Hormone Replacement Therapy (HRT)
Most women will spend half of their life in perimenopause and menopause, so it is very important to consider your options. For some women, the symptoms are mild, and they go away on their own within several years of the final menstrual period. For other women, the symptoms are severe and life changing; therefore, it is important not to compare yourself to other women!
Hormone replacement therapy comes in many forms: pills, patches, lotions, gels, sprays, rings and vaginal inserts. Most of these options contain the bioidentical hormone estradiol - the active form of estrogen in human bodies. The dosing and administration are the difference between the options. Bioidentical progesterone is only given as a pill at night before bed, as it can cause sleepiness. Taking it orally is the only approved progesterone administration to protect the uterine lining. Bioidentical hormone therapy does not mean that the hormones are compounded; bioidentical simply means that the molecular structure of the hormone is identical to the molecular structure of the hormone your ovaries made.
Bioidentical hormones can be compounded or pre-made and available at your pharmacy for generic prices. The premade formulations will be regulated by the FDA and must meet certain purity standards. Compounded hormones are not subject to this regulation but can still be prescribed. Usually compounded hormones are not covered by insurance.
Synthetic hormones are available too. These are a minority of prescribed hormones but are still used for various reasons. Sometimes synthetic hormones have better side effect profiles and, therefore, are preferred by patients.
Testosterone therapy has not been approved by the FDA for use in women. However, it is used off label to treat the same "low T" symptoms men experience. Some of our providers treat with testosterone therapy.
Your provider will be able to guide you to find the best option for hormone replacement based on your symptoms, lifestyle, budget, insurance requirements, etc. It is not one size fits all!
