QUESTION: Do you work with patients who have had full hysterectomies?
ANSWER: The short answer to your question is yes. The term “full hysterectomies” is somewhat incomplete and the description of this procedure has undergone some changes. A full hysterectomy used to mean taking of the uterus, the cervix and the ovaries. Today, we use more specificity. A partial hysterectomy generally means taking the uterus only, while a “full” means the uterus and cervix. Neither of these really addresses the status of the ovaries and fallopian tubes. The terms “bi-lateral salpingo-oophorectomy” (BSO) means taking both ovaries and fallopian tubes, whereas a “left salpingo-oophorectomy” (LSO) or “right salpingo oophorectomy” (RSO) means the taking of the left or right ovary and corresponding fallopian tube. Therefore, if everything is removed, it would be a full (or total) hysterectomy with BSO.
In any event, when the ovaries are removed (the major source of your hormones) replacement may be indicated if you are symptomatic. If you retained your ovaries and had your uterus removed (with or without your cervix) your need for treatment would be indicated by your hormone levels and your body’s present ability to produce your estradiol or progesterone or testosterone in sufficient amounts to satisfy your body’s needs.
The best way to ascertain your level is to obtain blood tests of your estradiol, progesterone and testosterone as well as your FSH (follicle stimulating hormone), which is the hormone that stimulates the ovaries to produce your estradiol. Your blood levels along with your symptom report will give the provider information sufficient to determine your need for treatment.
QUESTION: I had breast cancer 4 yrs ago and was told by my Oncologist that I could not have hormone therapy. I have suffered for at least the last 8 years with most of the symptoms listed for hormone imbalances. I have asked every doctor I have ever went to and no one ever mentioned this therapy even before the cancer/treatment. Is hormone replacement ok for post cancer patients? ME?
ANSWER: I am not a physician, but I can tell you that many breast cancers can be related to estrogen dominance (and I am assuming your breast cancer was also). For that reason, many doctors advise against estrogen (estradiol) replacement therapies in those absent of this essential hormone for fear of ‘awakening’ a dormant cancer. Unfortunately, there is little said about the benefits of balancing estrogen and progesterone. I encourage you to search (“Google”, if you will) “progesterone balances estrogen in breast cancer” and read what has been posted by a number of experts. Estrogen is not your enemy. Estrogen dominance is the issue. You need estrogen for a multitude of body functions and a deficiency of estrogen will create many of the symptoms you suffer. The key is to prevent estrogen from becoming dominate. Progesterone opposes estrogen from becoming dominant. Do not confuse natural progesterone with the progestins. Taken from Women in Balance.org, “Is progesterone safe? Progesterone has been used in a number of clinical applications since 1940. Its early use was to assist women with infertility. Progesterone has NOT been linked to increased cancer risk. In fact, a large study conducted in France found that using bio-identical progesterone did not cause any increase in breast cancer, whereas use of synthetic progestins did result in a statistically significant increase in breast cancer risk. It is important to note that progesterone is often confused with progestins, which have been linked to increased cancer risk as noted in the Women’s Health Initiative in addition to the French study.” http://www.womeninbalance.org/resources and research/page.cfm?page id=44
Educate yourself as to the issue of estrogen dominance and progesterone balancing. Learn the differences between Natural (“bio-identical”) hormones and the synthetics. Then, speak again with your doctor. It may be unnecessary for you to have to suffer with estrogen deficiency. Our doctors would be willing to discuss potential treatment options with your oncologist if he/she is open to having the dialog.
Question – We have been asked if hormone replacement therapy can help as a fertility treatment.
Answer – Hormone replacement therapy is not a treatment for infertility. If you are lacking estradiol and have a healthy uterus, replacing estradiol can act to proliferate the endometrial lining. When giving estradiol, it must be balanced with progesterone, which helps support pregnancy. However, there are many other aspects related to fertility than estradiol and progesterone alone. Hormone therapy should not be considered fertility treatment.
QUESTION: I am wondering if i am able to do the consult and be able to have the first hormone replacement on sat all in one day. My days off of work are very limited.
ANSWER: We are open Monday through Friday. Our process is that first you must meet with a consultant who will review with you your symptoms and present the process for you to consider. If you wish to proceed, blood is taken at that time. Blood levels are a very important part of the process as blood levels are always checked prior to any hormones being administered. Usually, lab results take 24 hours. The Provider then needs to review your labs and correlate them to your symptoms. The provider can then gauge a hormone level adequate for your initial treatment and order your hormones. Ultimately, you meet with the provider prior to the administration of any hormones for a review of your medical history, a physical exam and this is when the provider will present the treatment plan. It is not possible that the entire process can be done in a day. The procedure itselftakes only about 15 minutes, after your initial consultation. You can return to work following the procedure with very few restrictions (no submersion in water, no deep knee bending or rigorous exercising for about 5 days). Showers are fine, walking, light housekeeping and driving are all acceptable. I encourage you to visit our website.
QUESTION: What is the optimal age range for this therapy? Would you avoid it if you are menopausal? (i.e. is this basically for perimenopausal women).
ANSWER: Thank you for posting your question. Hormone replacement therapy is for anyone experiencing a reduction in their natural hormone levels resulting in symptoms. While we certainly expect a decline in hormones to happen in menopause for women and andropause for men, perimenopausal women often experience symptoms related to hormone deficiency. Women generally begin to lose their testosterone in their 20’s, their progesterone in their 30’s and their estradiol in their 40’s, 50’s and 60’s as they enter menopause.
