Find a physician you can trust to help you make this significant decision. It is important to understand that there is no one-size-fits-all approach. Every person’s body is different. There are many genetic components to look at, such as your risks for cancer, clotting, how you metabolize hormones, as well as your lifestyle and what your lifestyle might tolerate.
BHRT is typically placed into TWO broad categories:
Same daily dose or static hormone replacement therapy: daily estrogen with progesterone does not mimic normal physiology and has no withdrawal bleed or monthly period. (continuous combined)
Physiologic Hormone Restoration Therapy: mimics the normal menstrual cycle, estrogen alone for two weeks then add progesterone the second two weeks in doses to restore a normal menstrual bleed every month.
The goal of PR is to mimic the natural monthly fluctuation and levels of hormones of a young reproductive woman by using differing doses of estradiol and progesterone that send messages to all of the cells in the body. It’s important to use the native bioidenitical hormones, in addition to have the concentration and timing natural to the body.
The well-tested formula is made in a compounding pharmacy in small batches and applied to the skin in small amounts. This mode of restoration can produce a withdrawal menstrual bleed in non-hysterectomized menopausal women and the menses continues to be a signal that the body’s hormonal system is operating correctly. This may be the most optimal style of hormone restoration for many; however, since daily dosing may vary and a menstrual cycle is initiated, some women may find it does not suit their lifestyle.
This is replacement of the same dose of hormone, used on a daily basis. The dose is typically fairly low, when compared to the hormone levels that your body produced in its prime years (20’s and 30’s). Even though it does not mimic the body’s own natural tendencies, it can still alleviate certain symptoms of menopause for some women and improve their quality of life. Static hormones are available in forms such as creams, tablets, gels, troches, suppositories, drops, subdermal pellets, injections, patches etc. The use of the hormone estriol is also a popular mode of administration along with estradiol since there is a plethora of data implicating safety and efficacy – allowing physicians to mitigate the mitogenic effects of estradiol therapy.