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How would I use the hormones?


Cathys friend Lily takes her estrogen in pill form, but Cathy has trouble swallowing pills. She hasnt yet decided whether or not to use hormones, but if they only come as a pill, that would be part of her decision.

Estrogen comes in many forms and dosages. You could use a skin patch or vaginal tablet or cream, take a pill, or get an implant, shot, or vaginal ring insert. Progesterone or progestin is often taken as a pill, sometimes in the same pill as the estrogen. It also comes as a patch, shot, IUD (intrauterine device), vaginal gel, or suppository.

The form your doctor suggests may depend on your symptoms. For example, patches or pills can relieve hot flashes, night sweats, and vaginal dryness. They will also slow or prevent bone loss and help delay osteoporosis while you are using them. Other formsvaginal creams, tablets, or ringsare used for vaginal dryness. The vaginal ring insert might also help some urinary tract symptoms. But, the dose found in these other forms is probably too low to relieve hot flashes.

What are natural hormones?

Cathys friend Susan thinks she is not at risk for side effects from menopausal hormone therapy because she uses natural hormones to treat her hot flashes and night sweats. Cathy asked her doctor about them.

The natural hormones Susan uses are estrogen and progesterone made from plants such as soy or yams. Some people also call them bioidentical hormones because they are supposed to be chemically the same as the hormones naturally made by a womans body. So-called natural hormones are put together(compounded)by a compounding pharmacist. This pharmacist follows a formula decided on by your doctor.

Drug companies also make estrogens and progesterone from plants like soy and yams. Some of these are also chemically identical to the hormones made by your body. You get these from any pharmacy with a prescription from your doctor.

One difference between the natural hormones prepared by a compounding pharmacist and those made by a drug company is that the compounded natural hormones are not regulated and approved by the U.S. Food and Drug Administration (FDA). So, we dont know much about how safe or effective they are or how the quality varies from batch to batch. Hormones made by drug companies are regulated and approved by the FDA.

There are also natural treatments for the symptoms of menopause that are available over-the-counter, without a prescription. Some of these are also made from soy or yams. They are not regulated or approved by the FDA.

Cathys doctor told her that there is very little reliable scientific information from clinical trials about the safety of bioidentical hormones, how well they control the symptoms of menopause, and whether they are as good or better to use than FDA-approved estrogens, progesterone, and progestins.
Whats right for me?

There is no one size fits all answer for all women who are trying to decide whether to use menopausal hormone therapy (MHT). You have to look at your own needs and weigh your own risks.

Ask yourself and your doctor these questions:

* How much are you bothered by menopausal symptoms such as hot flashes or vaginal dryness? Like many women your hot flashes or night sweats will likely go away over time, but vaginal dryness may not. MHT can help if your symptoms are troubling you.
* Are you at risk for developing osteoporosis? Estrogen might protect bone mass while you use it. However, there are other drugs that can protect your bones without the same risks as MHT.
* Do you have a history of heart disease? Using estrogen and progestin can increase your risk.
* Do you or others in your family have a history of breast cancer? If you have a family history of breast cancer, check with your doctor about your risk.
* Do you have a history of gall bladder disease or high levels of triglycerides? Some experts think that using a patch will not make your triglyceride (a type of fat in the blood)level go up or increase your chance of gall bladder problems. Using an estrogen pill might.
* Do you have liver disease or a history of stroke or blood clots in your veins? MHT might not be safe for you to use.
* Are you over age 65 and thinking about using MHT to prevent dementia? Estrogen and progestin could actually increase your risk of dementia. Estrogen alone might do that also.


Then, like Cathy, talk to your doctor about how best to treat or prevent your symptoms or the diseases for which you are at risk. Ask about your other choices. Remember, these too may have risks and benefits. If you decide to use MHT, the FDA suggests that you use the lowest dose that works for the shortest time needed.

If you are already using menopausal hormone therapy and think you would like to stop, first ask your health care provider how to do that. Some doctors suggest tapering off slowly.

