEA can be very helpful for maintaining your body, and preserving bone health as you age.


What are bio-identical hormones?

Throughout our lives our bodies make estrogen, progesterone, testosterone, DHEA, and other hormones. These are kept in balance and allow for libido, pregnancy, menstruation, and eventually menopause. Pharmaceutical companies have made hormone-like drugs for many years to treat symptoms of menopause. Some of these (Premarin, Prempro, medroxyprogesterone) have black box warnings describing risks of cancer and other serious problems. Bio-identical hormones, on the other hand, are synthesized to be the same molecules as those that are made by our bodies. They are very different compared to what is in the drug store with black box warnings. If bio-identical hormones were going to cause disease, wouldn’t it have happened when you were younger and the levels were much higher?


How can I get bio-identical hormone therapy (BHRT)?

Bio-identical hormones are dosed individually to each person in our practice. Each prescription is based on a patient’s particular needs and their laboratory tests. The prescriptions are filled at Compounding Pharmacies. These specialty pharmacies make the prescriptions specifically for you, and they use only bio-identical hormones in their formulations.


How can bio-identical hormones be taken?

Hormones are made by glands, which secrete them directly into the blood stream. The hormones then circulate and have an effect on every cell in the body that has a receptor for them—from brain to pelvis to bone and skin. Lastly the hormones go to the liver to change into something else and eventual disposal. Replacement hormones can be taken by mouth, applied through the skin in a cream, inserted with a pellet every 3 months, or absorbed through mucous membranes of the mouth or vagina.

Orally – Hormones taken by mouth go through the liver before getting to the rest of your body. This is not a good idea. Occasionally oral progesterone is prescribed for sleep, but most of the time there is a better way to take hormone replacement therapy.

Transdermal Cream – Only about 3% of the hormones in a cream are absorbable through the skin, and absorption is slow. Not only that, but fat cells under the skin will metabolize some of the hormone dose before it gets to the blood stream. Hormone levels from creams and gels cannot be effectively measured in the blood because the concentrations are too low. Instead they may be more accurately measured by testing levels in saliva. I think there is a better way for most people to get hormones into their body.

Pellets are inserted into your body every 3 months. Toward the end, they start to lose their potency. Pellets are a way for the doctor to make more of the money, with less to the pharmacy. I do not think the body is designed to have a steady level of hormones in the blood 24 hr/day.

Most of the women and men I have treated with bio-identical hormone replacement therapy have done best with oral mucous membrane administration through a troche. All the needed hormones are put into a case of small squares that dissolve the hormones through the gums at the back of the mouth outside the upper teeth. It takes about 15 minutes to absorb a dose, and this method gives the body a significant blood level within just a few minutes. This dose is given twice per day, and provides a blood level that any doctor can see on a standard blood test. More important, if a woman feels symptoms in the middle of the afternoon, she can give herself a small dose and the symptoms (such as hot flashes and mood changes) will resolve very quickly.

The Blatman Health and Wellness Center has 15 years of experience in treating both men and women with Bio-identical Hormone Replacement Therapy (BHRT).


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