the natural estrogen production confers a protective benefit by mitigating arterial plaque formation. It’s only after menopause, when estrogen production essentially ceases, that the protection is lost and plaque formation develops unchecked, resulting in increased risk of cardiac events.
The Benefits of Bio-Identical Hormone Replacement Therapy (BHRT)
BHRT not only is very safe, but there are numerous important health, preventive medicine, and wellness benefits.
Estrogen benefits include protection against, or decreased risk of: • Heart disease & strokes • Osteoporosis • Alzheimer’s Disease • Colon cancer • Urinary tract infections • Vaginal atrophy • Skin & breast atrophy & sagging • Incontinence • Macular degeneration& cataracts • Depression
Estrogen also increases libido and sexual responsiveness, de- creases mood swings, improves memory, and improves fatigue. Progesterone is a feel good hormone. Most women with
children will recall that they generally felt their best during the 3rd trimester of pregnancy—when progesterone levels are the highest of anytime in life. Progesterone benefits include: • Reduces symptoms of PMS • Protects against uterine cancer • Protects against breast cancer
• Reduces osteoporosis risk (synergistic with estrogen) • Cardiac protection
• Enhanced sense of well being While most physicians associate progesterone with childbearing and menstruation, there are progesterone receptors not just in the uterus but throughout the whole body, including the blood vessels, breast, vagina, brain and bones. Progesterone also modulates many of the potential side effects of estrogen excess such as fluid retention,
bloating, headaches, PMS, hot flashes, bleeding, and fibroids. Not only can ALL women benefit from progesterone, but they actually need it, whether menopausal or not. The bottom line is that there is a huge cumulative amount of
research documenting not only the safety of bio-identical hormone use but also the wellness and preventive medicine benefits as well. There is no compelling reason for women not to take estrogen and progesterone, other than active breast or uterine cancer and some select medical conditions.
Estrogen Replacement
Since estrogen levels markedly fall as women go through meno- pause, estrogen replacement should be initiated ideally within two years of going through menopause to reap the maximum long-term protective benefits. Although women at any stage of menopause can benefit, the earlier you start, the more you benefit. There are three forms of human estrogen—estrone, estradiol, and estriol. Estradiol is the main form responsible for the vast ma- jority of estrogen’s benefits. While estriol is often promoted as the safe form of estrogen, it has virtually none of estradiol’s protective benefits. The main benefit of estriol is to help treat vaginal dryness. So, for the purposes of our discussion, the term “estrogen” refers to estradiol.
Estrogen replacement can be achieved via topical or oral
administration. Women with cardiovascular disease or with signifi- cant cardiovascular risk factors (diabetes, high blood pressure, high cholesterol) generally should use the topical method. This is because these women likely have already developed arterial plaque. Topical estrogen has minimal risk of inducing adverse cardiovascular events. While topical estrogen does not confer as much long-term CV protection, it has all of the same benefits of oral estrogen and is less likely to cause arterial plaque rupture. Topical bio-identical estrogen is available as a commercial prescription, such as Estraderm® and Vivelle-Dot®, or as a custom compounded cream. The commercial estradiol patch works just as well—and is just as safe—as compounded estradiol. However, be- cause it only comes in fixed doses, it’s harder to fine-tune dosing to achieve optimum effectiveness with minimal side effects. Oral estrogen is available commercially as Estrace®. It can also
20 Natural Nutmeg May 2012
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