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.