If
you are a woman of a certain age, you are probably experiencing hormonal
changes. And take it from us -- hot
flashes, mood swings, weight gain and other physical and emotional issues are
no fun. To alleviate these troubling symptoms, your doctor might recommend hormone
replacement therapy.
But be aware that traditional HRT drugs like Premarin have been linked to an increased risk of
endometrial cancer and heart disease. An alternative, however, is the more
“natural” form of HRT you may have heard Oprah raving about, known as
bio-identical hormone replacement therapy (BHRT). To give us the skinny on bio-identical hormones, we
interviewed Dr. Gino Tutera, a respected obstetrician-gynecologist in Scottsdale,
Arizona.
Everything She Wants: What are the benefits of taking bio-identical hormones for
peri-menopausal and menopausal women?
Dr. Tutera:
The benefits for bio-identical hormones come from utilizing hormones that have
the exact chemical structures as what the body produces, therefore exerting a
much more natural effect compared to the effects of synthetic or non-human
hormones. The body recognizes these hormones as their own and receive the same
beneficial effects as if the body was increasing its production once again.
ESW: What
are the risk factors of taking bio-identical
hormones for peri-menopausal and menopausal women?
Dr. Tutera:
The risk factors are the same as any other hormone utilized. But the chances of
adverse effects are lessened considerably compared to the use of other forms of
hormone replacement.
ESW: You
work with a form of BHRT where rice sized pellets are
inserted under the skin tailored to a woman's unique body type and
hormonal needs. How does this differ from other types of BHRT?
Dr. Tutera:
The pellets can be placed painlessly under the skin. After placement, the body
itself controls the release of the hormone by the heart rate and cardiac
output, which is not the mechanism of action for all other forms of HRT. Those
other forms control the body and the body cannot alter the release, while the
pellets are under the complete control of the body. Also, the hormone released
from the pellets does not use the liver for metabolism unlike many of the oral
and injectable methods of hormone delivery.
ESW: What
age should women start taking bio-identical hormones, and how long should women
use them?
Dr. Tutera:
Starting the use of hormones differs from patient to patient. Women with testosterone
deficiency may need it in their late 20's; women with menstrual migraines may
start even earlier. The usual time to see if you need hormone therapy depends
on when the patient begins suffering the problems of anxiety, loss of libido,
difficulty sleeping, loss of muscle tone, decreasing exercise tolerance,
putting on fat, and loss of mental acuity.
ESW:
Other than the pellets, what is the efficacy of BHRT in pill form versus creams?
Dr. Tutera:
Hormones in a cream form are a safer route of administration, and may help with
symptoms. But you must have blood work before and after starting therapy to see
if you are getting internal benefits, and not the just the relief of symptoms.
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