Hormones are messengers. Translated from the Greek, ‘hormone’ means “to urge on”. Our natural hormones bring the signals to our cells to produce the substances they were designed to produce. When our hormones decline, so do those signals sent to the cells and the cells fail to function as they were intended. When this happens, symptoms develop. There are many reasons we lose our hormones in addition to menopause and andropause. Surgical removal of the ovaries for any reason would mean a reduction in hormone production resulting in symptoms. Some pathology such as Lupus has been associated with decreased androgen levels. It’s never too late to check your hormone levels. I invite you to take the symptom test and see if you are experiencing symptoms of hormone deficiency.
Testing hormone levels is nothing more than a simple blood test. Blood samples not only measure hormone levels but also measure pituitary hormones that cannot be measured in saliva testing.
QUESTION: We have received a number of questions about price and insurance coverage. First, from a price perspective, it would be difficult to sufficiently explain all the options available to answer each individual inquiry. We offer a number of approaches to hormone replacement from our all inclusive therapy to individual treatments and most everything in between.
As our hormone replacement treatment plan is individually created, it encompasses the needs and goals of each individual. These obviously vary as each of us is unique. The best way to learn all of the options available to meet your specific needs and goals is to schedule your free initial consultation. Our consultant will provide all the detail you need and help you arrive at a plan that is right for you. With regard to insurance coverage, there are so many different plans of coverage that it is difficult to answer this question in one way that fits all our inquiries. We can say that many of our patients receive some level of coverage from their carriers. It is best to check with your specific provider
QUESTION: Is the Therapy the same as bio-identical hormone replacement Therapy?
ANSWER: Yes. Our Therapy uses “bio-identical” (or what we refer to as bio-Natural) hormones. Bio Natural hormones are the exact same molecular structure as the hormones made in the body, by the body. A chemist could not discern a molecular or structural difference between compounded bio Natural and human hormones. Bio Natural hormones are natural to your body. Synthetics are not.
Question: Am I too old to take HRT? I have never had children, or had any cancers or a hysterectomy. I do take synthroid for an under active thyroid and walk 3 miles everyday. I began menopause around 49-50 and am still having hot flashes, moodiness and all other menopausal complaints. Thank you for any help.
Answer: Some women, due to surgery, may experience menopausal symptoms at early ages. We have women in their late 20’s who have had their uterus and ovaries removed and suffer from menopausal symptoms who are being treated successfully. We have women in their mid to late 60’s who have suffered from menopausal symptoms for years who find relief with therapy. The first thing to do is evaluate your symptoms with a subjective symptom questionnaire and review your hormone levels with objective blood tests. We prefer blood testing because it also measures pituitary hormones. It’s been said that, “We are healthier in every way when our natural hormones are in balance”. It’s never too late to begin anew.
Question: Do you test for Thyroid including T3, T4, and reverse T3? What is your experience in balancing the thyroid along with the hormones and what are you thoughts regarding the balance of these as well?
Answer: Your TSH (Thyroid Stimulating Hormone) is checked as part of your baseline lab studies. Deficiencies of or excess of thyroxine can create symptoms that mimic those of other hormone imbalances. If TSH results indicate the need for treatment, the medical provider may refer you to your PCP for treatment or he/she may treat your thyroid. This is at the discretion of the medical provider at the center. If he/she chooses to treat your thyroid, then a review of Free T3 and or Free T4 and or Reverse T3 will be a part of your ongoing therapy. Studies suggest that the proper balancing of Progesterone can enhance thyroid efficiency.
Q – When will I begin to feel the benefits of therapy?
A – While the answer to that question differs from individual to individual we often see a cessation of night sweats and hot flashes in the very short term. Some women report relief within days. Night sweats and hot flashes are generally related to low levels of estradiol. When natural estradiol is replenished, the body seems to recognize the restoration quickly and immediately utilizes the hormone to address that symptom.
The ability to enjoy a good night sleep is another symptom that we hear is addressed in the short term. Progesterone is a wonderful hormone often referred to as “the happy hormone”. It helps to quiet the mind and it is taken either orally or dissolved under the tongue about an hour before bedtime. Shortly after we see the decrease in hot flashes, night sweats and an improvement in the ability to sleep well, we see a revitalization of energy levels, mental clarity and sex drive. Testosterone is the “energy hormone”. It allows us to carry more oxygen to our cells providing for that energy and increased stamina. Testosterone also contributes to an increase in sexual desire and response.
While the timelines may vary from person to person, we can often address the symptoms noted above within days to weeks. We first must attain the necessary blood levels and then sustain those blood levels sufficient to maintain a consistent level of relief. Be patient. The key is determining your individual maintenance level. Arriving at that level for long-term symptom relief is often accomplished within the first few months. So, to say it another way, we see an immediate response that may peak and wane for a brief period until we are able to determine your particular maintenance level and develop the administration frequency to hold and sustain symptom relief over the long term.
Should I be using different makeup?
Q – I’ve noticed my skin has more moisture and oils. How does this effect make-up I may be using?
A- When restoring estradiol and testosterone levels in women, you will see an increase in skin moisture and natural oils. Estradiol retains fluid that brings moisture to the skin, fuller breasts and vaginal lubrication. Testosterone restores natural oils of the skin lost in menopause.
Often, women in menopause, due to increased dryness of the skin, have switched to using makeups rich in emollients. Most emollients are forms of oil or grease, such as mineral oil, squalene and lanolin. They work by increasing the ability of the skin to hold water, providing the skin with a layer of oil to prevent water loss, and lubricating the skin. With the restoration of the skin’s natural fluids and oils in hormone replacement, the addition of emollients can add too many moisturizers to the skin that may result in clogging pores or untoward skin reactions. Some women have found it best to switch back to using “oil-free” makeups the same as those used when they were younger.