HRT - Hormone Replacement Therapy - Hormone Treatment

Joe Bella asked:


The Postmenopausal Estrogen/Progestin Interventions (PEPI) Trial not only validated the beneficial effects of hormone-replacement therapy (HRT) on serum cholesterol, it also turned the spotlight on natural progesterone. That hormone appeared to be more effective than the synthetic progesterone medroxyprogesterone acetate, or MPA, (Provera) in preserving estrogen’s beneficial effects on the heart and was just as effective in preventing estrogen -induced overgrowth of the uterine lining.

Moreover, earlier studies had indicated that natural progesterone’s side effects are minor. Some women taking it experience some drowsiness, but they are spared many of the symptoms associated with MPA - fluid retention, breast tenderness, and depression.

Many people have asked why doctors aren’t suggesting natural progesterone as an option for HRT. The answer is that in the United States natural progesterone isn’t available through conventional channels, and it is a relatively untested entity. However, it has a long and intriguing history.

Scientists first purified progesterone in 1934, but they soon found that the hormone was broken down to an inactive form in the intestine before it could be absorbed. In the 1950s chemists bonded progesterone to other compounds, which provided safe passage through the digestive system. These new synthetic compounds came to be known as “progestins.”

Progestins such as MPA and norgestrel were patented by pharmaceutical companies, studied extensively in clinical trials, and approved by the Food and Drug Administration for use in treating secondary amenorrhea, a condition in which premenopausal women who have had normal periods stop menstruating.

However, lower doses of progestins than those necessary to treat amenorrhea were found to eliminate endometrial overgrowth - a problem associated with postmenopausal estrogen use - and so progestins were added to HRT regimens. Yet the FDA hasn’t approved progestins specifically for HRT because there is little information on their long-term effects.

Researchers who continued to experiment with natural progesterone found that by pulverizing it into minute particles-a process called micronizationthey could make it absorbable in oral form. However, in early tests the oral preparation could not produce the sustained levels of progesterone necessary to stimulate menstruation. In the early 1980s researchers came up with a longer-lasting preparation - a gelatin capsule containing 200 mg of micronized progesterone suspended in oil.

A version of that product called Utrogestan, which is produced by the French pharmaceutical house Besins-Iscovesco, is now widely used for HRT in Mexico and Europe. Schering-Plough Corporation licensed micronized progesterone from LaSalle Laboratories, an affiliate of the French company, and supplied it in 200-mg capsules for the PEPI trial.

Schering plans to market that drug as Prometrium in the U.S., but doctors won’t be able to prescribe it for HRT until it is approved by the FDA for treating secondary amenorrhea, as many of the progestins were originally.



Richard

John Russell asked:


It is generally agreed by many physicians that the primary reason for Hormone Replacement Therapy (HRT) is symptom relief from menopause, with less emphasis on using hormone therapy for disease prevention. It is important that the woman know all risks and benefits associated with HRT and reminded that the risk for breast cancer does increase naturally for all women as they age, as does the risk of heart disease and osteoporosis. “Women with a uterus who are currently taking estrogen plus progestin should have a serious talk with their doctors to see if they should continue it. If they are taking this hormone combination for short-term relief of symptoms, it may be reasonable to continue, since the benefits are likely to outweigh the risks. Longer term use or use for disease prevention must be re-evaluated, given the multiple adverse effects noted in Women’s Health Initiative (WHI).”

One physician associated with the WHI says, “always cautions patients about the potential for increased breast cancer risks.” First, she rules out women who are not candidates for HRT - those with bleeding problems of an unknown cause, suspected breast cancer or history of breast cancer, history of endometrial cancer or certain cancers of the uterus, chronic liver disease such as cirrhosis or a history of blood clots.

She further tells her patients who want to stop HRT that they can certainly quit anytime. First of all, with menopause, we’re not treating a disease, and stopping HRT has no major consequences, except perhaps a return of the original menopausal symptoms.

For both women who want to stop taking HRT and for women who choose not to start HRT, there are alternative therapies. For almost everyone, there are other treatment options. For instance, women they can reduce their risk of heart disease by stopping smoking and by keeping their weight, cholesterol levels and blood pressure under control. Prozac and some other antidepressants can relieve hot flashes. Prescription drugs such as Fosamax help protect against osteoporosis. Also, the drug Evista (raloxiphene HCI), prevents osteoporosis and further claims to lower total cholesterol and prevent breast cancer. However, because women on Evista may experience more hot flashes, it raises questions about how that might affect the brain. Research now suggests a link between hot flashes and Alzheimer’s. Evista belongs to a class of drugs called SERMs, or Selective Estrogen Receptor Modulators. A SERM being used in Europe Tibolone, may be more effective without the side effects found in Evista.



Noah

dreamqueen asked:


but he sent me home until next week how dangerous is this concerned,im a 47 yr old female.

Douglas

Michelle asked:


Please explain to me what changes i can expect from male to female hormone replacement therapy in like 6 month to 2 years. If you have the time please be specific. I’m super serious about this so no bashing me. Thanks

Sonia

Martha Melendez asked:


What kind of weaponry does the FBI’s HRT unit have? I would assume they have access to a lot more than your local police department, considering they deal with major hostage situations and is the lead agency that fights terrorism in the U.S.

Susan

Mary L asked:


I am 50 years old. As I get closer to full menopause, my skin is becoming dry, scaly and itchy (severe at times). My family doctor has prescribed an ointment and then a lotion which did not help. OTC’s have not helped. Other than HRT, is there anything that I can do?

Edgar

Angel Shekina asked:


My family have a history of heart attacks and strokes. I have had a full Hysterectomy and my doctor has put me on HRT.
I dont want to further my risk of a heart attack or a stroke and wonder if anyone knows of a natural remedy i can take instead of HRT?

Dustin

Jimi asked:


in other words, how long did it take you to get to your feminine face figure while on HRT? (i just started yay!)

male to female transsexual<

Braxton

broncobillie asked:


i have been on hormone replacement therapy for over a year. i recently went off, it has been about 2 weeks now. when will it be all gone from my system?

Cesar

wilkyway79 asked:


I want a partial hysterectomy (uterus only) but my doctor is recommended that i get everything taken out and put me on HRT. I think this is defeating the purpose since i have had adverse effects from being on the pill. Has anyone had a complete done and taken HRT and have had any side effects? Has anyone just had a partial to assist with their endometriosis without the HRT? Are there any studies linking HRT with cancer or other diseases? Serious answers only from people who have had the procedure…no opinions please or inane comments about my disease or decision. (i already know a hysterectomy isnt a cure for endometriosis)

Adrienne