Whatever decision you make now about using MHT is not final. You can start or end the treatment at any time. If you stop, your risks will probably lessen over time, but so will the protection. Discuss your decision about menopausal hormone therapy each year with your doctor at your annual checkup.
Unanswered Questions

Dont forget at your checkup to ask your doctor about any new study results. Research on menopause is ongoing. Scientists are looking for answers to questions such as:

* How long can a woman safely use menopausal hormone therapy?
* Are some types of estrogen or progesterone safer than others?
* Is one form of hormone therapy (patch, pill, or cream, for example) better than another?
* Is MHT safer if you start it around the time of menopause instead of when you are older?

For now, we know that each woman is different, and the decision for each one will probably also be different. But, almost every study gives women and their doctors more information to answer the question: Is menopausal hormone therapy right for me?
For More Information

Other resources on menopausal hormone therapy include:

National Institutes of Health
Menopausal Hormone Therapy
Information
www.nih.gov/PHTindex.htm

National Library of Medicine
MedlinePlus
Search for:
Menopausal Hormone Therapy
Menopause
www.medlineplus.gov

American College of Obstetricians and Gynecologists
409 12th Street, SW
Box 96920
Washington, DC 20090-6920
202-638-5577
www.acog.org

North American Menopause Society
P.O. Box 94527
Cleveland, OH 44101
440-442-7550
800-774-5342 (toll-free)
www.menopause.org

For more information on health and aging, including menopause, contact:

National Institute on Aging Information Center
P.O. Box 8057
Gaithersburg, MD 20898-8057
800-222-2225 (toll-free)
800-222-4225 (TTY/toll-free)
www.nia.nih.gov

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Hormone Replacement Therapy after Breast Cancer

By Michael Russell

Generally speaking, a great deal has already been discussed on the issue of hormone replacement therapy. However, less is known specifically about this form of therapy for breast cancer survivors. One reason for this is that physicians are concerned about prescribing any of these drugs to their patients for fear that it might increase the risk of cancer recurrence. But along with this, blanket statements regarding hormone replacement therapy are quite inappropriate. Each individual woman should be given the chance to consider the risks and benefits of hormone replacement based on their personal situation. Every woman experiences menopause differently, with varying degrees of symptoms. Some women go through menopause with little difficulty and without increased risk of osteoporosis or heart disease. For others, menopause is traumatic and can introduce increased chances of illness into their lives.

Professional practice in medicine has endorsed allowing women to replace ovarian hormones with hormone replacement therapy once the ovaries begin to fail. Evidence and clinical experiences indicate that the benefits clearly outweigh the risk and expense of such therapy. However, evidence has yet to be found with regards to the risks to women surviving beast cancer. Most concerns are based on speculation and anecdotal experience alone.

For most women, the question lies in the correlation between hormone replacement therapy and an increased risk of breast cancer. Does hormone therapy contribute to breast cancer? Before starting such treatment, physicians often require their patients to get a baseline screening mammogram and because women receiving treatment are under a physician's surveillance, they are more likely to get annual screenings. Although there is no difference between women who are not on hormone replacement and those who are on it for less than ten years, once the duration exceeds the ten-year benchmark, there is a slight increase in breast cancer incidence, but the numbers are insignificant. There also appears to be anecdotal data that women with breast lobular neoplasm may have an increased risk for recurrence with hormone replacement therapy. However, with or without this form of therapy, these women are still at an increased risk of recurrence.

On the other end of the spectrum, how does one know that one is cured of breast cancer? Unfortunately, there is no absolute way to know. Statistical probabilities can be given based on the cancer's characteristics. If one is destined to relapse, it will usually happen in the first five years after the diagnosis. Regrettably, late recurrences do rarely occur. Breast cancer patients are advised that once treatment is complete, they should consider themselves cured, move on.

Medical research shows that low dose hormone replacement therapy for less than 10 years does not significantly contribute to the development of breast cancer in the general population, but the question is, does this apply to the population of women cured of breast cancer? Sadly, there are no studies to confirm this and no evidence has yet surfaced from past studies to answer this. The safest way to think about it though, is that for women with a high probability of cure, the benefits of this treatment far outweigh the risks.

Michael Russell
Your Independent guide to Breast Cancer.

Article Source: http://EzineArticles.com/?expert=Michael_Russell
http://EzineArticles.com/?Hormone-Replacement-Therapy-after-Breast-Cancer&id=357836

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